Fracture repair: modulation of fracture-callus and mechanical properties by sequential application of IL-6 following PTH 1-34 or PTH 28-48.

Fracture healing presents a sequence of three major stages: inflammation and granulation tissue formation, callus formation and remodeling. Our working hypothesis was that fracture-repair might be enhanced by stimulating proliferation of chondrocytes and osteoblasts in the early stages of fracture healing followed by sequential acceleration of the remodeling process. In the present study we employed a novel device developed by us implementing a standardized fracture in rat tibiae.

Enzymatic activities in limb muscles subjected to external fixation with ring-hybrid frames.

Enzymatic activities, which originate in the muscle envelope of tibiae with an experimental segmental bone loss, provide additional evidence for the intimate bone-muscle interrelationships in new bone formation.

Adult (somatic) stem cells and the musculoskeletal system.

Stem cells offer a glimpse into a future that might unravel the promising ability of wide-ranging biological reconstructions.

Low back pain.

This study attempts to define the validity of radiographic imaging for the diagnosis of low back pain.

How does pulsed low-intensity ultrasound enhance fracture healing?

Pulsed low-energy ultrasound, a non-invasive therapeutic treatment modality, may improve callus formation and enhance fracture healing by initiating enhanced angioneogenesis.

Extreme bone lengthening using distraction osteogenesis after trauma: a case report.

We are reporting herein the result of a 22 cm tibial lengthening after using an acute shortening technique with acute temporary angulation for salvage of a posttraumatic lower limb injury. The patient was referred to our center 2 weeks after a Gustilo IIIB open complex injury to the lower limb that included bone and soft-tissue loss. After surgical debridement, the tibial gap was 22 cm and the soft-tissue defect on the anterior aspect of the calf measured 12 x 20 cm.

Unilateral hinged external fixation frame for elbow compression arthrodesis: the stepwise attainment of a stable 90-degree flexion position: a case report.

We report a case of an elbow arthrodesis using a modular hinged external fixation device in a patient who sustained a complex high-energy injury. The extensive bone and soft-tissue loss and local infection precluded restoration of the articular anatomy. Other reconstructive options, including total elbow arthroplasty and allograft reconstruction, were not appropriate in this clinical situation.

The Ilizarov external fixation frame in compression arthrodesis of large, weight bearing joints.

Solid bony fusion of large joints affected with active chronic infections, is still the most effective surgical solution to establish a useful function of the affected limb. Even with extensive peri-articular bone loss and severe deformities, arthrodesis in a functional position can provide effective stability. The reported fusion rates in such patients are not encouraging however, and secondary amputations have been reported.

Compound high-energy limb fractures with delayed union: our experience with adjuvant ultrasound stimulation (exogen).

The use of low intensity pulsed ultrasound accelerates cortical and cancellous bone fracture healing. Seventeen patients with eighteen high-energy fractures of the long bones were treated with low intensity pulsed ultrasound supplementation to surgical skeletal stabilization and tissue flaps. Sixteen fractures were healed within 13-52 weeks after starting ultrasound supplementation despite severe soft-tissue injuries and varying degrees of tissue loss.

Hybrid thin wire external fixation: an effective, minimally invasive, modular surgical tool for the stabilization of periarticular fractures.

Hybrid thin wire external fixation is an effective, minimally invasive treatment for the stabilization of periarticular, supracondylar, and pilon fractures. The extent of bone and soft-tissue loss, high risk of infection, and further damage to the soft tissues precludes open reduction and internal fixation as a safe treatment method. External fixation preserves the soft-tissue envelope with minimal damage and allows fracture stabilization, early loading, and mobilization, which promote bone healing.

Treatment of nonunions with irretrievable broken nail pieces in the distal fragment.

Introduction: We present our experience in the treatment of nonunited fractures of long bones in the presence of a retained fragment of the broken intramedullary nail.

Materials And Method: Of 287 long bone fractures treated by intramedullary fixation, we recalled 5 patients with broken intramedullary nails. In two patients the distal fragments of broken nails were not extracted and refixation was performed by an Ilizarov ring fixation with the broken piece left in situ.

The diabetic foot: update on a common clinical syndrome.

A cross-sectional study was conducted in 3995 non-hospitalized diabetic patients to evaluate symptoms commonly associated with "diabetic foot" syndrome. Each patient was examined twice over 2 years during routine follow-up. The male/female ratio differed significantly between the study group and general population.

Minimally invasive surgical techniques for the reconstruction of calcaneal fractures.

The soft tissues play a crucial part in both the stabilization of the multiple joint surfaces of the calcaneus and in allowing propulsion as needed. Therefore, minimally invasive functional stabilization of heel bone fracture is a promising technique, which may bypass all published controversies. Experience has shown that ligamentotaxis, which means the use of mechanical forces applied to the soft-tissue envelope of fractures without the surgical disruption of the latter, contributes to fracture healing and reconstruction.

Vascularized muscle pedicle flap for osteonecrosis of the femoral head.

Osteonecrosis is a devastating, locally progressive degenerative condition that mainly affects young adults. Osteonecrosis of the femoral head requires biological hip reconstruction. This article describes a technique that uses a vascularized muscle pedicle flap as a viable bone graft for treatment of this condition.