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Fracture + remodeling

Hakan Ömeroğlu
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Xin Wang, Yi Zhang, Wenjun Ji, Jun Ao
Fracture hematoma formation describes a transitional phase that involves a dynamic and tightly choreographed interaction between the fibrin matrix, cells, and cytokines that guides the ensuing bone repair. Here we propose a novel hypothesis to explain why hematomas in conjunction with critical sized bone defects are prone to differentiate into fibrous tissues, which eventually results in non-unions of the bone. We postulate that certain hematoma qualities are triggers that influence cell biological behaviours and that the release of certain growth factors determines what pattern of remodelling will prevail: intramembranous or endochondral ossification...
April 2018: Medical Hypotheses
Susanne Roser-Page, Tatyana Vikulina, Kanglun Yu, Meghan E McGee-Lawrence, M Neale Weitzmann
Objective: Immunosuppressive biologics are used in the management of RA and additional immunomodulators are under investigation including modulators of the CD40/CD40 ligand (CD40L) costimulation pathway. Tampering with immune function can have unanticipated skeletal consequences due to disruption of the immuno-skeletal interface, a nexus of shared cells and cytokine effectors serving discrete functions in both immune and skeletal systems. In this study, we examined the effect of MR1, a CD40L neutralizing antibody, on physiological bone remodelling in healthy mice...
March 7, 2018: Rheumatology
D Henrich, C Seebach, R Verboket, A Schaible, I Marzi, H Bonig
Bone marrow mononuclear cells (BMC) seeded on a scaffold of β-tricalcium phosphate (β-TCP) promote bone healing in a critical-size femur defect model. Being BMC a mixed population of predominantly mature haematopoietic cells, which cell type(s) is(are) instrumental for healing remains elusive. Although clinical therapies using BMC are often dubbed as stem cell therapies, whether stem cells are relevant for the therapeutic effects is unclear and, at least in the context of bone repair, seems dubious. Instead, in light of the critical contribution of monocytes and macrophages to tissue development, homeostasis and injury repair, in the current study it was hypothesised that BMC-mediated bone healing derived from the stem cell population...
March 6, 2018: European Cells & Materials
Bhavita Walia, Elizabeth Lingenheld, Le Duong, Archana Sanjay, Hicham Drissi
Osteoporosis management is currently centered around bisphosphonates, which inhibit osteoclast (OC) bone resorption but do not affect bone formation. This reduces fracture risk, but fails to restore healthy bone remodeling. Studies in animal models showed that cathepsin K (CatK) inhibition by genetic deletion or chemical inhibitors maintained bone formation while abrogating resorption during bone remodeling and stimulated periosteal bone modeling. Recently, periosteal mononuclear tartrate-resistant acid phosphatase-positive (TRAP+ ) osteoclast precursors (OCPs) were shown to augment angiogenesis-coupled osteogenesis...
February 26, 2018: Annals of the New York Academy of Sciences
Jian Zhang, Xinyu Qiu, Kedi Xi, Wentao Hu, Hailong Pei, Jing Nie, Ziyang Wang, Jiahan Ding, Peng Shang, Bingyan Li, Guangming Zhou
Radiation therapy is one of the routine treatment modalities for cancer patients. Ionizing radiation (IR) can induce bone loss, and consequently increases the risk of fractures with delayed and nonunion of the bone in the cancer patients who receive radiotherapy. The orchestrated bone remodeling can be disrupted due to the affected behaviors of bone cells, including bone mesenchymal stem cells (BMSCs), osteoblasts and osteoclasts. BMSCs and osteoblasts are relatively radioresistant compared with osteoclasts and its progenitors...
February 15, 2018: Connective Tissue Research
Yuri Takamine, Noriko Ichinoseki-Sekine, Takamasa Tsuzuki, Toshinori Yoshihara, Hisashi Naito
The incidence of obesity in children and adolescents, which may lead to type 2 diabetes, is increasing. Exercise is recommended to prevent and improve diabetes. However, little is known about the bone marrow environment at the onset of diabetes in the young, and it is unclear whether exercise training is useful for maintaining bone homeostasis, such as mechanical and histological properties. Thus, this study clarified the histological properties of bone and whether exercise contributes to maintaining bone homeostasis at the onset of type 2 diabetes in rats...
2018: PloS One
Joseph L Roberts, David N Paglia, Hicham Drissi
PURPOSE OF REVIEW: Growing evidence supports the critical role of transcriptional mechanisms in promoting the spatial and temporal progression of bone healing. In this review, we evaluate and discuss new transcriptional and post-transcriptional regulatory mechanisms of secondary bone repair, along with emerging evidence for epigenetic regulation of fracture healing. RECENT FINDINGS: Using the candidate gene approach has identified new roles for several transcription factors in mediating the reactive, reparative, and remodeling phases of fracture repair...
February 13, 2018: Current Osteoporosis Reports
Amandeep Kumar, Gaurav Varshney, Pankaj K Singh, Deepak Agrawal, Guru D Satyarthee, Poodipedi S Chandra, Shashank S Kale, Ashok K Mahapatra
BACKGROUND: Atlantoaxial spondyloptosis (AAS), which is defined as complete displacement of facets of atlas anterior to the facets of axis such that there is no contact between the 2 articulating surfaces, is an extremely rare manifestation of atlantoaxial instability. The reason for an extreme rarity of traumatic AAS is probably the severity of injury in traumatic AAS that is usually incompatible to life. It represents the most severe form of atlantoaxial dislocation, and complete reduction in such a case presents a real technical challenge because of the interlocking of C1-C2 facets...
February 2018: World Neurosurgery
Liangsong Song, Zhixin Zhang, Yang Wang, Yang Liu, Zhigang Liu, Lei Chen, Laijin Lu
Management of complex foot injuries, which involve open fractures and severe trauma to soft tissues, represent a challenge to orthopedic clinicians. In the present case report, we treated a complex foot injury with a remodeled fibular osteocutaneous free flap to reconstruct the anterior and lateral areas of the foot. The flap survived completely. At the 9-month follow-up examination, bony union of the graft bone was identified by radiographic examination. The reconstructed foot could bear body weight, and the patient could maintain a bipedal gait without discomfort...
February 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Min Zhou, Hai Cai, Zhonghua Li, Yepeng Zhang, Zhao Liu, Hanfei Tang, Tong Qiao, ChangJian Liu
OBJECTIVES: To report the midterm safety and efficacy of the Aegis™-B (Microport, Shanghai, China) unibody bifurcated stent-graft for endovascular treatment of isolated abdominal aortic dissection (IAAD). BACKGROUND: Isolated abdominal aorta dissection (IAAD) is a rare event. Endovascular stent grafts seem to offer an efficient therapeutic approach to treating IAAD. However, the relatively small diameter of the infrarenal aorta and aortic bifurcation remains the main anatomical limitation to endovascular repair...
February 5, 2018: Annals of Vascular Surgery
Guillaume Mabilleau, Benoît Gobron, Béatrice Bouvard, Daniel Chappard
Bone fractures are common comorbidities of type 2 diabetes mellitus (T2DM). Bone fracture incidence seems to develop due to increased risk of falls, poor bone quality and/or anti-diabetic medications. Previously, a relation between gut hormones and bone has been suspected. Most recent evidences suggest indeed that two gut hormones, namely glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), may control bone remodeling and quality. The GIP receptor is expressed in bone cells and knockout of either GIP or its receptor induces severe bone quality alterations...
February 2018: Peptides
Kiminori Yukata, Chao Xie, Tian-Fang Li, Matthew L Brown, Tsukasa Kanchiku, Xinping Zhang, Hani A Awad, Edward M Schwarz, Christopher A Beck, Jennifer H Jonason, Regis J O'Keefe
Genetic ablation of cyclooxygenase-2 (COX-2) in mice is known to impair fracture healing. To determine if teriparatide (human PTH1-34) can promote healing of Cox-2-deficient fractures, we performed detailed in vivo analyses using a murine stabilized tibia fracture model. Periosteal progenitor cell proliferation as well as bony callus formation was markedly reduced in Cox-2-/- mice at day 10 post-fracture. Remarkably, intermittent PTH1-34 administration increased proliferation of periosteal progenitor cells, restored callus formation on day 7, and enhanced bone formation on days 10, 14 and 21 in Cox-2-deficient mice...
February 2, 2018: Bone
Karthik Shunmugavelu, Kumaravel Subramaniam
The main characteristic feature of the pediatric mandible is that of decreased dimension, which leads to compromises in the open reduction and internal fixation (ORIF). In the dental segment, the cervically bulbous short stature primary teeth might act an obstacle during the maxillomandibular fixation conventionally. An increased osteogenic potential of bones favors rapid consolidation and remodeling in the affected region. The mixed dentition of the ugly duckling stage adds more burden while stabilizing the fractured segments...
October 2017: International Journal of Clinical Pediatric Dentistry
Christopher D Kegelman, Devon E Mason, James H Dawahare, Daniel J Horan, Genevieve D Vigil, Scott S Howard, Alexander G Robling, Teresita M Bellido, Joel D Boerckel
The functions of the paralogous transcriptional coactivators Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) in bone are controversial. Each has been observed to promote or inhibit osteogenesis in vitro, with reports of both equivalent and divergent functions. Their combinatorial roles in bone physiology are unknown. We report that combinatorial YAP/TAZ deletion from skeletal lineage cells, using Osterix-Cre, caused an osteogenesis imperfecta-like phenotype with severity dependent on allele dose and greater phenotypic expressivity with homozygous TAZ vs...
January 10, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Samuel Vasikaran
An imbalance between bone formation and bone resorption is a factor in the development of osteoporosis. Bone turnover markers (BTM) are useful in assessing bone remodeling at the cellular level. Measurement of BTM is useful for assessing bone turnover and therefore fracture risk as well as for monitoring response to treatment response. This paper describes the steps that have been taken so far and the ongoing work to harmonize the total testing process for the assessment of bone turnover in osteoporosis internationally and collaboratively between the clinical and laboratory professions...
January 30, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Melissa F P Santos, Mariel J Hernández, Ivone B de Oliveira, Flávia R Siqueira, Wagner V Dominguez, Luciene M Dos Reis, Aluizio B Carvalho, Rosa M A Moysés, Vanda Jorgetti
Chronic kidney disease-mineral bone disorders (CKD-MBD) are associated with increased risk of fracture. Studies report about 3% of fractures in CKD patients, and these occur earlier than in the general population, namely 16 and 13 years earlier for men and women, respectively. Better understanding of the pathophysiology of fractures would probably contribute to new therapeutic approaches. This study aimed to evaluate report of long bone fractures from a bone biopsies bank from patients on hemodialysis and compare clinical and biochemical characteristics, as well as the results of the histomorphometric analysis of trabecular and cortical bone of these patients with a control group (without fractures), paired for age, gender, and time on hemodialysis...
January 25, 2018: Journal of Bone and Mineral Metabolism
N Hopper, E Singer, F Henson
OBJECTIVES: The exact aetiology and pathogenesis of microdamage-induced long bone fractures remain unknown. These fractures are likely to be the result of inadequate bone remodelling in response to damage. This study aims to identify an association of osteocyte apoptosis, the presence of osteocytic osteolysis, and any alterations in sclerostin expression with a fracture of the third metacarpal (Mc-III) bone of Thoroughbred racehorses. METHODS: A total of 30 Mc-III bones were obtained; ten bones were fractured during racing, ten were from the contralateral limb, and ten were from control horses...
January 2018: Bone & Joint Research
Suiyi Wu, Ximing Xu, Jingchuan Sun, Yao Zhang, Jiangang Shi, Tianming Xu
OBJECTIVES: Patients with traumatic vertebral fractures often have major associated postoperative morbidities such as healing failure and kyphosis. Low-intensity pulsed ultrasound (US) has been found to promote bone fracture healing. The objectives of our study were to determine whether low-intensity pulsed US could promote traumatic vertebral fracture healing and to explore its inner mechanisms. METHODS: A rat model of traumatic vertebral fracture was created and treated with low-intensity pulsed US after surgery...
January 24, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Qiaohui Hu, Thomas J Nelson, Edward P Snelling, Roger S Seymour
The nutrient artery passes through the nutrient foramen on the shaft of the femur and supplies more than one-half of total blood flow to the bone. Assuming that the size of the nutrient foramen correlates with the size of the nutrient artery, an index of blood flow rate (Qi) can be calculated from nutrient foramen dimensions. Interspecific Qi is proportional to locomotor activity levels in adult mammals, birds and reptiles. However, no studies have yet estimated intraspecific Qi to test for the effects of growth and locomotor development on bone blood flow requirements...
December 21, 2017: Journal of Experimental Biology
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