[Outcomes of surgical correction of congenital tibia pseudarthrosis depending on the activation of HHV-6/HHV-7 viral infection in a child with neurofibromatosis type-1].

Neurofibromatosis type-1 (NF-1)--is a common genetic disease effecting the skin, subcutaneous tissue peripheral nerves and bones (tibia pseudarthrosis). Immunomodulatory viruses HHV-6 and HHV-7 are classifying as a genus of roseoloviruses of subfamily beta-herpesviruses. Reactivation of HHV-6 and HHV-7 inhibits immune system and indirectly promote to other infectious agents. The article deals with a unique case repot of two repeated transplantations of fibula due to congenital tibia pseudarthrosis caused by NF-1. Results of the transplantations, related to active and latent HHV-6 and HHV-7 infection in a 6 years old child are discussed in the paper.

[Methylenetetrahydrofolate reductase polymorphism C677T in patients with consolidated fractures and pseudarthrosis of long bones: relationship with homocystein and inflammatory mediators].

In article described research the results of the prevalence of the genetic polymorphism of the gene Methylentetrahydrofolatereductase C677T (MTHFR) in 130 patients with pseudarthrosis of long bones and in those with consolidated fractures. The incidence of allele-T among patients with pseudarthrosis was 1.4 times higher than among those with consolidated fractures. Pathological genotype MTHFR 677-TT was associated with the development avital types of pseudarthrosis and increase the proportion of people with hyperhomocysteinemia, high content of inflammatory mediators and development refracture.

Nanocomposite therapy as a more efficacious and less inflammatory alternative to bone morphogenetic protein-2 in a rodent arthrodesis model.

The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in spine fusion has led to concerns regarding a potential accompanying inflammatory response. This study evaluates a combination therapy (TrioMatrix®; Pioneer Surgical, Inc., Marquette, MI) comprised of a demineralized bone matrix (DBM), hydroxyapatite, and a nanofiber-based collagen scaffold in a rodent spine fusion model. Thirty-six athymic rats that underwent a posterolateral intertransverse spinal fusion were randomly assigned to 1 of 5 treatment groups: absorbable collagen sponge alone (ACS, negative control), 10 µg rhBMP-2 on ACS (positive control), TrioMatrix®, Grafton® (Osteotech, Inc., Eatontown, NJ), and DBX® (Synthes, Inc., West Chester, PA). Both TrioMatrix® and rhBMP-2-treated animals demonstrated 100% fusion rates as graded by manual palpation scores 8 weeks after implantation. This rate was significantly greater than those of the ACS, Grafton®, and DBX® groups. Notably, the use of TrioMatrix® as evaluated by microCT quantification led to a greater fusion mass volume when compared to all other groups, including the rhBMP-2 group. T2-weighted axial MRI images of the fusion bed demonstrated a significant host response associated with a large fluid collection with the use of rhBMP-2; this response was significantly reduced with the use of TrioMatrix®. Our results therefore demonstrate that a nanocomposite therapy represents a promising, cost-effective bone graft substitute that could be useful in spine fusions where BMP-2 is contraindicated.

[Antibodies against staphylococci in patients of a department for orthopedic surgery (author's transl)]. / Staphylokokken-Antikörper-Titer bei unfallchirurgischen Patienten. I. Mitteilung.

Sera from different groups of patients in a department of traumatic surgery were examined for staphylococcal alpha-antitoxin-titres. In comparison to a group of normal controls the following changes were found: 1. Patients, had significantly raised titres, if they had undergone surgery because of closed fractures, pseudarthrosis and luxations and even if the postoperative course was uneventful. This can be explained through the wide-spread occurrence of staphylococci in hospitals, which can invade the organisms through an incision, the skin or mucous membranes. These findings should be kept in mind while estimating staphylococcal antitoxin-titres in patients hospitalized over a long period. 2. Patients suffering from surgical infections and also paraplegics showed still more significantly raised antitoxin-titres in comparison to the normal controls or to patients, who had undergone aseptic surgery. Increased titres were found even in the sera of patients, whose wounds did not drain staphylococcus aureus. Patients suffering from chronic staphylococcal osteomyelitis showed the highest mean values of antitoxin-titres; these patients, however, had also the greatest variations with high and low levels. The question arouse whether a high or a low level corresponds to the severity of the disease. It was found that it is necessary to titrate different antibodies against staphylococcal toxins. In a second paper the results of the simultaneous determination of alpha-antitoxin and anti-PV-leucocidin in patients with posttraumatic bone infections will be presented.