scholarly journals A Coupled Computational Framework for Bone Fracture Healing and Long-term Remodelling: Investigating the Role of Internal Fixation on Bone Fractures

2021 ◽  
Author(s):  
Conall Quinn ◽  
Alexander Kopp ◽  
Ted J Vaughan
Keyword(s):  
Internal Fixation ◽  
Fracture Healing ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Computational Modelling ◽  
Fracture Repair ◽  
Time Averaging ◽  
Fixation Devices

In this study, a coupled computational modelling framework for bone fracture repair is presented that enables predictions of both healing and remodelling phases of the fracture region and is used to investigate the role of an internal fixation plate on the long-term healing performance of a fracture tibia under a range of different conditions. It was found that introduction of a titanium plate allowed the tibia to undergo successful healing at higher loading conditions and fracture gaps, compared to the non-plated versions. While these plated cases showed faster rates of repair in the healing phase, their performance was substantially different once they entered the remodelling phase, with substan-tial regions of stress shielding predicted. This framework is one of the few im-plementations of both fracture healing and remodelling phases of bone repair and includes several innovative approaches to smoothing, time-averaging and time incrementation in its implementation, thereby avoiding any unwanted abrupt changes between tissue phenotypes. This provides a better representa-tion of tissue development in the fracture site when compared to fracture healing models alone and provides a suitable platform to investigate the long-term performance of orthopaedic fixation devices. This would enable the more effective design of permanent fixation devices and optimisation of the spatial and temporal performance of bioabsorbable implants

scholarly journals Role of Teriparatide in Accelerating Metatarsal Stress Fracture Healing: A Case Series and Review of Literature

2012 ◽  
Vol 5 ◽  
pp. CMED.S9663 ◽  
Author(s):  
Pooja Raghavan ◽  
Elena Christofides
Keyword(s):  
Fracture Healing ◽  
Bone Fractures ◽  
Case Series ◽  
Bony Union ◽  
Emergency Room Visits ◽  
The Us ◽  
Metatarsal Fractures

Bone fractures are one of the leading causes of emergency room visits worldwide, with approximately 8 million bony fractures occurring annually in the US alone. Although the majority of fractures do not cause significant long-term morbidity and mortality, approximately 10% of these fractures result in impaired fracture healing, drastically affecting quality of life in affected patients. By increasing bone formation, teriparatide, an anabolic agent used in the treatment of postmenopausal osteoporosis, has shown promise in accelerating the rate of fracture healing. We present two patients with impaired healing of metatarsal fractures who were subsequently treated with teriparatide. Both patients experienced successful bony union of the fracture after the use of teriparatide. These findings suggest that teriparatide may be useful in the clinical setting for the acceleration of fracture healing, especially in patients who are at risk for impaired fracture healing.

scholarly journals Pericytes as a Source of Osteogenic Cells in Bone Fracture Healing

2019 ◽  
Vol 20 (5) ◽  
pp. 1079 ◽  
Author(s):  
Sopak Supakul ◽  
Kenta Yao ◽  
Hiroki Ochi ◽  
Tomohito Shimada ◽  
Kyoko Hashimoto ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Bone Fracture ◽  
Bone Fractures ◽  
Callus Formation ◽  
Bone Diseases ◽  
Lineage Tracing ◽  
Osteogenic Potential ◽  
Bone Fracture Healing ◽  
Osteogenic Cells

Pericytes are mesenchymal cells that surround the endothelial cells of small vessels in various organs. These cells express several markers, such as NG2, CD146, and PDGFRβ, and play an important role in the stabilization and maturation of blood vessels. It was also recently revealed that like mesenchymal stem cells (MSCs), pericytes possess multilineage differentiation capacity, especially myogenic, adipogenic, and fibrogenic differentiation capacities. Although some previous studies have reported that pericytes also have osteogenic potential, the osteogenesis of pericytes can still be further elucidated. In the present study, we established novel methods for isolating and culturing primary murine pericytes. An immortalized pericyte line was also established. Multilineage induction of the pericyte line induced osteogenesis, adipogenesis, and chondrogenesis of the cells in vitro. In addition, pericytes that were injected into the fracture site of a bone fracture mouse model contributed to callus formation. Furthermore, in vivo pericyte-lineage-tracing studies demonstrated that endogenous pericytes also differentiate into osteoblasts and osteocytes and contribute to bone fracture healing as a cellular source of osteogenic cells. Pericytes can be a promising therapeutic candidate for treating bone fractures with a delayed union or nonunion as well as bone diseases causing bone defects.

scholarly journals What is the role of ultrasound in fracture management?

2019 ◽  
Vol 8 (7) ◽  
pp. 304-312 ◽  
Author(s):  
J. A. Nicholson ◽  
S. T. J. Tsang ◽  
T. J. MacGillivray ◽  
F. Perks ◽  
A. H. R. W. Simpson
Keyword(s):  
Image Processing ◽  
Fracture Healing ◽  
Bone Fractures ◽  
Therapeutic Ultrasound ◽  
Long Bone ◽  
Future Application ◽  
Current Evidence ◽  
Potential Clinical Benefit ◽  
Fracture Management

Objectives The aim of this study was to review the current evidence and future application for the role of diagnostic and therapeutic ultrasound in fracture management. Methods A review of relevant literature was undertaken, including articles indexed in PubMed with keywords “ultrasound” or “sonography” combined with “diagnosis”, “fracture healing”, “impaired fracture healing”, “nonunion”, “microbiology”, and “fracture-related infection”. Results The use of ultrasound in musculoskeletal medicine has expanded rapidly over the last two decades, but the diagnostic use in fracture management is not routinely practised. Early studies have shown the potential of ultrasound as a valid alternative to radiographs to diagnose common paediatric fractures, to detect occult injuries in adults, and for rapid detection of long bone fractures in the resuscitation setting. Ultrasound has also been shown to be advantageous in the early identification of impaired fracture healing; with the advent of 3D image processing, there is potential for wider adoption. Detection of implant-related infection can be improved by ultrasound mediated sonication of microbiology samples. The use of therapeutic ultrasound to promote union in the management of acute fractures is currently a controversial topic. However, there is strong in vitro evidence that ultrasound can stimulate a biological effect with potential clinical benefit in established nonunions, which supports the need for further investigation. Conclusion Modern ultrasound image processing has the potential to replace traditional imaging modalities in several areas of trauma practice, particularly in the early prediction of impaired fracture healing. Further understanding of the therapeutic application of ultrasound is required to understand and identify the use in promoting fracture healing. Cite this article: J. A. Nicholson, S. T. J. Tsang, T. J. MacGillivray, F. Perks, A. H. R. W. Simpson. What is the role of ultrasound in fracture management? Diagnosis and therapeutic potential for fractures, delayed unions, and fracture-related infection. Bone Joint Res 2019;8:304–312. DOI: 10.1302/2046-3758.87.BJR-2018-0215.R2.

scholarly journals Role of Dynamic Loading on Early Stage of Bone Fracture Healing

2018 ◽  
Vol 46 (11) ◽  
pp. 1768-1784 ◽  
Author(s):  
Smriti Ghimire ◽  
Saeed Miramini ◽  
Martin Richardson ◽  
Priyan Mendis ◽  
Lihai Zhang
Keyword(s):  
Fracture Healing ◽  
Dynamic Loading ◽  
Bone Fracture ◽  
Early Stage ◽  
Bone Fracture Healing

scholarly journals Amygdalin Promotes Fracture Healing through TGF-β/Smad Signaling in Mesenchymal Stem Cells

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Jun Ying ◽  
Qinwen Ge ◽  
Songfeng Hu ◽  
Cheng Luo ◽  
Fengyi Lu ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Fracture Healing ◽  
Bone Fracture ◽  
Transforming Growth Factor ◽  
Bone Fractures ◽  
Conditional Knockout ◽  
Mesenchymal Progenitor Cells ◽  
Bone Fracture Healing ◽  
Smad Signaling

Chondrogenesis and subsequent osteogenesis of mesenchymal stem cells (MSCs) and angiogenesis at injured sites are crucial for bone fracture healing. Amygdalin, a cyanogenic glycoside compound derived from bitter apricot kernel, has been reported to inhibit IL-1β-induced chondrocyte degeneration and to stimulate blood circulation, suggesting a promising role of amygdalin in fracture healing. In this study, tibial fractures in C57BL/6 mice were treated with amygdalin. Fracture calluses were then harvested and subjected to radiographic, histological, and biomechanical testing, as well as angiography and gene expression analyses to evaluate fracture healing. The results showed that amygdalin treatment promoted bone fracture healing. Further experiments using MSC-specific transforming growth factor- (TGF-) β receptor 2 conditional knockout (KO) mice (Tgfbr2Gli1-Cre) and C3H10 T1/2 murine mesenchymal progenitor cells showed that this effect was mediated through TGF-β/Smad signaling. We conclude that amygdalin could be used as an alternative treatment for bone fractures.

scholarly journals Role of Medicinal Plants and Natural Products on Osteoporotic Fracture Healing

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Mohd Azri Abd Jalil ◽  
Ahmad Nazrun Shuid ◽  
Norliza Muhammad
Keyword(s):  
Natural Products ◽  
Medicinal Plants ◽  
Fracture Healing ◽  
Bone Fractures ◽  
Bone Fracture Healing ◽  
Traditional Use ◽  
Eurycoma Longifolia ◽  
Hematoma Formation ◽  
Complex Process

Popularly known as “the silent disease” since early symptoms are usually absent, osteoporosis causes progressive bone loss, which renders the bones susceptible to fractures. Bone fracture healing is a complex process consisting of four overlapping phases—hematoma formation, inflammation, repair, and remodeling. The traditional use of natural products in bone fractures means that phytochemicals can be developed as potential therapy for reducing fracture healing period. Located closely near the equator, Malaysia has one of the world’s largest rainforests, which are homes to exotic herbs and medicinal plants.Eurycoma longifolia(Tongkat Ali),Labisia pumila(Kacip Fatimah), andPiper sarmentosum(Kaduk) are some examples of the popular ethnic herbs, which have been used in the Malay traditional medicine. This paper focuses on the use of natural products for treating fracture as a result of osteoporosis and expediting its healing.

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