Geriatric and physically oriented rehabilitation improves the ability of independent living and physical rehabilitation reduces mortality: a randomised comparison of 538 patients.

Objective: To examine effects of physical and geriatric rehabilitation on institutionalisation and mortality after hip fracture.

Design: Prospective randomised study.

Setting: Physically oriented (187 patients), geriatrically oriented (171 patients), and health centre hospital rehabilitation (180 patients, control group).

Calcium Sulfate with Stearic Acid as an Encouraging Carrier for Reindeer Bone Protein Extract.

Various bone proteins and growth factors in specific concentrations are required for bone formation. If the body cannot produce sufficient quantities of these factors, bone trauma can be healed with an implant that includes the required factors in a carrier. This study was designed to evaluate various calcium salt candidates that can be used as carrier with reindeer bone protein extract to induce ectopic bone formation in the muscle pouch model of mouse.

Reindeer bone extract can heal the critical-size rat femur defect.

Bone extract from reindeer induces new ectopic bone formation (BF) in muscle pouches, but its feasibility in experimental bone lesions has not been evaluated. We investigated the effects of implants, containing 2, 5, 15, 20 or 50 mg of reindeer bone extract in a collagen carrier, on the healing of 8-mm femur defects in 78 rats. We used 30 µg of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a collagen carrier, collagen and untreated defects as controls.

Bioglass as a carrier for reindeer bone protein extract in the healing of rat femur defect.

Bioactive glasses have been developed as scaffolds for bone tissue engineering but combination with reindeer bone protein extract has not been evaluated. We investigated the effects of bone protein extract implants (5-40 mg dosages) with bioglass (BG) carrier on the healing of rat femur defects. Bioglass implants and untreated defects served as controls.

Acromial shape in asymptomatic subjects: a study of 305 shoulders in different age groups.

Background: It has been reported that acromial morphology and age have an independent association with rotator cuff pathology. In a recent study, we found the acromial angle of patients with stage III impingement syndrome (tear in the rotator cuff, according to the Neer classification of shoulder impingement syndrome) to be significantly greater than the acromial angle of their age-matched healthy controls.

Purpose: To find out if acromial shape also changes, i.

Traumatic First Metatarsal Bone Loss Treated with a Staged Method Using an Antibiotic Cement Spacer and Subsequent Autografting: A Case Report.

Fractures with bone loss are rare. A staged method of using bone cement as a spacer and subsequent autografting has been used successfully to treat traumatic bone loss of long bones. We report a case of traumatic bone loss of the 1st metatarsal bone that was treated successively with a staged method of using antibiotic-impregnated bone cement as a spacer in the primary phase and cancellous autografting in second-stage surgery.

Treatment of congenital pseudarthrosis of the tibia with native bovine BMP: a case report.

Bone morphogenetic proteins (BMP) have been shown to induce bone formation and union in long bone defects and nonunions. We report a case of congenital pseudarthrosis of the tibia treated with a composite implant consisting of a biocoral frame, collagen carrier, and native bovine BMP extract. A six-year-old boy had persisting congenital proximal tibial pseudarthrosis despite six prior operations.

Staged method using antibiotic beads and subsequent autografting for large traumatic tibial bone loss: 22 of 23 fractures healed after 5-20 months.

Introduction: The vascularity of surrounding soft tissues, which is related to muscle cover, is important for the healing of traumatic bone loss. Muscle cover on the distal tibia is limited compared to the diaphyseal and proximal tibia, and delayed healing of fractures in this area is common. We evaluated the healing of traumatic bone loss in the proximal, diaphyseal, and distal tibia.

Reindeer BMP extract in the healing of critical-size bone defects in the radius of the rabbit.

Background: Native BMP extracts from reindeer effectively induce ectopic new bone formation in vivo, but their bone healing properties have not yet been evaluated. We investigated the effect of reindeer BMP extracts on the healing of long bone defects.

Methods: The implants tested contained 5 mg or 10 mg of unsterilized BMP extract from reindeer and 10 mg of gamma-sterilized BMP extract administered with collagen carrier (Lyostypt, B.

Two-ring hybrid external fixation of distal tibial fractures: a review of 47 cases.

Background: The healing of a metaphyseal fracture line is a major problem in cases of distal tibial fracture treated with external fixation.

Methods: Forty-seven distal tibial fractures treated with two-ring Ilizarov hybrid external fixation (16 AO/OTA type A and 31 type C, 10 open) were followed up. Fracture reduction and union time was evaluated and IOWA and RAND 36-Item Health Survey scores were used to assess functional outcome.

Effect of gamma irradiation on the osteoinductivity of morphogenetic protein extract from reindeer bone.

Background: Bone morphogenetic proteins (BMPs), which are capable of stimulating the production of new bone, must be sterilized before preclinical and clinical use to reduce the risk of infections and associated complications. In this study, we investigated the effects of gamma sterilization on the osteoinductivity of native reindeer BMP extract in the Balb/C mouse thigh muscle pouch model.

Methods: 5 mg of native reindeer BMP extract and 5 mg of bovine serum albumin were administered separately either in gelatine capsules or mixed with gelatine as injections.

Osteoinductivity of partially purified native ostrich (Struthio camelus) bone morphogenetic protein: comparison with mammalian species.

Bone morphogenetic proteins (BMPs) are members of the TGF-beta superfamily. They are capable of inducing ectopic bone formation. Until now, the main interest has been focused on mammalian osteoinductive BMPs, and there are no reports of native BMP extracts of birds.

Early revision after hemiarthroplasty and osteosynthesis of cervical hip fracture: short-term function mortality unchanged in 102 patients.

Background: There is no consensus on whether osteosynthesis or hemiarthroplasty is preferable in the treatment of cervical hip fractures. Osteosynthesis is associated with more reoperations than hemiarthroplasty but there is little information available on the consequences of these reoperations.

Patients And Methods: We studied the effect on mortality, hospital stay and functional outcome of revision performed within 4 months of primary surgery with hemiarthroplasty or osteosynthesis for cervical hip fracture.

Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture.

Bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is the main determinant of the clinical evaluation of hip fracture risk. However, it has been shown that BMD is not the only predictive factor for hip fracture, but that bone geometry is also important. We studied whether the combination of bone geometry and BMD could further improve the determination of hip fracture risk and fracture type.

Composite implant of native bovine bone morphogenetic protein (BMP), collagen carrier and biocoral in the treatment of resistant ulnar nonunions: report of five preliminary cases.

Introduction: Bone morphogenetic protein (BMP) has been shown to induce bone formation and union in long bone defects and nonunions. There are, however, no previous reports of BMP being used for ulnar nonunions. We report on five cases of resistant ulnar nonunions treated with a composite implant consisting of a biocoral frame, collagen carrier, and bovine BMP.

Functional comparison between uncemented Austin-Moore hemiarthroplasty and osteosynthesis with three screws in displaced femoral neck fractures--a matched-pair study of 168 patients.

There is no consensus as to whether osteosynthesis (OS) or hemiarthroplasty (HA) should be used as the primary treatment of displaced femoral-neck fracture. In a prospective matched-pair study, we compared 84 patients treated with OS with three screws and 84 patients treated with uncemented Austin-Moore HA focusing on functional parameters, reoperations and mortality. At 4 months after the fracture, functional recovery was not significantly different between the study groups.

Functional outcome after displaced femoral neck fractures treated with osteosynthesis or hemiarthroplasty: a matched-pair study of 714 patients.

Osteosynthesis (OS) and hemiarthroplasty (HA) are the commonest treatments for displaced cervical hip fractures in the elderly, but there is no consensus as to which is better. In this prospective matched-pair study we compared these methods as regards functional outcome. In 1989-1996, using the same standardized forms, all displaced cervical hip fractures were prospectively registered in the university hospitals of Oulu in Finland and Lund in Sweden.

Characteristics of lifetime factors, bone metabolism, and bone mineral density in patients with hip fracture.

Seventy-four postmenopausal women with nonpathological hip fracture were recruited to a study in which they were compared for lifetime factors, some biochemical measurements of bone metabolism, and bone mineral density (BMD), with 40 age-adjusted controls without fracture. The fracture patients were less independent; their walking ability was weaker; their vision was poorer; they had more general diseases (strokes, diabetes, malignant diseases, heart and vascular diseases); more of them had had deliveries; and they were using significantly more loop diuretics, and antidepressant, neuroleptic, and diabetes drugs than the controls. Thirty-seven patients and 19 controls were excluded from the statistical comparison of BMD and the biochemical measurements of bone metabolism because they had had treatments with calcium, vitamin D, bisphosphonates, estrogens, calcitonin, or corticosteroids, and one fracture patient was excluded for primary hyperparathyroidism.

Risk factors for cervical and trochanteric hip fracture during a fall on the hip.

Objective: The aim of this study was to elucidate factors related to hip fracture in patients who fall on the hip in order to identify those patients who might benefit from the use of hip protectors.

Design: The study was performed by comparing 146 persons who had fallen and sustained a soft tissue injury in the hip region with 146 cervical hip fracture and 146 trochanteric hip fracture patients matched for age, sex and place of residence.

Patients: The fall group was drawn from a prospectively collected cohort of 1,061 elderly people participating in an epidemiological survey on fall injuries; the fracture group was drawn from a prospectively recorded hip fracture database of the Oulu University Hospital (n = 1,714).

Microstructural properties of bone in rat vertebra after long-term clodronate treatment.

Bisphosphonates (BPs) are known to increase bone mineral density, but it is not known how this increase manifests at low hierarchic levels of the bone structure. The present study aimed to clarify the effects of the long-term use of clodronate on the microstructure and chemical composition of bone. The second lumbar vertebral body (L2) in growing rats, subjected to 32 weeks' treatment with clodronate at either a therapeutic dose of 2 mg/kg, or a high dose of 10 mg/kg, or physiological saline (control group), was studied by scanning electron microscopy for morphology, by backscattered electron image (BSE) for density, and by energy dispersive spectrometry for material analysis.

Hemiarthroplasty or osteosynthesis in cervical hip fractures: matched-pair analysis in 892 patients.

Our aim was to compare hemiarthroplasty (HA) and osteosynthesis (OS) in the treatment of cervical hip fractures using matched-pair analysis, especially with regard to different age groups. Data concerning all hip fractures (excluding pathological fractures) at the University Hospitals of Lund in Sweden, where osteosynthesis with LIH hook-pins was used exclusively, and of Oulu in Finland, using mainly cementless Austin-Moore hemiarthroplasty, were registered during 1989-1996 using the same standardized hip fracture forms filled in preoperatively and at 4 months follow-up. Altogether 446 pairs matched for age, sex, place of residence and walking ability at the time of fracture were found.