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Bone nonunion

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https://www.readbyqxmd.com/read/29785224/pseudarthrosis-of-the-calcaneus-advantages-of-regenerative-medicine-in-the-management-of-a-rare-entity-a-case-report-and-review-of-literature
#1
Bouaziz Wajdi, Mohamed Ali Rebai, Walid Baya, Nabil Krid, Wassim Zribi, Hassib Keskes
Background: The follow-up of calcaneal fractures has shown that they are difficult to manage and lead to multiple complications such as malunion and subtalar osteoarthritis. Pseudarthrosis of the calcaneus is an extremely rare complication, which was described in the literature through case reports.In the existing literature, only seven studies, including thirteen patients have reported the nonunion. However, to the best of our knowledge, no study elucidates the role of new techniques of regenerative medicine such as Bone Marrow Concentrates (BMC) or Platelet Rich Plasma (PRP) in the management...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29781821/basic-science-and-clinical-application-of-reamed-sources-for-autogenous-bone-graft-harvest
#2
Thomas F Higgins, Lucas S Marchand
Autologous bone graft remains the only clinically available source of graft material with osteogenic, osteoinductive, and osteoconductive properties. Although iliac crest autologous bone graft has long served as the benchmark, reamed autogenous bone graft offers several advantages. Reamed autograft has a biochemical and cellular profile that is at least equivalent, and perhaps superior, to that of iliac crest autograft. In addition, larger volumes of reamed autograft can be obtained via less-invasive techniques, giving surgeons an accessible source of mesenchymal stem cells that can be reliably and repeatedly harvested...
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29771401/mir-133a-inhibits-fracture-healing-via-targeting-runx2-bmp2
#3
H Peng, S-L Lu, Y Bai, X Fang, H Huang, X-Q Zhuang
OBJECTIVE: To analyze the mechanism of miR-133a in inhibiting fracture healing through regulating runt-related transcription factor 2 (RUNX2) signaling pathway. PATIENTS AND METHODS: A total of 80 patients with fracture admitted to our hospital from January 2016 to January 2017 were divided into 2 groups according to nonunion fracture or healing fracture: nonunion fracture group (n = 40) and control group (n= 40). After admission, patients underwent the surgery, respectively, and the bone tissues were taken for stand-by application...
May 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29740250/ilizarov-method-in-combination-with-autologous-mesenchymal-stem-cells-from-iliac-crest-shows-improved-outcome-in-tibial-non-union
#4
Hui Zhang, Feng Xue, Hai Jun Xiao
Autologous bone grafting and ilizarov technique are the preferred mode of treatment for bone nonunion, studies suggest that bone marrow derived mesenchymal stem cells can be effective in treatment of tibial non-union where there is length of bone defect. The current study investigates the beneficial clinical outcome of combining the ilizarov procedure with intraosseous injection of autologous mesenchymal stem cells. The open-label study enrolled 25 patients with infected tibial non-union at the Shanghai Fengxian District Central Hospital, Shanghai, China between April 2010 and July 2014...
May 2018: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/29736522/injectable-shear-thinning-hydrogels-for-delivering-osteogenic-and-angiogenic-cells-and-growth-factors
#5
Emine Alarçin, Tae Yong Lee, Sobha Karuthedom, Marzieh Mohammadi, Meadhbh A Brennan, Dong Hoon Lee, Alessandra Marrella, Jin Zhang, Denata Syla, Yu Shrike Zhang, Ali Khademhosseini, Hae Lin Jang
Bone nonunion may occur when the fracture is unstable, or blood supply is impeded. To provide an effective treatment for the healing of nonunion defects, we introduce an injectable osteogenic hydrogel that can deliver cells and vasculogenic growth factors. We used a silicate-based shear-thinning hydrogel (STH) to engineer an injectable scaffold and incorporated polycaprolactone (PCL) nanoparticles that entrap and release vasculogenic growth factors in a controlled manner. By adjusting the solid composition of gelatin and silicate nanoplatelets in the STH, we defined optimal conditions that enable injection of STHs, which can deliver cells and growth factors...
May 8, 2018: Biomaterials Science
https://www.readbyqxmd.com/read/29734844/the-effect-of-patient-fracture-and-surgery-on-outcomes-of-high-energy-neck-of-femur-fractures-in-patients-aged-15-50
#6
Wayne Hoskins, Johnny Rayner, Rohan Sheehy, Harry Claireaux, Roger Bingham, Roselyn Santos, Andrew Bucknill, Xavier L Griffin
INTRODUCTION: High-energy femoral neck fractures in young patients can be devastating, with the risk of osteonecrosis, nonunion, malunion and lifelong morbidity. The aim of this study is to define the effects of patient, fracture and surgical factors on the outcome of high-energy femoral neck fractures in patients aged from 15 to 50 years. METHODS: A retrospective review was conducted of high-energy femoral neck fractures in patients aged 15-50 managed surgically at a Level 1 Trauma Centre, using a prospectively recorded trauma database...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29730840/technical-and-clinical-feasibility-of-contrast-enhanced-ultrasound-evaluation-of-long-bone-non-infected-nonunion-healing
#7
Simona Pozza, Armanda De Marchi, Chiara Albertin, Domenico Albano, Ginevra Biino, Domenico Aloj, Luca Maria Sconfienza
PURPOSE: To assess the technical feasibility of contrast-enhanced ultrasound (CEUS) in the monitoring of non-infected long bone nonunion healing. METHODS: Twenty-five patients (16 males; mean age: 40.4 ± 11.7) with long bone nonunion were treated using surgery and mesenchymal stem cells and platelet-rich plasma. They performed CEUS up to 15 days before, 7 days, 4 and 8 weeks after treatment. To categorize the angiogenesis around the fracture site, the microvascular blood flow from CEUS was classified into four categories, depending on the portion of the investigated area that was involved in the neovascularization process: grade 0 = 0%; grade 1 = 0-30%; grade 2 = 30-70%; grade 3 = 70-100%...
May 5, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29703460/comparison-and-use-of-allograft-bone-morphogenetic-protein-versus-other-materials-in-ankle-and-hindfoot-fusions
#8
J George DeVries, Brandon Scharer
Bone grafting is a common procedure in foot and ankle surgery. Because autogenous graft use results in comorbidity to the patient, the search has been ongoing for the ideal substitute. A novel processing technique for allograft using bone marrow, which retains many of the growth factors, has shown promise in the spinal data and early reports of foot and ankle surgery. We performed a retrospective, comparative study of patients undergoing hindfoot and ankle arthrodesis, with a total of 68 patients included. Of the 68 patients, 29 (42...
April 24, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29701102/the-indications-and-donor-site-morbidity-of-tibial-cortical-strut-autografts-in-the-management-of-defects-in-long-bones
#9
O Lauthe, M Soubeyrand, A Babinet, V Dumaine, P Anract, D J Biau
Aims The primary aim of this study was to determine the morbidity of a tibial strut autograft and characterize the rate of bony union following its use. Patients and Methods We retrospectively assessed a series of 104 patients from a single centre who were treated with a tibial strut autograft of > 5 cm in length. A total of 30 had a segmental reconstruction with continuity of bone, 27 had a segmental reconstruction without continuity of bone, 29 had an arthrodesis and 18 had a nonunion. Donor-site morbidity was defined as any event that required a modification of the postoperative management...
May 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29701097/-rail-and-nail-bifocal-management-of-atrophic-femoral-nonunion
#10
K Davda, N Heidari, P Calder, D Goodier
Aims The management of a significant bony defect following excision of a diaphyseal atrophic femoral nonunion remains a challenge. We present the outcomes using a combined technique of acute femoral shortening, stabilized with a long retrograde intramedullary nail, accompanied by bifocal osteotomy compression and distraction osteogenesis with a temporary monolateral fixator. Patients and Methods Eight men and two women underwent the 'rail and nail' technique between 2008 and 2016. Proximal locking of the nail and removal of the external fixator was undertaken once the length of the femur had been restored and prior to full consolidation of the regenerate...
May 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29684921/clinical-efficacy-of-bone-reconstruction-surgery-with-frozen-cortical-bone-allografts-for-nonunion-of-radial-and-ulnar-fractures-in-toy-breed-dogs
#11
Shuntaro Munakata, Yukari Nagahiro, Daichi Katori, Norihiro Muroi, Hiroyuki Akagi, Nobuo Kanno, Yasuji Harada, Shinya Yamaguchi, Kei Hayashi, Yasushi Hara
OBJECTIVE:  To evaluate the effectiveness of frozen cortical bone allografts (FCBA) in the treatment of severe radial and ulnar atrophic nonunion fractures. ANIMALS:  Toy breed dogs with nonunion of radial and ulnar fractures ( n  = 15). METHODS:  Severe atrophic nonunion fractures were treated with FCBA (eight infected and seven non-infected fractures). Radiographs obtained immediately after surgery, and 1, 2, 3, 6 and 12 months later were evaluated and scored for the periosteal reaction at the bone regeneration sites, the healing process in the bone connection areas at both the proximal and distal sites, and the bone remodelling process within the allografts...
April 23, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29675505/locking-dorsal-plate-in-four-bone-arthrodesis-in-slac-and-snac-3-wrist
#12
Simona Odella, Amos M Querenghi, Francesco M Locatelli, Ugo Dacatra, Elia Creta, Pierluigi Tos
Purpose  The aim of this study was to evaluate the effectiveness and the safety of performing a four-bone arthrodesis (FBA) with dorsal locking plate in patients suffering from stage III scapholunate advanced collapse/scaphoid nonunion advance collapse (SLAC/SNAC) wrist. Methods  We evaluated retrospectively 20 patients surgically treated by a FBA with the use of locking dorsal plate. All the patients were clinically evaluated at follow-up for grip strength, range of motion, and pain (visual analog scale), and with the Disability of the Arm, Shoulder and Hand score and the Mayo wrist score...
March 2018: Joints
https://www.readbyqxmd.com/read/29663560/activation-of-hedgehog-signaling-by-systemic-agonist-improves-fracture-healing-in-aged-mice
#13
Jennifer A McKenzie, Clayton Maschhoff, Xiaochen Liu, Nicole Migotsky, Matthew J Silva, Michael J Gardner
Fracture healing is a complex process of many coordinated biological pathways. This system can go awry resulting in nonunion, which leads to significant patient morbidity. The Hedgehog (Hh) signaling pathway is upregulated in fracture healing. We hypothesized that the Hh signaling pathway can be pharmacologically modulated to positively affect fracture healing. Diaphyseal femur fractures were created in elderly mice (18 months, C57BL/6 females), which have a blunted and delayed healing response compared to younger mice, and were stabilized with intramedullary pins...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29657482/functional-and-radiological-outcome-in-management-of-compound-tibia-diaphyseal-fracture-with-ao-monolateral-fixator-versus-limb-reconstruction-system
#14
Hitesh J Mangukiya, Neetin P Mahajan, Eknath D Pawar, Aakash Mane, Jitsen Manna
Introduction: Tibia being the most common fractured long bone represents 36.7% of all long bone fractures in adults with open fracture comprises 23.5% of all tibial shaft fracture. The lack of the muscular covering over anteromedial aspect of the tibia and poor blood supply predispose open tibial fractures to a 10-20 fold increased risk of developing infection than open fracture in any other anatomical areas and a nonunion rate as high as 28% has been reported in the literature. Methods: We did a prospective study at our institute from 2014-2016 comprising 40 patients with compound tibia diaphyseal fracture managed with AO monolateral external fixator (Group 1) (n = 20) and Limb reconstruction system (Group 2) (n = 20) as primary and definitive tool...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29651831/does-age-affect-outcome-in-children-with-clavicle-fracture-treated-conservatively-quickdash-and-mrc-evaluation-of-131-consecutive-cases
#15
Vito Pavone, Claudia DE Cristo, Gianluca Testa, Federico Canavese, Ludovico Lucenti, Giuseppe Sessa
BACKGROUND: Non-operative treatment with immobilization is the gold-standard for paediatric clavicular fractures. Purpose of this study is to evaluate functional outcomes and efficacy of non-operative treatment of clavicular fractures in a succession of 131 children. METHODS: Between 2006 and 2012, we treated non-surgically 131 children for a clavicular fracture. All fractures have been classified according to Robinson classification. Clavicle shortening, range of movements and muscular strength through the Medical Research Council (MRC) scale were evaluated...
April 12, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/29650375/vascularized-distal-radius-bone-graft-for-treatment-of-ulnar-nonunion
#16
REVIEW
Ezequiel Ernesto Zaidenberg, Ezequiel Martinez, Carlos Rodolfo Zaidenberg
Various methods have been reported to treat forearm nonunions with good results. However, in the presence of infection, inadequate vascularity of surrounding tissues, or failed prior grafts, vascularized bone grafts are a valid alternative. We describe the surgical technique to obtain distal radius vascularized bone graft pedicled on the radial artery (RA) and its clinical application in 1 case of an ulnar nonunion. We studied the surgical technique in 12 freshly injected cadavers. In the distal forearm, the RA provides several periosteal branches to supply the distal radius metaphysis...
April 9, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29648876/use-of-patient-specific-3d-printed-titanium-implants-for-complex-foot-and-ankle-limb-salvage-deformity-correction-and-arthrodesis-procedures
#17
Travis J Dekker, John R Steele, Andrew E Federer, Kamran S Hamid, Samuel B Adams
BACKGROUND: The advancement of 3D printing technology has allowed for the use of custom-designed implants for difficult-to-treat foot and ankle pathologies. This study reports on the radiographic and functional outcomes of a case series of patients treated with patient-specific 3D-printed titanium implants. METHODS: Fifteen consecutive patients treated with custom-designed 3D-printed implant cages for severe bone loss, deformity correction, and/or arthrodesis procedures were included in this study...
April 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29645343/activation-of-hedgehog-signaling-by-systemic-agonist-improves-fracture-healing-in-aged-mice
#18
Jennifer A McKenzie, Clayton Maschhoff, Xiaochen Liu, Nicole Migotsky, Matthew J Silva, Michael J Gardner
Fracture healing is a complex process of many coordinated biological pathways. This system can go awry resulting in nonunion, which leads to significant patient morbidity. The Hedgehog (Hh) signaling pathway is upregulated in fracture healing. We hypothesized that the Hh signaling pathway can be pharmacologically modulated to positively affect fracture healing. Diaphyseal femur fractures were created in elderly mice (18 months, C57BL/6 females), which have a blunted and delayed healing response compared to younger mice, and were stabilized with intramedullary pins...
April 12, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29629592/revision-of-failed-total-ankle-arthroplasty-to-a-hindfoot-fusion
#19
A A Ali, R A Forrester, P O'Connor, N J Harris
Aims The aim of this study was to present a series of patients with aseptic failure of a total ankle arthroplasty (TAA) who were treated with fusion of the hindfoot using a nail. Patients and Methods A total of 23 TAAs, in 22 patients, were revised for aseptic loosening and balloon osteolysis to a hindfoot fusion by a single surgeon (NH) between January 2012 and August 2014. The procedure was carried out without bone graft using the Phoenix, Biomet Hindfoot Arthrodesis Nail. Preoperative investigations included full blood count, CRP and ESR, and radiological investigations including plain radiographs and CT scans...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29629591/displaced-femoral-neck-fractures-in-patients-60-years-of-age-or-younger-results-of-internal-fixation-with-the-dynamic-locking-blade-plate
#20
MULTICENTER STUDY
J H Kalsbeek, A D P van Walsum, J P A M Vroemen, H M J Janzing, J T Winkelhorst, B P Bertelink, W H Roerdink
Aims The objective of this study was to investigate bone healing after internal fixation of displaced femoral neck fractures (FNFs) with the Dynamic Locking Blade Plate (DLBP) in a young patient population treated by various orthopaedic (trauma) surgeons. Patients and Methods We present a multicentre prospective case series with a follow-up of one year. All patients aged ≤ 60 years with a displaced FNF treated with the DLBP between 1st August 2010 and December 2014 were included. Patients with pathological fractures, concomitant fractures of the lower limb, symptomatic arthritis, local infection or inflammation, inadequate local tissue coverage, or any mental or neuromuscular disorder were excluded...
April 1, 2018: Bone & Joint Journal
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