ZnO-mesoporous glass scaffolds loaded with osteostatin and mesenchymal cells improve bone healing in a rabbit bone defect.

The use of 3D scaffolds based on mesoporous bioactive glasses (MBG) enhanced with therapeutic ions, biomolecules and cells is emerging as a strategy to improve bone healing. In this paper, the osteogenic capability of ZnO-enriched MBG scaffolds loaded or not with osteostatin (OST) and human mesenchymal stem cells (MSC) was evaluated after implantation in New Zealand rabbits. Cylindrical meso-macroporous scaffolds with composition (mol %) 82.2SiO2-10.3CaO-3.3P2O5-4.2ZnO (4ZN) were obtained by rapid prototyping and then, coated with gelatin for easy handling and potentiating the release of inorganic ions and OST. Bone defects (7.5 mm diameter, 12 mm depth) were drilled in the distal femoral epiphysis and filled with 4ZN, 4ZN + MSC, 4ZN + OST or 4ZN + MSC + OST materials to evaluate and compare their osteogenic features. Rabbits were sacrificed at 3 months extracting the distal third of bone specimens for necropsy, histological, and microtomography (µCT) evaluations. Systems investigated exhibited bone regeneration capability. Thus, trabecular bone volume density (BV/TV) values obtained from µCT showed that the good bone healing capability of 4ZN was significantly improved by the scaffolds coated with OST and MSC. Our findings in vivo suggest the interest of these MBG complete systems to improve bone repair in the clinical practice.

Management of sternoclavicular dislocation in young children: considerations about diagnosis and treatment of four cases.

The records of 4 children of under 14 years of age treated at our institution for traumatic sternoclavicular dislocation (SCJ) were reviewed. Closed reduction in posterior SCJ after computed tomography (CT) was successful as immediate procedure. For anterior SCJ instability, open reduction and SCJ reconstruction obtained satisfactory results. Conservative treatment of SCJ subluxation for asymptomatic children was sufficient. Radiographs in "serendipity view" were useful for confirming reduction and stability in children. No postoperative CT was needed for this purpose. Closed reduction in posterior SCJ dislocation and surgical treatment in anterior SCJ dislocation in young children can provide stability and a satisfactory return to a normal function, but with some limitation when intense or competitive shoulder motion is required during sport. Young children and parents should be aware about this possibility. Conservative treatment of SCJ subluxation for asymptomatic children is useful. Reflection is required regarding the correct imaging examination after treatment to check stable reduction in a SCJ injury.

Fractura por estrés del cuello femoral en una niña con síndrome de Down / Femoral neck stress fractures in a young girl with Down’s syndrome

Las fracturas por estrés son lesiones que suelen estar en relación con ciclos repetidos de carga sobre un hueso normal sometido a un exceso de solicitaciones mecánicas, o bien sobre un hueso con resistencia menor. Se presenta el caso de una niña de 5 años con síndrome de Down que acude a la consulta por dificultad de la marcha y dolor inguinal izquierdo de 3-4 días de evolución. En la anamnesis, destaca la tendencia de la niña a realizar saltos repetidos con apoyo monopodálico sobre la extremidad inferior izquierda. La exploración radiológica reveló la existencia de una fractura por estrés del cuello femoral izquierdo. Tras un tratamiento conservador, la paciente presentó una evolución satisfactoria(AU)

Stress fractures are injuries that are often related to repeated cycles of loading on a normal bone subjected to excessive mechanical stress, as well on a bone of less resistance. We report the case of a 5 year old girl with Down syndrome and consults because of her walking difficulty and a left groin pain of 3-4 days duration. In the history highlights the tendency of the girl to make repetitive jumps in monopodal support on the left lower extremity. Radiographic examination revealed a stress fracture of the left femoral neck. After conservative treatment the patient had a satisfactory outcome(AU)

Condromatosis sinovial de cadera en un niño con síndrome de Down / Synovial chondromatosis of the hip in a child with down syndrome

La condromatosis sinovial de la cadera es una patologíapoco frecuente, generalmente benigna que se caracterizapor múltiples cuerpos libres intraarticulares.Se presenta el caso clínico de un paciente de 14 añoscon síndrome Down, afecto de condromatosis sinovialsintomática de cadera, intervenido mediante artrotomíacon control radiológico intraoperatorio para confirmarla exéresis de todos los cuerpos libres.Se revisa la bibliografía sobre las opciones terapéuticas,y los puntos más controvertidos de esta patología (AU)

Synovial chondromatosis of the hip is a rare benigncondition characterized by multiple intraarticular loosebodies. We report the case of a fourteen-year-old childwith Down syndrome who suffered symptomatic synovialchondromatosis of the hip, treated by means ofarthrotomy and intraoperative radiological assessmentto confirm the removal of all loose bodies.The literature about treatment options is reviewed,and controversial points of this condition are discussed (AU)