scholarly journals Physiology of fracture healing: New aspects

2003 ◽  
Vol 56 (1-2) ◽  
pp. 39-42 ◽  
Author(s):  
Djordje Gajdobranski ◽  
Dragana Zivkovic
Keyword(s):  
Fracture Healing ◽  
Animal Studies ◽  
Healing Process ◽  
Contemporary Literature ◽  
Delayed Union ◽  
Functional Restoration ◽  
Bone Fracture Healing ◽  
Non Union ◽  
Impaired Healing ◽  
High Incidence

Introduction Skeletal system has a great regenerative potential, but it isn't the case with other tissues. Bone fracture healing includes a complex cascade of processes at cellular and biochemical levels, ending with a complete structural and functional restoration of the damaged bone. Impaired healing occurs in 5-10% of all fractures, manifesting as delayed union or non-union Such a high incidence of impaired healing certainly presents a problem, and therefore, permanent research regarding physiology of fracture healing is justified. Phases of fracture healing In this paper we described four phases of fracture healing. They are not clearly separated, but overlap. These data are based on contemporary literature and newest achievements in the field of fracture healing. Discussion Many data regarding this phenomenon were obtained from animal studies, but they may also be applied in human medicine since there is a great similarity between fracture healing in animal models and humans. Conclusion Full and complete knowledge of mechanisms of bioregulation of normal fracture healing process certainly presents the basic prerequisite for successful surgical and orthopedic treatment.

scholarly journals Impaired fracture healing

2003 ◽  
Vol 56 (3-4) ◽  
pp. 146-151 ◽  
Author(s):  
Djordje Gajdobranski ◽  
Dragana Zivkovic
Keyword(s):  
Gene Therapy ◽  
Fracture Healing ◽  
Delayed Union ◽  
Functional Restoration ◽  
Clinical Use ◽  
Bone Fracture Healing ◽  
Non Union ◽  
Impaired Healing ◽  
The World ◽  
Therapeutic Procedures

Introduction Bone fracture healing is a complex cascade of events at cellular and biochemical levels, that ends by complete structural and functional restoration of a damaged bone. Impaired healing develops in 5-10% of all fractures, and manifests as delayed union or non-union. This paper deals with the problem of impaired healing as well as with methods of fracture healing enhancement. Causes of impaired fracture healing There are many factors causing impaired fracture healing (inadequate vascularization, mechanical causes, infection, etc.), and it is very important to recognize the principle cause of delayed union and non-union, since therapy is based on eliminating the factor that causes it. Fracture healing enhancement Through constant attempts to find adequate solutions and procedures in order to resolve the problem of impaired fracture healing, many alternatives in treatment of impaired healing have been developed. Some of these procedures may also be useful in treatment of fresh fractures, especially when it comes to fractures that are prone to delayed union and non-union more than usual. All currently known methods of healing enhancement may be classified as biological, mechanical and biophysical. Conclusion Certain methods are in clinical use for several decades. The newest methods, such as locally applied growth factors, composite biosynthetic grafts, gene therapy and systemic approaches are studied all around the world, and are on the verge of clinical application. Due to impressive number of therapeutic options, certain therapeutic procedures of choice will be developed for specific impairments.

In silico design of treatment strategies in wound healing and bone fracture healing

2010 ◽  
Vol 368 (1920) ◽  
pp. 2683-2706 ◽  
Author(s):  
L. Geris ◽  
R. Schugart ◽  
H. Van Oosterwyck
Keyword(s):  
Mathematical Models ◽  
Fracture Healing ◽  
Bone Fracture ◽  
In Silico ◽  
Healing Process ◽  
Treatment Strategies ◽  
Experimental Models ◽  
Bone Fracture Healing ◽  
Impaired Healing ◽  
Healing Processes

Wound and bone fracture healing are natural repair processes initiated by trauma. Over the last decade, many mathematical models have been established to investigate the healing processes in silico , in addition to ongoing experimental work. In recent days, the focus of the mathematical models has shifted from simulation of the healing process towards simulation of the impaired healing process and the in silico design of treatment strategies. This review describes the most important causes of failure of the wound and bone fracture healing processes and the experimental models and methods used to investigate and treat these impaired healing cases. Furthermore, the mathematical models that are described address these impaired healing cases and investigate various therapeutic scenarios in silico . Examples are provided to illustrate the potential of these in silico experiments. Finally, limitations of the models and the need for and ability of these models to capture patient specificity and variability are discussed.

scholarly journals CLINICAL APPLICATION OF BONE MORPHOGENETIC PROTEIN ON FRACTURE HEALING PROCESS

2019 ◽  
Vol 6 (2) ◽  
pp. 48
Author(s):  
Riko Febrian Kunta Adjie
Keyword(s):  
Fracture Healing ◽  
Clinical Application ◽  
Bone Morphogenetic Proteins ◽  
Bone Healing ◽  
Healing Process ◽  
Delayed Union ◽  
Non Union ◽  
Morphogenetic Protein ◽  
Number Of Patients ◽  
And Function

Delayed union or non-union often occurs in bone healing fracture process. The clinical application of Bone Morphogenetic Proteins (BMPs) has helped an increasing number of patients achieve bone regeneration in clinical area lacking simple solutions for difficult bone healing situations. Many researches has proved that BMPs improved fracture healing regeneration. In this review article, introduction and current clinical issues are summarized on efficacy and function of BMPs. Currently, rhBMP-2 and rhBMP-7 have shown clinical significance but other subfamily members of BMPs still lacked of evidence.

Ultrasonic Diagnosis for Bone Fracture Healing Process

2020 ◽  
Author(s):  
Satoshi Kimura ◽  
Keisuke Oe ◽  
Yohei Kumabe ◽  
Tomoaki Fukui ◽  
Takahiro Niikura ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Bone Fracture ◽  
Healing Process ◽  
Ultrasonic Diagnosis ◽  
Bone Fracture Healing

Radiographic Long Bone Fracture Healing Scores: Can they predict non-union?

Injury ◽  
2020 ◽  
Vol 51 (8) ◽  
pp. 1693-1695
Author(s):  
George D. Chloros ◽  
Anthony Howard ◽  
Vincenzo Giordano ◽  
Peter V. Giannoudis
Keyword(s):  
Fracture Healing ◽  
Bone Fracture ◽  
Long Bone ◽  
Bone Fracture Healing ◽  
Non Union ◽  
Long Bone Fracture

PREDICTION OF THE TREND OF BONE FRACTURE HEALING BASED ON THE RESULTS OF THE EARLY STAGES SIMULATIONS: A FINITE ELEMENT STUDY

2019 ◽  
Vol 19 (05) ◽  
pp. 1950021
Author(s):  
JALIL NOURISA ◽  
GHOLAMREZA ROUHI
Keyword(s):  
Finite Element ◽  
Fracture Healing ◽  
Bone Fracture ◽  
Mechanical Stability ◽  
Early Stage ◽  
Healing Process ◽  
Fibrous Tissue ◽  
Fe Model ◽  
Bone Fracture Healing ◽  
Early Stages

To date, several studies have implied the importance of early stage mechanical stability in the bone fracture healing process. This study aimed at finding a correlation between the predicted different tissue phenotypes in the early stages of healing and the ultimate healing outcome. For this purpose, the process of fracture healing was numerically simulated employing an axisymmetric bi-phasic finite element (FE) model for three initial gap sizes of 1, 3 and 6[Formula: see text]mm and four initial interfragmentary strains (IFS) of 7%, 11%, 15% and 19%. The model was validated with experimental and other numerical studies from the literature. Results of this study showed that the amount of cartilage and fibrous tissue observed in the early stage after fracture can be used to qualitatively assess the outcome of complete bone healing process. Greater amount of cartilage in early stage of healing process yielded faster callus maturation, and delayed maturation of callus was predicted in the case of high fibrous tissue production. Results of this study can be used to provide an estimation of the performance of different fixation systems by considering the amounts of cartilage and fibrous tissues observed in the early stage of healing.

scholarly journals Management of Alveolar Osteitis in Dental Practice: A Literature Review

2017 ◽  
Vol 1 (34) ◽  
pp. 147-155
Keyword(s):  
Clinical Studies ◽  
Animal Studies ◽  
English Language ◽  
Case Reports ◽  
Healing Process ◽  
Third Molar ◽  
Exclusion Criteria ◽  
Dry Socket ◽  
High Incidence ◽  
Alveolar Osteitis

Background: Dry socket is one of the most common post-extraction complications with its incidence reaching up to 30% after impacted third molar extractions. In spite of its high incidence, there is no established treatment for the condition. Objectives: To investigate how efficient different management methods of Alveolar osteitis are, in regards to pain relief, healing process and reduction of the incidence. Materials and Methods: A literature search of “PubMed-MEDLINE” database was conducted using the keywords “dry socket management”, “alveolar osteitis”, “fibrinolytic alveolitis”, “post-extraction complications”. The inclusion criteria were clinical studies, case reports, reviews and human studies, related to alveolar osteitis published from 2011-2016, written in English language. The exclusion criteria were animal studies, studies that discussed other post-extraction complications, and in any other languages than English. Results: 63 articles were found and only 31 were reviewed. 18 out of 31 articles were included in the results, after reading the full text, due to lack of significant results in the rest of the articles. Out of these there were 12 clinical studies, 3 systematic reviews and 1 retrospective study. Conclusion: It was concluded that there is no specific management that could be rated as the best to treat dry socket, due to the lack of evidence to support the use of one management over the other, although there are many options that can help manage it and have proved to be highly effective recently and until today.

scholarly journals Knockdown of SERPINB2 enhances the osteogenic differentiation of human bone marrow mesenchymal stem cells via activation of the Wnt/β-catenin signalling pathway

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kai Hang ◽  
Li Ying ◽  
Jinwu Bai ◽  
Yibo Wang ◽  
Zhihui Kuang ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Osteogenic Differentiation ◽  
Bone Fracture ◽  
Osteoblast Differentiation ◽  
Tibial Fracture ◽  
Bone Fractures ◽  
Bone Fracture Healing ◽  
Non Union

Abstract Background Globally, bone fractures are the most common musculoskeletal trauma, and approximately 8–10% of cases that fall into the categories of delayed or non-union healing. To date, there are no efficient pharmacological agents to accelerate the healing of bone fractures. Thus, it is necessary to find new strategies that accelerate bone healing and reduce the incidence of non-union or delayed fracture healing. Previous studies have revealed that the plasminogen activation system has been demonstrated to play an important role in bone metabolism. However, the function of SERPINB2 in the osteogenesis of hBMSCs remains unclear. Therefore, in this study, we investigated the effects and mechanism of SERPINB2 on osteogenic differentiation. Methods We investigated the osteogenesis effects of hBMSCs by both exogenous SerpinB2 protein and SERPINB2 gene silencing in vitro. Cell proliferation assay was used to assess the effect of exogenous SerpinB2 or SERPINB2 silencing on proliferation of hBMSCs. qPCR and Western blotting analysis detected the expression of target genes and proteins respectively. ALP staining was used to evaluated ALP activity and Alizarin Red staining (ARS) was used to evaluate mineral deposition. In vivo, a murie tibial fracture model was established, histological evaluation and radiographic analysis was used to confirm the therapeutic effects of SERPINB2 silencing in fracture healing. Statistical significance between two groups was determined by Student’s t test, one-way ANOVA or Bonferroni’s post-hoc test according to the distribution of the tested population. Results The addition of exogenous SerpinB2 protein inhibted osteoblast differentiation of hBMSCs in vitro, while SERPINB2 gene silencing significant promote osteoblast differentiation of hBMSCs in vitro. And silenced SERPINB2 gene also increased mineral deposits. Moreover, β-catenin levels were up-regulated by SERPINB2 gene depletion. And the enhancement of osteogenic differentiation induced by SERPINB2 silencing was almost inhibited by specific Wnt/β-catenin signaling pathway inhibitor. In a murine tibial fracture model, local injection of SERPINB2 siRNA improved bone fracture healing. Conclusions Taken together, these findings indicate that SERPINB2 silencing promoted osteogenic differentiation of BMSCs via the Wnt/β-catenin signaling pathway, and silenced SERPINB2 in vivo effectively promotes fracture healing, suggesting that SERPINB2 may be a novel target for bone fracture healing.

scholarly journals Influence of high-frequency cyclical stimulation on the bone fracture-healing process: mathematical and experimental models

2011 ◽  
Vol 369 (1954) ◽  
pp. 4278-4294 ◽  
Author(s):  
María José Gómez-Benito ◽  
Libardo Andrés González-Torres ◽  
Esther Reina-Romo ◽  
Jorge Grasa ◽  
Belén Seral ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Bone Healing ◽  
Mechanical Stimulation ◽  
Bone Fracture ◽  
High Frequency ◽  
Endochondral Ossification ◽  
Healing Process ◽  
Bone Fracture Healing ◽  
Bone Healing Process ◽  
Low Magnitude

Mechanical stimulation affects the evolution of healthy and fractured bone. However, the effect of applying cyclical mechanical stimuli on bone healing has not yet been fully clarified. The aim of the present study was to determine the influence of a high-frequency and low-magnitude cyclical displacement of the fractured fragments on the bone-healing process. This subject is studied experimentally and computationally for a sheep long bone. On the one hand, the mathematical computational study indicates that mechanical stimulation at high frequencies can stimulate and accelerate the process of chondrogenesis and endochondral ossification and consequently the bony union of the fracture. This is probably achieved by the interstitial fluid flow, which can move nutrients and waste from one place to another in the callus. This movement of fluid modifies the mechanical stimulus on the cells attached to the extracellular matrix. On the other hand, the experimental study was carried out using two sheep groups. In the first group, static fixators were implanted, while, in the second one, identical devices were used, but with an additional vibrator. This vibrator allowed a cyclic displacement with low magnitude and high frequency (LMHF) to be applied to the fractured zone every day; the frequency of stimulation was chosen from mechano-biological model predictions. Analysing the results obtained for the control and stimulated groups, we observed improvements in the bone-healing process in the stimulated group. Therefore, in this study, we show the potential of computer mechano-biological models to guide and define better mechanical conditions for experiments in order to improve bone fracture healing. In fact, both experimental and computational studies indicated improvements in the healing process in the LMHF mechanically stimulated fractures. In both studies, these improvements could be associated with the promotion of endochondral ossification and an increase in the rate of cell proliferation and tissue synthesis.

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