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Turkish Journal of Medical Sciences Nov 2020The success of treatment of bone fracture and defects are based on a proper contact and compression between the bone fracture fragments. Intraoperative manipulations... (Review)
Review
BACKGROUND/AIM
The success of treatment of bone fracture and defects are based on a proper contact and compression between the bone fracture fragments. Intraoperative manipulations such as bone compression or distractions are generally done in order to achieve this. However, none of the bone plates currently in routine use allow these manipulations after fixation to the bone, requiring refixation and repeated drilling, and screwing operations. Based on this shortcoming, we designed a novel adjustable bone plate (ABP) system which allows bone shortening and lengthening even after fixation to the bone surface. The aim of the paper is to clarify the unique properties of the novel bone plate.
MATERIALS AND METHODS
In this paper, the new generation adjustable bone plate applicability, design, indication, and new characteristics in addition to conventional bone plates with review of the literature were discussed and surgical technique was demonstrated in a saw bone model.
RESULTS
This novel design allows for compression and distraction at the fracture ends post fixation as well as bone segment transfers.
CONCLUSIONS
The potential of the new generation ABP plate for use in bone compression, distraction, and the segmental bone transfer is a promising invention for clinical applications in the future.
Topics: Bone Plates; Fracture Fixation, Internal; Fractures, Bone; Humans
PubMed: 32222126
DOI: 10.3906/sag-2002-69 -
Ugeskrift For Laeger Nov 2020Metacarpal fractures are common. Stable, extra-articular fractures can often be treated non-operatively with or without closed reduction, splinting and then mobilisation... (Review)
Review
Metacarpal fractures are common. Stable, extra-articular fractures can often be treated non-operatively with or without closed reduction, splinting and then mobilisation with buddy taping. Unstable or displaced extra-articular fractures, where adequate reduction cannot be maintained, and most intra-articular fractures require osteosynthesis. The goal for any treatment is early mobilisation. Intra-articular fractures, open fractures and certain paediatric fractures can lead to poor functional outcome; hence, referral to a hand surgeon is recommended in this review.
Topics: Child; Fracture Fixation, Internal; Fractures, Bone; Humans; Plastic Surgery Procedures; Treatment Outcome
PubMed: 33215581
DOI: No ID Found -
Journal of Dental Research Jan 2017The formation of the mandibular condylar cartilage (MCC) and its subchondral bone is an important but understudied topic in dental research. The current concept... (Review)
Review
The formation of the mandibular condylar cartilage (MCC) and its subchondral bone is an important but understudied topic in dental research. The current concept regarding endochondral bone formation postulates that most hypertrophic chondrocytes undergo programmed cell death prior to bone formation. Under this paradigm, the MCC and its underlying bone are thought to result from 2 closely linked but separate processes: chondrogenesis and osteogenesis. However, recent investigations using cell lineage tracing techniques have demonstrated that many, perhaps the majority, of bone cells are derived via direct transformation from chondrocytes. In this review, the authors will briefly discuss the history of this idea and describe recent studies that clearly demonstrate that the direct transformation of chondrocytes into bone cells is common in both long bone and mandibular condyle development and during bone fracture repair. The authors will also provide new evidence of a distinct difference in ossification orientation in the condylar ramus (1 ossification center) versus long bone ossification formation (2 ossification centers). Based on our recent findings and those of other laboratories, we propose a new model that contrasts the mode of bone formation in much of the mandibular ramus (chondrocyte-derived) with intramembranous bone formation of the mandibular body (non-chondrocyte-derived).
Topics: Animals; Chondrocytes; Fracture Healing; Fractures, Bone; Humans; Osteogenesis
PubMed: 27664203
DOI: 10.1177/0022034516668321 -
Endokrynologia Polska 2022Obesity is a major health problem that has multisystemic consequences. One of the addressed topics in the current investigation regards the influence of obesity on bone... (Review)
Review
Obesity is a major health problem that has multisystemic consequences. One of the addressed topics in the current investigation regards the influence of obesity on bone metabolism. Despite of the broadly accepted notion that obesity is associated with a positive effect on bone health, recent evidence has challenged this idea by suggesting an increased risk of fracture in specific sites. Therefore, this review intends to review succinctly the intricate connections between obesity and bone metabolism by addressing the roles of the mechanical, inflammatory, and hormonal factors, among others. It will also focus on the overall impact on bone mineral density and bone fracture occurrence.
Topics: Humans; Bone Density; Obesity; Fractures, Bone; Bone and Bones
PubMed: 36519653
DOI: 10.5603/EP.a2022.0063 -
Injury Oct 2022Treatment of fractures remains challenging and carries a high economical burden to both patients and society. In order to prevent some of the complications, the use of... (Review)
Review
Treatment of fractures remains challenging and carries a high economical burden to both patients and society. In order to prevent some of the complications, the use of bone adhesives has been proposed, but up to date, bone adhesives are not part of the current clinical practice. Early results of use of bone cements and bone glues are promising, focusing in the areas of highly fragmented fractures, fixation of long bone fractures, filling bone voids and defects, promoting osseointegration, preventing non-union while maintaining the reduction of fracture fixation. This review aims to describe the state-of-the-art of the development, properties and use of adhesives in fracture treatment.
Topics: Adhesives; Bone Cements; Fracture Fixation; Fracture Fixation, Internal; Fractures, Bone; Humans
PubMed: 33752878
DOI: 10.1016/j.injury.2021.02.019 -
European Review For Medical and... Nov 2022Fractures are commonly encountered in clinical practice. Early diagnosis and individualized treatment are the basis for achieving high-quality fracture healing and... (Review)
Review
Fractures are commonly encountered in clinical practice. Early diagnosis and individualized treatment are the basis for achieving high-quality fracture healing and functional recovery. Radiographic examinations play an important role in the diagnosis and treatment of fractures. In recent years, with the innovation in ultrasonic examination technology and equipment, its application in the diagnosis and treatment of fractures has greatly increased. Long bone, rib, radius and ulnar, metacarpal, cartilage, nasal bone, and occult are common fracture types. Ultrasound has long been used in fracture diagnosis and treatment. This narrative review summarizes and discusses the application of ultrasound in the diagnosis and treatment of fractures.
Topics: Humans; Fractures, Bone; Ultrasonography; Fracture Healing; Radius
PubMed: 36394743
DOI: 10.26355/eurrev_202211_30146 -
Shock (Augusta, Ga.) Dec 2020The purpose of this study was to reveal possible consequences of long-bone fracture on cardiac tissue and to analyze the role of systemically elevated danger associated...
The purpose of this study was to reveal possible consequences of long-bone fracture on cardiac tissue and to analyze the role of systemically elevated danger associated molecular patterns, complement anaphylatoxins and cytokines. Blood samples of mice, pigs, and humans after a fracture were analyzed by ELISAs for complement component 5a (C5a), tumor necrosis factor (TNF), and extracellular histones. In vivo results were completed by in vitro experiments with human cardiomyocytes treated with TNF and extracellular histones. The influence of histones and human plasma after fracture on isolated human polymorphonuclear leukocytes (PMNs) was investigated. An elevation of TNF, C5a, and extracellular histones after long bone fracture was measured. Moreover, the appearance of systemic troponin I levels was observed and structural changes in connexin 43 and desmin were detected. Further, the presence of TNF leads to elevation of reactive oxygen species, troponin I release, and histone appearance in supernatant of human cardiomyocytes. Incubation of human PMNs with histones and plasma of patients after fracture lead to formation of neutrophil extracellular traps. Present results suggest that structural alterations in the heart might be consequences of the complement activation, the release of extracellular histones, and the systemic TNF elevation in the context of a long bone fracture.
Topics: Animals; Complement C5a; Extracellular Traps; Fractures, Bone; Histones; Humans; Leukocytes, Mononuclear; Male; Mice; Myocytes, Cardiac; Swine; Tumor Necrosis Factor-alpha
PubMed: 32205793
DOI: 10.1097/SHK.0000000000001536 -
Frontiers in Endocrinology 2022Type 2 diabetes mellitus (T2DM) is a risk factor for osteoporosis. The effects of T2DM and anti-diabetic agents on bone and mineral metabolism have been observed.... (Meta-Analysis)
Meta-Analysis Review
Type 2 diabetes mellitus (T2DM) is a risk factor for osteoporosis. The effects of T2DM and anti-diabetic agents on bone and mineral metabolism have been observed. Sodium-glucose co-transporter 2 inhibitors (SGLT-2is) promote urinary glucose excretion, reduce blood glucose level, and improve the cardiovascular and diabetic nephropathy outcomes. In this review, we focused on the extraglycemic effect and physiological regulation of SGLT-2is on bone and mineral metabolism. SGLT-2is affect the bone turnover, microarchitecture, and bone strength indirectly. Clinical evidence of a meta-analysis showed that SGLT-2is might not increase the risk of bone fracture. The effect of SGLT-2is on bone fracture is controversial, and further investigation from a real-world study is needed. Based on its significant benefit on cardiovascular and chronic kidney disease (CKD) outcomes, SGLT-2is are an outstanding choice. Bone mineral density (BMD) and fracture risk evaluation should be considered for patients with a high risk of bone fracture.
Topics: Diabetes Mellitus, Type 2; Fractures, Bone; Glucose; Humans; Minerals; Sodium-Glucose Transporter 2 Inhibitors
PubMed: 35872985
DOI: 10.3389/fendo.2022.918350 -
Computer Methods and Programs in... Sep 2022Obtaining bone models that represent certain types of fractures is limited by the need for such fractures to occur in real life and to be processed from medical images....
BACKGROUND AND OBJECTIVE
Obtaining bone models that represent certain types of fractures is limited by the need for such fractures to occur in real life and to be processed from medical images. This work aims to propose a method that starts from the design of specific fracture patterns in order to be projected on 3D geometric bone models, being prepared for their subsequent geometric fracturing.
METHODS
The process of projecting expert-generated fracture patterns has been approached in such a way that they contain geometrical and topological information for the subsequent fracture of the triangle mesh representing the bone model, giving information about the validity of the fracture pattern due to the design process, the validation performed, and the relationships between the fracture lines.
RESULTS
Different 3D models of long bones have been used (femur, humerus, ulna and fibula). Also, different types of fracture patterns have been created. These patterns have been used to obtain their projection on three-dimensional bones. In this study, an expert validation of the fracture patterns projected on the bone models is performed. A forensic validation of the fracture patterns used as starting point for the projection is also performed for cases in which this fracture is produced by impact, for which there is scientific evidence based on forensic analysis. This validation also supports the experts, giving them the necessary feedback to complete or modify their fracture patterns according to criteria analyzed from a forensic point of view.
CONCLUSIONS
The patterns fit the bone models correctly, despite the irregularities of the bone models, and correspond to the expected projection. In addition, it provides us with a clear line of work, by using the topological information of the fracture pattern and the bone model, which allows us to establish a consistent basis for future guided fractures.
Topics: Bone and Bones; Femur; Fractures, Bone; Humans
PubMed: 35810507
DOI: 10.1016/j.cmpb.2022.106980 -
Frontiers in Endocrinology 2023Alzheimer's disease (AD) is a neurodegenerative disorder that is the major cause of dementia in the aged population. Recent researches indicate that patients with AD... (Review)
Review
BACKGROUND
Alzheimer's disease (AD) is a neurodegenerative disorder that is the major cause of dementia in the aged population. Recent researches indicate that patients with AD have a significantly increased fracture risk, but the pathological mechanisms are still unclear.
OBJECTIVE
We systematically reviewed studies regarding bone fracture risk in AD to uncover links between the pathologies of osteoporosis and AD.
METHODS
We searched the literature using the databases of PubMed, Web of Science, Embase and Cochrane Library. Studies were included if they evaluated bone fracture risk in AD patients and if they explored the pathogenesis and prevention of bone fractures in these patients.
RESULTS
AD patients had a significantly higher risk of bone fractures than age-matched controls. Multiple factors contributed to the increased risk of bone fractures in AD patients, including the direct effects of amyloid pathology on bone cells, abnormal brain-bone interconnection, Wnt/β-catenin signalling deficits, reduced activity, high risk of falls and frailty, and chronic immune activity. Exercise, prevention of falls and fortified nutrition were beneficial for reducing the fracture risk in AD patients. However, the efficacy of anti-osteoporotic agents in preventing bone fractures should be further evaluated in AD patients as corresponding clinical studies are very scarce.
CONCLUSION
Alzheimer's disease patients have increased bone fracture risk and decreased bone mineral density owing to multiple factors. Assessment of anti-osteoporotic agents' efficacy in preventing bone fractures of AD patients is urgently needed.
Topics: Humans; Aged; Alzheimer Disease; Fractures, Bone; Osteoporosis; Amyloidogenic Proteins; Brain
PubMed: 37635980
DOI: 10.3389/fendo.2023.1190762