scholarly journals Comparison of Outcome of Bone Autograft and Allograft in Union of Long Bone Fractures

2021 ◽  
Vol 48 (2) ◽  
pp. 13-18
Author(s):  
H. Valiyollahpoor-Amiri ◽  
S. M. Esmaeilnejad-Ganji ◽  
R. Jokar ◽  
B. Baghianimoghadam ◽  
S. Kamali-Ahangar ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Bone Fractures ◽  
Bone Allograft ◽  
Fracture Site ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Surgical Methods ◽  
Long Bone Fracture ◽  
Bone Autograft

Abstract Background and Purpose There are few studies addressing the rate of application of bone allograft and its use; hence, the present study aimed to compare the clinical outcomes of using bone allograft and autograft in patients with long bone fracture. Method In this clinical trial study, all patients who underwent bone graft surgery with the diagnosed long bone fractures of upper and lower limbs at Shahid Beheshti Hospital were included in the research. Patients were divided into two groups, autograft and allograft, according to type of treatment. They were evaluated for their union, complications, and range of motion. Results In the present study, 124 people were studied. Among them, 100 patients were eligible and included in the study. The allograft and autograft groups did not have any statistical significant differences in terms of age, sex, location, causes of fracture, and surgical methods. Results of the present research on patients in terms of fracture site indicated that there was no significant relationship between the two groups in rate of union (P = 0.18). Allograft and autograft had no difference in terms of complications. Studied range of motion indicated that patients were not different in terms of their ranges of motion. Conclusion Based on findings of the present study, allograft could be a suitable substitute for the autograft. The two graft methods were similar in terms of complications, union, and ranges of motion.

scholarly journals Percutaneous administration of allogeneic bone-forming cells for the treatment of delayed unions of fractures: a pilot study

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Marc Jayankura ◽  
Arndt Peter Schulz ◽  
Olivier Delahaut ◽  
Richard Witvrouw ◽  
Lothar Seefried ◽  
...  
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Phase I ◽  
Bone Fractures ◽  
Fracture Site ◽  
Post Treatment ◽  
Long Bone ◽  
Allogeneic Bone ◽  
Hla Antibodies ◽  
Long Bone Fractures

Abstract Background Overall, 5–10% of fractures result in delayed unions or non-unions, causing major disabilities and a huge socioeconomic burden. Since rescue surgery with autologous bone grafts can cause additional challenges, alternative treatment options have been developed to stimulate a deficient healing process. This study assessed the technical feasibility, safety and preliminary efficacy of local percutaneous implantation of allogeneic bone-forming cells in delayed unions of long bone fractures. Methods In this phase I/IIA open-label pilot trial, 22 adult patients with non-infected delayed unions of long bone fractures, which failed to consolidate after 3 to 7 months, received a percutaneous implantation of allogeneic bone-forming cells derived from bone marrow mesenchymal stem cells (ALLOB; Bone Therapeutics) into the fracture site (50 × 106 to 100 × 106 cells). Patients were monitored for adverse events and need for rescue surgery for 30 months. Fracture healing was monitored by Tomographic Union Score (TUS) and modified Radiographic Union Score. The health status was evaluated using the Global Disease Evaluation (GDE) score and pain at palpation using a visual analogue scale. The presence of reactive anti-human leukocyte antigen (HLA) antibodies was evaluated. Results During the 6-month follow-up, three serious treatment-emergent adverse events were reported in two patients, of which two were considered as possibly treatment-related. None of the 21 patients in the per-protocol efficacy population needed rescue surgery within 6 months, but 2/21 (9.5%) patients had rescue surgery within 30 months post-treatment. At 6 months post-treatment, an improvement of at least 2 points in TUS was reached in 76.2% of patients, the GDE score improved by a mean of 48%, and pain at palpation at the fracture site was reduced by an average of 61% compared to baseline. The proportion of blood samples containing donor-specific anti-HLA antibodies increased from 8/22 (36.4%) before treatment to 13/22 (59.1%) at 6 months post-treatment, but no treatment-mediated allogeneic immune reactions were observed. Conclusion This pilot study showed that the percutaneous implantation of allogeneic bone-forming cells was technically feasible and well tolerated in patients with delayed unions of long bone fractures. Preliminary efficacy evidence is supporting the further development of this treatment. Trial registration NCT02020590. Registered on 25 December 2013. ALLOB-DU1, A pilot Phase I/IIa, multicentre, open proof-of-concept study on the efficacy and safetyof allogeneic osteoblastic cells (ALLOB®) implantation in non-infected delayed-union fractures.

scholarly journals Management of infected non-union of lower limb long bone fractures using ilizarov technique: a study of outcomes

2017 ◽  
Vol 3 (3) ◽  
pp. 557 ◽  
Author(s):  
Hrishikesh Pande ◽  
Chander Mohan Singh ◽  
Anjan Prabhakara ◽  
Vivek Mathew Philip ◽  
Mohd Shezan Iqbal ◽  
...  
Keyword(s):  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bones ◽  
Ilizarov Technique ◽  
Infected Nonunion ◽  
Ring Fixator ◽  
Long Bone Fractures ◽  
Ilizarov Ring Fixator

<p class="abstract"><strong>Background:</strong> Nonunion of long bone fractures is a common condition treated by an orthopaedic surgeon. Many nonunions can be treated effectively by internal fixation with or without bone grafting but, an infected nonunion can prove to be a tough challenge. The Ilizarov method is effective in managing infected nonunion of long bones. This study aims to assess the outcome of management of infected nonunions of long bones of lower limb with Ilizarov Ring fixator using bone and functional results as per Association for the Study and Application of Methods of Ilizarov (ASAMI) Scoring System.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 18 patients (16 Male: 2 Female; Mean age 43.2 years) managed with Ilizarov technique for an infected tibial or femoral nonunion between 01 January 2013 and 31 December 2014. They were followed up for an average of 25.4 months after removal of fixator. They were assessed for functional and Bone (radiological) outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 17 limbs were salvaged and union could be achieved. One limb required amputation due to severe persistent intractable infection. None required any additional skeletal stabilisation after removal of fixator frame except casting in a few patients for a period of 6 weeks. Mean time to union was 211.83 days (range 136 - 320days/median 184) or 7.01 months. As per the ASAMI score, Bone results were excellent in 10, good in 5, fair in 2 and poor in 1. Functionally 7 were graded as excellent, 6 as good, 3 as fair and 1 as poor and 1 patient underwent amputation.</p><p><strong>Conclusions:</strong> The Ilizarov’s method remains one of the most versatile and successful means of achieving bone healing in infected nonunions of long bones of lower limbs with additional benefits of correcting bone defects, deformities and limb length inequalities. </p>

Internal Fixation of Long Bone Fractures in Farm Animals

1993 ◽  
Vol 06 (01) ◽  
pp. 36-41 ◽  
Author(s):  
A. Steiner ◽  
U. Iselin ◽  
C. Lischer ◽  
J. A. Auer
Keyword(s):  
Internal Fixation ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Farm Animals ◽  
Long Bone ◽  
Fracture Treatment ◽  
Long Bone Fractures ◽  
Long Bone Fracture

This study demonstrates that long bone fracture treatment in food and fibre producing animals is in most cases successful. The greatest disadvantage of such treatment are the costs of the surgery and implants.

PREDICTION OF LONG BONE FRACTURES VIA RECONSTRUCTION OF PEDESTRIAN ACCIDENTS USING MULTI-BODY SYSTEM AND FE MODELS

2015 ◽  
Vol 15 (01) ◽  
pp. 1550016 ◽  
Author(s):  
BINGYU WANG ◽  
JIKUANG YANG ◽  
OTTE DIETMAR ◽  
YONG PENG
Keyword(s):  
Lower Extremity ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Long Bone ◽  
Fe Model ◽  
Body System ◽  
Long Bone Fractures ◽  
Long Bone Fracture ◽  
Pedestrian Accidents ◽  
Multi Body

This study aimed at prediction of long bone fractures and analysis of lower extremity injury mechanisms in real world passenger car to pedestrian collision. For this purpose, two cases of car to pedestrian accidents with detail recorded lower extremity injuries were reconstructed using Multi-body system (MBS) and Finite element (FE) models. The MBS models were used to determine lower extremity impact conditions, such as impact velocity, contact location as well as impact orientation. Furthermore, impact conditions were used to define initial boundary conditions in the simulation of lower extremity colliding with car front end using FE models. The bending moment and von Mises stress distributions of long bone were calculated in FE model to evaluate long bone fracture risks. Then, injury outcomes from simulations were compared with hospital recorded injury data. The simulation results of long bone fracture were consistent with the injury pattern and positions from hospital records. Moreover, the calculated fracture moments of tibia and fibula shaft as well as femur neck region were 310.8, 21.4 and 304.7 Nm, respectively. The FE model is capable to reproduce the dynamic injury process and is an effective tool to demonstrate the dynamic response of the injury and to predict the risk of long bone fractures.

Practical Application of Concept "Damage Control" in Treatment of Long Bone Extremity Fractures in Patients with Poly­trauma

2005 ◽  
Vol 12 (1) ◽  
pp. 3
Author(s):  
V. A Sokolov ◽  
E. I Baylik ◽  
P. A Ivanov ◽  
D. A Garaev
Keyword(s):  
Surgical Treatment ◽  
Bone Fractures ◽  
Damage Control ◽  
Long Bone ◽  
Critical Conditions ◽  
Individual Response ◽  
Surgical Interventions ◽  
Trauma Severity ◽  
Long Bone Fractures ◽  
Surgical Methods

On the base of experience in treatment of 646 patients with polytrauma (1995—2004) the necessity to use damage control was for the treatment of long bone fractures was proved. The principle of damage control assumes subdivision of surgical treatment of patients with severe polytrauma into two steps. At the I st step only minimum traumatic procedures were performed. At the 2 nd step major surgical interventions were performed. According to trauma severity and individual response all patients were divided into four groups: stable, borderline, unstable and critical. In patients with stable and borderline conditions major surgical procedures did not result in aggravation of patient's state, therefore one-step surgical treatment was used. In patients with unstable and critical conditions no surgical methods of fixation of long bone fractures were applied at the I st step. In the last two groups definitive fracture fixation were performed at the 2' d step within 4—14 days after injury. The application of damage control allows improving the results of treatment, reducing the rate of complication and lethal outcomes in patients with severe polytrauma.

scholarly journals Risk factors for long-bone fractures in children up to 5 years of age: a nested case–control study

2014 ◽  
Vol 100 (5) ◽  
pp. 432-437 ◽  
Author(s):  
Ruth Baker ◽  
Elizabeth Orton ◽  
Laila J Tata ◽  
Denise Kendrick
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Fractures In Children ◽  
Long Bone Fracture ◽  
Prevention Interventions ◽  
Nested Case Control ◽  
Control Study

AimTo investigate risk factors for first long-bone fractures in children up to 5 years old in order to provide evidence about which families could benefit from injury prevention interventions.MethodsPopulation-based matched nested case–control study using The Health Improvement Network, a UK primary care research database, 1988–2004.Maternal, household and child risk factors for injury were assessed among 2456 children with long-bone fractures (cases). 23 661controls were matched to cases on general practice. Adjusted ORs and 95% CIs were estimated using conditional logistic regression.ResultsFractures of long-bones were independently associated with younger maternal age and higher birth order, with children who were the fourth-born in the family, or later, having a threefold greater odds of fracture compared to first-born children (adjusted OR 3.12, 95% CI 2.08 to 4.68). Children over the age of 1 year had a fourfold (13–24 months, adjusted OR 4.09 95% CI 3.51 to 4.76) to fivefold (37+ months, adjusted OR 4.88 95% CI 4.21 to 5.66) increase in the odds of a long-bone fracture compared to children aged 0–12 months. Children in families with a history of maternal alcohol misuse had a raised odds of long-bone fracture (adjusted OR 2.33, 95% CI 1.13 to 4.82) compared to those with no documented history.ConclusionsRisk factors for long-bone fractures in children less than 5 years old included age above 1 year, increasing birth order, younger maternal age and maternal alcohol misuse. These risk factors should be used to prioritise families and communities for injury prevention interventions.

scholarly journals The experience of use the bioactive coated intramedullary flexible nailiing in treatment of long bone fracture

2021 ◽  
Vol 3 (2) ◽  
pp. 40-47
Author(s):  
Arnold V. Popkov ◽  
Dmitriy A. Popkov ◽  
Konstantin V. Trofimov ◽  
Alexander I. Nikiforov ◽  
Alexey А. Isupov
Keyword(s):  
Bone Formation ◽  
Bone Fracture ◽  
Fracture Zone ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bone Fracture ◽  
Formation Dynamics ◽  
Diaphyseal Fractures ◽  
Intramedullary Implants

The study concerns a new method of treatment of bone fractures of upper and lower limbs based on osteogenesis stimulation by intramedullary implants with bioactive organic hydroxyapatite (HA). The method decreases consolidation period of diaphyseal fractures to 2-4 times. A technology of osteosynthesis and bone formation dynamics at the fracture zone and around the implant is described.

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