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Journal articles on the topic 'Bone fracture treatment'
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SILVA, JONATHAN RIBEIRO DA, CARLOS FERNANDO DE ALMEIDA BARROS MOURÃO, HERNANDO VALENTIM DA ROCHA JÚNIOR, LUIZ FERNANDO MAGACHO, GUTO FIDALGO DAUMAS MORAES, and NICOLAS HOMSI. "Treatment of frontal bone fracture sequelae through inversion of the bone fragment." Revista do Colégio Brasileiro de Cirurgiões 43, no. 6 (December 2016): 472–75. http://dx.doi.org/10.1590/0100-69912016006011.
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ABSTRACT Treatment of frontal sinus fractures depends on the structures involved: the anterior wall, the posterior wall and the nasofrontal duct. It may vary from the correction of the defect in the anterior wall to the cranialization with obliteration of the nasofrontal duct. The inversion of the frontal sinus's anterior wall to correct the defect in the fractured region is a good treatment option for sequelae, since this technique eliminates or reduces the use of biomaterial in the area, and allows direct assessment of the permeability of the nasofrontal duct. This work describes the technique of fractured segment inversion for the treatment of frontal sinus fracture sequelae in a motorcycle accident victim.
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Kumar, B. S. Vijaya. "Treatment of diaphyseal fractures of tibia with intramedullary interlocking nail." International Journal of Research in Orthopaedics 5, no. 5 (August 26, 2019): 783. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20193130.
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<p class="abstract"><strong>Background:</strong> The tibia, or shinbone, is the most commonly fractured long bone in the body. A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. It typically takes a major force to cause this type of broken leg. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures. In many tibia fractures, the smaller bone in the lower leg (fibula) is broken as well. The objective was to study fracture healing and union rates with closed intra-medullary interlocking nailing.</p><p class="abstract"><strong>Methods:</strong> Patients of both sexes belonging to adult age group presenting with fracture tibia to Orthopedic Department, Vydehi Institute of Medical Sciences, of are admitted from January 2015 to December 2015.<strong></strong></p><p class="abstract"><strong>Results:</strong> In the present study maximum number of patients belongs to 18 to 27 years age group (18 cases) followed by 28 to 37 years age group (15 cases), maximum number of patients sustained tibia fracture due to RTA (38 cases) followed by fall (12 cases), maximum number of patients sustained simple tibia fracture (32 cases), followed by type 2 compound tibia fracture (13 cases) and 36 patients had excellent functional results and 8 patients had good functional outcome, while only 4 patients had fair functional outcome.</p><p class="abstract"><strong>Conclusions:</strong> IM rods are secured within the bone by screws both above and below the fracture. The metal screws and the rod can be removed if they cause problems, but can also be left in place for life. Tibial rodding provides excellent fixation and alignment of the bones.</p>
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Moldovan, Flaviu, Adrian Gligor, and Tiberiu Bataga. "Structured Integration and Alignment Algorithm: A Tool for Personalized Surgical Treatment of Tibial Plateau Fractures." Journal of Personalized Medicine 11, no. 3 (March 10, 2021): 190. http://dx.doi.org/10.3390/jpm11030190.
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The planning of the surgical treatment in orthopedics, with the help of three-dimensional (3D) technologies, arouses an increasing scientific interest. Scientific literature describes some semi-automatic reconstructive attempts at fragmented bone fractures, but the matching algorithms presented are likely to improve. The aim of this paper is to develop a new method of aligning fragments of comminutive fractures. We have created a structured integration process and an alignment algorithm integrated in a clinical workflow for personalized surgical treatment of fractures. The provided solution is able to align the surfaces of bone fragments derived from the segmentation process of volumetric tomographic data. Positional uncertainties are eliminated interactively by the user, who selects the corresponding pairs of fracture surfaces. The final matching and the right alignment are performed automatically by the innovative alignment algorithm. The paper solves a challenging problem for the reconstruction of fractured bones, namely the choice of the optimal matching option from the situation in which surface portions of a fracture fragment correspond to multiple high fragments. The method is validated in practice for preoperative planning of a 49-year-old male patient who had a tibial plateau fracture of Schatzker type VI.
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Mohiuddin, M., M. Hasan, M. Shohag, R. N. Ferdousy, M. M. Alam, and N. S. Juyena. "Surgical management of limb fractures in calves and goats." Bangladesh Veterinary Journal 52, no. 1-4 (December 25, 2018): 46–56. http://dx.doi.org/10.32856/bvj-2018.06.
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The study was conducted to determine the occurrence of fractures in calves and goats at Veterinary Teaching Hospital (VTH), Bangladesh Agricultural University (BAU) and to compare the efficacy of fracture treatment with external and internal fixation using splints and bone plate/wire suture respectively. Patients brought to VTH with the history of automobile accident, trauma and clinical signs suggestive of fractures were subjected to detailed physical, orthopaedic and radiographic examinations to confirm fractures. A total of 6 calves and 4 Black Bengal goats were presented to VTH with limb fractures. Fractures were treated with close reduction and external fixation with splints and bandage, and open reduction and internal fixation with wire suture and bone plate. 50% and 75% fracture cases healed properly in calves and goats respectively. Among the affected animals, 60% were females irrespective of species. Metacarpal bone was the most susceptible for limb fracture. Three were open fractures and 7 cases were closed fracture with the occurrence of 70%. The healing percentage of open fracture treated with external fixation was very poor and amputation was needed in the fractured limb. Overall treatment success rate was 60 %. Biochemical analysis revealed very significant (p<0.01) difference in serum calcium level before and after healing due to hard callus formation. This study shows that bone plating fixation give a satisfactory results to calves with fracture. Moreover, the study could help veterinarians to set up proper treatment method depending on location of fracture.
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Davies, Michael. "Non HRT Options for the Treatment of Osteoporosis." British Menopause Society Journal 4, no. 3 (September 1998): 96–101. http://dx.doi.org/10.1177/136218079800400306.
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Osteoporosis is now a treatable condition with an abundance of evidence for the efficacy of certain therapeutic strategies in preventing recurrent fractures. Most of these treatments act by improving bone mineral density through inhibition or reduction of bone resorption. For those women who are unable to take HRT; bisphosphonates, calcium, vitamin D, calcitriol or calcitonin may confer certain benefits. The bisphosphonate alendronate reduces both vertebral and long bone fractures, an effect seen soon after starting treatment. The changes in BMD and fracture reduction are less with the use of etidronate but it is certainly beneficial in reducing recurrent vertebral fracture. In the elderly calcium and vitamin D in combination can reduce non-vertebral and hip fracture and supplemental calcium of 1 g/day has been predicted to reduce bone loss and thus hip fractures by 22%. Evidence that calcitriol or calcitonin reduce fracture incidence is not good but calcitonin has been shown to have analgesic properties in those with acute vertebral fracture. The role of calcitriol is less certain and should be reserved for women with vertebral fractures in whom HRT or bisphosphonates cannot be used.
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Tkacheva, Olga N., Natalia V. Brailova, Ekaterina N. Dudinskaya, and Veronika A. Kuznesova. "Osteoporosis drug treatment after fracture." Osteoporosis and Bone Diseases 23, no. 4 (June 6, 2021): 30–36. http://dx.doi.org/10.14341/osteo12694.
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The prevalence of osteoporosis, especially among the elderly, is increasing exponentially, leading to an increase in the number of fractures and disability. As a result, new requirements for anti-osteoporotic therapy appear, associated with its influence not only on the remodeling of healthy bone, but also on the acceleration of fracture consolidation. The article provides a brief overview of the effect of various anti-osteoporotic drugs on the healing of bone fractures. An assessment of the consolidating effect of antiresorptive drugs — bisphosphonates and denosumab, and anabolic drug — teriparatide, monoclonal antibodies blocking the protein sclerostin, strontium ranelate is given. The use of antiresorptive drugs did not affect, according to the literature, the slowing down of consolidation after fractures of various parts of the skeleton (hip, vertebrae, distal radius). The introduction of anabolic drugs, in particular teriparatide, is accompanied by faster healing of fractures in comparison with the timing of natural bone regeneration or the intake of bisphosphonates, causing an improvement in the formation of callus. The use of drugs that block sclerostin also increases bone formation and bone strength. Based on the available data, it can be concluded that fractures should not be considered as a contraindication to the use of these drugs and be the reason for the late initiation of drug treatment of osteoporosis.
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Lukošiūnas, Algirdas, Ričardas Kubilius, Gintautas Sabalys, Tadas Keizeris, and Dalius Sakavičius. "An Analysis of Etiological Factors for Traumatic Mandibular Osteomyelitis." Medicina 47, no. 7 (July 28, 2011): 380. http://dx.doi.org/10.3390/medicina47070054.
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Objective. The aim of this study was to analyze the factors that were associated with the development of osteomyelitis during the treatment of mandibular fractures. Material and Methods. The data of 3188 patients with mandibular fractures treated during 2002–2009 were analyzed. Traumatic osteomyelitis of the mandible was diagnosed in 207 patients. The background factors of complications were studied and compared with the control group (100 patients) not having complications after treatment of mandibular fractures. The data of clinical, roentgenologic, microbiological, and immunological investigations were analyzed. A logistic regression model was developed to identify the factors for osteomyelitis development. Results. The treatment in 6.5% of patients was complicated with osteomyelitis; 88.5% of these patients were men, and more than 80% of patients were younger than 50 years. In 86.8% of cases, Staphylococcus species were isolated, with Staphylococcus aureus accounting for 69.1% of cases. The following factors were found to be associated with osteomyelitis development: immunity dysfunction, caries-affected teeth at the fracture line, mobile fractured bones, bone fixation after more than 7 days following trauma, healthy teeth at the fracture line, insufficient bone reposition, and bone fixation after 3–7 days following trauma. Conclusion. Comparative analysis of factors influencing the treatment results revealed a great importance of immunological and dental status and microflora at the affected site. Insufficient or late reposition and fixation of fractured bone fragments play a significant role in the healing process.
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Gajdobranski, Djordje, Dragoljub Zivanovic, Aleksandra Mikov, Andjelka Slavkovic, Dusan Maric, Zoran Marjanovic, and Vukadin Milankov. "Scaphoid fractures in children." Srpski arhiv za celokupno lekarstvo 142, no. 7-8 (2014): 444–49. http://dx.doi.org/10.2298/sarh1408444g.
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Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011). The outcome of the treatment of ?acute? scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with ?acute? fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of ?acute? scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.
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Cederholm, Tommy, and Margareta Hedström. "Nutritional treatment of bone fracture." Current Opinion in Clinical Nutrition and Metabolic Care 8, no. 4 (July 2005): 377–81. http://dx.doi.org/10.1097/01.mco.0000172576.48772.a8.
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Vucetic, Cedomir, Borislav Dulic, Zoran Vukasinovic, Goran Tulic, Nevena Kalezic, and Aleksandar Todorovic. "The treatment of subtrochanteric fractures." Srpski arhiv za celokupno lekarstvo 139, no. 7-8 (2011): 540–47. http://dx.doi.org/10.2298/sarh1108540v.
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Subtrochanteric fractures of the femur have a special place because of a significant number of complications following treatment. Powerful loading forces asymmetrically acting to this bone segment, as well as poor vascularization interfere with bone union. There are basically two current approaches in the fixation of subtrochanteric fractures; the first involves a plate with a compression screw and another one is intramedullary (IM) nail, with two options: centromedullary (standard interlocking femoral nail) and cephalomedullary femoral nail with two modifications, reconstructive and trochanteric. All IM nails may be used by open technique or closed minimal invasive method. IM nailing is favoured in view of a shorter operative time, shorter hospitalisation and complications. Indirect fracture reduction and knowledge of biology of bone fracture may result in full success without any bone graft.
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Golubovic, Zoran, Predrag Stojiljkovic, Milorad Mitkovic, Srbobran Trenkic, Zoran Vukasinovic, Aleksandar Lesic, Milomir Kosutic, et al. "Treatment of multiple fractures in a patient wounded by aircraft bombing." Srpski arhiv za celokupno lekarstvo 138, no. 5-6 (2010): 362–66. http://dx.doi.org/10.2298/sarh1006362g.
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Introduction Aircraft cluster bombs can cause severe fractures characterized by extensive destruction of affected tissues and organs. Case Outline We present the methods and results of treatment of multiple fractures (left supracondilar humeral fracture, comminuted fracture of the distal right tibia, fracture of right trochanter major without dislocation and fracture of the right second metacarpal bone) in a 24-year old soldier after multiple wounding by a cluster bomb. After short pre-operative preparation a surgical debridement of all wounds was done in general anesthesia and the fractures of the humerus and tibia were stabilized with the Mitkovic-type external fixator after adequate reposition. For the reconstruction of bone defect of the tibia we used the method of bone transport using the Ilizarov external fixator. Conclusion Radical wound debridement, abundant rinsing, leaving the wound open, administration of antibiotics and antitetanus immunization, external fixation and early reconstruction of soft tissue and bone defects are the basic elements of the treatment of serious fractures caused by war injuries and aimed at saving the extremities. .
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Abdul Ghani, Mahmoud Beerens, Rui Dos Santos Barroco, Bruno Rodrigues de Miranda, and Letícia Zaccaria Prates de Oliveira. "Bilateral fracture-dislocation of the calcaneus." Scientific Journal of the Foot & Ankle 12, no. 2 (June 30, 2018): 164–69. http://dx.doi.org/10.30795/scijfootankle.2018.v12.754.
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The calcaneus is the most commonly fractured tarsal bone. However, locked fracture-dislocation of the calcaneus is a rare condition because of the bone and ligament stability between the calcaneus, talus, and cuboid. We report the unique features of a case of bilateral fracture-dislocation of the calcaneus, including open fractures, bilateral fibular dislocation, and bilateral interposition of the flexor hallucis longus tendon at the fracture site. A literature review identified only 19 cases of locked fracture-dislocation, but none of these cases involved the combination of injuries observed in this case. Fracture of the calcaneus may be associated with a variety of injuries requiring proper diagnosis and treatment.
Level of evidence V; Therapeutic Studies; Expert Opinion.
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Ferrero, Francesca C., Alessandro Boero Baroncelli, Caleb C. Hudson, Bruno Peirone, Ullrich Reif, and Lisa A. Piras. "Fracture Repair in Cats Using a Conical Coupling Mini 1.9 to 2.5 mm Locking Plate System." Veterinary and Comparative Orthopaedics and Traumatology 33, no. 06 (September 20, 2020): 443–50. http://dx.doi.org/10.1055/s-0040-1713005.
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Abstract Objective The aim of this study was to retrospectively evaluate the clinical application of the Fixin mini 1.9 to 2.5 system for the treatment of long bone fractures in cats. We proposed that the Fixin mini system would successfully stabilize long bone fractures in cats with a healing time and complication rate similar to those previously reported for feline fractures using other locking bone plate systems. Materials and Methods Medical records and radiographs of cats with long bone fractures stabilized with the Fixin mini 1.9 to 2.5 system were retrospectively reviewed. Signalment, body weight, bone(s) fractured, region of bone fractured, fracture classification, concurrent orthopaedic injuries, complications, time to functional union, if minimally invasive plate osteosynthesis techniques were used, plate size, number of plates, bone graft use and ancillary methods of fixation were recorded. Results Fifty-six fractures in 54 cats were included. Mean time to radiographic union was 8.8 weeks. Complications were recorded in 8 out of 56 fractures. Major complications occurred in 4 of 56 fractures and minor complications occurred in 4 of 56 fractures. Conclusion The Fixin mini 1.9 to 2.5 system had an overall complication rate and time to functional union similar to that of other implant systems used to treat feline long bone fractures and it appears suitable for repair of a wide variety of long bone fracture configurations in cats.
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Sousse, Linda E., Amanda Staudt, and Christopher VanFosson. "521 Incidence of Bone Fracture Rate Post-Burn and Trauma in Role 2 and 3 Treatment Centers." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S107—S108. http://dx.doi.org/10.1093/jbcr/irab032.172.
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Abstract Introduction One of the hallmarks of critical illness and trauma is that it triggers resorptive bone loss, as well as an increase in bone fractures and a reduction in bone density. Sustained markers of bone resorption, bone formation, and regulators of bone signaling pathways are linked to prolonged inflammatory activities and the prolonged deterioration of bone microstructure. The objective of this study is to evaluate the bone fracture rate of the U.S Military, non-U.S. Military, North Atlantic Treaty Organization (NATO) Military, local civilian, and Coalition Forces population in Operation Enduring Freedom and Operation Freedom’s Sentinel with burns from 2005 to 2018 using the Department of Defense Trauma Registry (DoDTR; n=28,707). Our hypothesis is that there is a direct relationship between burn injury severity and bone fracture rates. Methods Pearson’s correlation coefficient and scatterplots were used in this retrospective, observational study to demonstrate the correlation between total body surface area (TBSA) burn and number of fractures by anatomical location. Results Approximately 15,195 patients (age: 26 ± 10 years) in Role 2 and Role 3 treatment centers reported fractures. Of those patients, 351 suffered from burns with 632 anatomical fracture locations. Facial fractures were most prominent (16%), followed by foot (12%), skull (12%), tibia/fibula (11%), hand (11%), and ulna/radius (10%). There was no initial correlation between n increasing severity of TBSA burn and count of fracture locations (ρ=-0.03, p=0.8572). Conclusions There was no acute correlation between burn severity and bone fracture rates; however, further analyses are required to assess chronic post-burn fracture rates.
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Wu, Jie, Pavani Davuluri, Kevin R. Ward, Charles Cockrell, Rosalyn Hobson, and Kayvan Najarian. "Fracture Detection in Traumatic Pelvic CT Images." International Journal of Biomedical Imaging 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/327198.
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Fracture detection in pelvic bones is vital for patient diagnostic decisions and treatment planning in traumatic pelvic injuries. Manual detection of bone fracture from computed tomography (CT) images is very challenging due to low resolution of the images and the complex pelvic structures. Automated fracture detection from segmented bones can significantly help physicians analyze pelvic CT images and detect the severity of injuries in a very short period. This paper presents an automated hierarchical algorithm for bone fracture detection in pelvic CT scans using adaptive windowing, boundary tracing, and wavelet transform while incorporating anatomical information. Fracture detection is performed on the basis of the results of prior pelvic bone segmentation via our registered active shape model (RASM). The results are promising and show that the method is capable of detecting fractures accurately.
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Cain, Jarrett D., Michelle Titunick, Patricia McLaughlin, and Ian Zagon. "Effects of Local Opioid Antagonist on Diabetic Fracture Rat Model." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 2473011418S0017. http://dx.doi.org/10.1177/2473011418s00178.
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Category: Diabetes Introduction/Purpose: Complications associated with the diabetes include increased incidence of fracture healing, delayed fracture healing, delayed osteoblasts cell replication, decreased angiogenesis, migration and/or osteoblast cell differentiation. The cellular events involved in bone healing are adversely affected by diabetes; however, can be modulated by the Opioid Growth Factor (OGF)–OGF receptor (OGFr) is an inhibitory peptide that downregulates DNA synthesis in a tissue nonspecific manner. Diabetes is associated with elevated serum levels of OGF and dysregulation of the OGFr leading to multiple complications related to healing, sensitivity, and regeneration. This study explores the presence and function of the OGF-OGFr axis in bone tissue from type 1 diabetic rats examining intact and fractured femurs during early phases of the repair process Methods: Seven-week-old Sprague Dawley rats were injected with streptozotocin (40mg/kg i.p.) to induce T1D; other rats received buffer only and served as controls. After one month, hyperglycemia rats underwent surgery to produce a fracture at the distal third of the femur. Four diabetic rats received opioid antagoinist (naltrexone) and calcium sulfate and all remaining rats received calcium sulfate with water only. X-rays were taken immediately after surgery and after rats were euthanized on post-surgery; femur and tibia were collected for protein isolation, western blot analysis along with frozen or paraffin-embedded for histological analysis Results: Immunofluorescence indicated approximately 90% increase in opioid growth factor receptor expression in diabetic femurs compared to age-matched normal femurs. Western Blotting also suggested an increase in the receptor protein in diabetic bones relative to normal bone. TRAP staining for osteoclasts was greater in control and opioid antagonist-treated diabetic fractures when compared to the number of osteoclasts in vehicle-treated diabetic fractured femurs. Safranin O stained sections revealed approximately more bone in opioid growth receptor antagonist-treated diabetic bone fractures than in vehicle-treated bone fractures Conclusion: These data support our hypothesis that expression levels of OGFr are dysregulated in the bone of diabetic patients leading to complications in bone healing. Moreover, modulation of the OGF-OGFr pathway with receptor antagonists restored some aspects of bone healing. With further study, these preliminary results support the role of the OGF-OGFr axis in treatment of diabetic bone healing. New therapies to target dysregulation of the OGF-OGFr regulatory pathway in diabetes would provide a safe and effective disease-modifying treatment for delayed bone healing.
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Cristea, Stefan, A. Groseanu, A. Prundeanu, D. Gartonea, and S. Dragosloveanu. "Synthesis of Controlateral Hip Fracture in Osteoporotic Patients – Prophylactic Treatment." Key Engineering Materials 587 (November 2013): 391–96. http://dx.doi.org/10.4028/www.scientific.net/kem.587.391.
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the study tried to evaluate the advantages of mini-invasive prophylactic synthesis of controlateral hip fractures in osteoporotic patients. Material and method: 4 patients have been operated between 2009-2010 with hip fractures in osteoporotic patients. Neck fractures Garden IV in 2 patients and pertrochanteric fractures Kyle III and IV in two others patients. The fracture site was operated in dorsal decubitus under spinal anesthesia, we took adventage of this operation and anesthesia to performe a minimal invasive percutaneous synthesis for the nonfracture controlateral side. We used a simple implant, a quickly method during the same surgery time and anesthesia. The K wires with injected cement were percutaneously inserted. Through a 5 mm skin incision, a channel is created in the proximal femur bone and the implant, made of a fabric pouch hosting Titanium rods, is built percutaneously within the femur. A small amount of bone cement is then added, and interdigitates to the osteoporotic bone to further fixate the implant. Results: Rehabilitation was obtained and full weight bearing was allowed immediately. The potential benefits expected with the use of this minimally invasive method are: Quick procedure 15 min, No soft tissue or bone damage, No bleeding, short rehabilitation period, reduced morbidity and mortality, Low cost, same drape, single anesthesia. Conclusions: The method is simple, reproductible and economically. It can be made in emergency by the resident surgeon. The patient will be operated during the same anesthesia after the operation of fractured hip.
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Sharma, Ashish, Sanjay Rastogi, Manish Shukla, Rupshikha Choudhury, Siddhi Tripathi, and Jawed Iqbal. "Use of Transgingival Lag Screw Osteosynthesis in the Management of Alveolar Process Fracture." Craniomaxillofacial Trauma & Reconstruction 12, no. 1 (March 2019): 27–33. http://dx.doi.org/10.1055/s-0038-1629906.
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The purpose of this study is to check the efficacy of transgingival lag screw osteosynthesis in alveolar process fractures of maxilla and mandible. A single-arm nonrandomized observational study was performed for the treatment of alveolar process fractures of maxilla and mandible. In this study, 20 mixed age group patients with alveolar process fracture were included. All the patients were treated by a 2.0-mm transgingival screw fixation under local or general anesthesia. All the patients were evaluated for fracture stability, anatomical reduction, bone loss and bone resorption of alveolar process, tooth loss, and wound infection at 3 months of follow-up. A simple descriptive statistical analysis was done to evaluate the parameters and it was shown that the treatment of alveolar process fracture with two or three lag screws provides adequate fracture stability and anatomical reduction with no signs of bone loss and tooth loss, and wound infections were noted post lag screw fixation. The study concludes that transgingival lag screw fixation is a suitable alternative for alveolar process fractures in all the age groups and two to three lag screws are generally sufficient to fix fractured alveolar process either under local anesthesia or general anesthesia.
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Adamiak, Z., and T. Rotkiewicz. "A histological evaluation of bone calluses in the treatment of tibia fractures in sheep with the use of a semicircular fixator ." Veterinární Medicína 55, No. 11 (December 1, 2010): 547–50. http://dx.doi.org/10.17221/3013-vetmed.
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This study discusses the results of a histological examination of bone calluses in the treatment of tibia fractures in sheep with the involvement of a semi-circular fixator. In all sheep, callus samples revealed the presence of well-developed, compact bone tissue in the area of fracture healing. It was found that the use of a semi-circular fixator promoted bone growth, and that it is an effective method for tibia fracture treatment in sheep.
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Viana Pereira Filho, Miguel, Kelly Cristina Stéfani, and Mônica Paschoal Nogueira. "TL 18206 - Foot and ankle insufficiency fractures among postmenopausal sedentary women." Scientific Journal of the Foot & Ankle 13, Supl 1 (November 11, 2019): 110S. http://dx.doi.org/10.30795/scijfootankle.2019.v13.1088.
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Introduction: Insufficiency fractures occur in bones with decreased elastic strength. In contrast to fatigue or stress fractures, which affect normal bones and have been extensively studied in the literature, foot and ankle insufficiency fractures have been poorly researched to date. The objective of this study was to identify behavioral, biomechanical and metabolic factors associated with the development of foot and ankle insufficiency fractures. Methods: In total, 53 sedentary postmenopausal female patients who had foot and ankle insufficiency fractures and who were treated at the São Paulo State Civil Servant Hospital (Hospital do Servidor Público do Estado de São Paulo) were included in the treatment group, and 53 individuals were included in the control group. Data were collected on fracture site, body mass index (BMI), corticoid use, femoral and lumbar T-score measured by bone densitometry, and serum 25-hydroxyvitamin D level. The calcaneal angle, the angle between the first metatarsal and the talus and the metatarsus adductus angle were measured in radiographs. Results: The fractures affected the metatarsal bones in 47 patients. Other fracture sites included the lateral malleolus, lateral cuneiform bone, cuboid bone, tibia and calcaneus. All metatarsal bones were affected, most frequently the 5th. The most common fracture was a 5th metatarsal base fracture in zone II. There was no significant difference in mean BMI, serum 25-hydroxyvitamin D levels, alcohol consumption or smoking between the groups. The development of fractures was significantly associated with corticoid use (p<0.0001), low femur (p=0.028) and lumbar spine (p=0.002) bone mineral density and metatarsus adductus angle (p=0.02). When analyzed separately, 4th and 5th metatarsal fractures were associated with smaller angles between the talus and the first metatarsal (p=0.01). Conclusion: Foot and ankle insufficiency fractures among sedentary postmenopausal women are associated with corticoid use, low bone mineral density and biomechanical characteristics, such as pes cavus and metatarsus adductus. The presence of such fractures may be the first sign of bone fragility and should be used as criteria for initiating adequate treatment to prevent other fractures.
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Cosman, Felicia. "ANABOLIC THERAPY AND OPTIMAL TREATMENT SEQUENCES FOR PATIENTS WITH OSTEOPOROSIS AT HIGH RISK FOR FRACTURE." Endocrine Practice 26, no. 7 (July 2020): 777–86. http://dx.doi.org/10.4158/ep-2019-0596.
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Objective: Provide an update regarding anabolic medications for osteoporosis, which are often considered to be the last resort for patients with osteoporosis, after multiple fractures have already occurred and other medications have already been administered. Methods: Literature review and discussion. Results: Recent pivotal trial data for anabolic agents and randomized trials comparing anabolic and antiresorptive medications suggest that three anabolic agents (teriparatide, abaloparatide, and romosozumab) reduce nonvertebral and vertebral fractures faster and to a greater extent than potent antiresorptive treatments. Furthermore, bone density accrual is maximized when patients are given anabolic agents first, followed by potent antiresorptive therapy. Since total hip bone density during or after osteoporosis treatment has emerged as an excellent surrogate for future fracture risk, attaining a greater hip bone mineral density is a treatment goal for high-risk osteoporosis patients. Conclusion: This review defines the highest-risk patients and summarizes the rationale for the evolving role of anabolic therapy in the management of postmenopausal women at high risk for fracture. Abbreviations: ACTIVE = Abaloparatide Comparator Trial in Vertebral Endpoints; ARCH = Active Controlled Fracture Study in Postmenopausal Women with Osteoporosis at High Risk; BMD = bone mineral density; FRAME = Fracture Study in Postmenopausal Women with Osteoporosis; FRAX = Fracture Risk Assessment Tool; PTH = parathyroid hormone; TBS = trabecular bone score
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Noble, Jane A., Malachi J. McKenna, and Rachel K. Crowley. "Should denosumab treatment for osteoporosis be continued indefinitely?" Therapeutic Advances in Endocrinology and Metabolism 12 (January 2021): 204201882110100. http://dx.doi.org/10.1177/20420188211010052.
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Denosumab was approved for the treatment of postmenopausal osteoporosis in 2010, based on the FREEDOM study, which indicated a benefit in terms of increased bone mineral density and reduced risk of major osteoporotic fracture. In the initial clinical studies it was noted that discontinuation of denosumab can lead to a rebound of bone turnover markers and loss of accrued bone mineral density. An increased risk of fractures (multiple vertebral fractures in particular) associated with discontinuation was noted after approval and marketing of denosumab. For many patients experiencing gain in bone mineral density and fracture prevention while taking denosumab, there is no reason to stop therapy. However, discontinuation of denosumab may happen due to non-adherence; potential lack of efficacy in an individual; where reimbursement for therapy is limited to those with bone mineral density in the osteoporosis range, when assessment reveals this has been exceeded; or patient or physician concern regarding side effects. This review paper aims to discuss these concerns and to summarize the data available to date regarding sequential osteoporosis therapy following denosumab cessation to reduce the risk of multiple vertebral fracture.
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Gilbert, Matthew P., and Richard E. Pratley. "The Impact of Diabetes and Diabetes Medications on Bone Health." Endocrine Reviews 36, no. 2 (March 4, 2015): 194–213. http://dx.doi.org/10.1210/er.2012-1042.
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Abstract Patients with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fractures despite increased body weight and normal or higher bone mineral density. The mechanisms by which T2DM increases skeletal fragility are unclear. It is likely that a combination of factors, including a greater risk of falling, regional osteopenia, and impaired bone quality, contributes to the increased fracture risk. Drugs for the treatment of T2DM may also impact on the risk for fractures. For example, thiazolidinediones accelerate bone loss and increase the risk of fractures, particularly in older women. In contrast, metformin and sulfonylureas do not appear to have a negative effect on bone health and may, in fact, protect against fragility fracture. Animal models indicate a potential role for incretin hormones in bone metabolism, but there are only limited data on the impact of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 agonists on bone health in humans. Animal models also have demonstrated a role for amylin in bone metabolism, but clinical trials in patients with type 1 diabetes with an amylin analog (pramlintide) have not shown a significant impact on bone metabolism. The effects of insulin treatment on fracture risk are inconsistent with some studies showing an increased risk and others showing no effect. Finally, although there is limited information on the latest class of medications for the treatment of T2DM, the sodium-glucose co-transporter-2 inhibitors, these drugs do not seem to increase fracture risk. Because diabetes is an increasingly common chronic condition that can affect patients for many decades, further research into the effects of agents for the treatment of T2DM on bone metabolism is warranted. In this review, the physiological mechanisms and clinical impact of diabetes treatments on bone health and fracture risk in patients with T2DM are described.
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Bonfield, Christopher M., Sanjay Naran, Oluwaseun A. Adetayo, Ian F. Pollack, and Joseph E. Losee. "Pediatric skull fractures: the need for surgical intervention, characteristics, complications, and outcomes." Journal of Neurosurgery: Pediatrics 14, no. 2 (August 2014): 205–11. http://dx.doi.org/10.3171/2014.5.peds13414.
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Object Head trauma is a common cause of morbidity and mortality in the pediatric population and often results in a skull fracture. Pediatric skull fractures are distinct from adult fractures. Pediatric fractures have a greater capacity to remodel, but the pediatric brain and craniofacial skeleton are still developing. Although pediatric head trauma has been extensively studied, there is sparse literature regarding skull fractures. The authors' aim was to investigate the characteristics, injuries, complications, and outcomes of the patients in whom surgical intervention was needed for skull fractures. Methods The authors performed a retrospective review of patients presenting to the emergency department of a pediatric Level I trauma center between 2000 and 2005 with skull fractures. Patient demographics, mechanism of injury, associated injuries, fracture bone involvement, surgical intervention, complications, and outcomes were analyzed. Groups treated nonoperatively, for skull fracture repair, and for traumatic brain injury were compared. Results A total of 897 patients with a skull fracture were analyzed. Most patients (n = 772, 86.1%) were treated nonoperatively (Non-Op group). Fifty-eight patients (6.5%) underwent repair of the fracture (Repair group) and 67 (7.5%) required intervention for treatment of traumatic brain injury (TBI group). The Non-Op group was significantly younger, and the TBI group had a lower initial Glasgow Coma Scale (GCS) score. A fall (51.2%) was the most common mechanism of injury in the Non-Op group, whereas a motor vehicle crash (23.9%) and being hit in the head with an object (48.2%) were most prevalent in the TBI and Repair groups, respectively. Associated injuries were seen in all 3 groups, with brain injury (hematoma) being the most common. Frontal bone fracture was seen most in the Repair and TBI groups, and the parietal bone was the most frequent bone fractured in the Non-Op group. Patients in the TBI group were much more likely to have 2 or 3 skull bones fractured. In the Repair group, 36.2% had a complication (38.0% intervention related and 62.0% trauma related), but no patient had a worsening of their neurological status. In the TBI group, 48.7% of the patients suffered a complication, the vast majority (90.6%) of which were related to the trauma. Conclusions The majority of pediatric skull fractures can be managed conservatively. Of those requiring surgical intervention, fewer than half of the surgeries are performed solely for skull fracture repair only. Patients hit in the head with an object or involved in a motor vehicle crash are more likely to need surgical intervention either to repair the skull fracture or for TBI management, respectively. Frontal bone fractures are more likely to necessitate repair, and those patients treated for TBI have a greater incidence of 2 or 3 bones involved in the fracture. Complications occurred but most were related to underlying trauma, not the surgery. No patients who underwent intervention for repair of their skull fracture only had a worsening of their neurological status.
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Wu, Yipeng, Yi Wang, Yang Li, Xiaoqing He, Mingjie Wei, Yancunxin Li, Xiaoyan Zhang, and Yongqing Xu. "Treatment of Femoral Traumatic Fractures with a Custom Bridge Combined Fixation System." Journal of Biomaterials and Tissue Engineering 9, no. 7 (July 1, 2019): 914–21. http://dx.doi.org/10.1166/jbt.2019.2076.
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Background: With the development of transportation in modern China, the incidence of traumatic fracture and the global degree of fracture complexity are increasing. This study explored the use and curative effect of a novel custom-manufactured bridge combined fixation system for traumatic fractures of the femur. The bridge combined fixation system can be tailored to the specific patient's requirements by bending the rods and sliding the attachment modules. Methods: From May 2013 to August 2017, 14 patients with traumatic femur fractures were managed with the bridge combined fixation system. The operation was conducted according to the routine incision approach of femur fracture. The patients were given early postoperative functional rehabilitation exercise. The curative effect was evaluated according to clinical manifestations, postoperative imaging, and a self-developed standard for bone healing. Results: All patients were followed for 12–24 (median: 12.5) months. Fracture healing was assessed based on clinical symptoms and postoperative X-ray. After 3 months, complete weight-bearing on the affected leg was painless. X-ray showed that the fracture line had disappeared by 6–9 months postoperatively and showed bone healing. According to the self-developed standard for bone healing, 13/14 (92.8%) patients achieved excellent/good clinical outcomes. Bone union was achieved in all patients within 2 years. Conclusion: The custommanufactured bridge combined fixation system is simple and can effectively achieve tailored reduction of the fracture. The fixation was stable, with few complications after surgery and with good treatment effect for traumatic fractures.
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Sultana, Farjana, Md Rezaul Karim, and Ismat Ara Haider. "Epidemiological & Clinical Profile of Patients Presented with Mandible Fracture in a Tertiary Care Hospital." Journal of Bangladesh College of Physicians and Surgeons 36, no. 3 (June 17, 2018): 107–11. http://dx.doi.org/10.3329/jbcps.v36i3.37034.
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Mandible is the second most commonly fractured bone after nasal bone, though it is the largest and strongest facial bone. Fractures of the mandible can involve only one site or can often involve multiple anatomic sites. It account for 36% to 59% of all maxillofacial fracture. The large variability in reported prevalence is due to a variety of contributing factors such as gender, age, environment, and socio-economic status of patient, as well as the mechanism of the injury. The most favorable site of fracture (in descending order) in mandible is the body, angle, condylar region, symphysis, and coronoid process. The descriptive type of cross sectional retrospective study was undertaken to determine the epidemiological & clinical profile of patients presented with fractures of mandible and their different methods of treatment modalities. Four hundred and thirty five patients with mandible fractures were treated during the year 2014-2015. A review of patient’s record was conducted. Data regarding age, gender, cause of fracture, anatomic site and treatment modalities were reviewed. There was higher prevalence in male (3.9:1), with occurrence peak between 21-30 years. The principal causes of fracture in this study were RTA (Road Traffic Accidents) representing 54.02% followed by physical assault 17.24%, Fall, Sports injury, Blow by heavy objects, Tube well injury & others which includes Tire blast injury, Gunshot injury, Iatrogenic cause, Pathological fracture, Boat handle injury, Penetrating injury by metal etc. The most injured sites were in parasymphysis (26.31%) followed by angle of mandible 17.89% then symphysis, condyle, body of mandible, dentoalveolar, ramus, coronoid process of mandible. Most patients (70.11%) of mandible fractures were treated by closed reduction (arch bar, arch bars with intermaxillary fixation IMF, eyelet wiring & lateral compression plate) & 21.83% of patients were treated with open reduction (miniplates fixation. 3D plate fixation) .Only 8.05% patients were managed by conservative approach. This study reflects patterns of mandible fracture within the community and discuss various methods of mandible fracture management in the department of Maxillofacial casualty in Dhaka Dental college hospital. It is hoped that information presented here will be useful to the government agencies and health care professionals involved in planning future programs of prevention & treatment of mandible fracture.J Bangladesh Coll Phys Surg 2018; 36(3): 107-111
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Uemura, Hiroji, Hideo Fusayasu, Shinji Ohtake, Narihiko Hayashi, Yumiko Yokomizo, Yasuhide Miyoshi, Yoshinobu Kubota, and Kouji Izumi. "Incidence of bone fracture in Japanese patients receiving long-term hormone therapy for prostate cancer." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e16098-e16098. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e16098.
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e16098 Background: For patients with advanced prostate cancer, long-term treatment of androgen deprivation has been conventionally performed. Among the adverse events such as hormonal therapy, bone fracture due to osteoporosis or metastatsis is one of indispensable events. We assessed the frequency of bone fractures in Japanese patients received hormonal therapy. Methods: Between 2000 and 2010, 1,108 Japanese patients were treated with hormonal therapy including GnRH agonist plus anti-androgens or GnRH agonist alone at Yokohama City University Hospital. Of those patients, 48 patients (4.3%) had bone fractures during their treatment. In this retrospective study, we examined the association of bone fracture with the long-term hormonal therapy by investigating the duration of hormonal therapy, fracture sites, and the occurrence of fracture in castration resistant prostate cancer (CRPC) patients. Results: The median age of the patients with fracture was 77 (60-85) years; the median duration from the start of hormonal therapy to fracture was 29.4 (5.4-110.4) months. Eight patients with CRPC had pathological fractures at bone metastases. With respect of fracture sites, 22 patients (46%) had spinal fractures and 10 patients (21%) had fracture of lower legs. Of 8 CRPC patients, 7 patients had spinal fracture after long-term hormonal therapy (median: 38.6 months, range: 15.7-99.1 months). Conclusions: Japanese patients with prostate cancer treated with hormonal therapy have lower risk for bone fracture compared with those in western countries and USA, and interestingly, it is recognized that vertebral body is vulnerable to fracture in Japanese, especially in CRPC patients treated for long-term hormonal therapy. Because bone fracture in patients with prostate cancer endanger their prognosis, the bone management how to prevent bone fracture is very important during hormonal therapy. For the purpose of it, more detailed analysis in this retrospective study should be required.
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Grützner, Paul Alfred, and Norbert Suhm. "Computer aided long bone fracture treatment." Injury 35, no. 1 (June 2004): 57–64. http://dx.doi.org/10.1016/j.injury.2004.05.011.
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Kang, Lana. "Operative Treatment of Acute Scaphoid Fractures." Hand Surgery 20, no. 02 (June 2015): 210–14. http://dx.doi.org/10.1142/s021881041540002x.
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Optimal treatment of acute scaphoid fractures is a necessary goal for many reasons. One is that the scaphoid is the most commonly fractured carpal bone. Another is that a missed diagnosis of an acute scaphoid fracture leads to the more challenging situation of a delayed union, non-union and risk for premature radiocarpal arthrosis. Because the scaphoid has an inherent risk for nonunion due to its the tenuous blood supply, timely diagnosis and appropriate treatment are considered critical to achieving acceptable results and to avoiding the consequences of failed union.
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Wada, T., and T. Oda. "Mallet fingers with bone avulsion and DIP joint subluxation." Journal of Hand Surgery (European Volume) 40, no. 1 (October 21, 2014): 8–15. http://dx.doi.org/10.1177/1753193414554772.
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One-third of all mallet fingers are associated with a fracture. Mallet fractures associated with large fracture fragments may result in volar subluxation of the distal phalanx. The management of mallet fractures varies based on injury pattern and surgeon preference. These treatment options include splinting regimens, closed reduction and percutaneous pinning and open reduction and internal fixation. Although numerous surgical techniques have been described, there is little clear consensus on operative treatment. Moreover, there is insufficient evidence to support operative over nonoperative treatment for mallet fractures. Level of evidence: Level V
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Lewiecki, E. Michael. "New and emerging concepts in the use of denosumab for the treatment of osteoporosis." Therapeutic Advances in Musculoskeletal Disease 10, no. 11 (October 22, 2018): 209–23. http://dx.doi.org/10.1177/1759720x18805759.
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Denosumab is a fully human monoclonal antibody to receptor activator of nuclear factor kappa-B ligand (RANKL), a cytokine expressed by cells of the osteoblast lineage that is a key regulator of osteoclastic bone resorption. By binding and neutralizing RANKL, denosumab inhibits osteoclast differentiation, activity, and survival. Clinical trials in postmenopausal women with osteoporosis have shown that it reduces the risk of vertebral fractures, nonvertebral fractures, and hip fractures, with a generally favorable safety profile. With a dose of 60 mg subcutaneously every 6 months, it is approved for: treatment of postmenopausal women and men with osteoporosis, and for women and men with glucocorticoid-induced osteoporosis who are at high risk for fracture; treatment to increase bone mass in men at high risk for fracture receiving androgen-deprivation therapy for nonmetastatic prostate cancer; and treatment to increase bone mass in women at high risk for fracture receiving adjuvant aromatase inhibitor therapy for breast cancer. Atypical femur fractures and osteonecrosis of the jaw have been reported in patients treated with denosumab. Discontinuation of denosumab is followed by rapidly rising bone turnover markers, decreasing bone density, and vertebral fracture risk that returns to baseline, with a possible increase in the risk of multiple vertebral fractures. Further study is needed to clarify this potential risk. After stopping long-term denosumab, patients should be switched to another antiresorptive agent to maintain the benefit achieved with denosumab.
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Alsamhan, A., M. M. ELSingergy, M. M. Zamzam, and S. M. Darwish. "Engineering Judgment of Children Bone Fracture." International Journal of Biomaterials 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/737054.
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Supracondylar humerus fracture (SCHF) is one of the commonest elbow fractures in children. It is common injury for children with age from four to fourteen. In current study, the finite element technique is used to evaluate two techniques, namely, parallel and crossed K-wire fixation for treatment of SCHF, using K-wire fixation.
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Al-Hammami, Ali R., Auday M. Al-Anee, Thair Abdul Lateef, and Adil Al-khayat. "Complications of Bone Plating Following Different Facial Bones Fractures." European Scientific Journal, ESJ 14, no. 6 (February 28, 2018): 351. http://dx.doi.org/10.19044/esj.2018.v14n6p351.
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The Aim of our study was to evaluate the complication of bone plating fixation used for treatment of multiple type of facial fracture, reconstruction procedure and bone graft in maxillofacial trauma. This prospective study was performed on 42 patients to evaluates complications of the bone plates had been used in fixation of multiple facial fractures, between October 2013 and March 2015, The age of the patients ranged from 17 – 65 years The mean age of the patients was (31.7± 9.4) years. There were 31 males and 11 females, with male to female ratio (2.81:1), patients were followed up for minimum 6 months. Seventy-one plates were inserted over 17 months. Among the 42 patients there were 45 fracture sites, 26 (57.8%) were mandibular fractures, 15 (33.3%) were ZMC fractures, and four (8.9%) were maxillary; it is worth mentioning that some patients had fracture at more than one site. Complications due to fracture fixation with bone plating were 33 represented 46.5% of the total 71 plates inserted, which included Infection/wound dehiscence 15 (21.1%), Discomfort/ palpability 9 (12.7%), Plate exposure 4 (5.6%), hardware failure (broken plate & loosening screw) 1 (1.4%), Cold/heat intolerance 3 (4.2%) and Pain (TMJ) account for one plate (1.4%). According to this study, there will be a need for hardware removal in a portion of patients treated with metallic osteosynthesis devices. This study states that the infection is most common reason for plate removal, followed by discomfort due to cold/heat climate, particularly in those facial regions that provide only thin soft tissue cover over the plate.
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El-Sallakh, Sameh, Weam Mousa, and Tarek Aly. "INTERCALATED BONE PEG IN THE TREATMENT OF NON-UNITED SCAPHOID FRACTURES." Hand Surgery 18, no. 01 (January 2013): 27–33. http://dx.doi.org/10.1142/s0218810413500056.
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Introduction: Untreated ununited scaphoid fractures will almost inevitably progress to radiographic and symptomatic osteoarthritis of the wrist. This may lead to subsequent morbidity and lifelong disability especially in young males in which the fracture scaphoid is more common. Patients and methods: Twenty-one patients presenting non-united fracture scaphoid were operated upon by using disto-proximal bone peg technique with average time between injury and operation as 11 months (6–18 months). All of them male with average age of 26 years (17–35 years). There were 17 patients with fracture waist (80.9%) and four patients with fracture proximal pole (19.1%). Results: Anatomy of the wrist was restored and radiological healing confirmed in 17/21, partial healing in 3/21 and non-union in 3/21 patients. Eighteen patients (85.7%) were graded as satisfactory, 5 patients (23.8%) were graded as excellent, ten patients (47.6%) were graded as good, and three patients (14.3%) were graded as fair. The remaining three patients (14.3%) were graded as unsatisfactory. Conclusion: We conclude that the disto-proximal bone peg technique of taking the graft from the ipsilateral ulna without using any metal work for fixing scaphoid non-union fracture is a reliable, easy, and inexpensive alternative method. However, we would not recommend it for the non-union of the scaphoid proximal pole fracture. Also we find the time lag before operation is one of the most important factors to achieve union in non-united fractures of the scaphoid. Level of evidence: Therapeutic case series, level 1V.
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Ingrassia, Tommaso, Vincenzo Nigrelli, Daniele Pecorella, Laura Bragonzoni, and Vito Ricotta. "Influence of the Screw Positioning on the Stability of Locking Plate for Proximal Tibial Fractures: A Numerical Approach." Applied Sciences 10, no. 14 (July 18, 2020): 4941. http://dx.doi.org/10.3390/app10144941.
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Tibial fractures are common injuries in people. The proper treatment of these fractures is important in order to recover complete mobility. The aim of this work was to investigate if screw positioning in plates for proximal tibial fractures can affect the stability of the system, and if it can consequently influence the patient healing time. In fact, a more stable construct could allow the reduction of the non-weight-bearing period and consequently speed up the healing process. For that purpose, virtual models of fractured bone/plate assemblies were created, and numerical simulations were performed to evaluate the reaction forces and the maximum value of the contact pressure at the screw/bone interface. A Schatzker type I tibial fracture was considered, and four different screw configurations were investigated. The obtained results demonstrated that, for this specific case study, screw orientation affected the pressure distribution at the screw/bone interface. The proposed approach could be used effectively to investigate different fracture types in order to give orthopaedists useful guidelines for the treatment of proximal tibial fractures.
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Lloyd, Ashley A., Bernd Gludovatz, Christoph Riedel, Emma A. Luengo, Rehan Saiyed, Eric Marty, Dean G. Lorich, et al. "Atypical fracture with long-term bisphosphonate therapy is associated with altered cortical composition and reduced fracture resistance." Proceedings of the National Academy of Sciences 114, no. 33 (July 31, 2017): 8722–27. http://dx.doi.org/10.1073/pnas.1704460114.
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Bisphosphonates are the most widely prescribed pharmacologic treatment for osteoporosis and reduce fracture risk in postmenopausal women by up to 50%. However, in the past decade these drugs have been associated with atypical femoral fractures (AFFs), rare fractures with a transverse, brittle morphology. The unusual fracture morphology suggests that bisphosphonate treatment may impair toughening mechanisms in cortical bone. The objective of this study was to compare the compositional and mechanical properties of bone biopsies from bisphosphonate-treated patients with AFFs to those from patients with typical osteoporotic fractures with and without bisphosphonate treatment. Biopsies of proximal femoral cortical bone adjacent to the fracture site were obtained from postmenopausal women during fracture repair surgery (fracture groups, n = 33) or total hip arthroplasty (nonfracture groups, n = 17). Patients were allocated to five groups based on fracture morphology and history of bisphosphonate treatment [+BIS Atypical: n = 12, BIS duration: 8.2 (3.0) y; +BIS Typical: n = 10, 7.7 (5.0) y; +BIS Nonfx: n = 5, 6.4 (3.5) y; −BIS Typical: n = 11; −BIS Nonfx: n = 12]. Vibrational spectroscopy and nanoindentation showed that tissue from bisphosphonate-treated women with atypical fractures was harder and more mineralized than that from bisphosphonate-treated women with typical osteoporotic fractures. In addition, fracture mechanics measurements showed that tissue from patients treated with bisphosphonates had deficits in fracture toughness, with lower crack-initiation toughness and less crack deflection at osteonal boundaries than that of bisphosphonate-naïve patients. Together, these results suggest a deficit in intrinsic and extrinsic toughening mechanisms, which contribute to AFFs in patients treated with long-term bisphosphonates.
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Sarma, Nayanjyoti, and Abhinandan Bhattacharjee. "Understanding Nasal Bone Fractures and Its Effects on Management: A Prospective Study." An International Journal Clinical Rhinology 7, no. 2 (2014): 58–60. http://dx.doi.org/10.5005/jp-journals-10013-1195.
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ABSTRACT Objective To evaluate mode of injury and different management options reliant on types of nasal bone fractures. Study design Prospective analytical study. Subjects and methods Seventy-five patients with nasal bone fractured were clinically and radiologically evaluated and divided into different types according to Lee's classification. They were provided conservative, closed reduction and/or osteotomy according to the type of fracture and outcome noted. Results Lee's classification is found to be valid in real patient scenarios and using good radiological evaluation better post operative outcome can be achieved. For type 1 and 3 fractures, closed reduction and osteotomy are the treatment of choice. Conclusion We confirm that systematic approach on Lee's classification for nasal bone fracture can be used to select appropriate management strategy. How to cite this article Sarma N, Bhattacharjee A. Understanding Nasal Bone Fractures and Its Effects on Management: A Prospective Study. Clin Rhinol An Int J 2014;7(2):58-60.
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Vikmanis, Andris, and Andris Jumtins. "The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma Patient." Acta Chirurgica Latviensis 11, no. 1 (January 1, 2011): 164–66. http://dx.doi.org/10.2478/v10163-012-0035-3.
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The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma PatientPelvic bone fractures are related to a high energy injury. Therefore with an increase of the traffic intensity simultaneously grows the number of polytrauma patients, who have pelvic bone fractures of various severity levels. In the case of acetabular fractures, as the most frequent complication is the hip joint post-traumatic degeneratively destructive osteoarthritis, in whose treatment very often the hip joint arthroplasty is necessary. The frequency of this complication is affected by the precision of repositioning and the strength of fixation of an acetabular fracture.
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Hernigou, J., and F. Schuind. "Tobacco and bone fractures." Bone & Joint Research 8, no. 6 (June 2019): 255–65. http://dx.doi.org/10.1302/2046-3758.86.bjr-2018-0344.r1.
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Objectives The aim of this study was to review the impact of smoking tobacco on the musculoskeletal system, and on bone fractures in particular. Methods English-language publications of human and animal studies categorizing subjects into smokers and nonsmokers were sourced from MEDLINE, The Cochrane Library, and SCOPUS. This review specifically focused on the risk, surgical treatment, and prevention of fracture complications in smokers. Results Smokers have an increased risk of fracture and experience more complications with delayed bone healing, even if they have already stopped smoking, because some adverse effects persist for a prolonged period. Some risks can be reduced during and after surgery by local and general prevention, and smoking cessation is an important factor in lessening this risk. However, if a patient wants to stop smoking at the time of a fracture, the cessation strategies in reducing tobacco use are not easy to implement. The patient should also be warned that using e-cigarettes or other tobaccos does not appear to reduce adverse effects on health. Conclusion The evidence reviewed in this study shows that smoking has a negative effect in terms of the risk and treatment of fractures. Cite this article: J. Hernigou, F. Schuind. Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone Joint Res 2019;8:255–265. DOI: 10.1302/2046-3758.86.BJR-2018-0344.R1.
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Yamano, Seiichi, Mark Nissenbaum, Thomas B. Dodson, German O. Gallucci, and Cortino Sukotjo. "Multidisciplinary Treatment for a Young Patient With Severe Maxillofacial Trauma From a Snowmobile Accident: A Case Report." Journal of Oral Implantology 36, no. 2 (April 1, 2010): 141–44. http://dx.doi.org/10.1563/aaid-joi-d-09-00058r1.
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Abstract This clinical report describes the oral rehabilitation of a 15-year-old male patient who was involved in a snowmobile accident and suffered multiple mid-face and mandibular fractures. Consequences of the accident included avulsion of teeth numbers 5 to 10 and 21 to 26, and a significant amount of maxillary and mandibular anterior alveolar bone loss. The patient underwent open reduction and rigid fixation of the fractured left zygoma, comminuted LeFort I maxillary fracture, and left body of the mandible; closed reduction of the bilateral condylar fractures; autologous corticocancellous bone grafting to the maxilla and mandible; implant placement; and prosthesis fabrication. This multidisciplinary approach successfully restored function and esthetics.
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Fatma Sjoraida, Diah, Evi Novianti, Edwin Rizal, and Diah Sri Rezeki. "People's Motives Toward Bone Fracture Alternative Treatment in District of Bandung Barat." International Journal of Engineering & Technology 7, no. 2.29 (May 22, 2018): 1041. http://dx.doi.org/10.14419/ijet.v7i2.29.14306.
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The purpose of this study is to determine the community motive towards an alternative treatment of bone fractures in the district of West Bandung. Today, alternative treatment, especially fracture bone treatment is still popular with the societies, whereas technology and science in the medical world are growing very rapidly. The research method used is qualitative with phenomenology approach. The results of the study show some motives that are the reasons for choosing alternative treatment, among others: [1] Economic motives. The cost of alternative treatment of fractures is fairly cheap because it is not emphasized on a certain amount of cost. [2] Social motives. Believe in the neighbor's experience or experience of the public figures who have done the alternative treatment. [3] Psychological motives. Feel safe and not afraid when doing alternative treatments.
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Wedayanti, Desak P. K., Gusti N. K. Dinatha, Putu Gosen Partama, and Made Kurniawan Ardi Saputra. "Management of mandibular parasymphysis fracture: a case report." International Journal of Advances in Medicine 8, no. 9 (August 21, 2021): 1423. http://dx.doi.org/10.18203/2349-3933.ijam20213249.
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Mandibular fractures are among the most common injuries to the facial skeleton. Mandibular parasymphysis fractures lead to the loss of occlusion with step deformity formation. Treatment of mandibular fractures aims to restore occlusion and function and facilitate direct bone healing by adequate reduction and immobilization on the fractured site. We report a mandibular parasymphysis fracture of 17 years old male patient due to the road traffic accidents. Patient reported severe jaw pain during movement and abundant intraoral bleeding was observed. A clinically computed tomography scan of the face with axial, coronal, and 3-D reconstruction was performed, which showed parasymphysis fracture. The following treatment done was the application Arch bar and open reduction internal fixation (ORIF) mini plate under general anesthesia. After access, mandibulomaxillary fixation was performed to ensure satisfactory occlusion after adequate fragment reduction. The fractures were properly fixed with 6 hole and 3 hole, screw 8mm for the left mandibular, and for the right mandibular used 5 hole and 3 hole, screw 8 mm. Mandibular fractures are the most common fractures of facial region and treatment options depend upon the type of fracture of mandible according to the anatomic variations.
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Golubovic, Zoran, Goran Vidic, Srbobran Trenkic, Zoran Vukasinovic, Aleksandar Lesic, Predrag Stojiljkovic, Goran Stevanovic, Ivan Golubovic, Aleksandar Visnjic, and Stevo Najman. "Treatment of open tibial shaft fracture with soft tissue and bone defect caused by aircraft bomb: Case report." Srpski arhiv za celokupno lekarstvo 138, no. 7-8 (2010): 510–14. http://dx.doi.org/10.2298/sarh1008510g.
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Introduction. Aircraft bombs can cause severe orthopaedic injuries. Tibia shaft fractures caused by aircraft bombs are mostly comminuted and followed by bone defects, which makes the healing process extremely difficult and prone to numerous complications. The goal of this paper is to present the method of treatment and the end results of treatment of a serious open tibial fracture with soft and bone tissue defects resulting from aircraft bomb shrapnel wounds. Case Outline. A 26-year-old patient presented with a tibial fracture as the result of a cluster bomb shrapnel wound. He was treated applying the method of external bone fixation done two days after wounding, as well as of early coverage of the lower leg soft tissue defects done on the tenth day after the external fixation of the fracture. The external fixator was removed after five months, whereas the treatment was continued by means of functional plaster cast for another two months. The final functional result was good. Conclusion. Radical wound debridement, external bone fixation of the fracture, and early reconstruction of any soft tissue and bone defects are the main elements of the treatment of serious fractures.
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Yang, Liu, Xiangbei Qi, Tao Lei, Jingtao Zhang, and Junming Cao. "Treatment of Osteoporotic Vertebral Compression Fracture with Target-Anchored Vertebral Body Plasty." Journal of Biomaterials and Tissue Engineering 9, no. 8 (August 1, 2019): 1081–85. http://dx.doi.org/10.1166/jbt.2019.2073.
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Objective: To analyze the clinical effect of target-anchored vertebroplasty and traditional percutaneous vertebroplasty on the treatment of osteoporotic vertebral compression fractures. Methods: 50 female New Zealand rabbits were selected for establishing the osteoporotic vertebral compression fracture model and divided into two groups, traditional group and target group followed by analysis of the anterior, posterior, and posterior vertebral body anterior height of the fracture and the injection volume of the bone cement at full filling, and to compare the ultimate compressive strength and stiffness differences between the two groups of specimens by biomechanical testing. Results: In traditional group, the operative time was significantly shorter than that of target group, and the intraoperative bleeding was significantly lower than that of target group (P < 0.05). The fracture area of target group was filled with sufficient bone cement, in the traditional group, 3 cases (12%) showed that bone cement was not filled in the fracture area (P < 0.05), but the total bone cement filling volume was not significantly different between the two groups, but the traditional group had more complete bone cement filling than the bone cement filling, the difference was statistically significant (P < 0.05). In addition, the anterior vertebral body height of each group was significantly higher than other observation points in the group (P < 0.05). However, the distribution of permeability and osmotic type of bone cement between the two groups was not significantly different (P > 0.05). Conclusion: Target-anchored vertebroplasty can improve the quality of clinical treatment of osteoporotic vertebral compression fractures, indicating that it might be a new surgical method.
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Chitra, V., and Evelyn Sharon.S. "Diagnosis, Screening and Treatment of Osteoporosis –A Review." Biomedical and Pharmacology Journal 14, no. 2 (June 30, 2021): 567–75. http://dx.doi.org/10.13005/bpj/2159.
Full textAbstract:
Osteoporosis is the multifactorial skeletal disease that leads to fracture risk in individuals. It is characterized by a decrease in bone mineral density leading to increased fracture risk. It is often silent and only known when fractures occur in the elderly leading to death. The reason is that the disease is always underdiagnosed and not treated properly. It affects men and women, but women are more susceptible to it due to estrogen deficiency. Osteoporosis is diagnosed based on the fragility fractures, low bone mineral density assessed by DEXA scan. Pharmacological (anti-resorptive and anabolic drugs) and lifestyle modifications (dietary intake, weight-bearing exercise, hip protectors, and fall prevention measures) are helpful in the prevention and treatment of Osteoporosis. Clinicians must take proper measures in finding out the patients who are at higher risk of Osteoporosis and providing treatment by either diagnosing or by screening the previous history of fracture risk in the patients. This article provides an overview of the diagnosis, screening, and treatment of Osteoporosis.
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Lakatos, Péter. "Pharmacologic treatment of osteoporosis – 2011." Orvosi Hetilap 152, no. 33 (August 2011): 1320–26. http://dx.doi.org/10.1556/oh.2011.29111.
Full textAbstract:
Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis. Orv. Hetil., 2011, 152, 1320–1326.
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Marongiu, Giuseppe, Andrea Contini, Andrea Cozzi Lepri, Matthew Donadu, Marco Verona, and Antonio Capone. "The Treatment of Acute Diaphyseal Long-bones Fractures with Orthobiologics and Pharmacological Interventions for Bone Healing Enhancement: A Systematic Review of Clinical Evidence." Bioengineering 7, no. 1 (February 24, 2020): 22. http://dx.doi.org/10.3390/bioengineering7010022.
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Background: The healing of long bones diaphyseal fractures can be often impaired and eventually end into delayed union and non-union. A number of therapeutic strategies have been proposed in combination with surgical treatment in order to enhance the healing process, such as scaffolds, growth factors, cell therapies and systemic pharmacological treatments. Our aim was to investigate the current evidence of bone healing enhancement of acute long bone diaphyseal fractures. Methods: A systematic review was conducted by using Pubmed/MEDLINE; Embase and Ovid databases. The combination of the search terms “long-bones; diaphyseal fracture; bone healing; growth factors; cell therapies; scaffolds; graft; bone substitutes; orthobiologics; teriparatide”. Results: The initial search resulted in 4156 articles of which 37 papers fulfilled the inclusion criteria and were the subject of this review. The studies included 1350 patients (837 males and 513 females) with a mean age of 65.3 years old. Conclusions: General lack of high-quality studies exists on the use of adjuvant strategies for bone healing enhancement in acute shaft fractures. Strong evidence supports the use of bone grafts, while only moderate evidence demineralized bone matrix and synthetic ceramics. Conflicting results partially supported the use of growth factors and cell therapies in acute fractures. Teriparatide showed promising results, particularly for atypical femoral fractures and periprosthetic femoral fractures.
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Rao, Santhosh, Sameer Pandey, and Sruthi Rao. "Rhytidectomy approach for treatment of zygomatic arch fractures." BMJ Case Reports 14, no. 1 (January 2021): e238972. http://dx.doi.org/10.1136/bcr-2020-238972.
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Comminuted zygomatic arch fractures are a challenge to manage without complete exposure owing to their instability. The presence of facial nerve branches near the bone often means that these fractures are often treated by closed methods or left untreated. The disadvantages of such comminuted fracture left untreated cannot be overemphasised. Hence, there is a need of a surgical approach for exposure and fixation of such fractures without limitation of facial nerve injury. We propose and report a case of malunited comminuted fracture of zygomatic arch using facelift approach.
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Rolvien, Tim, and Michael Amling. "Bone biology in the elderly: clinical importance for fracture treatment." Innovative Surgical Sciences 1, no. 2 (December 1, 2016): 49–55. http://dx.doi.org/10.1515/iss-2016-0025.
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AbstractAge-related bone impairment often leads to fragility fractures in the elderly. Although excellent surgical care is widely provided, diagnosis and treatment of the underlying bone disorder are often not kept in mind. The interplay of the three major bone cells – osteoblasts, osteoclasts, and osteocytes – is normally well regulated via the secretion of messengers to control bone remodeling. Possible imbalances that might occur in the elderly are partly due to age, genetic risk factors, and adverse lifestyle factors but importantly also due to imbalances in calcium homeostasis (mostly due to vitamin D deficiency or hypochlorhydria), which have to be eliminated. Therefore, the cooperation between the trauma surgeon and the osteologist is of major importance to diagnose and treat the respective patients at risk. We propose that any patient suffering from fragility fractures is rigorously screened for osteoporosis and metabolic bone diseases. This includes bone density measurement by dual-energy X-ray absorptiometry, laboratory tests for calcium, phosphate, vitamin D, and bone turnover markers, as well as additional diagnostic modalities if needed. Thereby, most risk factors, including vitamin D deficiency, can be identified and treated while patients who meet the criteria for a specific therapy (i.e. antiresorptive and osteoanabolic) receive such. If local health systems succeed to manage this process of secondary fracture prevention, morbidity and mortality of fragility fractures will decline to a minimum level.
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Aslan, Ahmet, Yakup Barbaros Baykal, Emin Uysal, Tolga Atay, Vecihi Kirdemir, Metin Lütfi Baydar, and Nevres Hürriyet Aydoğan. "Surgical Treatment of Osteopetrosis-Related Femoral Fractures: Two Case Reports and Literature Review." Case Reports in Orthopedics 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/891963.
Full textAbstract:
Osteopetrosis is a rare hereditary disease which is characterized by increased bone density. Bone resorption is insufficient or fails due to the osteoclast defect in osteopetrosis. Half of the patients are asymptomatic and diagnosed incidentally or based on the presence of fracture. Adult onset osteopetrosis usually presents with hip and proximal femoral fractures. Internal fixation can be performed; however, technical challenges may be experienced due to increased bone density. As in other fractures, nonunion or varus malunion of these fractures may occur. Although rare, osteopetrosis may complicate treatment of fractures in such patients. In this study, we aimed to present two new cases of ADO type II with an osteopetrotic femoral fracture along with the clinical and radiological findings in the light of a comprehensive literature review. Orthopaedics surgeons should be aware of intraoperative technical difficulties and possible postoperative complications during the follow-up period. Investigation would be beneficial for the diagnosis of osteopetrosis such the patient with fractures who has minor trauma history and increased bone density in radiography.