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Bone nonunion

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https://www.readbyqxmd.com/read/28533002/the-radial-aspect-of-the-distal-radial-metaphysis-diaphysis-as-a-source-of-cortical-bone-graft
#1
REVIEW
Steven Regal, Aakash Chauhan, Peter Tang
Cortical bone grafting is commonly required in the finger, hand, and carpus when managing bony trauma. A donor site that can provide a small or large amount of cortical bone graft that is easily accessible and within the same surgical field would be the ideal donor site. In high-energy injuries, a long cortical graft may be needed to reconstruct massive bony defects. In low-energy injuries such as scaphoid nonunions in which a wedge graft is needed, a reliable and easily accessible source of bone grafting would be beneficial...
May 19, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28532896/healing-of-fracture-nonunions-treated-with-low-intensity-pulsed-ultrasound-lipus-a-systematic-review-and-meta-analysis
#2
Ross Leighton, J Tracy Watson, Peter Giannoudis, Costas Papakostidis, Andrew Harrison, R Grant Steen
INTRODUCTION: Bone fractures fail to heal and form nonunions in roughly 5% of cases, with little expectation of spontaneous healing thereafter. We present a systematic review and meta-analysis of published papers that describe nonunions treated with low-intensity pulsed ultrasound (LIPUS). METHODS: Articles in PubMed, Ovid MEDLINE, CINAHL, AMED, EMBASE, Cochrane Library, and Scopus databases were searched, using an approach recommended by the Methodological Index for Non-Randomized Studies (MINORS), with a Level of Evidence rating by two reviewers independently...
May 15, 2017: Injury
https://www.readbyqxmd.com/read/28529014/comparative-prospective-study-between-medial-and-lateral-distal-tibial-locking-compression-plates-for-distal-third-tibial-fractures
#3
Sandeep Garg, Vikram Khanna, Mahaveer Prashad Goyal, Narendra Joshi, Amrut Borade, Ishan Ghuse
PURPOSE: Tibial fracture is the most common long bone fracture. Distal third tibial fractures are challenging though open reduction and plating can result in anatomical reduction and rigid fixation. This paper aimed to evaluate and compare the results of medial and lateral locking compression plates for distal third tibial fractures. METHODS: This prospective clinical study involved 36 patients with distal tibial fractures admitted in Department of Orthopaedics, Sawai Mansingh Medical College & Affiliated Hospital, Jaipur, India, from June 2011 to May 2012, including 29 closed fractures and 7 open fractures at the mean age of 38...
April 14, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#4
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28515335/in-situ-bone-tissue-engineering-via-ultrasound-mediated-gene-delivery-to-endogenous-progenitor-cells-in-mini-pigs
#5
Maxim Bez, Dmitriy Sheyn, Wafa Tawackoli, Pablo Avalos, Galina Shapiro, Joseph C Giaconi, Xiaoyu Da, Shiran Ben David, Jayne Gavrity, Hani A Awad, Hyun W Bae, Eric J Ley, Thomas J Kremen, Zulma Gazit, Katherine W Ferrara, Gadi Pelled, Dan Gazit
More than 2 million bone-grafting procedures are performed each year using autografts or allografts. However, both options carry disadvantages, and there remains a clear medical need for the development of new therapies for massive bone loss and fracture nonunions. We hypothesized that localized ultrasound-mediated, microbubble-enhanced therapeutic gene delivery to endogenous stem cells would induce efficient bone regeneration and fracture repair. To test this hypothesis, we surgically created a critical-sized bone fracture in the tibiae of Yucatán mini-pigs, a clinically relevant large animal model...
May 17, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28512472/pulsed-electromagnetic-field-regulates-microrna-21-expression-to-activate-tgf-%C3%AE-signaling-in-human-bone-marrow-stromal-cells-to-enhance-osteoblast-differentiation
#6
Nagarajan Selvamurugan, Zhiming He, Daniel Rifkin, Branka Dabovic, Nicola C Partridge
Pulsed electromagnetic fields (PEMFs) have been documented to promote bone fracture healing in nonunions and increase lumbar spinal fusion rates. However, the molecular mechanisms by which PEMF stimulates differentiation of human bone marrow stromal cells (hBMSCs) into osteoblasts are not well understood. In this study the PEMF effects on hBMSCs were studied by microarray analysis. PEMF stimulation of hBMSCs' cell numbers mainly affected genes of cell cycle regulation, cell structure, and growth receptors or kinase pathways...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28508762/results-of-the-treatment-of-infected-nonunions-of-the-lower-limbs-using-the-ilizarov-method
#7
Marek Dróżdż, Stanisław Rak, Paweł Bartosz, Jerzy Białecki, Wojciech Marczyński
BACKGROUND: Infected nonunion is a complex complication of the treatment of long bone fractures. An in creased incidence of injuries, including high energy injuries (often open ones), contributes to a higher incidence of nonunion. These primarily infected injuries cause osteomyelitis, which prevents bone union, resulting in an infected nonunion. The Ilizarov method meets the biological and biomechanical treatment requirements, opti mising the process of inflammation healing and producing bone union...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28497247/-medial-closed-wedge-osteotomy-of-the-distal-femur-in-biplanar-technique-and-a-specific-plate-fixator
#8
REVIEW
P Lobenhoffer, K Kley, D Freiling, R van Heerwaarden
OBJECTIVE: Correction of distal femur deformity by closed-wedge biplanar osteotomy. INDICATIONS: Metaphyseal frontal plane deformities of the femur. CONTRAINDICATIONS: Osteoarthritis of the contralateral compartment, total loss of the contralateral meniscus, acute/chronic infection, limited range-of-motion, poor soft-tissue conditions at site of surgery. SURGICAL TECHNIQUE: Skin incision at metaphyseal area of femur...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28496198/bone-forming-peptide-2-derived-from-bmp-7-enhances-osteoblast-differentiation-from-multipotent-bone-marrow-stromal-cells-and-bone-formation
#9
Hyung Keun Kim, Jun Sik Lee, Ji Hyun Kim, Jong Keun Seon, Kyung Soon Park, Myung Ho Jeong, Taek Rim Yoon
Strategies for efficient osteogenic differentiation and bone formation from stem cells would have clinical applications in treating nonunion fracture healing. Many researchers have attempted to develop adjuvants as specific stimulators of bone formation for therapeutic use in patients with bone resorption. Therefore, development of specific stimulators of bone formation has therapeutic significance in the treatment of osteoporosis. To date, investigations of the mature forms of bone morphogenetic proteins (BMPs) have focused on regulation of bone generation...
May 12, 2017: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/28495360/fractures-and-osteomalacia-in-a-patient-treated-with-frequent-home-hemodialysis
#10
Mark R Hanudel, Larry Froch, Barbara Gales, Harald Jüppner, Isidro B Salusky
Bone deformities and fractures are common consequences of renal osteodystrophy in the dialysis population. Persistent hypophosphatemia may be observed with more frequent home hemodialysis regimens, but the specific effects on the skeleton are unknown. We present a patient with end-stage renal disease treated with frequent home hemodialysis who developed severe bone pain and multiple fractures, including a hip fracture and a tibia-fibula fracture complicated by nonunion, rendering her nonambulatory and wheelchair bound for more than a year...
May 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28493494/stat3-promotes-bone-fracture-healing-by-enhancing-the-foxp3-expression-and-the-suppressive-function-of-regulatory-t-cells
#11
Guojing Sun, Zhen Wang, Yunfan Ti, Yicun Wang, Jun Wang, Jianning Zhao, Hongbo Qian
Signal transducer and activator of transcription 3 (STAT3) is a key signaling protein in the skeletal system as well as in the immune system. Accumulating evidence demonstrates that the inflammatory response is deeply involved in the healing process of bone fractures, but how the immune system is regulated during this process is unclear. In this study, we examined STAT3-mediated regulation of immunity in adult patients with closed tibia fracture. In all patients, the expression and activation of STAT3 peaked at around day 7 to day 14 after surgery, and gradually decreased during the rest of the healing period...
May 11, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28486284/transitioning-to-an-intramedullary-lengthening-and-compression-nail
#12
Austin T Fragomen
The magnetic intramedullary lengthening nail is an innovative technology that allows for creative ways to treat difficult problems. The lengthening option has revolutionized femur fracture management with bone loss and malunion therapy. The compression version of this nail has provided a gradual method to compress nonunions and difficult fractures that may obviate the need for many current uses of external fixation. Three cases are presented in this manuscript demonstrating a new paradigm in the management of bone loss/shortening of the tibia and femur, and recalcitrant nonunions...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28465197/effect-of-four-corner-fusion-with-locking-plate-without-bone-graft-on-functional-recovery-of-the-wrist-new-treatment-guidelines
#13
A Tielemans, F Van Innis, S Troussel, C Detrembleur, X Libouton, T Lequint
We assessed the effect of four-corner intercarpal fusion with locking plate without bone graft on daily activities and pain in patients with stage II and III scapholunate advanced collapse and scaphoid nonunion. Twenty-one patients who underwent four-corner fusion with scaphoidectomy without bone graft were evaluated with the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Visual Analog Scale (VAS) pain scores before and 16 months after surgery. We also compared postoperative grip strength between the operated and the healthy side...
April 5, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28460882/extended-applications-of-the-reamer-irrigator-aspirator-ria-system
#14
Niloofar Dehghan, Emil H Schemitsch
While the RIA system was initially designed for reaming and clearing the femoral canal contents in preparation for femoral nailing, it has since been used in various other applications in the field of orthopaedic surgery. The RIA is an ideal device for accessing large quantities of autogenous bone graft, to be used in the treatment of nonunions, segmental bone loss, or arthrodesis. The RIA has also been used for treatment of intramedullary infections and osteomyelitis, as well as intramedullary nailing of long bones with metastatic lesions, as it allows for clearing the canal of infectious/tumour burden, and lowers the risk of dissemination into the soft tissues and systemic circulation...
April 28, 2017: Injury
https://www.readbyqxmd.com/read/28455560/factors-associated-with-adverse-postoperative-outcomes-in-patients-with-long-bone-post-traumatic-osteomyelitis
#15
Vivek Chadayammuri, Benoit Herbert, Jiandong Hao, Andreas Mavrogenis, Juan C Quispe, Ji Wan Kim, Heather Young, Mark Hake, Cyril Mauffrey
AIMS: To evaluate short-term clinical and functional outcomes following operative treatment of long bone post-traumatic osteomyelitis (PTOM). METHODS: We retrospectively analyzed a consecutive cohort of 142 adult patients undergoing operative treatment of long bone PTOM at our Level I trauma center over a 10-year study period. In addition to subjective patient evaluations, surveyed postoperative outcomes included incidence of residual infection, fracture malunion or nonunion, and requirement for limb amputation...
April 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28453337/venous-bridge-arterial-grafting-for-thumb-replantation
#16
Eric R Wagner, Allen T Bishop, Alexander Y Shin
BACKGROUND: The purpose of this study is to describe a novel technique using an interposition vein graft for thumb replantation in these severe avulsion injuries. METHODS: From 2002 to 2012, 8 patients underwent interposition venous bridge grafting from the dorsal radial artery at the anatomic snuffbox to the ulnar digital artery of the thumb. All patients had a traumatic thumb amputation with a severe injury to the ulnar digital artery. The technique began with bony stabilization; the radial artery at the anatomic snuffbox is exposed, vein graft harvested, and microsurgical end-to-side (proximally) and end-to-end (distally) anastomoses are carried out...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28448706/-prognostic-factors-for-post-surgical-complications-in-bone-infection-and-pseudarthrosis
#17
A Cicero-Álvarez, S R León-Hernández, K Gutiérrez-Enríquez, S Zapata-Rivera
Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28445273/staged-management-of-open-lisfranc-injury-experience-from-14-patients
#18
Wenqi Gu, Zhongmin Shi
There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications.Patients who received a staged strategy for open Lisfranc injury were reviewed.One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28438404/quantitative-ultrasound-and-tibial-dysplasia-in-neurofibromatosis-type-1
#19
David A Stevenson, Heather Hanson, Austin Stevens, John Carey, David Viskochil, Xiaoming Sheng, Karen Wheeler, Hillarie Slater
Neurofibromatosis type 1 (NF1) is a common autosomal dominant disorder associated with unilateral anterolateral bowing with subsequent fracture and nonunion. In infancy, physiologic bowing of the lower leg can be confused with pathologic tibial dysplasia in NF1. Little is known about the bone physiology of the tibiae prior to fracture or predictors of fracture. The aim of this study was to characterize bone quality of bowed tibiae prior to fracture in NF1 using quantitative ultrasound (QUS). Bone quality was assessed on both tibiae (the non-bowed and bowed tibiae) using QUS to measure speed of sound (SOS) at the mid-shaft in 23 individuals with NF1...
April 21, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28435567/role-of-antibiotic-cement-coated-nailing-in-infected-nonunion-of-tibia
#20
C Bhatia, A K Tiwari, S B Sharma, S Thalanki, A Rai
INTRODUCTION: Infected nonunion of long bones is a chronic and debilitating disorder. It is more difficult to deal with when the implant used for internal fixation itself becomes a potential media for infection because of bacterial adhesion and biofilm formation. Traditionally, it is managed by two-stage procedure for controlling the infection first and then treating the nonunion. This study has been undertaken to explore antibiotic cement coated nailing as single stage treatment modality for treating infection and achieving stability at the same time...
March 2017: Malaysian Orthopaedic Journal
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