Acceleration of Fresh Fracture Repair Using the Sonic Accelerated Fracture Healing System (SAFHS): A Review

2000 ◽  
Vol 66 (2) ◽  
pp. 157-163 ◽  
Author(s):  
S. J. Warden ◽  
K. L. Bennell ◽  
J. M. McMeeken ◽  
J. D. Wark
2021 ◽  
Vol 11 (2) ◽  
pp. 229-239
Author(s):  
Yun Li ◽  
Guanghua Liu ◽  
Feng Xiao ◽  
Wenqin Gu ◽  
Zhengdong Gao ◽  
...  

We did this research to observe the effect of LIPUS on long bone fracture repair and caveolin-1, β-catenin signaling expression in the radius defects of rabbits, to explore its possible molecular mechanisms. 24 male New Zealand rabbits with bilateral radial bone defects were divided into 4 groups randomly, n = 6. The right side had daily LIPUS exposure for 20 minutes, while the left received sham treatment. After 7, 14, 21, 28 days, respectively, fracture healing was observed by X-ray imaging and Dual Energy X-ray Absorptiometry (DXA) scan, specimens were harvested for histology, immunohistochemistry, and gene expression analysis. We found that LIPUS brought forward endochondral ossification, increased the bone callus size without changes in Bone Mineral Density (BMD). The caveolin-1 expression increased first then decreased, while the β-catenin kept growing during the process. These demonstrated that caveolin-1 participated in fracture healing accelerated by LIPUS, which was speculated to play a dual role in β-catenin signaling expression.


Author(s):  
D.K. Dwivedi ◽  
R.B. Kushwaha ◽  
M.S. Bhadwal ◽  
A.K. Gupta ◽  
J.S. Soodan ◽  
...  

Background: Fracture repair is one of most common procedure carried out by veterinary clinicians. Fracture healing most of the time associated with delayed union, non-union and mal-uinon. Therefore, the objective of this study was to evaluate the clinical, haemato-biochemical and radiological outcome in patients after implantation of β-tricalcium phosphate as a bone graft substitute to promote the fracture healing.Methods: Eight clinical cases brought to the clinics with femur fracture were divided into two groups viz. A and B, with four animals in each group. Femur fractures were stabilized with intramedullary pinning and β-TCP biomaterial and intramedullary pinning and β-TCP plus autologous bone marrow aspirate (BMA) composite in group A and B respectively. The efficacy of fixation was studied on the basis of clinical evaluation, haemato-biochemical and radiographical parameters on day 0 and on 7th, 15th, 30th, 45th and 60th post-operative day. Result: Excellent weight bearing was noticed in group B. The overall functional outcome in group B was better in comparison to group A animals. Haematological parameters viz. haemoglobin, packed cell volume, total leukocyte count and differential leukocyte count did not differ significantly within and between the groups. The biochemical parameters viz. serum calcium increased significantly (P less than 0.05) on 7th and 15th post-operative day. A significant reduction in serum alkaline phosphatase level observed on successive post-operative days in both groups. Radiographs of fractures treated in both the groups showed good reduction and fracture fixation, early signs of fracture healing in group B than group A animals. The size of callus formation was more in group A than group B. No any graft related complications observed during the study period. The β-tricalcium phosphate facilitated fracture healing and early ambulation of affected limb.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Yuhui Chen ◽  
He Cao ◽  
Dawei Sun ◽  
Changxin Lin ◽  
Liang Wang ◽  
...  

Bone fracture is a global healthcare issue for high rates of delayed healing and nonunions. Although n-3 polyunsaturated fatty acid (PUFA) is considered as a beneficial factor for bone metabolism, only few studies till date focused on the effects of n-3 PUFAs on fracture healing. In this study, we investigated the effect of endogenous n-3 PUFAs on fracture healing by measuring femur fracture repair in bothfat-1transgenic mice and WT mice. Proximal femoral fracture model was established infat-1transgenic mice and WT mice, respectively, and then the fracture was analyzed by using X-ray, micro-computed tomography (micro-CT), and histological assessment at 7, 14, 21, 28, and 35 days after fixation. The results showed that compared with WT mice,fat-1mice exhibited acceleration in fracture healing through radiographic and histological analysis (18–21 days versus 21–28 days postfracture). Meanwhile, X-ray and micro-CT analysis that showed better remodeling callus formation were in thefat-1group compared to WT group. Furthermore, histological analysis revealed that endogenous n-3 PUFAs promoted local endochondral ossification and accelerated the remodeling of calcified calluses after fracture. In conclusion, the present study indicated that endogenously produced n-3 PUFAs promote fracture healing process and accelerate bone remodeling in mice, and supplementation of n-3 PUFAs was positively associated with fracture healing.


Author(s):  
Aaron S. Weaver ◽  
Yu-Ping Su ◽  
Dana L. Begun ◽  
Ralph T. Zade ◽  
Andrea I. Alford ◽  
...  

Fracture healing is a complex process involving numerous cell types, whose actions are regulated by many factors in their local environment. Mechanical factors are known to exert a strong influence on the actions of these cells and the progression of the repair process. While prior studies have investigated the effect of physical forces on cell differentiation, biofactor expression, and mechanical competence of repair, the mechanosensory and response mechanisms are poorly understood. This study was designed to explore the influence of a controlled mechanical environment on temporal aspects of the bone repair process. Specifically, this study examines how the timing of an applied strain influences local cell behavior during fracture repair, and how this load affects the migration of systemically introduced mesenchymal stem cells (MSCs) to the fracture site.


Author(s):  
Cheng Ma ◽  
Huan Liu ◽  
Yifan Wei ◽  
He Li ◽  
Dengshun Miao ◽  
...  

Fracture healing is a complicated, long-term, and multistage repair process. Intermittent administration of parathyroid hormone (PTH) has been proven effective on intramembranous and endochondral bone formation during the fracture healing process, however, the mechanism is unclear. In this study, we investigated the role of exogenous PTH and endogenous PTH deficiency in bone fracture healing and explored the mechanism by using PTH knockout (PTH-/-) mice and ATDC5 cells. In a mouse femur fracture model, endogenous PTH deficiency could delay endochondral ossification whereas exogenous PTH promotes accumulation of endochondral bone, accelerates cartilaginous callus conversion to bony callus, enhances maturity of bony callus, and attenuates impaired fracture healing resulting from endogenous PTH deficiency. In fracture callus tissue, endogenous PTH deficiency could inhibit chondrocyte proliferation and differentiation whereas exogenous PTH could activate the IHH signaling pathway to accelerate endochondral ossification and rescue impaired fracture healing resulting from endogenous PTH deficiency. In vitro, exogenous PTH promotes cell proliferation by activating IHH signaling pathway on ATDC5 cells. In mechanistic studies, by using ChIP and luciferase reporter assays, we showed that PTH could phosphorylate CREB, and subsequently bind to the promoter of IHH, causing the activation of IHH gene expression. Therefore, results from this study support the concept that exogenous PTH 1-34 attenuates impaired fracture healing in endogenous PTH deficiency mice via activating the IHH pathway and accelerating endochondral ossification. Hence, the investigation of the mechanism underlying the effects of PTH treatment on fracture repair might guide the exploration of effective therapeutic targets for fracture.


2016 ◽  
Vol 44 (1) ◽  
pp. 5
Author(s):  
José Arthur De Abreu Camassa ◽  
Leonardo Augusto Lopes Muzzi ◽  
Fernando Yoiti Kitamura Kawamoto ◽  
Camila Cardoso Diogo ◽  
Ruthnéa Aparecida Lázaro Muzzi ◽  
...  

Background: Ferrets (Mustela putorius furo) are increasingly popular as pets. They require similar medical and surgical care as small animals, and orthopedic lesions are more and more common. Fracture diagnosis is based on history, orthopedic exam, and diagnostic imaging. The preferred treatment for femur fractures is surgery, which has a favorable outcome in the majority of cases. However, surgical fracture repair in ferrets can be challenging due to the small size of the bones. The objective of thispaper is to report the surgical repair of a femoral fracture in a ferret using an external skeletal fxation system type IA connected to an intramedullary pin (tie-in confguration).Case: An adult ferret was referred to the veterinary hospital after being stepped on. The ferret was diagnosed with an oblique diaphyseal fracture of the left femur and surgery was recommended. Open fracture reduction was performed with a 1 mm in tramedullary pin (Kirschner wire) placed in a retrograde direction into the proximal bone segment. After fracture reduction, the intramedullary pin was inserted into the distal bone segment. The external skeletal fxator type IA was created by the insertionof a 1.5 mm Schanz pin into the distal diaphysis and another, also 1.5 mm, inserted into the proximal metaphysis, both percuta neously. The three pins were connected externally to an aluminum bar with the aid of three staples to form a tie-in system. Rest and restriction of activity were recommended during the frst month after surgery. The ferret recovered well and, at 120 days, orthopedic and radiographic exams showed complete fracture healing. The implant was removed and no functional changesrelated to ambulation were observed.Discussion: The orthopedic knowledge applied to ferrets commonly originates in procedures performed on cats and dogs. Overall,the main objective when dealing with fractures is to stabilize the broken bone to allow early ambulation. Due to the location and type of fracture, an external immobilization was contraindicated in this case. A plate was considered, but the small diameter of the femur and the consequent risk of iatrogenic fractures made this option not feasible. Therefore, the external skeletal fxator in a tie-in confguration was selected. This method permitted control of the forces acting on the fracture site and had the advantage of low cost and ease of application and removal. Nevertheless, the vast musculature that covers the femur could hinder the use ofthe external pins and lead to discomfort. The method has been reported with some changes in ferrets, though with inconclusive results due to lack of follow-up. In the present report, a less rigid method, type I, was used since types II and III have a biplanar confguration and were thus inadequate due to the possible contact between the fxator and the abdominal or inguinal region. The precautions taken during placement of the implant were the same as in cats and dogs since their anatomy follows the same pattern. The implant was rigid, light, and effective, allowing early weight-bearing on the affected limb without discomfort to the patient. As such, the external fxator type IA connected to the intramedullary pin in a tie-in confguration was an effective method for the treatment of the oblique diaphyseal femoral fracture in this ferret. Although it is not the recommended method for this type of fracture in cats and dogs, there were no complications in the ferret, with complete fracture healing and return tofunction of the affected limb. Since there has yet to be a consensus on the recommended procedures in these animals, reports of this nature are important due to the growing number of ferret patients in veterinary practice.Keywords: ferret, osteosynthesis, bone fxation, repair of fractures.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong Zhang ◽  
Yifan Wu ◽  
Zonghuan Li ◽  
Hairen Chen ◽  
Siyuan Huang ◽  
...  

Abstract Background Patients with diabetes have an increased risk of nonunion and delayed union of fractures. Macrophages have been shown as a key player in diabetic complications. However, it remains obscure how diabetic milieu affects macrophage-derived exosomes and its implications on osteogenic differentiation of BMSCs. In this study, we aim to define the impact of diabetic milieu on macrophage-derived exosomes, role of extracellular vesicles in intercellular communication with BMSCs, and subsequent effects on osteogenic differentiation and fracture repair. Results The osteogenic potential and the ability of fracture repair of exosomes derived from diabetic bone marrow-derived macrophages (dBMDM-exos) were revealed to be lower, as compared with non-diabetic bone marrow-derived macrophages (nBMDM-exos) in vitro and in vivo. Interestingly, miR-144-5p levels were sharply elevated in dBMDM-exos and it could be transferred into BMSCs to regulate bone regeneration by targeting Smad1. In addition, the adverse effects of dBMDM-exos on the osteogenic potential and the ability of fracture repair were reversed through the suppression of miR-144-5p inhibition in vitro and vivo. Conclusions The results demonstrated an important role of exosomal miR-144-5p in bone regeneration, offering insight into developing new strategy for the improvement of fracture healing in patients with diabetes mellitus. Graphic Abstract


2020 ◽  
Vol 3 ◽  
Author(s):  
Anthony McGuire ◽  
Adam Knox ◽  
Caio de Andrade Staut ◽  
Melissa Kacena ◽  
Roman Natoli ◽  
...  

Background/Objective: Long bone fractures are an expensive and frequent cause of disability in humans. Research seeking to accelerate and improve the healing process is more essential than ever. Animal models, mice especially, provide an inexpensive and reproducible model of in vivo fracture healing. However, many measures of murine fracture healing outcomes are either expensive or destructive, limiting their ability to be translated to clinical studies. We seek to determine how these measures such as biomechanics, µCT, and histology correlate to the relatively new, inexpensive, and non-destructive method of mRUST scoring in a mouse model.  Methods: One hundred and thirty-five, 12-week old male C57BL6/J mice were divided into nine groups of 15 mice. Mice underwent a surgically created, femoral fracture. At biweekly timepoints, anteroposterior and lateral radiographs were taken, and 15 mice were sacrificed at each time point (7, 10, 14, 17, 21, 24, 28, 35, and 42 days post-surgery) for biomechanical, µCT, and histological analyses. The modified Radiographic Union Scale for Tibial fractures (mRUST scoring) provides a score based on the visualization of a callus and fracture line in four cortices on the radiographs. Data analysis will be performed to determine the degree of correlation between mRUST scoring and other fracture healing outcomes.  Results/Conclusion: Data collection in this experiment is still forthcoming. Upon successful completion of this project, we will have established numerical correlations between mRUST scoring and other fracture healing outcomes, such as biomechanics, µCT microarchitecture, and histology. These correlations will provide a powerful tool in future mouse fracture healing studies, as data on the state and strength of fracture repair could be determined by simple radiograph.  Scientific/Clinical Policy Impact and Implications: This study will both provide future murine fracture studies with an inexpensive and non-destructive method of assessment that is more directly translatable to human fracture studies. 


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