Biomechanical Comparison of Cannulated Screw Osteosynthesis With Tension-Band Wiring for Proximal Fractures of the Fifth Metatarsal (Jones Fracture).

Jones fractures, which lie at the junction of the diaphysis to the metaphysis of the fifth metatarsal, are a well-described clinical issue. There are various surgical approaches, including the commonly performed cannulated screw osteosyntheses, and the less frequently used tension-band approach. The aim is to compare the biomechanical stability of these osteosyntheses. We performed an osteotomy on 16 fresh frozen fifth metatarsal bones from body donors representing a Jones fracture. The fractures were treated pairwise with screw osteosynthesis or tension-band wiring. This was followed by cyclic axial bending until osteosynthesis failure. Stability under axial bending force was higher in the screw osteosynthesis (mean: 70.0 ± 66.5 N) compared to the tension-band wiring (mean: 35.7 ± 23.3 N) group although not reaching statistical significance (p = .116). The study shows no statistically significant difference in biomechanical stability under axial loading between screw osteosynthesis and tension band wiring. Based on the data obtained, no differences can be observed from a biomechanical point of view. The study supports the established method of treating Jones fractures primarily with screw osteosynthesis. In addition, the data suggest that tension band wiring may be a good alternative osteosynthesis, for example, after failed casting treatment or failure of primary osteosynthesis.

Bone morphogenetic protein 2 (BMP2) may contribute to partition of energy storage into visceral and subcutaneous fat depots.

OBJECTIVE: Bone morphogenetic proteins (BMPs) are important regulators of adipogenesis and may play a role in obesity. In this study, the hypothesis that BMP2 is related to adipose tissue (AT) distribution in obesity was tested. METHODS: BMP2 serum concentration (n = 439) and BMP2 and Schnurri-1 and -2 mRNA expression were measured in paired samples of visceral and subcutaneous AT from 547 individuals with a wide range of body mass index. In addition, a single nucleotide polymorphism rs979012 in the BMP2 gene was genotyped for subsequent association studies on quantitative traits related to obesity in 631 individuals. RESULTS: BMP2 and Schnurri-1 mRNA were significantly higher in visceral compared with subcutaneous AT. Compared with individuals who were healthy and lean, BMP2 expression in both depots was significantly higher in people with obesity. Significantly higher BMP2 serum concentrations were found in patients with type 2 diabetes with moderate but not morbid obesity. Schnurri-1 and -2 mRNA expression was not related to either BMP2 expression or circulating BMP2. Finally, rs979012 showed nominal association with body mass index and total cholesterol levels. CONCLUSIONS: Data suggest that with increasing demand to store excessive energy, AT BMP2 expression increases and may contribute to partitioning of energy storage into visceral and subcutaneous AT depots.