The objectives of this study were to investigate the patient characteristics and mortality of Vancouver type B periprosthetic femoral fractures (PFF) subgroups divided into two groups according to femoral component stability and to compare postoperative clinical outcomes according to treatment in Vancouver type B2 and B3 fractures. A total of 126 Vancouver type B fractures were analyzed from 2010 to 2019 in 11 associated centres' database (named TRON). We divided the patients into two Vancouver type B subtypes according to implant stability. Patient demographics and functional scores were assessed in the Vancouver type B subtypes. We estimated the mortality according to various patient characteristics and clinical outcomes between the open reduction internal fixation (ORIF) and revision arthroplasty (revision) groups in patients with unstable subtype.Aims
Methods
Periprosthetic hip fractures (PPFs) after total hip arthroplasty are difficult to treat. Therefore, it is important to identify modifiable risk factors such as stem selection to reduce the occurrence of PPFs. This study aimed to clarify differences in fracture torque, surface strain, and fracture type analysis between three different types of cemented stems. We conducted biomechanical testing of bone analogues using six cemented stems of three different types: collarless polished tapered (CPT) stem, Versys Advocate (Versys) stem, and Charnley-Marcel-Kerboull (CMK) stem. Experienced surgeons implanted each of these types of stems into six bone analogues, and the analogues were compressed and internally rotated until failure. Torque to fracture and fracture type were recorded. We also measured surface strain distribution using triaxial rosettes.Aims
Methods
Postoperative malalignment of the femur is one of the main complications in distal femur fractures. Few papers have investigated the impact of intraoperative malalignment on postoperative function and bone healing outcomes. The aim of this study was to investigate how intraoperative fracture malalignment affects postoperative bone healing and functional outcomes. In total, 140 patients were retrospectively identified from data obtained from a database of hospitals participating in a trauma research group. We divided them into two groups according to coronal plane malalignment of more than 5°: 108 had satisfactory fracture alignment (< 5°, group S), and 32 had unsatisfactory alignment (> 5°, group U). Patient characteristics and injury-related factors were recorded. We compared the rates of nonunion, implant failure, and reoperation as healing outcomes and Knee Society Score (KSS) at three, six, and 12 months as functional outcomes. We also performed a sub-analysis to assess the effect of fracture malalignment by plates and nails on postoperative outcomes.Aims
Methods
It is accepted that the development of scoliosis has a close relationship with physical growth, but the aetiology and mechanism of the disease remain unknown. Few studies have assessed the bone microarchitecture and histomorphological findings in vertebrae. After the occurrence of scoliosis, those include secondary changes caused by mechanical compression. It is important to investigate those data in the period prior to the occurrence of scoliosis.
Study Two: Sixty female Broiler chickens were divided into three groups: the control group (group C, n=20), the sham operation group (group S, n=20), and the pinealectomy group (group P, n=20). Each group was then subdivided into two groups according to the time of sacrificing: 3 days after the operation (group 3-C, 3-S, 3-P, n=10), and six days after the operation (group 6-C, 6-S, 6-P, n=10). Decalcified thin sagittal sections were made using a tartrate-resistant acid phosphatase (TRAP) stain. Histological examinations of the growth plate, trabecular structure and osteoclast number were performed.
Study Two: Nine out of ten chickens in group 6-P showed scoliosis deformity, while the presence of scoliosis was unclear in any of chickens in group 3-P. The osteoclast number increased significantly in group 3-P, compared to groups 3-C and 3-S, and the trabecular thickness was greater in group 3-P than in groups 3-C and 3-S. There was no significant change in the growth plate or in other aspects of the trabecular structure, except for trabecular thickness, in any of the groups. The results of study one showed that the change of microarchitecture might be caused by Wolff’s law and was the secondary response to the scoliotic deformity. Therefore, it was difficult to clarify the cause of scoliosis using micro CT. In study 2 we found that the number of osteoclast increased in pinealectomised chickens after 3 days postoperatively, just before scoliosis began to develop. We also found there was no change in the growth plate. These outcomes suggest that there are no relationships between changes in the growth plate and the development of scoliosis. However, the change in osteoclast number may have a relationship with the development of scoliosis through changes in bone modelling.
