ABSTRACT
Bone regeneration and healing is an area of extensive research providing an ever-expanding set of not only therapeutic solutions for surgeons but also diagnostic tools. Multiple factors such as an ideal graft, the appropriate biochemical and mechanical wound environment, and viable cell populations are essential components in promoting healing. While bony tissue performs many functions, critical is mechanical strength, followed closely by structure. Many tools are available to evaluate bone quality in terms of quantity, structure, and strength; the purpose of this article is to identify the factors that can be evaluated and the advantages and disadvantages of each in assessing the quality of bone healing in both preclinical research and clinical settings.
Subject(s)
Bone Regeneration , Bone and Bones/pathology , Bone and Bones/physiopathology , Osteoblasts/pathology , Osteogenesis , Wound Healing , Bone Density , Bone Morphogenetic Proteins/metabolism , Bone and Bones/anatomy & histology , Cell Proliferation , Cell Survival , Humans , Tensile Strength , Tissue EngineeringABSTRACT
PURPOSE: The mandible is the most commonly fractured bone in the craniomaxillofacial skeleton among military casualties. The purpose of this study was to characterize the nature and severity of mandibular fractures incurred by US military personnel during combat. MATERIALS AND METHODS: We queried the Joint Theater Trauma Registry from October 2001 to April 2011 using all pertinent International Classification of Diseases, Ninth Revision codes to identify fractures of the mandible. Fractures were then classified based on type and location. Chart reviews were performed on the subset of patients who were treated at San Antonio Military Medical Center to further classify the anatomic pattern and treatment of these fractures. RESULTS: We identified 391 patients with mandibular fractures, of whom 45 were transferred to San Antonio Military Medical Center. Open fractures were seen in 75% of patients. Two or more fractures of the mandible were seen in 51% of patients. Comminuted fractures were present in 84%, and 31% had segmental losses. Eighty-six percent of fractures were operative; two-thirds of patients required a single surgical procedure, whereas the remaining one-third required multiple procedures. Forty-six percent of patients had pan-facial fractures. CONCLUSIONS: Mandibular fractures as a result of combat blast injuries were characterized by a high incidence of open, comminuted, multiple fractures. Associated facial fractures were common.
