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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-5, 01/jan./2022. tab
Article in English | LILACS | ID: biblio-1358203

ABSTRACT

Objectives: The present study was designed to examine the efficacy of Cissus quadrangularis paste on fracture healing in artificially induced fractured rabbits. Methods: Fifteen rabbits were separated into three groups namely A, B, and C. Veldt grape paste was applied in groups B and C (Treatment Group) by close reduction and open reduction methods of fracture management; respectively, while group A was kept as control. The blood parameter and fracture healing properties in all animals have been monitored and examined routinely during the study period. Results: Both treated groups revealed lower serum calcium levels (SCL) than the control group after 24 hours of fracture that became within the normal range on the 14th day. Fracture healing in the treated groups has been commenced more rapidly than the control group with complete bridging of discontinuity by a distinct osseous callus in the fracture line on day 7 and complete effacing of fracture line on day 14. Conclusion: We did not find any type of anomalousness, clinical deviations, and alteration of serum calcium level on the 14th day of the fracture in treated animals hence Veldt Grape paste could be readily applicable to the management of the fracture in animals.


Objetivos: avaliar a eficácia da pasta de Cissus quadrangularis na consolidação de fraturas em coelhos fraturados artificialmente. Metodos: quinze coelhos foram separados em três grupos (A, B e C). A pasta foi aplicada nos grupos B e C (Grupo de Tratamento) pelos métodos de redução fechada e redução aberta de gerenciamento de fraturas; respectivamente. O grupo A foi mantido como controle. O parâmetro sanguíneo e as propriedades de cicatrização de fraturas em todos os animais foram monitorados e examinados, rotineiramente, durante o período do estudo. Resultados: ambos os grupos tratados revelaram níveis séricos de cálcio (SCL) mais baixos do que o grupo controle, após 24 horas de fratura que se tornou normal no 14º dia. A cicatrização da fratura nos grupos tratados foi iniciada mais rapidamente do que o grupo controle, com ponte completa de descontinuidade por um calo ósseo distinto na linha de fratura no dia 7 e apagamento completo da linha de fratura no dia 14. Conclusao: não encontramos nenhum tipo de anomalia, desvios clínicos e alteração do nível sérico de cálcio no 14º dia da fratura nos animais tratados, portanto, a pasta Veldt Grape pode ser aplicável ao manejo da fratura em animais.


Subject(s)
Fracture Healing , Cissus , Ointments , Therapeutics , Bony Callus , Fractures, Bone , Goals , Animals, Laboratory , Methods
2.
Rev. cuba. estomatol ; 59(2): e4122, abr.-jun. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1408391

ABSTRACT

RESUMEN Introducción: Las lesiones traumáticas maxilofaciales son un problema de salud importante en todo el mundo. Suponen una carga para la salud pública. Objetivo: Reflexionar sobre la necesidad de combinar en el contexto cubano principios y recursos clásicos y modernos en el manejo de fracturas tipo Le Fort. Comentarios principales: El tratamiento de las fracturas faciales ha evolucionado mucho a lo largo de los años. Tradicionalmente, el alambre de acero inoxidable se utilizaba para la osteosíntesis en cirugía maxilofacial hasta la aparición de las miniplacas. Los sistemas de osteosíntesis de titanio son actualmente los de elección en cirugía maxilofacial. A pesar de sus ventajas indiscutibles, en los países en desarrollo ocasionalmente no se cuenta con todo el equipamiento necesario para su empleo. Consideraciones globales: El manejo del trauma maxilofacial se centra en la reobtención de la forma y la función original de la región afectada. Sin vulnerar los principios teóricos de manejo de fracturas tipo Le Fort, se impone de los profesionales cubanos la búsqueda de soluciones en concordancia con la disponibilidad de recursos. La unión de técnicas clásicas y recursos modernos como las suspensiones craneofaciales alámbricas, los arcos barra y los tornillos de fijación maxilomandibular puede ser una alternativa terapéutica confiable.


ABSTRACT Introduction: Traumatic maxillofacial lesions are an important global health problem, as well as a public health burden. Objective: Reflect on the need to combine classical and modern principles and resources in the management of Le Fort fractures in the Cuban context. Main remarks: Treatment of facial fractures has evolved considerably through the years. Before the appearance of miniplates, stainless steel wire was used for osteosynthesis in maxillofacial surgery. Titanium osteosynthesis systems are currently the systems of choice in maxillofacial surgery. Despite their undeniable advantages, developing countries occasionally do not have all the equipment required for their use. General considerations: Management of maxillofacial trauma is aimed at recovering the original form and function of the affected area. Without disregarding the theoretical principles of the management of Le Fort fractures, Cuban professionals should search for solutions in keeping with the resources available. The combination of classical techniques and modern resources, such as wired craniofacial suspensions, bar arches and maxillomandibular fixation screws, may be a reliable therapeutic alternative.

3.
Rev. bras. ortop ; 57(2): 218-222, Mar.-Apr. 2022. tab
Article in English | LILACS | ID: biblio-1388004

ABSTRACT

Abstract Objective Several animal models have been used in fracture healing and bone graft studies, but hematological responses are seldom reported. Therefore, the present study reported the hematological changes observed in rabbits that underwent xenografting of caprine demineralized bone matrix (CDBM). Method Twenty-four (24) male rabbits (2.5 0.5kg) were acquired for the purpose of this study and were randomly assigned to three groups: autologous bone graft (ABG), unfilled (NC), and caprine demineralized bone matrix (CDBM). Blood samples were collected through cardiac puncture under xylazine-ketamine anesthesia on day 0 (baseline), and on days 28 and 56 postsurgery and were analyzed manually within 2hours of collection. Statistical analysis was performed using a two-way analysis of variance (ANOVA) with repeated measures, and a p-value< 0.05 was considered significant. Result There was an overall significant difference in the values of total white blood cell count (p» 0.0043), neutrophil count (p< 0.0001), monocyte count (p» 0.0184), red blood cell count (p» 0.003), hemoglobin concentration (p< 0.0001) and packed cell volume (p< 0.0001) across the days and the treatment groups. There was, however, no overall significant difference in lymphocyte count (p» 0.4923), basophil count (p» 0.4183), and eosinophil count (0.4806) within days. Conclusion Response to CDBM grafting in rabbits could, therefore, be said to be characterized by marked leukocytosis with neutrophilia, lymphocytosis, and monocytosis by day 28 of postgrafting. This could form the basis with which hematology can be used to monitor body response of bone graft animal models.


Resumo Objetivo Diversos modelos animais têm sido usados em estudos sobre enxertos ósseos e o tratamento de fraturas, mas as respostas hematológicas são raramente relatadas. Este estudo descreveu as alterações hematológicas observadas em coelhos submetidos a xenoenxertos de matriz óssea desmineralizada caprina (MODC). Métodos Vinte e quatro (24) coelhos machos (2,5 0,5 kg) foram adquiridos para este estudo e divididos aleatoriamente em três grupos: enxerto ósseo autólogo (EOA); controle negativo sem preenchimento (SP) e matriz óssea desmineralizada caprina (MODC). Amostras de sangue foram coletadas por punção cardíaca sob anestesia com xilazina-quetamina no dia 0 (para estabelecimento dos valores basais) e aos dias 28 e 56 após a cirurgia; essas amostras foram submetidas à análise manual em até 2 horas após a coleta. A análise estatística foi composta por análise de variância (ANOVA) de dois fatores com medidas repetidas, e o valor de p< 0,05 foi considerado significativo. Resultados Houve uma diferença geral significativa nos números de leucócitos totais (p» 0,0043), neutrófilos (p< 0,0001), monócitos (p» 0,0184) e hemácias (p» 0,003), na concentração de hemoglobina (p< 0,0001) e no hematócrito (p< 0,0001) ao longo dos dias e entre os grupos de tratamento. No entanto, não houve diferença global significativa no número de linfócitos (p» 0,4923), basófilos (p» 0,4183) e eosinófilos (p» 0,4806) entre os dias. Conclusão A resposta ao enxerto de MODC em coelhos é, portanto, caracterizada por leucocitose intensa com neutrofilia, linfocitose e monocitose no 28° dia após o procedimento. Esses dados podem basear a utilização da hematologia no monitoramento da resposta corporal em modelos animais de enxerto ósseo.


Subject(s)
Animals , Rabbits , Bone Transplantation , Fracture Healing , Models, Animal , Heterografts , Hematology
4.
Journal of Medical Biomechanics ; (6): E162-E168, 2022.
Article in Chinese | WPRIM | ID: wpr-920685

ABSTRACT

Objective To investigate the effects of cyclic stretch on migration of MC3T3-E1 cells and its related mechanism. Methods The strain loading system was used to stretch MC3T3-E1 cells cultured in vitro with 15% amplitude, to simulate the mechanical condition in vivo. The wound healing assay was used to detect the migration of MC3T3-E1 cells. Western blotting was used to test Runx2 expression. RNA interfering was used to decrease Runx2 expression. Results Cyclic mechanical stretch with 15% amplitude, 1.25 Hz frequency and lasting for 24 hours could promote the migration of MC3T3-E1 cells and increase the expression level of Runx2. Runx2 interference inhibited the migration of MC3T3-E1 cells in static culture condition. Interference with Runx2 expression in MC3T3-E1 cells could partially reduce the positive effect of cyclic mechanical stretch on cell migration. Conclusions Cyclic stretch can promote the migration of MC3T3-E1 cells, and Runx2 may play an important role in this process. This study provides experimental basis for finding innovative clinical treatment method to promote fracture healing.

5.
Article in Chinese | WPRIM | ID: wpr-931604

ABSTRACT

Objective:To investigate the efficacy of proximal femoral intramedullary nail antirotation fixation in the treatment of intertrochanteric fracture of the femur and its effects on Harris hip scores.Methods:Sixty-eight patients with intertrochanteric fracture of the femur who received treatment in Cixi People's Hospital from April 2018 to October 2019 were included in this study. They were randomly assigned to receive dynamic hip screw fixation (control group, n = 34) or proximal femoral intramedullary nail antirotation fixation (observation group, n = 34). Clinical efficacy, Harris score, surgical indicators, and the incidence of complications were compared between the two groups. Results:The response rate was significantly higher in the observation group than in the control group [94.12% (32/34) vs. 76.47% (26/34), χ2 = 5.81, P < 0.05]. The excellent and good rate of hip function as evaluated by Harris hip scores was significantly higher in the observation group than in the control group [91.18% (31/34) vs. 73.53% (25/34), χ2 = 6.05, P < 0.05]. The operative time, blood loss, incision length, and fracture healing time in the observation group were (51.66 ± 10.52) minutes, (120.26 ± 12.29) mL, (8.09 ± 2.62) cm, and (9.86 ± 2.67) weeks respectively, and those in the control group were (78.32 ± 12.23) minutes, (238.45 ± 17.85) mL, (12.95 ± 3.29) cm, and (13.65 ± 3.46) weeks, respectively. There were significant differences in these indices between the two groups ( t = 14.55, 14.03, 14.85, 14.60, all P < 0.05). The incidence of complications was significantly lower in the observation group than in the control group [5.88% (2/34) vs. 23.53% (8/34), χ2 = 6.51, P < 0.05]. Conclusion:Proximal femoral intramedullary nail antirotation fixation is superior to dynamic hip screw fixation in the treatment of intertrochanteric fracture of the femur. The former increases Harris hip score, decreases the incidence of complications, and is of great clinical innovation.

6.
Article in Chinese | WPRIM | ID: wpr-928326

ABSTRACT

OBJECTIVE@#To observe the effects of Taohong Siwu Decoction(, THSWD) on the mesenchymal stem cells(MSCs) migration, homing number and cytokine expression in callus during the early process of fracture healing, and to explore the mechanism of THSWD on accelerationg fracture healing by regulating the homing of MSCs in rats.@*METHODS@#A rat model of right femoral shaft open fracture was established. Thirty-two 5-week-old male Sprague-Dawley rats, weighting 110 to 130 g, were divided into control group, low-dose group, medium-dose group and high-dose group by using random number table. Distilled water was given to the control group, and the other groups were given Taohong Siwu Decoction. The rats were gavaged twice a day for 5 consecutive days after surgery. Bone volume/tissue volume(BV/TV) and bone mineral density(BMD) were observed using micro-computed tomography (micro-CT) at 21 days after surgery. At 5 days post-fracture, peripheral blood MSCs from THSWD treated and untreated rats were cultured in vitro. Subsequently, the migration ability of MSCs was observed by cell migration assay. The number of MSCs homing to the callus at the early stage of fracture (5 d) was detected by Immunohistochemistry (IHC). Protein chip was used to detect the expression of cytokines in callus.@*RESULTS@#Micro-CT results showed that BV/TV was higher in the high-dose group than in the medium-dose group (P=0.032), and higher in the medium-dose group than in the low-dose group(P=0.041), with no difference between the control and low-dose group (P=0.651). In addition, there was no difference in BMD between low-dose group and the model group (P=0.671), and lower in the low-dose group than in the medium-dose group(P=0.018), and the medium-dose group was lower than the high-dose group(P=0.008). Cell migration assay showed that THSWD promotes enhanced the migration ability of peripheral blood MSCs. IHC assay revealed that CD45-, CD90+, CD29+ MSCs significantly increased in bone callus after THSWD intervention compared with the control group. Protein chip showed that THSWD promoted the upregulation of CINC-1(×2.91), CINC-3(×1.59), LIX(×1.5), Thymus Chemokine (×2.55), VEGF (×1.22) and the down-regulation of TIMP-1 (×2.98).@*CONCLUSION@#THSWD, a representative formula of "promoting blood circulation and removing blood stasis", can significantly accelerate fracture healing, and its mechanism may be related to enhancing the migration ability of peripheral blood MSCs and up-regulating CINC-1, CINC-3, LIX, Thymus Chemokine, VEGF and down-regulating TIMP-1 in bone callus, which promotes the peripheral blood MSCs homing in the early stage of fracture.


Subject(s)
Animals , Drugs, Chinese Herbal , Fracture Healing , Fractures, Bone/drug therapy , Humans , Male , Mesenchymal Stem Cells , Rats , Rats, Sprague-Dawley , Tissue Inhibitor of Metalloproteinase-1/pharmacology , Vascular Endothelial Growth Factor A , X-Ray Microtomography
7.
Rev. Col. Bras. Cir ; 49: e20223301, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1406747

ABSTRACT

ABSTRACT Introduction: open tibial fractures are challenging due to the frequent severe bone injury associated with poor soft tissue conditions. This is relevant in low- and middle-income countries, mainly related to delayed definitive fixation and lack of adequate training in soft tissue coverage procedures. Due to these factors, open tibial fracture is an important source of disability for Latin American countries. Herein we sought to provide an epidemiological overview of isolated open tibial shaft fracture across seven hospitals in southern cone of Latin America. The secondary goal was to assess the impact on quality of life based on return-to-work rate (RWR). Methods: patients with an isolated open tibial shaft fracture treated in seven different hospitals from Brazil and Argentina from November 2017 to March 2020 were included in the study. Clinical and radiographic results were evaluated throughout the 120-day follow-up period. Final evaluation compared RWR with the SF-12 questionnaire, bone healing, and gait status. Results: Seventy-two patients were treated, 57 followed for 120 days and 48 completed the SF-12 questionnaire. After 120 days, 70.6% had returned to work, 61.4% had experienced bone healing. Age, antibiotic therapy, type of definitive treatment, and infection significantly influenced the RWR. Gait status exhibited strong correlations with RWR and SF-12 physical component score. Conclusions: Isolated open tibial shaft fractures are potentially harmful to the patient's quality of life after 120 days of the initial management. RWR is significantly higher for younger patients, no history of infection, and those who could run in the gait status assessment.


RESUMO Introdução: o tratamento de fraturas expostas isoladas da diáfise da tíbia (FEIDT) apresenta desafios por frequentemente associar severa lesão óssea com condições ruins de tecido mole, fatores relevantes em países de média e baixa renda, especialmente devido a atrasos na implementação da fixação definitiva e falta de treinamento adequado no manejo de tecidos moles. Consequentemente, FEIDTs representam importante fonte de incapacitação na América Latina. Este estudo objetivou apresentar uma visão geral das FEIDTs em sete hospitais do cone sul da América Latina. O objetivo secundário foi avaliar o seu impacto na qualidade de vida baseado na taxa de retorno ao trabalho (TRT). Métodos: foram incluídos no estudo pacientes com FEIDT tratados em sete hospitais de Brasil e Argentina entre novembro de 2017 e março de 2020. Resultados clínicos e radiográficos foram analisados num período de 120 dias. Avaliação final comparou TRT com o questionário SF-12, consolidação óssea e condições de marcha. Resultados: setenta e dois pacientes foram tratados, 57 seguidos por 120 dias e 48 completaram o questionário SF-12. Após 120 dias, 70,6% havia retornado ao trabalho, 61,4% tinha fratura consolidada. Idade, antibioticoterapia, tipo de tratamento definitivo e infecção influenciaram significativamente na TRT. A condição de marcha apresentou forte correlação com TRT e o componente físico do SF-12. Conclusão: FEIDTs são potencialmente deletérias à qualidade de vida dos pacientes 120 dias após o tratamento inicial. TRT é significativamente maior para pacientes mais jovens, sem história de infecção e que conseguem correr na avaliação da condição de marcha..

8.
Int. j. morphol ; 39(6)dic. 2021.
Article in English | LILACS-Express | LILACS | ID: biblio-1385551

ABSTRACT

SUMMARY: The aim of this study was to explore promoting effect of external applying Panax Notoginseng Saponins (PNS) on fractures. For this analysis 18 New Zealand male rabbits were divided into control group, splintage group and PNS group. All rabbits were performed left radius fractures and natural healing, splintage healing and splintage coated with PNS healing. 2 rabbits in each group were sacrificed on day 14, day 28 and day 42 after surgery, separately. Atomic force microscope scanning and nanoindentation tests were performed on the callus sections. The particle size and roughness in PNS group was both less than that in splintage group. The elastic modulus of callus in PNS group was consistent with normal bone tissue started from day 28 after surgery, two weeks earlier than that in splintage group. PNS could significantly reduce fracture healing time and increase strength of callus.


RESUMEN: El objetivo de este estudio fue evaluar el efecto de la aplicación externa de Panax Notoginseng Saponins (PNS) en fracturas óseas. Se usaron 18 conejos machos de raza Nueva Zelanda divididos en grupos control, entablillado y PNS. Se realizaron fracturas del radio izquierdo y cicatrización natural en todos los animales, además de la cicatrización con entablillado y entablillado recubierto con PNS. Se sacrificaron, posterior a la cirugía, dos conejos de cada grupo los día 14, 28 y 42. Se realizaron pruebas de escaneo con microscopio de fuerza atómica y nanoindentación en las secciones de callos. El tamaño de la partícula y la rugosidad en el grupo de PNS fue menor que en el grupo entablillado. El módulo elástico del callo en el grupo de PNS fue consistente con el tejido óseo normal iniciado el día 28 después de la cirugía, dos semanas antes que en el grupo de entablillado. El PNS podría redu- cir significativamente el tiempo de curación de la fractura y aumentar la fuerza del callo.

9.
Rev. bras. ortop ; 56(6): 784-789, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357136

ABSTRACT

Abstract Objective To measure the levels of vitamin D in patients hospitalized for fractures and to evaluate its relationship with fractures. Methods A primary, analytical, cross-sectional, non-interventional, observational, controlled study was conducted in humans. The serum measurement of: vitamin D, parathyroid hormone (PTH), calcium, phosphorus, magnesium and albumin was performed in 49 patients who were consecutively hospitalized for surgery due to fracture(s) (study group), and in 50 patients without fractures, from the various outpatient clinics, and who underwent routine tests (control group). Results The mean level of 25-hydroxyvitaminD (25[OH]D) in patients with fractures was of 23.78 ± 8.01 ng/mL (61.22% of patients with fractures had hypovitaminosis D). The mean 25(OH)D of the control group was of 37.52 ± 9.21 ng/mL (10% of the patients had hypovitaminosis D). Most cases of hypovitaminosis (96%) did not course with secondary hyperparathyroidism (mean PTH = 41.80 ± 22.75 pg/mL). Conclusion Hypovitaminosis D was found in a significant percentage (61.22%) of the patients who suffered fractures. Further studies on the subject are needed to better understand the influence of hypovitaminosis D on the occurrence of fractures, as well as the benefits of vitamin D supplementation in these patients.


Resumo Objetivo Dosar a vitamina D nos pacientes internados por fratura e avaliar sua relação com as fraturas. Métodos Realizou-se estudo primário, analítico, transversal, não intervencional, observacional, controlado, em seres humanos. Fez-se a dosagem sérica de: vitamina D, paratormônio(PTH), cálcio, fósforo, magnésio e albumina em 49 pacientes que foram internados consecutivamente para cirurgia devido a fratura(s) (grupo de estudo), e em 50 pacientes, dos diversos ambulatórios, sem fraturas, e que realizaram exames de rotina (grupo de controle). Resultados A média de 25-hidroxivitamina D (25[OH]D) nos pacientes com fraturas foi de 23,78 ± 8,01 ng/mL (61,22% dos pacientes com fraturas apresentaram hipovitaminose D). A média de 25(OH)D do grupo de controle foi de 37,52 ± 9,21 ng/mL (10% dos pacientes apresentaram hipovitaminose D). A maioria dos casos de hipovitaminose (96%) não cursou com hiperparatireoidismo secundário (média do PTH = 41,80 ± 22,75 pg/mL). Conclusão A hipovitaminose D foi encontrada em um percentual expressivo (61,22%) dos pacientes que sofreram fraturas. Mais estudos sobre o assunto são necessários para se compreender melhor a influência da hipovitaminose D na ocorrência das fraturas e os benefícios da suplementação com vitamina D nesses pacientes.


Subject(s)
Humans , Osteoporosis , Avitaminosis , Vitamin D , Vitamin D Deficiency , Fracture Healing , Fractures, Bone , Hip Fractures
10.
Arq. bras. med. vet. zootec. (Online) ; 73(3): 589-597, May-June 2021. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1278368

ABSTRACT

This study aimed to evaluate the effectiveness of bridge plating of simple tibial fractures in dogs by minimally invasive plate osteosynthesis (MIPO). Medical and radiographic records of twenty-nine dogs with simple tibial fractures that underwent bridge fixation by MIPO were retrospectively evaluated. The clinical outcome was classified considering the presence of lameness at the end of the treatment. The tibial mechanical joint angles were measured and compared with the values described in the literature. Additionally, fragment apposition and implant disposition were evaluated. Based on the modified Radiographic Union Scale for Tibial fractures, the moment of clinical union was determined. Clinically, at the end of treatment, only one patient presented lameness at a trot. While there was no significant difference between the bone alignment in the frontal plane values and the values described in the literature (P>0.05), the caudal proximal tibial angle was significantly higher (P=0.001). The median fragment apposition was considered acceptable. The average bridge plate ratio, plate working length, and plate screw density were 0.8, 0.57, and 0.48, respectively. The median time to clinical union was 30 days. Bridge plating in simple tibial fractures resulted in fast healing and low complication rates.(AU)


Objetivou-se avaliar a efetividade da estabilização em ponte de fraturas tibiais simples em cães utilizando-se a técnica de osteossíntese minimamente invasiva com placa (MIPO). Registros médicos e radiográficos de 29 cães com fraturas simples de tíbia, fixadas em ponte por meio da MIPO, foram retrospectivamente avaliados. O resultado clínico foi classificado com base na deambulação ao final do tratamento. Os ângulos articulares mecânicos da tíbia foram aferidos e comparados aos valores descritos na literatura. Adicionalmente, foram avaliadas a aposição dos fragmentos e a disposição dos implantes. Por meio da escala modificada de união radiográfica para fraturas de tíbia, determinou-se o momento de união clínica. Clinicamente, ao final do tratamento, apenas um animal apresentou claudicação ao trote. Não houve diferença significativa entre o alinhamento ósseo no plano frontal quando comparado com dados da literatura (P>0,05), enquanto, no plano sagital, o ângulo mecânico caudal proximal da tíbia foi significativamente maior (P=0,001). A mediana para aposição dos fragmentos foi considerada aceitável. As médias para relação placa em ponte, comprimento de trabalho da placa e densidade de parafusos da placa foram, respectivamente, 0,8; 0,57 e 0,48. A mediana para união clínica foi de 30 dias. A estabilização em ponte de fraturas tibiais simples resultou em rápida consolidação óssea, com baixas taxas de complicação.(AU)


Subject(s)
Animals , Dogs , Tibial Fractures/veterinary , Fracture Healing , Fracture Fixation, Internal/veterinary , Radiography/veterinary
11.
Rev. bras. ortop ; 56(1): 36-41, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1288660

ABSTRACT

Abstract Objective To virtually prototype a device for external circular fixation of long bone fractures with controlled dynamization made of two different materials and predict their mechanical behavior by using the finite element analysis (FEA) method. Method A software was used for 3D modeling two metal parts closely attached by a sliding dovetail joint and a high-density silicone damper. Distinctive FEAs were simulated by considering two different materials (stainless steel or titanium), modes (locked or dynamized) and loading conditions (static/point or dynamic/0.5 sec) with uniform 150 kg axial load on top of the device. Results The finite elements (FEs) model presented 81,872 nodes and 45,922 elements. Considering stainless steel, the maximum stress peak (140.98 MPa) was reached with the device locked under static loading, while the greatest displacement (2.415 × 10−3 mm) was observed with the device locked and under dynamic loading. Regarding titanium, the device presented the maximum stress peak (141.45 MPa) under static loading and with the device locked, while the greatest displacement (3.975 × 10−3 mm) was found with the device locked and under dynamic loading. Conclusion The prototyped device played the role of stress support with acceptable deformation in both locked and dynamized modes and may be fabricated with both stainless steel and titanium.


Resumo Objetivo Construir um protótipo virtual de um dispositivo de fixação circular externa para fraturas em ossos longos com dinamização controlada a partir de dois materiais diferentes e prever seu comportamento mecânico por meio da análise de elementos finitos AEF). Método Modelos tridimensionais compostos de duas peças metálicas unidas por uma junta deslizante em rabo de andorinha e um amortecedor de silicone de alta densidade foram criados em um software. Análises de elementos finitos distintas foram simuladas considerando dois materiais (aço inoxidável ou titânio), modos (bloqueado ou dinamizado) e condições de carregamento (estático/pontual ou dinâmico/0,5 segundo) diferentes com carga axial uniforme de 150 kg na porção superior do dispositivo. Resultados O modelo de elementos finitos (EFs) apresentou 81.872 nós e 45.922 elementos. Com aço inoxidável, o pico de tensão máxima (140,98 MPa) foi alcançado com o dispositivo bloqueado e sob carga estática, enquanto o maior deslocamento (2.415 × 10−3 mm) foi obtido com o dispositivo bloqueado e sob carga dinâmica. Com titânio, o pico de tensão máxima (141,45 MPa) ocorreu com o dispositivo bloqueado e sob carga estática, enquanto o maior deslocamento (3.975 × 10−3 mm) foi observado com o dispositivo bloqueado e sob carga dinâmica. Conclusão O protótipo do dispositivo desempenhou o papel de suporte de tensão com deformação aceitável nos dois modos, bloqueado ou dinamizado, e pode ser fabricado com aço inoxidável ou titânio.


Subject(s)
Humans , Adult , Scoliosis/physiopathology , Scoliosis/therapy , Finite Element Analysis , Intervertebral Disc Degeneration
12.
Acta cir. bras ; 36(2): e360206, 2021. tab, graf
Article in English | LILACS | ID: biblio-1152698

ABSTRACT

ABSTRACT Purpose To evaluate clinical outcome following minimally invasive plate osteosynthesis (MIPO) associated with percutaneous transplantation of allogeneic adipose-derived mesenchymal stem cells (AD-MSC) at the tibial fracture site in dogs. Methods Thirty-six dogs presenting with nonarticular complete tibial fracture were included in this study. All fractures were treated by the same MIPO technique. The animals were divided in group 1 (n = 20) received a percutaneous application of 3 × 106 AD-MSC at the fracture site and group 2 (n = 16) did not receive any adjuvant treatment. Postoperative radiographic examinations were made at 15, 30, 60, 90 and 120 days. Results Fifty-eight percent of the patients were classified as skeletally immature. The median weight of the animals was 18.8 kg. The mean radiographic union time differed statistically between the AD-MSC group (28.5 days) and the control group (70.3 days). Sixty percent of dogs in group 1 and 56.25% of the group 2 were considered immature. Conclusions The use of allogeneic AD-MSC cell therapy and MIPO is a safe, viable and effective technique for promoting bone healing in nonarticular tibial fractures in dogs.


Subject(s)
Humans , Animals , Dogs , Hematopoietic Stem Cell Transplantation , Mesenchymal Stem Cells , Tibia/surgery , Bone Plates , Fracture Fixation, Internal
13.
Article in Chinese | WPRIM | ID: wpr-921907

ABSTRACT

OBJECTIVE@#To explore effect of tobramycin (TOB) on healing of femoral fractures in rats.@*METHODS@#Totally 32 male sprague-dawley (SD) rats were selected and randomly divided into sham group (group A), fracture group (group B), fracture with TOB group (group C) and fracture + TOB + IWR-1 group (group D), 8 rats in each group. Close femoral fracture model in rats were established in group B, C and D, group A was sham operation without otherwise process. Group D was intraperitoneal injected 100 μl (8 μM) of Wnt pathway inhibitor IWR-1-endo (IWR-1) before molding at 1 day. At 1 day after molding, 100 μl (100 μM) of TOB was intraperitoneally injected into group C and D at once a day for 7 days. At 7 weeks after modling, fracture healing of group B, C and D were observed by X-ray, Western blotting was appilied to detect alkaline phosphatase(ALP) and Runt related transcription factor 2 (RUNX2) and β-catenin of Wnt passway.@*RESULTS@#X-ray results showed fracture line disappeared, callus formation and fracture healing well in group C compared with begning of molding; while a little fracture line, callus formation and fracture malunion in group B and d could be seen. Western blotting results showed ALP, RUNX2 and expression of β-catenin in group B, C and D were higher than that of group A (@*CONCLUSION@#Tobramycin could promote osteoblast differentiation and fracture healing by stimulating Wnt / β-catenin signaling pathway, up regulating expression of ALP and RUNX2.


Subject(s)
Alkaline Phosphatase , Animals , Cell Differentiation , Core Binding Factor Alpha 1 Subunit/genetics , Femoral Fractures , Fracture Healing , Male , Osteogenesis , Rats , Tobramycin , Wnt Signaling Pathway , beta Catenin/metabolism
14.
Article in Chinese | WPRIM | ID: wpr-910078

ABSTRACT

The process of bone healing is absolutely complicated and affected by a wide variety of factors. The quality of bone healing directly determines management approaches. Therefore, it is crucial to evaluate accurately outcomes of bone healing. The assessments of bone healing mostly used in current clinical practice are a combination of clinical manifestations and X-ray examination while computed tomography (CT) and ultrasound may be applied alternatively for particular parts and populations. As understanding of bone healing process and bone biomechanical structure is deepening in recent years, both traditional and novel assessments of bone healing have been well refined. This review will expound on the advantages, disadvantages and clinical indications of various assessments, as well as their future development trends, to provide useful information for clinicians.

15.
Chinese Journal of Trauma ; (12): 968-972, 2021.
Article in Chinese | WPRIM | ID: wpr-909964

ABSTRACT

The osteoporotic fracture is characterized by a high disability rate,poor internal fixation strength,delayed bone healing,etc.,which greatly affects elderly health,so accelerating fracture healing is the key point of therapeutic strategies. Current researches mainly concentrate in bone formation acceleration and resorption inhibition,but the outcomes turn out to be unsatisfactory under the coupling of osteoblasts and osteoclasts. The accumulation of yellow adipose tissue in the medullary cavity is often arisen in patients with osteoporotic fractures,but its role and mechanism in bone metabolism remain unclear. Bone marrow adipocytes are differentiated from mesenchymal stromal cells and possess unique metabolic and secretory functions involving in energy metabolism,maintenance of hematopoietic microenvironment and regulation of bone metabolism balance. However,the role of bone marrow adipose tissue(BMAT)in osteoporotic fracture healing requires more elucidation. In this study,the authors discuss the key role and molecular mechanism of BMAT in the regulation of bone metabolism and homeostasis,aiming to provid new ideas and targets for the promotion of osteoporotic fracture healing.

16.
Chinese Journal of Trauma ; (12): 683-687, 2021.
Article in Chinese | WPRIM | ID: wpr-909922

ABSTRACT

The osteoporotic fracture is characterized by difficult treatment and poor prognosis. The studies of bone biology show that bone microenvironment changes during osteoporotic fractures,such as changes in immune factors,abnormal chemotaxis and differentiation of mesenchymal stem cells(MSCs),decreased estrogen secretion and receptor down-regulation and decreased mechanical sensitivity,which affect the fracture healing process. Current studies have shown that by improving the phenotypic polarization of macrophages,enhancing the chemotactic osteogenic activity of MSCs,supplementing estrogen and improving the biomechanical properties of bone can remodel the balance of bone microenvironment,thereby effectively improve the bone quality. The authors explore the effect and mechanism of bone microenvironment on healing of osteoporotic fractures from the perspectives of changes in bone microenvironment and imbalance of bone microenvironment that affect fracture healing and methods of bone microenvironment reconstruction,so as to provide new ideas for clinical treatment of osteoporotic fractures.

17.
Chinese Journal of Trauma ; (12): 473-480, 2021.
Article in Chinese | WPRIM | ID: wpr-909893

ABSTRACT

Fracture healing is a complex biological process. After a fracture, a hematoma will first form at the injured site, and immune cells and inflammatory factors will quickly reach the fracture site to facilitate the repair and reconstruction of bone tissue. Immune cells and inflammatory factors are an important part of the body's immune system, and the immune system plays a key role in removing necrotic tissue and maintaining the homeostasis of the body's environment. Proper immune regulation after a fracture is beneficial to fracture healing; if immune regulation is improper, the fracture site will gradually develop into a chronic inflammatory state, which may impair healing. The authors summarize the mechanism of action of the innate immune system and adaptive immune system in fracture healing, as well as the research progress of therapeutic drugs that affect the state of the immune system and thus affect the healing of fractures, so as to deepen the understanding of the immune system affecting bone regeneration and provide new ideas for clinical treatment of fracture.

18.
Article in Chinese | WPRIM | ID: wpr-847197

ABSTRACT

BACKGROUND: The choice of standard femoral prosthesis or lengthened femoral prosthesis for the treatment of femoral intertrochanteric fracture in the elderly with hemihip replacement has always troubled clinicians. OBJECTIVE: To compare the short-term clinical efficacy of standard and long-stem prosthesis replacement in the treatment of elderly comminuted intertrochanteric Jensen V fractures. METHODS: Data of 216 elderly patients with comminuted intertrochanteric femoral Jensen V fractures undergoing bone cement artificial half hip arthroplasty in Loudi Central Hospital from January 2008 to January 2019 were retrospectively analyzed. According to the type of prosthesis, the patients were divided into standard stem prosthesis placement group (n=92) and long-stem prosthesis replacement group (n=124). According to the fracture situation, the wire Kirschner wire was used to reduce the trochanteric fracture. At 1 year after surgery, Hariss score of the hip joint was evaluated. X-ray examination was used to observe imaging manifestations around the prosthesis. RESULTS AND CONCLUSION: (1) Two patients in the standard stem prosthesis placement group died; three patients in the long-stem prosthesis replacement group died. The remaining patients were followed up for 12-24 months. (2) At 1 year after surgery, Hariss scores were (88.6±2.9) in the standard stem prosthesis placement group with an excellent and good rate of 83.3%, and (86.9±2.7) in the long-stem prosthesis replacement group with an excellent and good rate of 82.6%; no significant difference was found between the two groups (P > 0.05). (3) In the standard stem prosthesis placement group, one case affected femoral greater trochanteric fracture nonunion; two cases had femoral small trochanteric fracture nonunion; two cases experienced Brooker’s grade 1 heterotopic ossification. In the long-stem prosthesis replacement group, one case affected femoral greater trochanteric fracture nonunion; three cases had femoral small trochanteric fracture nonunion; two cases experienced Brooker’s grade 1 heterotopic ossification. There was no significant difference in the incidence of complications between the two groups (P > 0.05). (4) It is indicated that the short-term clinical efficacy of standard and long-stem cement-type prosthesis replacement in the treatment of Jensen V type trochanteric fracture in elderly patients is satisfactory, with no statistical difference, but the long-term effect remains to be studied.

19.
Article in Chinese | WPRIM | ID: wpr-847180

ABSTRACT

BACKGROUND: The common straight plate can affect the biomechanical conduction of fracture ends, and the combined variable stress plate can retain the continuous biomechanical stimulation of the fracture end, affect the changes of bone tissue cell function and bone mineral density, and promote fracture healing. OBJECTIVE: To investigate the effects of internal fixation with two kinds of plates on bone tissue cell function and bone mineral density in experimental goat femoral fracture healing. METHODS: Thirty healthy adult goats were raised in normal environment, and used to successfully construct the models of right lower limb femur fracture. The models were randomly divided into the experimental group (given the combined variable stress plate fixation) and the control group (given the common straight steel plate fixation) (n=15 per group). Serum levels of bone specific alkaline phosphatase, osteocalcin and tartrate resistant acid phosphatase activity were determined at 4, 8, and 12 weeks after surgery in both groups. The goats were sacrificed in batches, and the femoral stump tissue was taken for bone mineral density and histopathological observation. RESULTS AND CONCLUSION: (1) At 4 and 8 weeks, the serum bone specific alkaline phosphatase in the experimental group increased faster than that in the control group, but it was significantly lower than that in the control group at 12 weeks (P < 0.05). (2) At 4 weeks after surgery, the serum osteocalcin of the experimental group was higher than that of the control group, but lower than that of the control group at 12 weeks (P < 0.05). (3) At 4 and 8 weeks after operation, the serum tartrate resistant acid phosphatase activity of the experimental group was significantly higher than that of the control group, but lower than that of the control group at 12 weeks (P < 0.05). (4) At 8 and 12 weeks after operation, the bone mineral density of the fracture end in the experimental group was significantly higher than that of the control group (P < 0.05), while the bone mineral density of the experimental group and the control group increased gradually at 4, 8 and 12 weeks (P < 0.05). (5) At 4 and 8 weeks, the number of osteoblasts of the experimental group was significantly higher than that of the control group. At 8 weeks, the number of osteoclasts of the experimental group was significantly higher than that of the control group. At 12 weeks, the number of osteoblasts and osteoclasts of the experimental group was significantly lower than that of the control group (P < 0.05). (6) Combined variable stress plate fixation can produce continuous compressive stress at the fracture end of goat femur, stimulate the change of the number of bone tissue cells, lead to the secretion of corresponding bone tissue cell functional protein, promote the formation of callus, accelerate the reconstruction of callus, and promote the fracture healing.

20.
Article in Chinese | WPRIM | ID: wpr-909215

ABSTRACT

Objective:To investigate the clinical effects of vacuum sealing drainage (VSD) negative pressure suction combined with Masquelet technique in the treatment of open comminuted fractures of limbs.Methods:120 patients with open comminuted fractures of limbs who received treatment in Rongjun Hospital of Zhejiang Province from June 2017 to June 2020 were included in this study. All of them underwent treatment by VSD negative pressure suction combined with Masquelet technique. The changes in rehabilitation indices, inflammatory factors and quality of life relative to before surgery and Visual Analogue Scale score before and 1 and 3 months after surgery were determined.Results:All 120 patients were included in the final analysis. Granulation tissue growth time was (10.53 ± 2.39) days. Infection control time was (14.32 ± 3.24) days. Wound closure time was (10.87 ± 2.84) days. Fracture healing time was (9.57 ± 1.84) weeks. The VAS score at 1 and 3 months after surgery was (3.21 ± 1.58) points and (1.45 ± 0.76) points, respectively, which was significantly decreased compared with before surgery [(8.23 ± 1.52) points, t = 25.082, 43.704, both P < 0.05]. The VAS score at 3 months after surgery was lower than that at 1 month after surgery ( t = 10.996, P < 0.05). Serum tumor necrosis factor-α, C-reactive protein and interleukin-6 levels at 1 and 3 months after surgery were significantly decreased compared with before surgery ( t = 14.798, 29.598, 30.599, 47.970, 17.161, 31.587, all P < 0.05). Serum tumor necrosis factor-α, C-reactive protein and interleukin-6 levels at 3 months after surgery were significantly lower than those at 1 month after surgery ( t = 14.401, 21.218, 17.513, all P < 0.05). The World Health Organization Quality of Life-BREF score at 1 and 3 months after surgery were significantly increased compared with before surgery ( t = 17.803, 36.482, both P < 0.05). The World Health Organization Quality of Life-BREF score at 3 months after surgery was significantly higher than that at 1 month after surgery ( t = 10.488, P < 0.05). Conclusion:VSD negative pressure suction combined with Masquelet technique for the treatment of open comminuted fractures of limbs exhibits good efficacy, can alleviate pain, reduce inflammatory reactions, improve quality of life, and thereby is of important clinical value.

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