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European Cells & Materials Jun 2018Calcium and vitamin D are essential for maintaining bone health. Therefore, deficiencies in calcium and vitamin D are major risk factors for osteoporosis development.... (Review)
Review
Calcium and vitamin D are essential for maintaining bone health. Therefore, deficiencies in calcium and vitamin D are major risk factors for osteoporosis development. Because sufficient amounts of calcium are also required for fracture-callus mineralisation, compromised bone repair that is frequently observed in osteoporotic patients might be attributed to calcium and vitamin D deficiencies. Consequently, calcium and vitamin D supplementation represents a potential strategy for treating compromised fracture healing in osteoporotic patients. Growing clinical evidence suggests that a fracture event may induce post-traumatic bone loss in the non-fractured skeleton, particularly in osteoporotic patients, which might further exacerbate osteoporosis and increase the risk of secondary fractures. Because the skeleton represents the main source of calcium, which is increasingly required during fracture-callus mineralisation, post-traumatic calcium mobilisation might occur under conditions of insufficient calcium and vitamin D status. However, to date, investigations of the roles of calcium and vitamin D in bone repair and post-traumatic bone turnover are very limited. The current review summarises the state of the literature, focusing on the role of calcium and vitamin D in fracture healing and post-traumatic bone turnover, and critically discusses the therapeutic potential of calcium and vitamin D supplementation in this context.
Topics: Animals; Bone Remodeling; Calcium; Fracture Healing; Fractures, Bone; Humans; Vitamin D; Wounds and Injuries
PubMed: 29931664
DOI: 10.22203/eCM.v035a25 -
Journal of Bone and Mineral Metabolism May 2021Fractures have a great impact on health all around the world and with fracture healing optimization; this problem could be resolved partially. To make a practical... (Review)
Review
Fractures have a great impact on health all around the world and with fracture healing optimization; this problem could be resolved partially. To make a practical contribution to this issue, the knowledge of bone tissue, cellularity, and metabolism is essential, especially cytoskeletal architecture and its transformations according to external pressures. Special physical and chemical characteristics of the extracellular matrix (ECM) allow the transmission of mechanical stimuli from outside the cell to the plasmatic membrane. The osteocyte cytoskeleton is conformed by a complex network of actin and microtubules combined with crosslinker proteins like vinculin and fimbrin, connecting and transmitting outside stimuli through EMC to cytoplasm. Herein, critical signaling pathways like Cx43-depending ones, MAPK/ERK, Wnt, YAP/TAZ, Rho-ROCK, and others are activated due to mechanical stimuli, resulting in osteocyte cytoskeletal changes and ECM remodeling, altering the tissue and, therefore, the bone. In recent years, the osteocyte has gained more interest and value in relation to bone homeostasis as a great coordinator of other cell populations, thanks to its unique functions. By integrating the latest advances in relation to intracellular signaling pathways, mechanotransmission system of the osteocyte and bone tissue engineering, there are promising experimental strategies, while some are ready for clinical trials. This work aims to show clearly and precisely the integration between cytoskeleton and main molecular pathways in relation to mechanotransmission mechanism in osteocytes, and the use of this theoretical knowledge in therapeutic tools for bone fracture healing.
Topics: Animals; Bone Matrix; Cytoskeletal Proteins; Fracture Healing; Fractures, Bone; Humans; Mechanotransduction, Cellular; Osteocytes
PubMed: 33151416
DOI: 10.1007/s00774-020-01168-0 -
Current Osteoporosis Reports Oct 2020The goal of this review is to summarize recent advances in modeling of bone fracture using fracture mechanics-based approaches at multiple length scales spanning nano-... (Review)
Review
PURPOSE OF REVIEW
The goal of this review is to summarize recent advances in modeling of bone fracture using fracture mechanics-based approaches at multiple length scales spanning nano- to macroscale.
RECENT FINDINGS
Despite the additional information that fracture mechanics-based models provide over strength-based ones, the application of this approach to assessing bone fracture is still somewhat limited. Macroscale fracture models of bone have demonstrated the potential of this approach in uncovering the contributions of geometry, material property variation, as well as loading mode and rate on whole bone fracture response. Cortical and cancellous microscale models of bone have advanced the understanding of individual contributions of microstructure, microarchitecture, local material properties, and material distribution on microscale fracture resistance of bone. Nano/submicroscale models have provided additional insight into the effect of specific changes in mineral, collagen, and non-collagenous proteins as well as their interaction on energy dissipation and fracture resistance at small length scales. Advanced modeling approaches based on fracture mechanics provide unique information about the underlying multiscale fracture mechanisms in bone and how these mechanisms are influenced by the structural and material constituents of bone at different length scales. Fracture mechanics-based modeling provides a powerful approach that complements experimental evaluations and advances the understanding of critical determinants of fracture risk.
Topics: Biomechanical Phenomena; Cancellous Bone; Cortical Bone; Finite Element Analysis; Fractures, Bone; Humans; Models, Biological; Models, Theoretical
PubMed: 32740775
DOI: 10.1007/s11914-020-00615-1 -
Journal of Ultrasound in Medicine :... Mar 2022Low-intensity pulsed ultrasound (LIPUS) is a developing technology, which has been proven to improve fracture healing process with minimal thermal effects. This... (Review)
Review
Low-intensity pulsed ultrasound (LIPUS) is a developing technology, which has been proven to improve fracture healing process with minimal thermal effects. This noninvasive treatment accelerates bone formation through various molecular, biological, and biomechanical interactions with tissues and cells. Although LIPUS treatment has shown beneficial effects on different bone fracture locations, only very few studies have examined its effects on deeper bones. This study provides an overview on therapeutic ultrasound for fractured bones, possible mechanisms of action, clinical evidences, current limitations, and its future prospects.
Topics: Bone and Bones; Fracture Healing; Fractures, Bone; Humans; Ultrasonic Therapy; Ultrasonic Waves
PubMed: 33949710
DOI: 10.1002/jum.15738 -
Injury Jun 2021Nonunion following a long bone fracture causes considerable morbidity when it occurs. Risk factors depend on specific fractures but there is a complex interplay of... (Review)
Review
Nonunion following a long bone fracture causes considerable morbidity when it occurs. Risk factors depend on specific fractures but there is a complex interplay of injury severity, comorbidities, patient medication and infection. The majority of nonunions occur after long bone fractures with the tibia, femur, forearm, humerus and clavicle predominating. Despite interest in the biological augmentation of fracture healing, the majority of nonunions can be effectively managed with conventional surgical techniques. In this review we present a review of risk factors for nonunion and the outcome following surgical management.
Topics: Clavicle; Fracture Healing; Fractures, Bone; Fractures, Ununited; Humans; Retrospective Studies; Risk Factors
PubMed: 33221036
DOI: 10.1016/j.injury.2020.11.029 -
International Journal of Environmental... Dec 2018Fracture healing complications are common and result in significant healthcare burden. The aim of this study was to determine the rate, costs and predictors of two-year...
Fracture healing complications are common and result in significant healthcare burden. The aim of this study was to determine the rate, costs and predictors of two-year readmission for surgical management of healing complications (delayed, mal, non-union) following fracture of the humerus, tibia or femur. Humeral, tibial and femoral (excluding proximal) fractures registered by the Victorian Orthopaedic Trauma Outcomes Registry over five years ( = 3962) were linked with population-level hospital admissions data to identify two-year readmissions for delayed, mal or non-union. Study outcomes included hospital length-of-stay (LOS) and inpatient costs. Multivariable logistic regression was used to determine demographic and injury-related factors associated with admission for fracture healing complications. Of the 3886 patients linked, 8.1% were readmitted for healing complications within two years post-fracture, with non-union the most common complication and higher rates for femoral and tibial shaft fractures. Admissions for fracture healing complications incurred total costs of $4.9 million AUD, with a median LOS of two days. After adjusting for confounders, patients had higher odds of developing complications if they were older, receiving compensation or had tibial or femoral shaft fractures. Patients who are older, with tibial and femoral shaft fractures should be targeted for future research aimed at preventing complications.
Topics: Australia; Female; Fracture Healing; Fractures, Bone; Hospital Costs; Humans; Incidence; Leg Bones; Length of Stay; Male; Outcome Assessment, Health Care; Retrospective Studies; Risk Factors
PubMed: 30551632
DOI: 10.3390/ijerph15122845 -
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 -
Nephrology, Dialysis, Transplantation :... Feb 2021In chronic kidney disease (CKD), phosphate homoeostasis plays a central role in the development of mineral and bone disorder (MBD) together with decreased serum calcium... (Review)
Review
In chronic kidney disease (CKD), phosphate homoeostasis plays a central role in the development of mineral and bone disorder (MBD) together with decreased serum calcium and elevated serum parathyroid hormone, fibroblast growth factor 23 and sclerostin levels. Today there are only a few data exploring the direct role of abnormal phosphate homoeostasis and hyperphosphataemia in the development of CKD-MBD. On the other hand, several studies have looked at the link between hyperphosphataemia and cardiovascular morbidity and mortality in CKD, but there is a lack of evidence to indicate that lowering phosphate levels improves cardiovascular outcomes in this population. Furthermore, the impact of liberalizing phosphate targets on CKD-MBD progression and bone fracture is currently not known. In this review we discuss the central role of phosphate in the pathogenesis of CKD-MBD and how it may be associated with fracture risk, both in hyper- and hypophosphataemia.
Topics: Chronic Kidney Disease-Mineral and Bone Disorder; Fractures, Bone; Humans; Phosphates; Prognosis
PubMed: 31620773
DOI: 10.1093/ndt/gfz196 -
Osteoporosis International : a Journal... Jun 2011Fracture healing is a multistage repair process that involves complex, well-orchestrated steps initiated in response to tissue injury. The early upregulation of IL-6,... (Review)
Review
Fracture healing is a multistage repair process that involves complex, well-orchestrated steps initiated in response to tissue injury. The early upregulation of IL-6, osteoprotegerin (OPG), VEGF, and BMPs indicates a central role for these factors in the initiation of cartilage and periosteal woven bone formation. In both callus fracture repair and stress fracture repair, the RANKL/OPG ratio is initially reduced, but peaks earlier in stress fracture healing than callus fracture healing. Though the understanding of the biological processes and molecular signals that coordinate fracture repair has advanced, the cause of variability observed in fracture repair is poorly understood.
Topics: Bone Remodeling; Fracture Healing; Fractures, Bone; Fractures, Stress; Humans; Intercellular Signaling Peptides and Proteins; Signal Transduction
PubMed: 21523400
DOI: 10.1007/s00198-011-1611-4 -
The Veterinary Clinics of North... Jan 2020A concise review of the history of meta-bone fracture repair is provided. The relevant surgical anatomy, available instrumentation, and execution of preoperative,... (Review)
Review
A concise review of the history of meta-bone fracture repair is provided. The relevant surgical anatomy, available instrumentation, and execution of preoperative, intraoperative, and postoperative surgical care using minimally invasive plate osteosynthesis are discussed in detail. A short discussion that touches on future directions for care of meta-bone fractures follows.
Topics: Animals; Bone Plates; Fracture Fixation, Internal; Fractures, Bone; Metacarpal Bones; Metatarsal Bones; Minimally Invasive Surgical Procedures
PubMed: 31648818
DOI: 10.1016/j.cvsm.2019.08.011