Biomechanical environment of early stage of bone healing under biological internal fixation

2012 ◽  
pp. 691-695
Author(s):  
S Miramini ◽  
L Zhang ◽  
P Mendis ◽  
M Richardson
Keyword(s):  
Internal Fixation ◽  
Bone Healing ◽  
Early Stage ◽  
Biological Internal Fixation

Parathyroid hormone promotes cartilage healing after free reduction of mandibular condylar fractures by upregulating Sox9

2021 ◽  
pp. 153537022110271
Author(s):  
Yuanyuan Jia ◽  
Liuqin Xie ◽  
Zhenglong Tang ◽  
Dongxiang Wang ◽  
Yun Hu ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Internal Fixation ◽  
Early Stage ◽  
Rabbit Model ◽  
Mandibular Condyle ◽  
Fracture Site ◽  
Control Group ◽  
Condylar Cartilage ◽  
Cartilage Healing ◽  
Experimental Group

After high fractures of the mandibular condyle, the insufficient blood supply to the condyle often leads to poor bone and cartilage repair ability and poor clinical outcome. Parathyroid hormone (PTH) can promote the bone formation and mineralization of mandibular fracture, but its effects on cartilage healing after the free reduction and internal fixation of high fractures of the mandibular condyle are unknown. In this study, a rabbit model of free reduction and internal fixation of high fractures of the mandibular condyle was established, and the effects and mechanisms of PTH on condylar cartilage healing were explored. Forty-eight specific-pathogen-free (SPF) grade rabbits were randomly divided into two groups. In the experimental group, PTH was injected subcutaneously at 20 µg/kg (PTH (1–34)) every other day, and in the control group, PTH was replaced with 1 ml saline. The healing cartilages were assessed at postoperative days 7, 14, 21, and 28. Observation of gross specimens, hematoxylin eosin staining and Safranin O/fast green staining found that every-other-day subcutaneous injection of PTH at 20 µg/kg promoted healing of condylar cartilage and subchondral osteogenesis in the fracture site. Immunohistochemistry and polymerase chain reaction showed that PTH significantly upregulated the chondrogenic genes Sox9 and Col2a1 in the cartilage fracture site within 7–21 postoperative days in the experimental group than those in the control group, while it downregulated the cartilage inflammation gene matrix metalloproteinase-13 and chondrocyte terminal differentiation gene ColX. In summary, exogenous PTH can stimulate the formation of cartilage matrix by triggering Sox9 expression at the early stage of cartilage healing, and it provides a potential therapeutic protocol for high fractures of the mandibular condyle.

Mechanical Failure of Angle Locking Plates in Distal Comminuted Tibial Fractures

2016 ◽  
Vol 695 ◽  
pp. 118-122 ◽  
Author(s):  
Razvan Ene ◽  
Zsombor Panti ◽  
Mihai Nica ◽  
Marian Pleniceanu ◽  
Patricia Ene ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Healing ◽  
Tibial Fracture ◽  
Weight Bearing ◽  
Healing Process ◽  
Biomechanical Properties ◽  
Implant Failure ◽  
Locking Plates ◽  
Non Union ◽  
Tibial Pilon

Distal comminuted tibial fracture with or without intra-articular involvement is a very common injury of the lower limb, especially in younger patients due to high energy trauma. The anatomical and biomechanical properties of this segment of tibia, makes this pathology a major surgical challenge with a preserved clinical outcome. The aim of this study is to present different outcome of tibial fracture, treated with open reduction and internal fixation (ORIF) with titanium angle locking plates (ALP) and to underline the physiological and non-physiological bone healing effects on implants. In this study we included 48 patients with tibial pilon fracture who underwent to ORIF, applying ALP in the Orthopedics and Trauma department of the University Emergency Hospital in Bucharest. Due to preserved biomechanical properties of ALP and this anatomical region, weight bearing is not allowed till 6 to 8 weeks. Comminuted fracture of this part of tibia often have de-vascularized bony fragments which leads to delayed union or non-union. These complications often lead to implant failure, improper bone healing or non-union. Internal fixation with angle stable screws, offers a good stability of reduction in the early postoperative period. Titanium angle locking plates offers good anatomical reduction and stable fixation in the early period of healing process. Due to its rigid, fixed position of the screws in the plates, bone remodelling during healing process and early weight bearing, increases the mechanical failure of implant.Keywords: tibial pilon fractures, angle locking plates, implant failure.

scholarly journals Two-stage open reduction and internal fixation versus limited internal fixation combined with external fixation: a meta-analysis of postoperative complications in patients with severe Pilon fractures

2018 ◽  
Vol 46 (7) ◽  
pp. 2525-2536 ◽  
Author(s):  
Xueliang Cui ◽  
Hui Chen ◽  
Yunfeng Rui ◽  
Yang Niu ◽  
He Li
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Bone Healing ◽  
Open Reduction ◽  
Lower Risk ◽  
Meta Analysis ◽  
Two Stage ◽  
Superficial Infection ◽  
Tibial Pilon ◽  
Pilon Fractures

Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF. Eight studies involving 360 fractures in 359 patients were included in the meta-analysis. Results The two-stage ORIF group had a significantly lower risk of superficial infection, nonunion, and bone healing problems than the LIFEF group. However, no significant differences in deep infection, delayed union, malunion, arthritis symptoms, or chronic osteomyelitis were found between the two groups. Conclusion Two-stage ORIF was associated with a lower risk of postoperative complications with respect to superficial infection, nonunion, and bone healing problems than LIFEF for tibial Pilon fractures. Level of evidence 2.

scholarly journals Image-Based Radiodensity Profilometry Measures Early Remodeling at the Bone-Callus Interface in Sheep

2021 ◽  
Author(s):  
Tianyi Ren
Keyword(s):  
Bone Healing ◽  
Callus Formation ◽  
Early Stage ◽  
Numerical Models ◽  
Fracture Repair ◽  
Density Gradients ◽  
Intact Bone ◽  
Processing Techniques ◽  
Early Healing

Bone healing has been traditionally described as a four-phase process: inflammatory response, soft callus formation, hard callus development, and remodeling. The remodeling phase has been largely neglected in most numerical mechanoregulation models of fracture repair in favor of capturing early healing using a pre-defined callus domain. However, in vivo evidence suggests that remodeling occurs concurrently with repair and causes changes in cortical bone adjacent to callus that are typically neglected in numerical models of bone healing. The objective of this study was to use image processing techniques to quantify this early-stage remodeling in ovine osteotomies. To accomplish this, we developed a numerical method for radiodensity profilometry with optimization-based curve fitting to mathematically model the bone density gradients in the radial direction across the cortical wall and callus. After assessing data from 26 sheep, we defined a dimensionless density fitting function that revealed significant remodeling occurring in the cortical wall adjacent to callus during early healing, a 23% average reduction in density compared to intact. This fitting function is robust for modeling radial density gradients in both intact bone and fracture repair scenarios and can capture a wide variety of the healing responses. The fitting function can also be scaled easily for comparison to numerical model predictions and may be useful for validating future mechanoregulatory models of coupled fracture repair and remodeling.

Deformation Analysis of Internal Fixation Plate on Femur Bone Fracture: A Study Case on Local Raw

2020 ◽  
Vol 867 ◽  
pp. 196-203
Author(s):  
Achmad Syaifudin ◽  
Djoko Kuswanto ◽  
Teguh Hari Prasetyo
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Internal Fixation ◽  
Bone Healing ◽  
Bone Fracture ◽  
Healing Process ◽  
Material Type ◽  
Femur Bone ◽  
Implant Material ◽  
Fixation Plate

In the case of femur bone fracture, internal fixation is usually applied for the treatment due to the convenience and amenities of follow-up care. Due to a high demand for internal fixation implants in Indonesia, causing Pelopor Teknologi Implantindo Inc. (PTI Inc., Mojokerto - Indonesia) produces conventional implant material made from annealed local raw material of 316L stainless steel, with a yield strength of 317 MPa and ultimate tensile strength of 580 MPa. Compared to implant material in ASTM F138, it has a little higher value of both yield and ultimate tensile strength. To determine the effects of material type, normal stresses will be used to evaluate the fractured bone, while von Mises stresses will be used to analyze the strength of fixation plate. Besides, influence of material variation to the bone healing process is also discussed. Transversal-type fracture is chosen for fracture modeling of femoral shaft. The loading is taken from body weight of Asians, which is applied at femur head. The simulation result indicates that in the case of conventional fixation plate, there is no significant influence on the bone healing caused by different material type.

scholarly journals An Improved Methodology to Evaluate Cell and Molecular Signals in the Reparative Callus During Fracture Healing

2020 ◽  
Vol 68 (3) ◽  
pp. 199-208
Author(s):  
Anuradha Valiya Kambrath ◽  
Justin N. Williams ◽  
Uma Sankar
Keyword(s):  
Fracture Healing ◽  
Bone Healing ◽  
High Throughput Screening ◽  
Molecular Mechanisms ◽  
Structural Integrity ◽  
Bone Fractures ◽  
Early Stage ◽  
Antigen Retrieval ◽  
Sample Collection ◽  
Immunofluorescence Labeling

Approximately 5% to 10% of all bone fractures do not heal completely, contributing to significant patient suffering and medical costs. Even in healthy individuals, fracture healing is associated with significant downtime and loss of productivity. However, no pharmacological treatments are currently available to promote efficient bone healing. A better understanding of the underlying molecular mechanisms is crucial for developing novel therapies to hasten healing. The early reparative callus that forms around the site of bone injury is a fragile tissue consisting of shifting cell populations held together by loose connective tissue. The delicate callus is challenging to section and is vulnerable to disintegration during the harsh steps of immunostaining, namely, decalcification, deparaffinization, and antigen retrieval. Here, we describe an improved methodology for processing early-stage fracture calluses and immunofluorescence labeling of the sections to visualize the temporal (timing) and spatial (location) patterns of cellular and molecular events that regulate bone healing. This method has a short turnaround time from sample collection to microscopy as it does not require lengthy decalcification. It preserves the structural integrity of the fragile callus as the method does not entail deparaffinization or harsh methods of antigen retrieval. Our method can be adapted for high-throughput screening of drugs that promote efficacious bone healing:

Current concepts in bone healing. Review of the literature

1993 ◽  
Vol 83 (3) ◽  
pp. 123-129 ◽  
Author(s):  
MA Greenbaum ◽  
IO Kanat
Keyword(s):  
Internal Fixation ◽  
Bone Healing ◽  
Review Of The Literature ◽  
Rigid Internal Fixation ◽  
Primary Bone ◽  
Secondary Bone Healing

Bone healing is a process of reconstitution of tissue. With the development of rigid internal fixation, primary bone healing has exhibited certain histologic characteristics not previously seen. The authors discuss the histologic, biochemical, and physiologic processes seen in primary and secondary bone healing following fracture or osteotomy.

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