Abstract:
OBJECTIVE:To investigate whether a long bone cortex of well-defined thickness can be regenerated by using an anatomically designed membranous resorbable "tube-in-tube" implant and to establish the functions of membranes in the healing of segmental diaphyseal bone defects larger than the "critical size." DESIGN:Bone healing in segmental diaphyseal defects larger than the critical size in the sheep tibiae covered with a single porous tubular membrane or implanted with anatomically shaped porous double tube-in-tube membranes was evaluated. Membranes with different pore structures were applied alone and/or in combination with autogenous bone graft. BACKGROUND:Healing of segmental diaphyseal bone defects in animals can be enhanced by covering the defects with resorbable polylactide membranes. Based on the results of bone healing in defects ten millimeters long in the rabbit radii, it was suggested that the membrane prevents muscle and soft tissue from invading the defect and maintains osteogenic cells and osteogenic substances within the space covered with membrane, thus promoting new bone formation. The functions of membranes may differ, however, depending on the size and the location of the defect and on the experimental species used. Bone defects larger than the critical size may not heal at all, even if membranes are used. The critical-size defect is defined as the smallest bone defect that does not heal spontaneously when covered with polymeric membranes. To heal such defects, it is mandatory that membranes are used in combination with autogenic bone graft and/or a suitable bone substitute. If bone graft is used to fill the defect, the structure and geometry of the covering membrane will determine whether the graft will be vascularized and/or nourished from the surrounding soft tissue and, in consequence, survive. It can be appreciated that bone healing in areas of good vascularity should be more efficient than bone healing in poorly vascularized areas. The influence of all these factors on healing of bone in segmental diaphyseal defects covered with membranes is not known. METHODS:Four-centimeter-long diaphyseal segmental defects in the tibiae of six- to seven-year-old Swiss mountain sheep were covered with resorbable membranes from poly(LDL-lactide). In Group 1, a single microporous external membrane was used. In Group 2, one microporous membrane was inserted into the medullary cavity at the cut ends of the tibiae (internal membrane), and the other microporous membrane was placed on the outer surface of the cortex (external membrane). In Group 3, a single microporous external membrane was also laser-perforated to produce openings with a diameter in the range of 800 to 900 micrometers. In Group 4, the defect was filled with autogenous cancellous bone graft and covered with a single perforated membrane. In Group 5, one perforated internal membrane was inserted into the medullary cavity at the cut ends of the tibiae, and the other perforated membrane was placed on the outer surface of the cortex. Group 6 was identical to Group 5, except that cancellous bone graft was placed in the space between these two membranes. RESULTS:There was no bone healing in Groups 1, 2, 3, and 5. Only in Groups 4 and 6 did the defects heal. In Group 4, new bone was dispersed across the "medullary canal" formed by the membrane. In Group 6, the new bone had grown into the space between the outer and inner membranes, forming the "neocortex." CONCLUSIONS:The resorbable polymeric implant consisting of two concentric perforated membranes (the tube-in-tube implant) used in combination with cancellous bone graft to treat segmental diaphyseal defects in sheep tibiae allows for the reconstitution of the "neocortex" with well-defined thickness. (ABSTRACT TRUNCATED)
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Gugala Z,Gogolewski Sdoi
10.1097/00005131-199903000-00006subject
Has Abstractpub_date
1999-03-01 00:00:00pages
187-95issue
3eissn
0890-5339issn
1531-2291journal_volume
13pub_type
杂志文章abstract::Tubular poly(L-lactide) membranes with a pore size of 5-15 microns and a molecular weight of 70,000 Daltons were implanted into 24 New Zealand skeletally mature rabbits to cover 10-mm mid-diaphyseal defects of the radius of the forelimb. An identical defect on the contralateral limb was not treated with the membrane a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199604000-00006
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of anesthetic type on clinical outcomes after operative treatment of distal radius fractures. DESIGN:Retrospective review of prospectively collected data. SETTING:Academic medical center. PATIENTS:One hundred eighty-seven patients with a distal radius fracture (OTA type 23) were ide...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318238becb
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To report the outcomes of percutaneous autologous bone marrow injection for nonunion or delayed union of the distal tibial metaphysis in patients with prior plating. DESIGN:Consecutive case series. SETTING:Tertiary center. PATIENTS:Eleven consecutive patients (aged 24-51 years) were referred to us with a n...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828bf077
更新日期:2013-09-01 00:00:00
abstract::A prospective randomized study of severe open tibial fractures (Type II and III) was performed. Individual fractures were randomized to treatment groups according to initial antibiotic therapy: One consisted of a first-generation cephalosporin, and the other consisted of a third-generation cephalosporin. Initial antib...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-198802030-00001
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To biomechanically assess the angular stability provided by 3 techniques for reconstruction of the lateral ulnar collateral ligament. METHODS:Eight cadaveric elbows were tested with the lateral collateral ligament complex intact, disrupted from the origin at the lateral epicondyle, and reconstructed with 3 d...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001051
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To review and critically assess trends observed regarding the levels of evidence in published articles in orthopaedic traumatology literature. DATA SOURCES:The Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery-American, and Clinical Orthopaedics and Related Research. STUDY SELECTION:All artic...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000557
更新日期:2016-07-01 00:00:00
abstract::Many of the current techniques of internal fixation of proximal humerus fractures use tension band wires to achieve secure fixation, allowing immediate postoperative exercise of the affected limb. In addition, the use of a cancellous lag screw placed from the humeral shaft into the humeral head may have several advant...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199402000-00006
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To report on the anatomic variations of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection. DESIGN:Cadaveric anatomic study. PATIENTS/PARTICIPANTS:Sixty-eight ilioinguinal dissections performed in fifty cadavers. INTERVENTION:The lateral femoral cutaneous nerve was ide...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199901000-00005
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:To determine the angular rotation that maximizes screw tension without sacrificing screw pullout force yet minimizing loss of screw purchase. METHODS:Three pairs of human humeri in each of the 3 groups (osteopenic, osteoporotic, and normal) underwent screw tension and pullout protocols. For screw tension, 3...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000435631.71393.60
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of exchange reamed nails for treatment of aseptic femoral delayed unions and nonunions. DESIGN:Retrospective chart review. PATIENTS:Nineteen patients admitted to the Carolinas Medical Center Level I trauma center from 1990 to 1996 for repair of femoral shaft fracture nonunion ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200006000-00005
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To evaluate and compare the mechanical stability of two different fixation techniques on experimentally induced calcaneus fractures. METHODS:Thirteen fresh frozen cadaver lower limbs had intraarticular calcaneal fractures produced with an impact loading device. Internal fixation was then performed through la...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199708000-00010
更新日期:1997-08-01 00:00:00
abstract::A case of an angulated, greenstick fracture of the scapula mimicking scapular winging in a skeletally immature 12-year-old boy is described. The bony deformity was visualized with plain radiography. CT was helpful in exclusion of a thoracic injury or an underlying neoplasm. Closed reduction yielded satisfactory result...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000174707.10980.f4
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVES:This study was designed to investigate the relationship between upper extremity (UE) injuries and occupant restraint systems among front seat occupants who were involved in frontal motor vehicle collisions (MVCs). DESIGN:Case-control. SETTING:The 1995 through 2002 National Automotive Sampling System (NASS)...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000161543.52643.ab
更新日期:2005-09-01 00:00:00
abstract::A modified freehand method using a cannulated drill bit for the insertion of distal locking screws for interlocking intramedullary nails is described. It should be useful to introduce surgeons to interlocking and to aid those who are not comfortable with the freehand method. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199306000-00009
更新日期:1993-01-01 00:00:00
abstract::Minifragment implants provide several advantages for the stabilization of distal humerus fractures. Compared with small fragment implants, minifragment implants may provide enhanced fracture fixation because a greater number of screws can be placed into the distal fragments. In addition, minifragment plates are easier...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000157908.45939.d7
更新日期:2005-08-01 00:00:00
abstract::The pull-out strength of two types of bone staples (A, Techmedica; B, Richards) was evaluated in a canine model and compared with a control of 6.5 mm cancellous bone screw (Synthes). Fifteen adult mongrel dogs were divided into three groups of five animals each. The implants were placed in the lateral femoral condyle ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198701040-00009
更新日期:1987-01-01 00:00:00
abstract::Orthopaedic surgery and biomechanics are intimately partnered topics in medicine. Biomechanical principles are used to design implants and fashion treatment protocols. Although it would seem that biomechanical principles in the design of fixation devices and fracture repair constructs have been already finalized, ther...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001126
更新日期:2018-03-01 00:00:00
abstract::Business intelligence in the field of medicine, particularly with physicians, has been an abstract concept at best with no objective metric. Furthermore, in many arenas, it was taboo for medical students, residents, and physicians to discuss the business and finances of their work for fear that it would interfere with...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000177
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To study the activity and incidence of knee pain after sustaining an isolated tibia fracture treated with an infrapatellar intramedullary nail at 1 year. DESIGN:Retrospective review of prospective cohort. SETTING:Multicenter Academic and Community hospitals. PATIENTS:Four hundred thirty-seven patients with...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000475
更新日期:2016-03-01 00:00:00
abstract::Tibial plateau fractures can involve planes that require reduction and stabilization from a posterior approach. This includes posteromedial, posterolateral, and posterior column shear type injuries. This video outlines the prone posteromedial approach to the tibial plateau for posterior column fracture exposure, reduc...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001826
更新日期:2020-08-01 00:00:00
abstract::Rupture of the medial head of the gastrocnemius muscle ("tennis leg") is an affliction generally associated with athletic activity. The diagnosis is made by careful history and physical examination. Although its findings are characteristic, previous reports have documented misdiagnosis of this lesion as thrombophlebit...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199406000-00016
更新日期:1994-01-01 00:00:00
abstract::In patients who are candidates for a total knee arthroplasty and suffer a periarticular fracture of the femur, the arthroplasty may be performed after bony union of the fracture or immediately, in conjunction with the fracture repair. Herein we present the case of a sixty-year-old female with rheumatoid arthritis and ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199906000-00014
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:Screw fixation of the injured syndesmosis restores stability but may reduce motion. The purpose of this study is to determine whether functional outcomes and radiographic results after ankle fracture are affected by the status of the syndesmosis screw. DESIGN:Retrospective review of a consecutive clinical se...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a9f7a5
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:To identify factors affecting the outcomes of surgery for acetabular fracture in patients over the age of 60 years. DESIGN:Retrospective review of records and radiographs; current examination, radiographs and outcome surveys when possible. SETTING:Academic, Level 1 trauma center. PATIENTS/PARTICIPANTS:For...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200310000-00005
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this prospective study was to evaluate the safety, efficacy, and functional outcome of the locked proximal humerus plate (LPHP) to treat proximal humerus fractures. DESIGN:Prospective clinical trial. SETTING:University orthopedic center. PATIENTS:Over a 25-month period, 64 consecutive patie...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0b013e3181d2d04c
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Radiographic evaluation of the spine after an acute traumatic event is an integral part of the initial assessment of the patient. Despite this, an imaging protocol that includes detailed recommendations of the views, modalities, and techniques of radiographic work-up is lacking in the peer-reviewed literatur...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/01.bot.0000188036.69078.ef
更新日期:2005-10-01 00:00:00
abstract:PURPOSE:The purpose of this video is to demonstrate the surgical technique of a shoulder arthrodesis for a patient with multidirectional instability and multiple failed previous surgeries. METHODS:A 25-year-old woman with a long history of left shoulder multidirectional instability in the setting of Ehlers-Danlos synd...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001212
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:To report on the radiographic and clinical outcome of symphyseal plating techniques, with specific attention to the incidence of implant failure, reoperation secondary to implant complication, and ability to maintain reduction of the pelvic ring. DESIGN:Retrospective chart and radiographic review. SETTING:...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31817e49ee
更新日期:2008-07-01 00:00:00
abstract::We conducted a prospective, randomized study on 84 consecutive patients with 88 acute, traumatic femoral shaft fractures using 32 Grosse-Kempf nails, 29 Russell-Taylor nails, and 27 Synthes nails. Although total operative times and proximal and distal locking times were similar for the three groups, the procedure was ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0000000000000185
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVES:To introduce a modified operative technique for minimally invasive plate osteosynthesis (MIPO) for acute displaced humeral shaft fractures and to evaluate the clinical and radiological outcomes. DESIGN:: Prospective clinical series study. SETTING:University hospital. PATIENTS:Twenty-one patients with acut...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318254895f
更新日期:2012-10-01 00:00:00