Bone callus formation is highly disrupted by dietary restriction in growing rats sustaining a femoral fracture

Abstract Purpose: To evaluate the effects of food restriction on fracture healing in growing rats. Methods: Sixty-eight male Wistar rats were assigned to two groups: (1) Control and (2) Dietary restriction. After weaning the dietary restricted animals were fed ad libitum for 42 days with 50% of the standard chow ingested by the control group. Subsequently, the animals underwent bone fracture at the diaphysis of the right femur, followed by surgical stabilization of bone fragments. On days 14 and 28 post-fracture, the rats were euthanized, and the fractured femurs were dissected, the callus was analyzed by dual-energy X-ray absorptiometry, micro-computed tomography, histomorphometry, mechanical tests, and gene expression. Results: Dietary restriction decreased body mass gain and resulted in several phenotypic changes at the bone callus (a delay in cell proliferation and differentiation, lower rate of newly formed bone and collagen deposition, reductions in bone callus density and size, decrease in tridimensional callus volume, deterioration in microstructure, and reduction in bone callus strength), together with the downregulated expression of osteoblast-related genes. Conclusion: Dietary restriction had detrimental effects on osseous healing, with a healing delay and a lower quality of bone callus formation.

Nandrolone decanoate appears to increase bone callus formation in young adult rats after a complete femoral fracture

Abstract Purpose: To evaluate the influence of nandrolone decanoate on fracture healing and bone quality in normal rats. Methods: Male rats were assigned to four groups (n=28/group): Control group consisting of animals without any intervention, Nandrolone decanoate (DN) group consisting of animals that received intramuscular injection of nandrolone decanoate, Fracture group consisting of animals with a fracture at the mid-diaphysis of the femur, and Fracture and nandrolone decanoate group consisting of animals with a femur fracture and treatment with nandrolone decanoate. Fractures were created at the mid-diaphysis of the right femur by a blunt trauma and internally fixed using an intramedullary steel wire. The DN was injected intramuscularly twice per week (10 mg/kg of body mass). The femurs were measured and evaluated by densitometry and mechanical resistance after animal euthanasia. The newly formed bone and collagen type I levels were quantified in the callus. Results: The treated animals had longer femurs after 28 days. The quality of the intact bone was not significantly different between groups. The bone callus did show a larger mass in the treated rats. Conclusion: The administration of nandrolone decanoate did not affect the quality of the intact bone, but might have enhanced the bone callus formation.

Whole-body vibration improves fracture healing and bone quality in rats with ovariectomy-induced osteoporosis

PURPOSE: To investigate the effect of vibration therapy on the bone callus of fractured femurs and the bone quality of intact femurs in ovariectomized rats. METHODS: Fifty-six rats aged seven weeks were divided into four groups: control with femoral fracture (CON, n=14), ovariectomized with femoral fracture (OVX, n=14), control with femoral fracture plus vibration therapy (CON+VT, n=14), and ovariectomized with femoral fracture plus vibration therapy (OVX+VT, n=14). Three months after ovariectomy or sham surgery, a complete fracture was produced at the femoral mid-diaphysis and stabilized with a 1-mm-diameter intramedullary Kirschner wire. X-rays confirmed the fracture alignment and fixation. Three days later, the VT groups underwent vibration therapy (1 mm, 60 Hz for 20 minutes, three times per week for 14 or 28 days). The bone and callus quality were assessed by densitometry, three-dimensional microstructure, and mechanical test. RESULTS : Ovariectomized rats exhibited a substantial loss of bone mass and severe impairment in bone microarchitecture, both in the non-fractured femur and the bone callus. Whole-body vibration therapy exerted an important role in ameliorating the bone and fracture callus parameters in the osteoporotic bone. CONCLUSION: Vibration therapy improved bone quality and the quality of the fracture bone callus in ovariectomized rats.

Diaphyseal femoral fractures; outcome treated with close vs open

The femur fractures usually happen with oomph forces like motor vehicle accidents. To assess the mode of injury and complications of the management, in diaphyseal femoral fractures, in comparison of close versus open intramedullary interlocking nail [IMN]. Experimental and comparative study. April 2013 to March 2014. Department of Orthopaedic Surgery, Peoples University of Medical and Health sciences, Nawabshah. The cases were divided into two groups A and B. Group A was treated by open nailing [n = 20] and group B by close nailing [n = 20], all the cases were operated within 48 hours of admission. All the data were recorded on well structured proforma. Serial radiographies were performed at 3, 6, 12 weeks, and 6 months; additional radiographies were performed as needed postoperatively. Knee, ankle, and hip motions were begun and protected weight bearing was started on the second day postoperatively and increased gradually to full WB depending on x-ray findings of callus formation. The patients were followed for two years. Results of open and closed I.M.N were assessed and the complications if any were observed over a mean follow-up period of two years. The mean age in group A was 29.40 years and the mean age in group B was 30.45 years. Out of 40 cases, 32[80.0%] were males with male to female ratio 1:4. Mean +/- SD hospital stay was 19.80 +/- 14.60 days in group A, and 17.90 +/- 5.95 days in group B [p value 0.55]. Average time between injury and admission was 1.53 days [n = 40], in the group A it was 1.05 days, and in the group B it was 2.0 days [p value 0.03]. The average of time between injury and operation in the group A was 8.75 days, and in the group B, it was 8.20 days, [p value 0.71]. The average of time between admission and discharge in the group A was 11.0 days, and in the group B was 9.15 days, [p value 0.55]. Mean +/- SD union time was 11.70 +/- 6.45 weeks, in group A and 11.90 +/- 5.77 weeks, in group B. [p value 0.91]. All the patients had full ranged of hip motion and 2 [10.0%] patients of group A had mild limitation of knee motion with a flexion ranges between 80 and 110 degrees. Final functional results based on Thoresen BO criteria16. Excellent results were observed in 19 [47.5%] cases, out of them 5[25.0%] were in group A and 14[70.0%] were in group B. Good results were found in 13[32.5%] patients, out of these 7[35.0%] were in group A and 6[30.0%] were in group. Fair and poor results were detected in 4[10.0%] cases of group A. Road traffic accidents by motorcycle was found the commonest [47.5%] cause of femur fracture, a few complications were observed in open interlocking nailing as compared to closed interlocking nails

Avaliação do reparo ósseo por microtomografia por raio-X / Fracture healing valuation using X-ray microtomography

A microtomografia 3D por raio-X proporciona medidas quantitativas e tridimensionais da estrutura do calo eessas medidas podem potencialmente estar relacionadas com a resistência do calo. A avaliação quantitativa do reparo ósseo por meio de novas metodologias tem importante aplicação nas pesquisas experimentais relacionadas a tecnologias invasivas e não invasivas para a estimulação do mesmo. O objetivo desse estudo foi avaliar o reparo ósseo por meio da µCT em defeito ósseo em fêmur de rato. Trinta ratos machos da classe Wistar com peso médio de 300g foram divididos em grupos experimentais de 10 animais em cada grupo. Os animais foram anestesiados e um furo com 1,2mm de diâmetro foi realizada na porção medialdo fêmur utilizando-se uma broca odontológica. No 7º, 14º e 21ºpós-cirúrgico, os animais dos grupos experimentais 1, 2 e 3, respectivamente, foram sacrificados e o fêmur esquerdo excisado. Os fêmures foram envolvidos em gaze e mergulhas em solução PBS e armazenados em um saco plástico em freezer a -20º atéa análise microtomográfica. Os fêmures foram escaneados pelo microtomógrafo 1172 (SkyScan, Bélgica). Os softwares NRecon, Dataviewer, CT-Analyzer and CT-Vol, fornecidos pelo fabricantedo microtomógrafo, foram utilizados para as seguinte análises: a) análise visual das reconstruções microtomográficas dos fêmures através de secções transversais, coronais e sagitais; b) segmentação do calo ósseo nas reconstruções através de algoritmo de processamento de imagem para quantificação dos parâmetros volume total do calo ósseo (TV), volume do calo ósseo mineralizado (BV), relação BV/TV e densidade mineral óssea volumétrica do calo ósseo (BMD); c) visualização 3D do calo ósseo. A análise estatística dos parâmetros medidos utilizou o teste t de Student com um nível de significância p < 0,05. Houve um aumento estatisticamente significante nos valores dos parâmetros BV/TVe BMD na comparação entre os grupos experimentais 1 e 2...

X-ray microtomography (uCT) provides quantitative and three dimensional measurements of the callus structure and these measurements could potentially be related to callus strength. The assessment of bone repair through new methodologies hasimportant application in animal investigations regarding invasive ornon invasive technologies for the stimulation of bone healing. The aim of this investigation was the use of µCT for the assessment of bone repair in a rat femur bone defect. Thirty male Wistar rats weighting about 300g were divided in three experimental groupswith 10 animals on each group. The animals were anesthetized and a circular hole with a 1.2mm diameter was generated at the medial region of the left femur using a dental drill. At the 7th, 14th and 21st day after surgery the animals of experimental groups 1, 2 and 3, respectively, were sacrificed and the left femur excised. The femurs were wrapped in gauze immersed in phosphate-bufferedsolution and stored in a plastic bag at -20o C until the analysis bymicrotomograph. The femurs were scanned by the 1172 microtomograph(SkyScan, Belgium). The softwares NRecon, Dataviewer, CT-Analyzer and CT-Vol, provided by the microtomograph manufacture, were used for the following assessments: a) visual examination of the femurs microtomographic reconstructions usingtransversal, coronal and sagittal sections; b) segmentation of the bone callus in the reconstructions using an image processing algorithm to quantify the parameters total bone callus volume(TV), volume of the mineralized bone callus (BV), the ratio BV/TV and the volumetric bone callus mineral density (BMD); c) 3D rendering of the bone callus. The statistical analysis of themeasured parameters was performed by the Student t test with a level of significance p < 0.05. There was a statistically significant increase in the mean values of the parameters BV/TV and BMD in the comparison of experimental groups 1 and 2...

A new hypothesis for faster healing of fractures in head injured patients.

A new hypothesis has been proposed to explain excessive callus formation seen after injury to brain or spinal cord. Nervous tissue is very active metabolically and when damaged or inflammed it extracts, utilises and inactivates most of the corticosteroids and other anti-inflammatory substances present in the blood. Therefore now very little active corticosteroids are left to exhibit the inhibitory effect on callus formation. This leads to faster fracture healing with excessive callus formation in head or spinal cord injured patients.

Alargamiento con el aparato de De Bastiani en pacientes con secuelas poliomielíticas / Long-bone lengthening by the De Bastiani external fixator in patients who have polio sequelae

Se realizaron 36 alargamientos en un periodo comprendido de septiembre de 1990 a agosto de 1993, usando la técnica de callotaxis con aparato de De Bastiani en pacientes con discrepancia en la longitud de los miembros pélvicos como secuela de poliomielitis. La edad promedio al momento de la cirugía fue de 15 años nueve meses (11 años seis meses - 19 años tres meses). El acortamiento de la extremidad afectada era en promedio de 72.7 mm. El alargamiento se realizó en 20 fémures y 16 tibias. El alargamiento logrado fue en promedio de 58.7 mm (en el fémur 62.9 mm y en la tibia 53.8 mm). El índice de consolidación (día/cm) fue en promedio para los pacientes en quienes se dinamizó el alargador del 37 (fémur de 36 y tibia de 38.7); y en los que no se dinamizó fue de 39.2 (fémur de 38.7 y tibia de 41.6). Hubo complicaciones en 29 alargamientos (80.55 por ciento); las complicaciones fueron en total 41 (113 por ciento). Existieron en promedio un total de 1.1 complicaciones por paciente. La complicación más frecuente fue la contractura articular. Siete pacientes (19.44 por ciento) no tuvieron ninguna complicación durante su alargamiento, tres en el fémur (15 por ciento) y cuatro en la tibia (25 por ciento). Al dinamizar el aparato de De Bastiani encontramos una corticalización del callo óseo en el sitio del alargamiento más rápido; esto se ve reflejado en un menor índice de consolidación

Charcoal bamboo as a bone substitute: an animal study.

Charcoal bamboo (Bambusae glaucescens) was placed in the resected tibial diaphysis of sixteen New Zealand White rabbits. At two, four and six weeks and again at six months after the operations, four rabbits in each period were killed and all specimens were examined under a light microscope and a scanning electron microscope. The six-week specimens showed that there was neobone invasion into the pores of the charcoal bamboo. There was no evidence of fibroencapsulation or inflammatory response. Due to its structure as a uniform porous material with interconnecting pores and carbon composition, the charcoal bamboo has been proved to be an osteotropic material. Clinical relevance: Charcoal bamboo should be an alternative bone substitute which may be used in humans in the near future. This material is available and easy to produce and prepare in developing countries.

Patrones radiológicos pronósticos del callo de elongación / Radiological patterns that forecast the bone elongation

Realizamos un estudio retrospectivo sobre 127 elongaciones óseas efectuadas en nuestro Depto de Diagnóstico por Imágenes y Ortopedia y Traumatología. El objetivo del trabajo fue poder establecer diferentes patrones radiológicos del foco de elongación, entre los 40 y 60 días de la misma y valorar su repercusión sobre la calidad final del hueso neoformado. La etiología más frecuente fue la acondroplasia, seguida en orden por el síndrome de Turner, postraumático, raquitismo hipofosfatérmico, displasias óseas, secuelas de polio, sepsis de cadera y la enfermedad de Ollier. Los patrones radiológicos se dividieron en dos grupos, metafisarios y diafisarios,según fuese el sitio de realizada la osteotomía percutánea. Dentro de los metafisarios encontramos cuatro patrones radiológicos: fusiforme, en bosque de abedules, excéntrico e hipotrófico. En los diafisarios observamos siete patrones: en bosque de abedules, fusiforme, fusiforme discontinuo, lacunar, en reloj de arena e hipotrófico. Concluimos que en aquellos casos en los cuales encontramos patrones radiológicos en bosque de abedules, fusiforme, fusiforme discontinuo o lacunar, se observó un mejor índice de elongación y una mejor calidad de hueso neoformado. El patrón excéntrico o en reloj de arena necesitó un tratamiento más prolongado (mayor índice de elongación). Ante un patrón hipotrófico se debió efectuar ejercicio del callo de elongación o el aporte de injerto óseo