Fracture healing is an issue that has not yet been fully elucidated. It is generally accepted in the literature that
There is evidence that fractures heal more rapidly in patients with
There is evidence to suggest that fractures heal more rapidly in patients with a
To evaluate the functional outcome of open humerus diaphyseal fractures treated with the Three-stitch technique of antegrade humerus nailing. This is a retrospective study conducted at the Department of Orthopaedics in D. Y. Patil University, School of Medicine, Navi Mumbai, India. The study included 25 patients who were operated on from January 2019 to April 2021 and follow-ups done till May 2022. Inclusion criteria were adult patients with open humerus diaphyseal fractures (Gustilo-Anderson Classification). All patients with closed fractures, skeletally immature patients, and patients with associated
The Dumfries and Galloway Royal Infirmary (DGRI) catchment area encompasses 5 of the “7 Stanes” mountain bike trails which had approximately 165000 visitors in 2010. Using our hospital coding system we identified potential mountain bike injuries in 2010. Patient postcode, injuries, operating theatre time and number of clinic appointments was recorded. We confirmed mountain bike related hospital admissions in 29 patients. 13 patients had local (DG) postcodes and 16 had non-DG post codes. The DG postcode patients required 41 bed days, 8 operations, 400 minutes theatre time, and 35 DGRI clinic appointments. The non-DG postcodes required 50 bed days, 11 operations, 730 minutes theatre time, 3 DGRI clinic appointments and 8 outpatient referrals to other hospitals. Totals for all postcodes were 91 bed days, 19 operations, 1130 minutes theatre time and 38 DGRI clinic appointments. The surgeries comprised: 2 ankle ORIF; 1 subsequent removal of syndesmosis screw; 5 wrist/forearm manipulations (+/−kwires); 2 distal radius ORIF; 1 DHS; 2 shoulder MUA, 1 calcaneus ORIF, 4 wound debridements, 1 facial wound closure. Other noteworthy admissions were 5
Systemic factors are believed to be pivotal for the development of heterotopic ossification in severely-injured patients. In this study, cell cultures of putative target cells (human fibroblastic cells, osteoblastic cells (MG-63), and bone-marrow stromal cells (hBM)) were incubated with serum from ten consecutive polytraumatised patients taken from post-traumatic day 1 to day 21 and with serum from 12 healthy control subjects. The serum from the polytraumatised patients significantly stimulated the proliferation of fibroblasts, MG-63 and of hBM cells. The activity of alkaline phosphatase in MG-63 and hBM cells was significantly decreased when exposed to the serum of the severely-injured patient. After three weeks in 3D cell cultures, matrix production and osteogenic gene expression of hBM cells were equal in the patient and control groups. However, the serum from the polytraumatised patients significantly decreased apoptosis of hBM cells compared with the control serum (4.3% Increased proliferation of osteoblastic cells and reduced apoptosis of osteoprogenitors may be responsible for increased osteogenesis in severely-injured patients.
Injuries to the spinal cord may be associated with increased healing of fractures. This can be of benefit, but excessive bone growth can also cause considerable adverse effects. We evaluated two groups of patients with fractures of the spinal column, those with neurological compromise (n = 10) and those without (n = 15), and also a control group with an isolated fracture of a long bone (n = 12). The level of transforming growth factor-beta (TGF-β), was measured at five time points after injury (days 1, 5, 10, 42 and 84). The peak level of 142.79 ng/ml was found at day 84 in the neurology group (p <
0.001 Our findings suggest that TGF-β may have a role in the increased bone turnover and attendant complications seen in patients with acute injuries to the spinal cord.