ABSTRACT
Technological and tissue engineering have enabled available, biologically inert, and low cost materials to be considered as viable alternatives in the surgical treatment of long bone fractures in birds. The aim of this study was to microscopically analyse osteotomized humerus of birds following the insertion of solid laser-sintered polyamide 12 rods in order to detect foreign body reaction and, thus, verify the bioinert property of the material in the bone fracture environment. Polyamide 12 intramedullary rods were inserted into the osteotomized humerus of 10 birds (white Plymouth Rock) and blocked using 2mm diameter cortical screws of varying lengths. The birds were operated at 60 days of age and monitored post-operatively for three months. Animals were euthanized at 150 days old and samples of the operated humerus collected for immunohistochemistry, light and scanning electron microscopy analysis. Results show bone consolidation without rejection of the implant and absence of inflammatory cells. Vascular Endothelial Growth Factor (VEGF) was expressed in the endothelial cells of the blood vessels at the site of the newly formed bone surrounding the implant, indicative of local angiogenesis. There was no bone growth on the surface of the rod; however, the implant did not interfere with the circumjacent bone repair. Thus, the findings of this study corroborate with the literature in characterizing polyamide as a bioinert material and, under the studied conditions, it can be concluded that polyamide 12 intramedullary rod is biocompatible and provides adequate bone consolidation in humeral fractures with no signs of rejection.(AU)
Com o desenvolvimento tecnológico e crescimento da engenharia de tecidos, o uso de materiais disponíveis, bioinertes e debaixo custo pode ser alternativa viável para o tratamento cirúrgico de fraturas em ossos longos nas aves. O objetivo do estudo foi realizar avaliação microscópica óssea após a implantação de haste maciça de poliamida, implantada em úmeros osteotomizados de galinhas para detectar reação do tipo corpo estranho, verificando a propriedade "bioinerte" do material no ambiente de fratura óssea. Foram utilizados 10 galos (Plymouth rock branca) e implantou-se a haste perfazendo o bloqueio das mesmas com parafusos corticais de 2 mm de diâmetro com comprimentos de acordo com a necessidade. As aves foram operadas aos 60 dias de vida e o acompanhamento pós-operatório ocorreu por três meses. Após a eutanásia, foram realizadas coletas do úmero operado (local de consolidação óssea) paraexame histopatológico, imuno-histoquímico e de microscopia eletrônica de varredura. Os resultados demonstraram consolidação óssea, sem presença de rejeição do material, com ausência de células inflamatórias. A neoformação óssea ao redor do implante expressou VEGF (fator de crescimento endotelial vascular) nas células endoteliais dos vasos sanguíneos caracterizando angiogênese no local. Na região de interface de tecido ósseo com a poliamida não foram observadas micro fraturas. Não houve crescimento ósseo na superfície da haste, porém a mesma não atrapalhou o reparo ósseo circunjacente. Assim, esse estudo corrobora com a literatura caracterizando a poliamida como um material bioinerte, e nas condições estudadas pode-se concluir que o uso da haste intramedular de poliamida 12 proporcionou consolidação óssea nesse modelo biológico nesse tipo de fratura, não havendo indícios de induzir rejeição.(AU)
Subject(s)
Animals , Biocompatible Materials , Biocompatible Materials/adverse effects , Chickens , Fracture Fixation, Internal/veterinary , Fracture Fixation, Intramedullary/veterinary , Host vs Graft Reaction , NylonsABSTRACT
Osteogenesis imperfecta (OI, Fragilitis Ossium or Brittle bone disease) is a group of rare inherited disorders with a broad spectrum of clinical and genetic variability. It is characterized by fragile bones that are prone to fracture often from mild trauma or with no apparent cause. People with OI are born with defective connective tissue or without the ability to make it, usually because of a deficiency of Type1 collagen. Incidence of OI is estimated to be one per twenty thousand live births. Eight types of OI can be distinguished. Most cases are caused by mutations in the COL1A1 and COL1A2 genes. We have reported a special case of OI, probably belonging to Type III group. The subject visited the PMR (Physical Medicine & Rehabilitation) OPD of Bankura Sammilani medical college (BSMC), Bankura ,West Bengal, India.. The details of etiology, diagnosis, genetic causes and treatment will be discussed in the study. Diagnosis of OI is based on clinical features and may be confirmed by collagen or DNA testing. There is no cure for OI. Our management is aimed at increasing over all bone strength to prevent fracture and maintain mobility. Nevertheless, life style modifications by adaptive equipments, oral drugs (Bisphosphonates) and Intramedullary rod insertions, provide a significant degree of autonomy to OI patients.
ABSTRACT
Three children with osteogenesis imperfecta who were treated with fragmentation, realignment and intramedullary rod fixation (Sofield and Millar, 1959) have been followed up for considerable period. Repeated fractures in other sites as well as deformities occurred in overgrown part as the children grew up necessitated further operations of same kind. However, level of activity afterwards was found very much enhanced by the operations in general.