A Salari; M Soleymanha; Dalaleh Khosousi; K Ezzati
Abstract
AbstractIntroduction: Non-union or delayed union after long bone fracture surgery is very common. This study aimed at evaluating the healing time of closed femoral shaft fractures in smokers and non-smokers following open reduction and internal fixation with plate and intramedullary nailing.Methods: ...
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AbstractIntroduction: Non-union or delayed union after long bone fracture surgery is very common. This study aimed at evaluating the healing time of closed femoral shaft fractures in smokers and non-smokers following open reduction and internal fixation with plate and intramedullary nailing.Methods: In a cohort study, patients were divided into two groups of smokers and non-smokers with closed transverse fracture of the femoral shaft bone. The patients who smoked 6 or more cigarettes per day were considered as smoker. Treatment method was based on the patient's preference and not based on being smoker or not. Patients were followed up for one year for clinical and radiological examinations on the status of the union. The collected data were analyzed using SPSS software version 19.Results: In our study, 220 patients were studied (110 smokers and 110 non-smokers). Most of the patients with closed femoral shaft fractures were men (79.7%). Their mean age was 32.78± 16.93 years. There was a statistically significant relationship between the bone healing in treatment with plate and intramedullary nailing in smokers (P = 0.004). All non-smokers had union (100%), 74.1% in the group treated with plate had union and 78.8% in the group treated with intramedullary nailing had union, respectively (P = 0.234) 180 days after surgery. There was also a statistically significant association between delayed union in plate treatment and intramedullary nailing in patients who smoked (P = 0.04).Conclusion: The treatment and daily function of smokers is usually worse than non-smokers and needs longer follow-up. It seems that the intramedullary nailing in smokers with closed femoral shaft fracture leads to more delayed union.
Amin Razi; Mohammad taghi Peivandi; Ali Birjandinejad; Sara Amel Farzad
Abstract
Abstract
Background: Nonunion is a serious complication following long-bone fracture that is known as a therapeutic challenge for surgeons and is associated with significant morbidity. It has been shown that osteogenesis stimulating factors combined with optimization of the mechanical environment could ...
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Abstract
Background: Nonunion is a serious complication following long-bone fracture that is known as a therapeutic challenge for surgeons and is associated with significant morbidity. It has been shown that osteogenesis stimulating factors combined with optimization of the mechanical environment could facilitate and accelerate nonunion healing. In this study, we aimed to treat nonunion using autologous bone marrow-derived mononuclear cell (BMDMC) aspirate as a source of osteoprogenitor cells combined with internal fixation.
Methods: From November 2010 to May 2013, 19 cases of nonunion were treated with bone marrow-derived mononuclear cell (BMDMC) grafting, that included 15 males and 4 females with an average age of 37.8 years (range, 18-81 years). The time from injury to therapy was 7 to 28 months, with an average of 13.4 months. At first, decortications were performed around the nonunion site to prepare a suitable bed for bone marrow grafting. Then, 2 ml of bone marrow concentrated cells was applied to the nonunion site in a mixture with partially demineralized cortical cancellous allograft chips. The healing rate in each patient was clinically and radiologically evaluated every 4 weeks.
Results: Bone union was obtained in 18 of the 19 patients during 1.06 to 6 months with an average time of 3.5 months. No complications during anesthesia nor any infection, hematoma or chronic pain at the nonunion site were observed in any patient.
Conclusion: Transplantation of autologous BMDMC aspirate is a reasonable, effective and easy treatment option for tibial and femoral nonunion after internal fixation.
Trial registration: This study has been registrated in ClinicalTrials.gov (https://clinicaltrials.gov).
TRN:NCT01788059
Siavash Sharifi; Amin Bigham-Sadegh; Ahmad Oryan; Yasamin Alavi
Abstract
AbstractBackground: Nowadays, bone grafts are used in both veterinary and human orthopaedics to stimulate fracture healing and to accelerate the restoration of bone defects. Autografts are still a high standard for comparing different bone-building stimuli. Autografts not only include healing stimulants ...
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AbstractBackground: Nowadays, bone grafts are used in both veterinary and human orthopaedics to stimulate fracture healing and to accelerate the restoration of bone defects. Autografts are still a high standard for comparing different bone-building stimuli. Autografts not only include healing stimulants but also contains cells that do not stimulate immune responses and do not transmit infectious diseases. However, bone grafting is not without side effects such as pain, infection, fracture, blood loss and increased surgical stages, besides the amount of bone removed is limited.Tarantula cubensis venom has an anti-inflammatory and re-epithelialization effect in bovine wound healing on the 14th day; it also plays a role in infection prevention since Theranekron can alter the process of inflammation. This study aims to examine the effect of hydroalcoholic extract of tarantula cubensis on the distal radius fracture healing in rabbitsMethods: This study was conducted on 20 male rabbits, in four study groups of five rabbits. A bone se was extracted from the distal radius. The first group was administrated with one microgram per kilogram of Theranekron injection at the site of the bone defection. The second and third (or negative control) groups were administrated with normal saline injection and no substance (no intervention), respectively. Lastly, the fourth group (or autograft group), the extracted bone segment was returned in its place, and the skin and muscles were sutured. Lateral view radiographs images were taken from rabbits on days of 14, 28, 42 and 56 after surgery.On the eighth week, a bone biopsy was performed to evaluate histopathology. Radiographs and biopsies were statistically examined for fusion rate, ossification activity and remodelling.Results and Conclusion: Both Theranekron and autograft group had similar behaviour and outperformed the normal saline and negative control group; therefore it is concluded that hydroalcoholic extract of tarantula cubensis was effective in distal radius fracture healing.
Mehrdad Yadegari; Amin Bigham-Sadegh; Sanaz Farhang; Sajad Farhangi
Abstract
AbstractBackground & Aim: Nowadays, bone grafts are used in veterinary and human orthopedic to stimulate fracture healing, accelerate joint connection, and healing of bone defects. In this study, we carried out the radiological and histopathological evaluation of the effects of nano-hydroxyapatite ...
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AbstractBackground & Aim: Nowadays, bone grafts are used in veterinary and human orthopedic to stimulate fracture healing, accelerate joint connection, and healing of bone defects. In this study, we carried out the radiological and histopathological evaluation of the effects of nano-hydroxyapatite concurrent with bone marrow treatment on rabbit fracture repair.Materials and Methods: This experimental study was performed in the spring and summer of 2019 on 20 male New Zealand white rabbits (12-month-old, weight=2 kg). The samples were randomly divided into four groups, and bone segments were removed from the radius. In the first group (n=5) (control), the bone defect remained empty and no substance was injected. Meanwhile, the defects in the second, third, and fourth groups (sample size of five in each group) were filled with nano-hydroxyapatite, bone marrow, and combination of nano-hydroxyapatite and bone marrow. Radiographs of the radius in each rabbit were taken at 2nd, 4th, 6th, and 8th post-operative weeks, and bone biopsy was performed in the eighth week for histopathological assessment. In addition, the radiographs and samples were evaluated in terms of union, ossification activity, and re-forming.Results: In this study, there was a significant difference among the groups in the second, fourth, sixth, and eight weeks regarding radiographical assessments (P<0.05). However, the difference was more evident in the sixth week, when a significant difference was found between the nano-hydroxyapatite group and a combination of bone marrow and nano-hydroxyapatite group (P=0.02). In this regard, the latter had a better performance, compared to the former. In histopathological evaluation, the group of a combination of nano-hydroxyapatite and bone marrow showed higher ossification activities, compared to the control group.Conclusion: According to the results of the study, the group of a combination of nano-hydroxyapatite and bone marrow had a better function in terms of bone healing, compared to the other two groups. Therefore, it is suggested that the method be applied to larger animal samples to confirm its clinical implications.
Mehran Soleymanha, MD; Ahmadreza Mirbolook, MD; Hossein Ettehad, MD; Zahra Haghparast-Ghadim-Limudahi
Abstract
Background: Tibial shaft fracture is the most common fractures of long bones. The aim of this study was to report the short-term results of intramedullary (IM) nailing in tibial shaft fractures in emergency setting. Methods: In a prospective study, 226 cases (193 men, 33 women) treated with IM nailing ...
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Background: Tibial shaft fracture is the most common fractures of long bones. The aim of this study was to report the short-term results of intramedullary (IM) nailing in tibial shaft fractures in emergency setting. Methods: In a prospective study, 226 cases (193 men, 33 women) treated with IM nailing during 2 years (2009-2011) in a training hospital in Rasht-Iran, and followed for two years. The mean age was 34±3 years old. We investigated for open or closed fractures, accompanied with fibular fractures, proneal nerve or anterior tibialis artery injury, degenerative changes in knee joint, knee pain, atrophy of quadericeps muscle, mal:::union:::, chronic osteomyelitis, delayed :::union:::, and non:::union:::. Short musculoskeletal function assessment questionnaire (SMFA) was also completed and the data were analysed by statistical software. Results: There were 151 Open fractures and 75 closed fractures. Open procedure was used in 155 cases and closed one in 71 cases. Knee pain was the most frequenct and non :::union::: the least common complication. Musculoskeletal limitation appeared more in open fractures and in association with fibular fracture and was more in female than male patients (p < /i>
Amin Bigham-Sadegh, PhD; Iraj Karimi, PhD; Mohammad Shadkhast, PhD; Mohammad Hossein Mahdavi, DVM
Abstract
Background: Synthetic hydroxyapatite (HAP), beta-tricalcium phosphate (ß-TCP) and their composite are promising biomaterials specifically in the orthopaedic and dental fields, as their chemical composition is similar to that of bone. Due to the need for safer bone graft applications, these bone graft ...
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Background: Synthetic hydroxyapatite (HAP), beta-tricalcium phosphate (ß-TCP) and their composite are promising biomaterials specifically in the orthopaedic and dental fields, as their chemical composition is similar to that of bone. Due to the need for safer bone graft applications, these bone graft substitutes are gradually gaining increased acceptability. The purpose of this study was the evaluation of concurrent use of hydroxyapatite with demineralized calf foetal growth plate (DCFGP) effects on bone healing process.Methods: Mid radii bone defect was created in fifteen female New Zealand white rabbits. They were divided into 3 equal groups: In group I the defect filled with DCFGP, in group II was with hydroxyapatite and DCFGP, and in group III with hydroxyapatite alone. Radiographic and histopathologic evaluations were performed blindly and results scored and analyzed statistically.Results: There was a significant difference in bone formation and remodeling at the 56th post-operative day (p < /em>=.03). Group II was superior to group I and III. Histopathologic evaluation revealed significant difference between group II with group I and III.Conclusions: The combination of osteoconductive effect of hydroxyapatiter and osteoinduction of DCFGP will lead to superior bone healing process in comparison with any of those agents when used alone.
