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At least 811 records · Page 45Linked to original sources
PubMed1984

Insulin-like growth factors I and II: aging and bone density in women.

Serum concentrations of insulin-like growth factors (IGF) were measured by RIA in 57 normal women, ages 30 - 90 yr, and in 29 untreated women with postmenopausal osteoporosis and vertebral compression fractures, ages 55 - 75 yr. These values were correlated with bone mineral density (BMD) of the distal and midradius assessed by single photon absorptiometry and of the lumbar spine assessed by dual photon absorptiometry as well as serum and urinary calcium, phosphorus, creatinine, alkaline phosphatase, immunoreactive PTH, urinary hydroxyproline, and creatinine clearance. Serum IGF-I levels declined markedly with age (r = -0.47, P less than 0.001). Serum IGF-II levels decreased only slightly with age, and this decrease was not statistically significant. Although BMD at all three scanning sites also declined significantly with age, neither serum IGF-I nor II concentrations correlated with BMD when age was held constant. In women with postmenopausal osteoporosis, serum IGF-I and II did not differ from the concentrations in normal women of similar age and did not correlate with BMD. In neither group was a correlation between serum IGF-I or II and serum or urinary proteins or cations found. Thus, there was no evidence that impaired synthesis of IGF-I and II contributes to pathogenesis of the syndrome of Type I (postmenopausal) osteoporosis, which is characterized by accelerated loss of trabecular bone and vertebral compression fractures. The possibility remains, however, that decreasing concentrations of serum IGF-I play a role in the more gradual loss of bone with aging (Type II osteoporosis) in which impared bone formation at the cellular level has been demonstrated.

Adult↗
PubMed2006

Synthesis and in vitro biocompatibility of injectable polyurethane foam scaffolds.

The development of therapeutics for orthopedic clinical indications exploiting minimally invasive surgical techniques has substantial benefits, especially for treatment of fragility fractures in the distal radius of osteoporotics and vertebral compression fractures. We have designed six formulations of injectable polyurethane foams to address these clinical indications. The polyurethanes were prepared by mixing two liquid components and injecting the reactive liquid mixture into a mold where it hardens in situ. Porous polyurethane foams were synthesized from lysine methyl ester diisocyanate, a poly(epsilon-caprolactone-co-glycolide) triol, a tertiary amine catalyst, anionic and non-ionic stabilizers, and a fatty acid pore opener. The rise time of the foams varied from 8-20 min. The porosity was approximately 95% and the pores varied in size from 100-1000 microm. The polyurethane foams supported attachment of viable (>95%) MG-63 cells under dynamic seeding conditions. We anticipate compelling opportunities will be available as a consequence of the favorable biological and physical properties of the injectable polyurethane foams.

Animals↗
PubMed1997

Scanning electron microscopic study of primary fracture healing.

Scanning electron microscopy was used to study primary bone healing. This technique, essential for a three-dimensional description, has provided excellent visualization and revealed new aspects of the micromorphology of primary bone healing. Calcifying collagen bundles were responsible for the first mechanical stability, bone healing took place later in fracture vaults generated by compressed fracture fragments which were partially nonvital. A direct bridging of the fracture fragments by sprouting osteons was not observed.

Animals↗
PubMed1992

[Lesions of the distal radio-ulnar joint in compression-extension fractures of the distal extremity of the radius. Six cases with associated anterior dislocation of the ulnar head].

A particular course of markedly displaced wrist fracture associated with complete dislocation of the distal radio-ulnar joint and a real anterior dislocation of the ulnar head is related. In 5 other identical cases, treatment with external fixation achieved a more favourable result. These 6 cases concerning a particular type of wrist fracture, and a review of the literature, led us to suggest a potential pattern of TFCC lesions. Finally, from an anatomical classification of the ulnar compartment, we propose some therapeutic guidelines concerning the ulnar side for more common fractures.

Adult↗
PubMed1995

Non-operative treatment of thoracolumbar fractures.

Between 1986 and 1992, 32 thoracolumbar fractures in 32 patients were treated nonoperatively with 4-6 weeks on a rotorest bed followed by bracing with a thoracolumbosacral orthosis for a total of 3-6 months. The fractures were classified as 20 burst, six fracture dislocations, five severe compression fractures, and one gunshot wound. There were 12 multilevel fractures. Nine patients had incomplete neurological injuries and three had complete neurological injuries. The average age was 36.8 years (range 17-63) and the average follow-up was 22.3 months (range 12-60). Fifty three percent (17/32) of these had multisystem injuries including visceral trauma and long extremity fractures. There were only two complications; a deep vein thrombosis and a heel ulcer. Neither of these complications extended the patients' hospital stay. All nine of those with incomplete neurological injuries improved at least one Frankel grade. Fifteen of 24 patients who were employed returned to their previous jobs, and only nine patients had persistent back pain requiring medication. Surgical treatment of thoracolumbar fractures is often favored over conservative treatment in the multitrauma and neurologically injured patient because of complications related to bedrest. However, by using a rotorest bed and aggressive physical therapy, conservative treatment may actually result in lower morbidity.

Adolescent↗
PubMed1984

Computed tomography of thoracic and lumbar spine injuries.

CT scans of 73 patients with acute thoracic/lumbar spine injuries from T3 to L5 were reviewed. Injuries were classified as burst fractures (48), fracture-dislocations (ten), wedge compression fractures (11), and seatbelt-type injuries (four). Thirty-one (42%) had motor deficits due to spinal cord or nerve root damage. Such neurologic deficits were present in all patients with fracture-dislocations, and 60% of those with burst fractures. Seven patients, four initially normal, developed progressive neurologic impairment early after injury. Burst fractures, one with dislocation, were the spinal injury associated with each progressive deficit. Burst fractures at T12 or L1 with 50% or more decrease of the mid-sagittal neural canal diameter had a significant risk of neurologic involvement, and of progressive deficit. CT scans demonstrate vertebral column damage well, and help identify those patients at risk of acute neurologic compromise.

Adolescent↗
PubMed2000

Nonunion of the humerus after failure of surgical treatment. Management using the Ilizarov circular fixator.

We used the Ilizarov circular external fixator to treat 16 patients with persistent nonunion of the diaphysis of the humerus despite surgical treatment. All patients had pain and severe functional impairment of the affected arm. In ten, nonunion followed intramedullary nailing. We successfully treated these by a closed technique. The nail was left in place and the fracture compressed over it. The fractures of the other six patients had previously been fixed by various methods. We explored these nonunions, removed the fixation devices and excised fibrous tissue and dead bone before stabilising with the Ilizarov fixator. In five patients union was achieved. Bone grafting was not required. In the single patient in whom treatment failed, there had been a severely comminuted open fracture. All except one patient had reduction of pain, and all reported an improvement in function.

Adult↗
PubMed1991

Stability of femoral neck fracture. Roentgen stereophotogrammetry of 29 hook-pinned fractures.

The stability of hook-pin fixation during weight bearing was studied in 29 femoral neck fractures using roentgen stereophotogrammetric analysis. Twenty-three fractures became stable within 1 to 9 months, whereas redisplacement or continuing movement of the fracture occurred in 6 cases. Displaced fractures shortened about 7 mm more than undisplaced ones before healing. The rotations of the femoral heads were greatest in the forward/backward direction, followed by varus-valgus tilting in both fracture groups. Rotation about the longitudinal axis was recorded in the displaced fractures, mainly as a retroversion, whereas no rotation occurred about this axis in the undisplaced fractures. Healing after 6 months, intermediate fracture fragments, and a decreased Pauwels' angle seemed to imply increased fracture compression or rotatory instability. Fractures that subsequently developed healing complications displayed an increased distal displacement of the femoral head during the first postoperative month.

Adult↗
PubMed2001

Stress fracture of the femoral neck in young adult: report of four cases.

Stress fracture of the femoral neck is an uncommon injury. If the diagnosis is missed or delayed and fracture displacement results, serious complications such as avascular necrosis of the femoral head, nonunion or varus deformity may occur. Treatment depends on the type of stress fracture. Compression and tension stress fractures can be successfully treated with conservative management or prophylactic internal fixation using multiple screws. Displaced stress fractures are an orthopedic emergency, requiring prompt surgical intervention. Poor outcomes after fracture displacement have been reported by many authors. We present four cases demonstrating three types of stress fracture of the femoral neck. It is hoped that these case reports will serve to increase practitioner awareness of this injury and emphasize the need for careful diagnosis and treatment of this potentially problematic injury.

Adult↗
PubMed1998

Idiopathic osteoporosis: a heterogeneous entity.

DEFINITION: Idiopathic osteoporosis refers to the development of osteopenia and fractures with minimal or no trauma in otherwise young, healthy individuals who are not postmenopausal or have other, identifiable secondary causes of osteoporosis. EPIDEMIOLOGY: It is a relatively rare disorder, with an incidence of 0.4 cases per 100,000 person-years. It appears to affect both sexes equally and results primarily in the development of trabecular bone fractures such as vertebral compression fractures and Colles' fractures, although hip fractures are also seen. PATHOPHYSIOLOGY: The disease may be temporally related to pregnancy and/or lactation in some patients, although it is unclear whether pregnancy plays a pathophysiological role or, more likely, simply leads to the clinical presentation of the disease in individuals who are already affected. Various pathophysiological abnormalities have been described in these patients, including hypercalciuria, abnormalities in vitamin D metabolism, and in the production of insulin-like growth factor I and interleukin 1. Findings on bone biopsy have been variable, with some patients having evidence of a defect in osteoblast function, whereas others having evidence for increased bone resorption. TREATMENT: No specific therapy has been proven to be effective in these patients. However, an individualized approach based on an assessment of bone turnover may be reasonable and may decrease the bone loss and subsequent fracture risk.

Adult↗