BACKGROUND Fracture nonunion represents a challenging complication during fracture repair,often necessitating surgical intervention.Teriparatide,a recombinant human parathyroid hormone,has demonstrated promise in enha...BACKGROUND Fracture nonunion represents a challenging complication during fracture repair,often necessitating surgical intervention.Teriparatide,a recombinant human parathyroid hormone,has demonstrated promise in enhancing fracture healing,although its efficacy in treating established nonunion remains under investigation.CASE SUMMARY We report a case of a 27-year-old male who presented with a right humerus fracture following a traffic accident.Despite undergoing open reduction and internal fixation,the fracture resulted in a delayed union and subsequent nonunion.After 4 years of conservative management,teriparatide treatment was initiated due to persistent nonunion.Teriparatide injections were administered daily for 6 months,resulting in complete fracture healing and resolution of pain.CONCLUSION Our case demonstrates the successful use of teriparatide in treating a prolonged nonunion of a humerus fracture.Teriparatide may provide a valuable therapeutic option for established bone nonunion,even in cases that have not responded to conservative treatments.展开更多
BACKGROUND Femoral neck stress fractures are rarely encountered among young adults and are often associated with either repetitive excessive loading or underlying bone pathology.Preliminary research has indicated huma...BACKGROUND Femoral neck stress fractures are rarely encountered among young adults and are often associated with either repetitive excessive loading or underlying bone pathology.Preliminary research has indicated human immunodeficiency virus(HIV)/antiretroviral therapy(ART)as predisposing agents to osteopenia and osteoporosis related complications.We report a case of HIV/ART induced insufficiency fracture in a resource limited setting in Central India.Our aim is to increase awareness and promote screening of HIV/ART related osteopenia and osteoporosis in order to prevent catastrophic orthopaedic complications.CASE SUMMARY A 35-year-old HIV positive male presented with a stress fracture of left femoral neck.The patient was on ART and reported no comorbidities.He went on to be successfully managed surgically.However,during work-up osteopenia of the contralateral proximal femur was recognised using Singh’s Index.Six months post-op the patient presented with right-sided femoral-neck stress fracture.At this stage the patient was nonconcordant with ART and denied surgical fixation.CONCLUSION In the absence of co-morbidities,several mechanisms of HIV/antiretroviral therapy may have played a role in predisposing our patient towards such a presentation.We recommend routine screening all HIV-infected patients for osteopenia,especially in younger individuals.In low resource settings and district hospitals,pelvis radiograph&Singh’s index can be used for screening.展开更多
Objective:To evaluate the effectiveness of surgical combination with traditional Chinese medicine dialectical therapy in three phases for the treatment of intertrochanteric fracture of the femur(IFF).Methods:84 patien...Objective:To evaluate the effectiveness of surgical combination with traditional Chinese medicine dialectical therapy in three phases for the treatment of intertrochanteric fracture of the femur(IFF).Methods:84 patients with IFF admitted to the hospital from December 2022 to December 2024 were selected and randomly divided into two groups using a random number table.The combined group received surgery and traditional Chinese medicine dialectical therapy in three phases,while the control group received surgery alone.The total effective rate,fracture healing time,hip function score,and lower extremity function score were compared between the two groups.Results:The total effective rate was higher in the combined group than in the control group(P<0.05).After treatment,the fracture healing time was shorter in the combined group than in the control group,and the hip function and lower extremity function scores were higher in the combined group than in the control group(P<0.05).Conclusion:Surgical combination with traditional Chinese medicine dialectical therapy in three phases can shorten the fracture healing time of IFF patients and restore their hip and lower extremity function,demonstrating significant efficacy.展开更多
Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type Ⅱ fractures are the most common fracture pattern in elderly patients. Treatment(rigid and non-rigid im...Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type Ⅱ fractures are the most common fracture pattern in elderly patients. Treatment(rigid and non-rigid immobilization, anterior screw fixation of the odontoid and posterior C1-C2 fusion) remains controversial and represents a unique challenge for the treating surgeon. The aims of treatment in the elderly is to quickly restore pre-injury function while decreasing morbidity and mortality associated with inactivity, immobilization with rigid collar and prolonged hospitalization. Conservative treatment of type Ⅱ odontoid fractures is associated with relatively high rates of non-union and in a few cases delayed instability. Options for treatment of symptomatic non-unions include surgical fixation or prolonged rigid immobilization. In this report we present the case of a 73-year-old woman with post-traumatic odontoid nonunion successfully treated with Teriparatide systemic anabolic therapy. Complete fusion and resolution of the symptoms was achieved 12 wk after the onset of the treatment. Several animal and clinical studies have confirmed the potential role of Teriparatide in enhancing fracture healing. Our case suggests that Teriparatide may have a role in improving fusion rates of C2 fractures in elderly patients.展开更多
Bone fractures represent a significant global healthcare burden.Although fractures typically heal on their own,some fail to regenerate properly,leading to nonunion,a condition that causes prolonged disability,morbidit...Bone fractures represent a significant global healthcare burden.Although fractures typically heal on their own,some fail to regenerate properly,leading to nonunion,a condition that causes prolonged disability,morbidity,and mortality.The challenge of treating nonunion fractures is further complicated in patients with underlying bone disorders where systemic and local factors impair bone healing.Traditional treatment approaches,including autografts,allografts,xenografts,and synthetic biomaterials,face limitations such as donor site pain,immune rejection,and insufficient mechanical strength,underscoring the need for alternative strategies.Biologic therapies have emerged as promising tools to enhance bone regeneration by leveraging the body’s natural healing processes.This review explores the critical role of conventional and emerging biologics in fracture healing.We categorize biologic therapies into protein-based treatments,gene and transcript therapies,small molecules,peptides,and cell-based therapies,highlighting their mechanisms of action,advantages,and clinical relevance.Finally,we examine the potential applications of biologics in treating fractures associated with bone disorders such as osteoporosis,osteogenesis imperfecta,rickets,osteomalacia,Paget’s disease,and bone tumors.By integrating biologic therapies with existing biomaterial-based strategies,these innovative approaches have the potential to transform clinical management and improve outcomes for patients with difficult-to-heal fractures.展开更多
Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods...Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods: A total of 72 patients with osteoporotic distal radial fractures who were treated in the hospital between September 2015 and January 2017 were collected and divided into control group (n=36) and observation group (n=36) according to the random number table method. Control group received routine external fixation, and observation group received mid-frequency pulse therapy combined with external fixation. The differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups. After 1 month of treatment, serum BGP, TAC and SOD levels of both groups of patients were higher than those before treatment whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those before treatment, and serum BGP, TAC and SOD levels of observation group were higher than those of control group whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those of control group.Conclusion: Mid-frequency pulse therapy combined with external fixation can promote fracture healing and reduce postoperative inflammatory response and oxidative stress response in patients with osteoporotic distal radial fracture.展开更多
It is being increasingly recognized that patients with liver disease develop bone loss that can be severe enough to lead to atraumatic fractures and thus markedly diminish life quality and expectancy. The estimated pr...It is being increasingly recognized that patients with liver disease develop bone loss that can be severe enough to lead to atraumatic fractures and thus markedly diminish life quality and expectancy. The estimated prevalence for liver-related osteoporosis is between 20-420/100000 of the general population, and fractures between 60-880/100000. It should be kept in mind that up to 40% of patients with chronic liver disease may experience a fracture. The pathogenic mediators include fibronectin, insulin like growth factor-I, and various cytokines, but decreased vitamin D and/or treatment with corticosteroids contribute to worsening bone health. Despite the advances in bone biology that have shed some light on the pathogenesis of this bone loss, treatment options remain nonspecific and tightly linked to treatments of other forms of osteoporosis. Thus, treatment should include calcium and vitamin D supplementation in all patients with chronic liver disease. Therapy with bisphosphonates should be considered, especially in patients receiving corticosteroids. This review focuses on the prevalence of this entity as well as the evidence available with regard to the pathogenesis of bone loss in liver disease, the diagnostic steps required in all patients, and the therapeutic options available.展开更多
BACKGROUND Simultaneous bilateral femoral neck fractures are relatively rare injuries.They are usually associated with underlying metabolic bone disorders or systemic diseases.Long-term use of narcotics and bisphospho...BACKGROUND Simultaneous bilateral femoral neck fractures are relatively rare injuries.They are usually associated with underlying metabolic bone disorders or systemic diseases.Long-term use of narcotics and bisphosphonates can also result in similar fracture patterns;however,association of this fracture type with longterm use of antiepileptic drugs is not very common.Only one such case has been reported in the literature.This article describes the second.CASE REPORT We report a case of simultaneous displaced bilateral femoral neck fractures in a 50-year-old epileptic patient,who had taken phenytoin for the past 3 years.The fractures were a result of low-velocity injury following a fall from the bed.The fractures were managed with a bilateral hemi-replacement arthroplasty.Oral bisphosphonates were given to improve the bone quality in the post-operative period.The patient had a good post-operative outcome,that was sustained throughout the entire follow-up period of 1 year.CONCLUSION Antiepileptic drugs should be supplemented with bisphosphonates and vitamin D to improve bone quality and prevent fractures in epileptic patients.展开更多
BACKGROUND Multiple myeloma(MM)bone disease is indicative of MM,and reduces patient life quality.In addition to oncological,antineoplastic systemic therapy,surgical therapy in patients with MM is an essential treatmen...BACKGROUND Multiple myeloma(MM)bone disease is indicative of MM,and reduces patient life quality.In addition to oncological,antineoplastic systemic therapy,surgical therapy in patients with MM is an essential treatment within the framework of supportive therapy measures and involves orthopedic tumor surgery.Nevertheless,there are few reports on intramedullary(IM)nailing in the treatment of MM-induced proximal humeral fracture to prevent fixation loss.We here describe a case of pathological fracture of the proximal humerus caused by MM successfully treated with IM nailing without removal of tumors and a review of the current literature.CASE SUMMARY A 64-year-old male patient complaining of serious left shoulder pain and limited movement was admitted.The patient was finally diagnosed with MM(IgAλ,IIIA/II).After treatment of the pathological fracture with IM nailing,the patient's function recovered and his pain was rapidly relieved.Histopathological examination demonstrated plasma cell myeloma.The patient received chemotherapy in the Hematology Department.The humeral fracture displayed good union during the 40-mo follow-up,with complete healing of the fracture,and the clinical outcome was satisfactory.At the most recent follow-up,the patient's function was assessed using the Musculoskeletal Tumor Society score,which was 29.CONCLUSION Early surgery should be performed for the fracture of the proximal humerus caused by MM.IM nailing can be used without removal of tumors.Bone cement augmentation for bone defects and local adjuvant therapy can also be employed.展开更多
In this paper the results of skeletal traction and irrigation therapy (STIT) used for open fracture complicated with large-sized full-thickness skin-deficit and infection wounds (OFIW) were presented. Fourteen patient...In this paper the results of skeletal traction and irrigation therapy (STIT) used for open fracture complicated with large-sized full-thickness skin-deficit and infection wounds (OFIW) were presented. Fourteen patients of OFIW were treated by the plaster cast and wound dressing (PCWD), and 30 patients of OFIW were treated by STIT. The results indicated that after one week of treatment, the white blood cell count in the STIT group, compared to 17. 6±l. 0×109/L from before treatment, returned to 8. 8±0. 8×109/L,and in contrast, the cell count of the PCWD group was about 13. 0±1. 4×109/L. All of wound exudate culture in the STIT group was negative, and those of 7 cases (7/14) in PCWD group were positive (P<0. 0l). The symptoms and signs such as pain, fever and septic exudate on the wound in the STIT group were much milder than those in the PCWD group. There were 5 cases (35. 7%) of toxicemia and septicemia, 2 cases (14. 3%) of osteomyelitis, 2 cases (14. 3 %) of amputation, 1 case (7. 1%) of delayed union and 3 cases (21. 4 %) of malunion in the PCWD group, and no complications in the STIT group.展开更多
Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the ...Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the elderly.Methods:Sixty elderly patients who had undergone hip fracture surgery from February 2021 to February 2022 were selected as the research subjects.The patients were divided into two groups via drawing lots.Both the groups received nursing care,but the patients in the observation group were treated with TCM acupoint application combined with pneumatic compression therapy,whereas the control group received pneumatic compression therapy.The evaluation indicators included the patients’quality of life and complications.Results:The incidence of lower extremity deep vein thrombosis in the observation group was more than twice(0.3%),whereas the incidence of lower extremity complications in the control group was more than 6 times(20%).There was a significant difference between the two groups(p<0.05).Conclusion:Traditional Chinese medicine acupoint application combined with pneumatic compression therapy is beneficial for the prevention of postoperative lower extremity deep vein thrombosis among elderly patients.In addition,the patients’overall quality-of-life scores in both physiological and psychological aspects improved significantly,which carries significant clinical reference value.展开更多
Objectives:To investigate the effect of traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy for treatment of Neerll-type distal humerus fra...Objectives:To investigate the effect of traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy for treatment of Neerll-type distal humerus fractures.Methods:Sample selection was carried out during time period from November 2014 to May 2019.Sixty-six patients admitted to our hospital were selected as sample patients.The control group was given plaster treatment,while the observation group was given traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy.Efficacy for the two groups of patients was observed.Results:In this study,the total effective rate of observation group patients with treatment of traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy was 100%.Meanwhile,total effective rate of patients in control group was 87.88%.The difference was significant,P<0.05.Conclusions:In this study of clinical treatment,traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy could provide better therapeutic effect for treatment of patients with Neerll-type distal humerus fracture.At the same time,it reduces economic burden of patients.It has higher promotion value for clinical practice.展开更多
Objective: to analyze the rehabilitation effects of physical therapy combined with exercise rehabilitation for postoperative dysfunction of patellar fracture. Methods: a total of 65 patients with postoperative dysfunc...Objective: to analyze the rehabilitation effects of physical therapy combined with exercise rehabilitation for postoperative dysfunction of patellar fracture. Methods: a total of 65 patients with postoperative dysfunction of patellar fracture were included in the study. They were grouped according to different treatment methods. Patients who received simple physical therapy were included in the reference group (34 cases), while patients who received physical therapy combined with exercise rehabilitation therapy were included in the research group (31 cases). The joint range of motion scores, daily function scores and pain scores of the two groups were observed and compared. Results: compared with the reference group, the joint range of motion score and daily function score were higher in the research group, while the pain score was lower, with significant differences between the groups (P<0.05). Conclusion: physical therapy and exercise rehabilitation after patellar fracture surgery can improve the dysfunction, relieve pain and increase the joint range of motion.展开更多
Objective: to observe the actual curative effect in the treatment of preoperative swelling of closed calcaneal fracture by combining unarmed lymphatic drainage and pneumatic therapy. Methods: 50 patients with closed c...Objective: to observe the actual curative effect in the treatment of preoperative swelling of closed calcaneal fracture by combining unarmed lymphatic drainage and pneumatic therapy. Methods: 50 patients with closed calcaneal fractures and preoperative swelling were admitted to the Second Peoples Hospital of Changzhi City. The period of receiving patients was from January 2020 to February 2022. All patients were randomly assigned to a standard grouping operation. All patients were treated with drugs to reduce swelling. At the same time, 25 patients in the observation group were treated with air pressure therapy on the basis of the 25 patients in the control group who were treated with the free-hand lymph reflux scheme alone. The swelling degree, the swelling ratio of the calf circumference, the pain score and the preoperative waiting time were compared. Results: the data in table 1 and table 2 show that after treatment, the observation group is more satisfactory than the other group in terms of each comparative index (p < 0.05). At the same time, investigation and understanding of the treatment satisfaction of the patients in both groups show that the satisfaction of the observation group is at a higher level, with a statistical value of p < 0.05. Conclusion: for the preoperative swelling problem of closed calcaneal fracture, the whole effect is better by carrying out free-hand lymphatic drainage treatment and pneumatic treatment.展开更多
Compare the effects of locomotion therapy and pelvis traction therapy to treat Ⅰ～Ⅱ° thoracolumbar compression fracture.Methods Ninety-two cases with Ⅰ～Ⅱ° thoracolumbar compression fracture were selecte...Compare the effects of locomotion therapy and pelvis traction therapy to treat Ⅰ～Ⅱ° thoracolumbar compression fracture.Methods Ninety-two cases with Ⅰ～Ⅱ° thoracolumbar compression fracture were selected and divided into 2 groups with locomotion therapy and pelvis traction thepapy respectively.Results Thoracolumbar height was measured according to X-ray results after 1 year follow-up.The height was (17.2±2.3)mm preoperatively and (24.4±3.1)mm postoperatively in locomotion therapy group while (16.8±2.6)mm preoperatively and (23.9±2.7)mm postoperatively in the pelvis traction therapy group.Conclusion There is no significant difference between effects on two groups.5 refs.展开更多
Vertical root fracture(VRF)in molars is a complex and frequently encountered dental condition.Successful management relies on accurate diagnosis,sequential treatment strategies,and systematic care.This paper provides ...Vertical root fracture(VRF)in molars is a complex and frequently encountered dental condition.Successful management relies on accurate diagnosis,sequential treatment strategies,and systematic care.This paper provides a comprehensive review of the sequential therapeutic approaches and systematic management models for molar VRF over the past five years.Particular attention is given to the diagnostic value of cone-beam computed tomography(CBCT),recent advances in tooth-preserving techniques,and the establishment of full-course management frameworks.By constructing an integrated pathway encompassing diagnostic assessment,treatment decision-making,clinical intervention,and long-term maintenance,a“dentist–nurse–patient community”model is proposed to promote standardized clinical guidance.This collaborative model aims to extend the lifespan of affected teeth and restore optimal masticatory function.展开更多
目的探究引膝痛疗法联合被动运动在膝关节周围骨折术中的作用。方法选择河北省沧州中西医结合医院创伤骨科膝关节周围骨折内固定术后100例患者进行研究,对照组接受持续被动运动训练,试验组在对照组基础上予以引膝痛疗法。治疗结束后评...目的探究引膝痛疗法联合被动运动在膝关节周围骨折术中的作用。方法选择河北省沧州中西医结合医院创伤骨科膝关节周围骨折内固定术后100例患者进行研究,对照组接受持续被动运动训练,试验组在对照组基础上予以引膝痛疗法。治疗结束后评估两组临床治疗效果、视觉模拟量表(visual analog scale,VAS)评分、纽约特种外科医院(hospital for special surgery,HSS)评分、改良的Barthel指数(modified Barthel index,MBI)评分、关节液中的白细胞介素-17(interleukin-17,IL-17)水平、骨代谢相关指标及生活质量。结果治疗后与对照组比较,试验组临床治疗总效率较高(P<0.05)。治疗后,两组患者VAS评分下降,HSS和MBI评分升高(P<0.05);与对照组比较,试验组VAS评分较低,HSS、MBI评分较高(P<0.05)。治疗后两组患者关节液中IL-17的水平均下降,关节液中骨代谢指标升高(P<0.05)。与对照组比较,试验组关节液中IL-17的水平较低,骨代谢指标水平较高(P<0.05)。治疗后两组患者的生活质量评分均有所提高,试验组评分较对照组高(P<0.05)。试验组并发症发生率较对照组低(P<0.05)。结论引膝痛疗法联合持续性被动运动锻炼对接受膝关节周围骨折内固定术的患者具有明显的治疗效果,可显著提升膝关节功能、生活质量,其效果实现可能与抑制炎症反应和促进骨代谢的改善存在密切相关性。展开更多
基金Supported by National Natural Science Foundation of China,No.82172441Suzhou City Major Disease Multicenter Clinical Research Project,No.DZXYJ202312+2 种基金Special Funding for Jiangsu Province Science and Technology Plan(Key Research and Development Program for Social Development),No.BE2023737Gusu Health Talent Plan Scientific Research Project,No.GSWS2022109Postgraduate Research and Practice Innovation Program of Jiangsu Province,No.SJCX24_2446.
文摘BACKGROUND Fracture nonunion represents a challenging complication during fracture repair,often necessitating surgical intervention.Teriparatide,a recombinant human parathyroid hormone,has demonstrated promise in enhancing fracture healing,although its efficacy in treating established nonunion remains under investigation.CASE SUMMARY We report a case of a 27-year-old male who presented with a right humerus fracture following a traffic accident.Despite undergoing open reduction and internal fixation,the fracture resulted in a delayed union and subsequent nonunion.After 4 years of conservative management,teriparatide treatment was initiated due to persistent nonunion.Teriparatide injections were administered daily for 6 months,resulting in complete fracture healing and resolution of pain.CONCLUSION Our case demonstrates the successful use of teriparatide in treating a prolonged nonunion of a humerus fracture.Teriparatide may provide a valuable therapeutic option for established bone nonunion,even in cases that have not responded to conservative treatments.
文摘BACKGROUND Femoral neck stress fractures are rarely encountered among young adults and are often associated with either repetitive excessive loading or underlying bone pathology.Preliminary research has indicated human immunodeficiency virus(HIV)/antiretroviral therapy(ART)as predisposing agents to osteopenia and osteoporosis related complications.We report a case of HIV/ART induced insufficiency fracture in a resource limited setting in Central India.Our aim is to increase awareness and promote screening of HIV/ART related osteopenia and osteoporosis in order to prevent catastrophic orthopaedic complications.CASE SUMMARY A 35-year-old HIV positive male presented with a stress fracture of left femoral neck.The patient was on ART and reported no comorbidities.He went on to be successfully managed surgically.However,during work-up osteopenia of the contralateral proximal femur was recognised using Singh’s Index.Six months post-op the patient presented with right-sided femoral-neck stress fracture.At this stage the patient was nonconcordant with ART and denied surgical fixation.CONCLUSION In the absence of co-morbidities,several mechanisms of HIV/antiretroviral therapy may have played a role in predisposing our patient towards such a presentation.We recommend routine screening all HIV-infected patients for osteopenia,especially in younger individuals.In low resource settings and district hospitals,pelvis radiograph&Singh’s index can be used for screening.
文摘Objective:To evaluate the effectiveness of surgical combination with traditional Chinese medicine dialectical therapy in three phases for the treatment of intertrochanteric fracture of the femur(IFF).Methods:84 patients with IFF admitted to the hospital from December 2022 to December 2024 were selected and randomly divided into two groups using a random number table.The combined group received surgery and traditional Chinese medicine dialectical therapy in three phases,while the control group received surgery alone.The total effective rate,fracture healing time,hip function score,and lower extremity function score were compared between the two groups.Results:The total effective rate was higher in the combined group than in the control group(P<0.05).After treatment,the fracture healing time was shorter in the combined group than in the control group,and the hip function and lower extremity function scores were higher in the combined group than in the control group(P<0.05).Conclusion:Surgical combination with traditional Chinese medicine dialectical therapy in three phases can shorten the fracture healing time of IFF patients and restore their hip and lower extremity function,demonstrating significant efficacy.
文摘Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type Ⅱ fractures are the most common fracture pattern in elderly patients. Treatment(rigid and non-rigid immobilization, anterior screw fixation of the odontoid and posterior C1-C2 fusion) remains controversial and represents a unique challenge for the treating surgeon. The aims of treatment in the elderly is to quickly restore pre-injury function while decreasing morbidity and mortality associated with inactivity, immobilization with rigid collar and prolonged hospitalization. Conservative treatment of type Ⅱ odontoid fractures is associated with relatively high rates of non-union and in a few cases delayed instability. Options for treatment of symptomatic non-unions include surgical fixation or prolonged rigid immobilization. In this report we present the case of a 73-year-old woman with post-traumatic odontoid nonunion successfully treated with Teriparatide systemic anabolic therapy. Complete fusion and resolution of the symptoms was achieved 12 wk after the onset of the treatment. Several animal and clinical studies have confirmed the potential role of Teriparatide in enhancing fracture healing. Our case suggests that Teriparatide may have a role in improving fusion rates of C2 fractures in elderly patients.
基金performed as part of the cmRNAbone project funded by the European Union’s Horizon 2020 research and innovation program under the Grant Agreement No 874790。
文摘Bone fractures represent a significant global healthcare burden.Although fractures typically heal on their own,some fail to regenerate properly,leading to nonunion,a condition that causes prolonged disability,morbidity,and mortality.The challenge of treating nonunion fractures is further complicated in patients with underlying bone disorders where systemic and local factors impair bone healing.Traditional treatment approaches,including autografts,allografts,xenografts,and synthetic biomaterials,face limitations such as donor site pain,immune rejection,and insufficient mechanical strength,underscoring the need for alternative strategies.Biologic therapies have emerged as promising tools to enhance bone regeneration by leveraging the body’s natural healing processes.This review explores the critical role of conventional and emerging biologics in fracture healing.We categorize biologic therapies into protein-based treatments,gene and transcript therapies,small molecules,peptides,and cell-based therapies,highlighting their mechanisms of action,advantages,and clinical relevance.Finally,we examine the potential applications of biologics in treating fractures associated with bone disorders such as osteoporosis,osteogenesis imperfecta,rickets,osteomalacia,Paget’s disease,and bone tumors.By integrating biologic therapies with existing biomaterial-based strategies,these innovative approaches have the potential to transform clinical management and improve outcomes for patients with difficult-to-heal fractures.
文摘Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods: A total of 72 patients with osteoporotic distal radial fractures who were treated in the hospital between September 2015 and January 2017 were collected and divided into control group (n=36) and observation group (n=36) according to the random number table method. Control group received routine external fixation, and observation group received mid-frequency pulse therapy combined with external fixation. The differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups. After 1 month of treatment, serum BGP, TAC and SOD levels of both groups of patients were higher than those before treatment whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those before treatment, and serum BGP, TAC and SOD levels of observation group were higher than those of control group whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those of control group.Conclusion: Mid-frequency pulse therapy combined with external fixation can promote fracture healing and reduce postoperative inflammatory response and oxidative stress response in patients with osteoporotic distal radial fracture.
文摘It is being increasingly recognized that patients with liver disease develop bone loss that can be severe enough to lead to atraumatic fractures and thus markedly diminish life quality and expectancy. The estimated prevalence for liver-related osteoporosis is between 20-420/100000 of the general population, and fractures between 60-880/100000. It should be kept in mind that up to 40% of patients with chronic liver disease may experience a fracture. The pathogenic mediators include fibronectin, insulin like growth factor-I, and various cytokines, but decreased vitamin D and/or treatment with corticosteroids contribute to worsening bone health. Despite the advances in bone biology that have shed some light on the pathogenesis of this bone loss, treatment options remain nonspecific and tightly linked to treatments of other forms of osteoporosis. Thus, treatment should include calcium and vitamin D supplementation in all patients with chronic liver disease. Therapy with bisphosphonates should be considered, especially in patients receiving corticosteroids. This review focuses on the prevalence of this entity as well as the evidence available with regard to the pathogenesis of bone loss in liver disease, the diagnostic steps required in all patients, and the therapeutic options available.
文摘BACKGROUND Simultaneous bilateral femoral neck fractures are relatively rare injuries.They are usually associated with underlying metabolic bone disorders or systemic diseases.Long-term use of narcotics and bisphosphonates can also result in similar fracture patterns;however,association of this fracture type with longterm use of antiepileptic drugs is not very common.Only one such case has been reported in the literature.This article describes the second.CASE REPORT We report a case of simultaneous displaced bilateral femoral neck fractures in a 50-year-old epileptic patient,who had taken phenytoin for the past 3 years.The fractures were a result of low-velocity injury following a fall from the bed.The fractures were managed with a bilateral hemi-replacement arthroplasty.Oral bisphosphonates were given to improve the bone quality in the post-operative period.The patient had a good post-operative outcome,that was sustained throughout the entire follow-up period of 1 year.CONCLUSION Antiepileptic drugs should be supplemented with bisphosphonates and vitamin D to improve bone quality and prevent fractures in epileptic patients.
文摘BACKGROUND Multiple myeloma(MM)bone disease is indicative of MM,and reduces patient life quality.In addition to oncological,antineoplastic systemic therapy,surgical therapy in patients with MM is an essential treatment within the framework of supportive therapy measures and involves orthopedic tumor surgery.Nevertheless,there are few reports on intramedullary(IM)nailing in the treatment of MM-induced proximal humeral fracture to prevent fixation loss.We here describe a case of pathological fracture of the proximal humerus caused by MM successfully treated with IM nailing without removal of tumors and a review of the current literature.CASE SUMMARY A 64-year-old male patient complaining of serious left shoulder pain and limited movement was admitted.The patient was finally diagnosed with MM(IgAλ,IIIA/II).After treatment of the pathological fracture with IM nailing,the patient's function recovered and his pain was rapidly relieved.Histopathological examination demonstrated plasma cell myeloma.The patient received chemotherapy in the Hematology Department.The humeral fracture displayed good union during the 40-mo follow-up,with complete healing of the fracture,and the clinical outcome was satisfactory.At the most recent follow-up,the patient's function was assessed using the Musculoskeletal Tumor Society score,which was 29.CONCLUSION Early surgery should be performed for the fracture of the proximal humerus caused by MM.IM nailing can be used without removal of tumors.Bone cement augmentation for bone defects and local adjuvant therapy can also be employed.
文摘In this paper the results of skeletal traction and irrigation therapy (STIT) used for open fracture complicated with large-sized full-thickness skin-deficit and infection wounds (OFIW) were presented. Fourteen patients of OFIW were treated by the plaster cast and wound dressing (PCWD), and 30 patients of OFIW were treated by STIT. The results indicated that after one week of treatment, the white blood cell count in the STIT group, compared to 17. 6±l. 0×109/L from before treatment, returned to 8. 8±0. 8×109/L,and in contrast, the cell count of the PCWD group was about 13. 0±1. 4×109/L. All of wound exudate culture in the STIT group was negative, and those of 7 cases (7/14) in PCWD group were positive (P<0. 0l). The symptoms and signs such as pain, fever and septic exudate on the wound in the STIT group were much milder than those in the PCWD group. There were 5 cases (35. 7%) of toxicemia and septicemia, 2 cases (14. 3%) of osteomyelitis, 2 cases (14. 3 %) of amputation, 1 case (7. 1%) of delayed union and 3 cases (21. 4 %) of malunion in the PCWD group, and no complications in the STIT group.
文摘Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the elderly.Methods:Sixty elderly patients who had undergone hip fracture surgery from February 2021 to February 2022 were selected as the research subjects.The patients were divided into two groups via drawing lots.Both the groups received nursing care,but the patients in the observation group were treated with TCM acupoint application combined with pneumatic compression therapy,whereas the control group received pneumatic compression therapy.The evaluation indicators included the patients’quality of life and complications.Results:The incidence of lower extremity deep vein thrombosis in the observation group was more than twice(0.3%),whereas the incidence of lower extremity complications in the control group was more than 6 times(20%).There was a significant difference between the two groups(p<0.05).Conclusion:Traditional Chinese medicine acupoint application combined with pneumatic compression therapy is beneficial for the prevention of postoperative lower extremity deep vein thrombosis among elderly patients.In addition,the patients’overall quality-of-life scores in both physiological and psychological aspects improved significantly,which carries significant clinical reference value.
文摘Objectives:To investigate the effect of traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy for treatment of Neerll-type distal humerus fractures.Methods:Sample selection was carried out during time period from November 2014 to May 2019.Sixty-six patients admitted to our hospital were selected as sample patients.The control group was given plaster treatment,while the observation group was given traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy.Efficacy for the two groups of patients was observed.Results:In this study,the total effective rate of observation group patients with treatment of traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy was 100%.Meanwhile,total effective rate of patients in control group was 87.88%.The difference was significant,P<0.05.Conclusions:In this study of clinical treatment,traditional Mongolian osteopathy manual reduction with medicinal wine spraying massage and small splint external fixation therapy could provide better therapeutic effect for treatment of patients with Neerll-type distal humerus fracture.At the same time,it reduces economic burden of patients.It has higher promotion value for clinical practice.
文摘Objective: to analyze the rehabilitation effects of physical therapy combined with exercise rehabilitation for postoperative dysfunction of patellar fracture. Methods: a total of 65 patients with postoperative dysfunction of patellar fracture were included in the study. They were grouped according to different treatment methods. Patients who received simple physical therapy were included in the reference group (34 cases), while patients who received physical therapy combined with exercise rehabilitation therapy were included in the research group (31 cases). The joint range of motion scores, daily function scores and pain scores of the two groups were observed and compared. Results: compared with the reference group, the joint range of motion score and daily function score were higher in the research group, while the pain score was lower, with significant differences between the groups (P<0.05). Conclusion: physical therapy and exercise rehabilitation after patellar fracture surgery can improve the dysfunction, relieve pain and increase the joint range of motion.
文摘Objective: to observe the actual curative effect in the treatment of preoperative swelling of closed calcaneal fracture by combining unarmed lymphatic drainage and pneumatic therapy. Methods: 50 patients with closed calcaneal fractures and preoperative swelling were admitted to the Second Peoples Hospital of Changzhi City. The period of receiving patients was from January 2020 to February 2022. All patients were randomly assigned to a standard grouping operation. All patients were treated with drugs to reduce swelling. At the same time, 25 patients in the observation group were treated with air pressure therapy on the basis of the 25 patients in the control group who were treated with the free-hand lymph reflux scheme alone. The swelling degree, the swelling ratio of the calf circumference, the pain score and the preoperative waiting time were compared. Results: the data in table 1 and table 2 show that after treatment, the observation group is more satisfactory than the other group in terms of each comparative index (p < 0.05). At the same time, investigation and understanding of the treatment satisfaction of the patients in both groups show that the satisfaction of the observation group is at a higher level, with a statistical value of p < 0.05. Conclusion: for the preoperative swelling problem of closed calcaneal fracture, the whole effect is better by carrying out free-hand lymphatic drainage treatment and pneumatic treatment.
文摘Compare the effects of locomotion therapy and pelvis traction therapy to treat Ⅰ～Ⅱ° thoracolumbar compression fracture.Methods Ninety-two cases with Ⅰ～Ⅱ° thoracolumbar compression fracture were selected and divided into 2 groups with locomotion therapy and pelvis traction thepapy respectively.Results Thoracolumbar height was measured according to X-ray results after 1 year follow-up.The height was (17.2±2.3)mm preoperatively and (24.4±3.1)mm postoperatively in locomotion therapy group while (16.8±2.6)mm preoperatively and (23.9±2.7)mm postoperatively in the pelvis traction therapy group.Conclusion There is no significant difference between effects on two groups.5 refs.
文摘Vertical root fracture(VRF)in molars is a complex and frequently encountered dental condition.Successful management relies on accurate diagnosis,sequential treatment strategies,and systematic care.This paper provides a comprehensive review of the sequential therapeutic approaches and systematic management models for molar VRF over the past five years.Particular attention is given to the diagnostic value of cone-beam computed tomography(CBCT),recent advances in tooth-preserving techniques,and the establishment of full-course management frameworks.By constructing an integrated pathway encompassing diagnostic assessment,treatment decision-making,clinical intervention,and long-term maintenance,a“dentist–nurse–patient community”model is proposed to promote standardized clinical guidance.This collaborative model aims to extend the lifespan of affected teeth and restore optimal masticatory function.
文摘目的探究引膝痛疗法联合被动运动在膝关节周围骨折术中的作用。方法选择河北省沧州中西医结合医院创伤骨科膝关节周围骨折内固定术后100例患者进行研究,对照组接受持续被动运动训练,试验组在对照组基础上予以引膝痛疗法。治疗结束后评估两组临床治疗效果、视觉模拟量表(visual analog scale,VAS)评分、纽约特种外科医院(hospital for special surgery,HSS)评分、改良的Barthel指数(modified Barthel index,MBI)评分、关节液中的白细胞介素-17(interleukin-17,IL-17)水平、骨代谢相关指标及生活质量。结果治疗后与对照组比较,试验组临床治疗总效率较高(P<0.05)。治疗后,两组患者VAS评分下降,HSS和MBI评分升高(P<0.05);与对照组比较,试验组VAS评分较低,HSS、MBI评分较高(P<0.05)。治疗后两组患者关节液中IL-17的水平均下降,关节液中骨代谢指标升高(P<0.05)。与对照组比较,试验组关节液中IL-17的水平较低,骨代谢指标水平较高(P<0.05)。治疗后两组患者的生活质量评分均有所提高,试验组评分较对照组高(P<0.05)。试验组并发症发生率较对照组低(P<0.05)。结论引膝痛疗法联合持续性被动运动锻炼对接受膝关节周围骨折内固定术的患者具有明显的治疗效果,可显著提升膝关节功能、生活质量,其效果实现可能与抑制炎症反应和促进骨代谢的改善存在密切相关性。
