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At least 19 recordsLinked to original sources

Prediction of bone fracture by bone mineral density in Taiwanese.

BACKGROUND AND PURPOSE: This study evaluated whether lumbar spine bone mineral density (BMDL) and the rate of change of BMDL could predict the risk of bone fracture in Taiwanese. METHODS: In 1989, a baseline survey was carried out in Lin-Kou Township. BMDL was measured using dual photon absorptiometry in 404 healthy volunteers. In 1994/95, a second survey was conducted to reexamine the BMDL and fracture history as well as the risk factors associated with fracture in these subjects. Fractures were classified according to the causes of the injury as severe or mild trauma. RESULTS: Of the 404 original examinees, 381 (79%) participated in the second survey. Twenty-six subjects had experienced a total of 32 fracture incidents during their lifetime and 10 subjects had experienced fracture during the observation period. After adjusting for the effect of body mass index, gender, and age, each standard deviation of decrease in BMDL was found to be associated with a significant 2.38-fold increase in the risk of mild trauma fracture, and a BMDL below the fracture threshold was associated with a 3.93-fold increase of fracture risk. Higher BMDL change rates were found in subjects with a history of fracture. CONCLUSION: This study indicates the importance of maintaining the BMDL above the fracture threshold (1 g/cm2). The strategy for fracture prevention should be directed at prevention of age-related bone loss.

Absorptiometry, Photon↗

Bone fracture history and prospective bone fracture risk of hemodialysis patients are related to apolipoprotein E genotype.

This investigation of 219 hemodialysis patients relates the history and prospective risk of bone fractures to apolipoprotein E (apoE) genotype. A greater percentage of the 41 patients with the E3/4 and E4/4 genotypes than of the 38 patients with the E2/3 and E2/2 genotypes had a history of bone fractures at the time of recruitment (44% versus 16%, P < 0.005). During the 4 years following recruitment, more of the patients with apoE genotypes E3/4 and E4/4 than with apoE genotypes E2/3 and E2/2 suffered bone fractures, but this difference was not statistically significant (17.1 versus 5.3%, P < 0.1). ApoE genotype appears to be an important genetic risk factor for bone fracture, possibly due to its previously reported influence on vitamin K concentrations in blood.

Adult↗

Pathological analysis of bone fractures in race horses.

Pathomorphological analysis was performed on fractured bones of 470 race horses. The most common fracture site was the limb (98% of cases), and the majority of fractures were intra-articular. Focal osteochondral lesions consisting of osteochondrosis, osteonecrosis and osteosclerosis were observed frequently in fractured and non-fractured bones. In the fractured bones, the lesions frequently appeared in the vicinity of the fractured site. Under the influence of antecedent osteochondrosis from the young stage, osteosclerotic and osteonecrotic lesions may have been induced by immoderate exercise and localized ischemia. These morbid conditions may be important as local predisposing factors for bone fracture because the osteosclerotic and osteonecrotic lesions may contribute to diminished resistance to torsion and shearing forces.

Age Factors↗

[Osteosynthesis of crural bone fractures using bone plates with pegs].

A metal plate with pegs for osteosynthesis was designed and introduced into practice for the treatment of diaphyseal fractures of the leg bones. Studies for appraising the tension-deformity condition proved that installation of 20 cone-shaped pegs on the inner surface of the plate increases the stability of fixation 3.6-fold. Besides, the cone-shaped pegs facilitate maintenance of intactness of the vessels of the periosteum and soft tissues as a result of which the conditions for healing of the fractures improve. Operations were carried out on 43 patients, in 41 with good outcomes. External immobilization was not applied in the postoperative period, early restorative treatment was conducted.

Adolescent↗

The effect of haemorrhage and bone fracture on bone marrow circulation.

Blood flow was measured in the bone marrow and trabecular bone of the dog using 133Xe and hydrogen clearance technique. Estimated from hydrogen wash-out curves, flow in the marrow of the femoral diaphysis was 0.207 ml.min(-1).g(-1), in the marrow of the humerus 0.123ml.min(-1).g(-1) and in the trabecular bone of femoral metaphysis 0.173ml.min(-1).g(-1). Haemorrhagic hypotension and fracture reduced the medullary flow. After haemorrhage an exponential relationship was found between blood pressure and effective bone marrow and muscle blood flow. The correlation between systemic arterial and intramedullary pressures was found to be exponential and between intramedullary pressure and flow linear.

Animals↗

Septal fracture in simple nasal bone fracture.

SUMMARY: Nasal bone fractures are the most common type of facial fractures. Previous studies have shown that most nasal fractures involve the septum, which can provide an obstacle to the successful reduction of nasal bone fractures. In particular, septal fractures in combination with simple nasal bone fractures are usually unrecognized and untreated at the time of injury. Furthermore, systemized treatment protocols and diagnostic tools for septal fractures in the case of simple nasal bone fracture have not previously been presented. In this study, the clinical findings of septal fractures in cases of simple nasal bone fracture were correlated with symptoms, signs, and computed tomography findings and assessed statistically. The patterns of septal fractures in simple nasal bone fractures were assessed by direct vision via hemitransfixion incision. Of the 52 patients with simple nasal bone fracture who presented over a 3-year period and were included in this study, 10 were female and 42 were male, with an average age of 33.8 years (age range, 18 to 61 years). Fifty of these patients (96.2 percent) showed septal fractures, and septoplasty or submucosal resection was performed on 41 patients (78.8 percent) who manifested severe septal fractures of perioperative septal grade 3 or higher. Closed reduction of the nasal bone fracture only was performed on the remaining 11 patients. Among the signs evident at physical examination, mucosal tearing was found to be statistically significant for septal fracture. Computed tomography was found to be very helpful in diagnosing septal fracture but could not predict its severity accurately (Spearman correlation coefficient between computed tomography septal grading and perioperative septal grading, 33.5 percent). Therefore, computed tomography could not be used as a definitive diagnostic modality for septal fractures in terms of deciding whether septoplasty or submucous resection was needed. It is evident that septal fractures are frequent in simple nasal bone fractures that are not combined with other facial bone fractures. This study confirms that there are differences between radiologic findings and perioperative findings. To reduce the incidence of posttraumatic nasal deformity, meticulous physical examinations with subsequent septoplasty or submucosal resection are needed in the treatment of simple nasal bone fracture.

Adolescent↗

Air in the temporomandibular joint fossa: CT sign of temporal bone fracture.

Temporal bone fractures can be difficult to detect clinically and radiographically. Air is sometimes present in the glenoid fossa of the temporomandibular joint (TMJ) at computed tomography (CT) of acute basilar skull fractures. This study evaluated TMJ fossa air as a sign of temporal bone fracture. Initial CT scans of the head in 114 patients with a diagnosis of basilar skull fracture at discharge were retrospectively reviewed. TMJ fossa air was present in 23 of 114 patients (20.2%) and was bilateral in three patients. Only temporal bone fractures were significantly (P less than .001) associated with TMJ fossa air. Temporal bone fractures were observed at CT in 23 of 26 cases of TMJ fossa air, but in three of 26 cases, TMJ fossa air was the only CT sign of clinically apparent temporal bone fractures. TMJ fossa air is associated with acute temporal bone fracture and may be the only CT sign of an otherwise inconspicuous temporal bone fracture.

Adolescent↗

Grafting long bone fractures with demineralized bone matrix putty enriched with bone marrow: pilot findings.

In this pilot study, the preliminary effectiveness of a composite graft consisting of demineralized bone matrix (DBM) putty (Grafton DBM) and aspirated bone marrow was evaluated for treating long bone fractures. Patients were ssigned randomly to treatment with the DBM putty composite (n = 10) or iliac crest autograft (n = 8), and had a minimum of 12 months of radiographic follow-up. Ninety percent of DBM patients (9/10) achieved full bone formation compared to 75% of autograft patients (6/8) (P = .41). Additionally, all 10 DBM patients were healed compared with 63% of autograft patients (5/8) (P = .07). These findings suggest that DBM putty enriched with bone marrow may be comparable to autograft for treating long bone fractures.

Adult↗

Biomechanics of bone-fracture fixation by stiffness-graded plates in comparison with stainless-steel plates.

BACKGROUND: In the internal fixation of fractured bone by means of bone-plates fastened to the bone on its tensile surface, an on-going concern has been the excessive stress-shielding of the bone by the excessively-stiff stainless-steel plate. The compressive stress-shielding at the fracture-interface immediately after fracture-fixation delays callus formation and bone healing. Likewise, the tensile stress-shielding of the layer of the bone underneath the plate can cause osteoporosis and decrease in tensile strength of this layer. METHOD: In order to address this problem, we propose to use stiffness-graded plates. Accordingly, we have computed (by finite-element analysis) the stress distribution in the fractured bone fixed by composite plates, whose stiffness is graded both longitudinally and transversely. RESULTS: It can be seen that the stiffness-graded composite-plates cause less stress-shielding (as an example: at 50% of the healing stage, stress at the fracture interface is compressive in nature i.e. 0.002 GPa for stainless steel plate whereas stiffness graded plates provides tensile stress of 0.002 GPa. This means that stiffness graded plate is allowing the 50% healed bone to participate in loadings). Stiffness-graded plates are more flexible, and hence permit more bending of the fractured bone. This results in higher compressive stresses induced at the fractured faces accelerate bone-healing. On the other hand, away from the fracture interface the reduced stiffness and elastic modulus of the plate causes the neutral axis of the composite structure to be lowered into the bone resulting in the higher tensile stress in the bone-layer underneath the plate, wherein is conducive to the bone preserving its tensile strength. CONCLUSION: Stiffness graded plates (with in-built variable stiffness) are deemed to offer less stress-shielding to the bone, providing higher compressive stress at the fractured interface (to induce accelerated healing) as well as higher tensile stress in the intact portion of the bone (to prevent bone remodeling and osteoporosis).

Animals↗

Prospects of computer models for the prediction of osteoporotic bone fracture risk.

Bone fractures are major problems for osteoporosis patients. To avoid such fractures, more information is needed about the factors that determine the bone fracture risk. In this chapter, it is discussed how recently developed finite element computer models that can represent the trabecular architecture in full detail can provide such information. It is concluded that a computer modeling approach to this problem is feasible, required and promising. It is expected that, eventually, such models can be used as a basis for an accurate diagnosis of the bone fracture risk.

Biomechanical Phenomena↗

[The biology of bones and of bone fracture healing].

For the treatment of fractures several systems are available. Biological and biomechanical aspects have to be considered in order to obtain an optimal final result. The vascular supply of the intact and of the fractured bone is reviewed. The role of the fracture hematoma with a low pO2 and a pH below the physiological range are discussed. In bone remodelling tension forces and cyclic loading are important factors in resorption and regeneration. The influence of the periosteum in bone healing after internal fixation is described.

Bone Regeneration↗

High resolution CT scan of temporal bone fractures: association of facial nerve paralysis with temporal bone fractures.

This radiologic study analyzed high resolution computed tomographic (CT) scans of 22 patients with temporal bone fractures. There were 19 males and three females. Fifteen of 22 had clinical evidence of facial nerve injury ranging from mild paresis to complete paralysis. The high resolution CT scan analysis identified a characteristic fracture of the temporal bone in every patient with facial nerve injury. A high percentage of these fractures (68%) could be classified as mixed and did not fall into a longitudinal or transverse fracture category. The characteristic fracture extends from the petrotympanic fissure at the glenoid fossa to the anterior inferior aspect of the medial bony external auditory canal. It resumes at the superior aspect of the external auditory canal (scutum) extending laterally along the external canal wall. If the vector force of the fracture is projected medially, it will cross the facial nerve in its horizontal portion. Often, the evaluation of trauma patients with routine CT scans for central nervous system (CNS) (brain) evaluation is inadequate for evaluation of temporal bone fractures. A high resolution CT scan should be performed when clinical criteria warrant its use. It is recognized that the incidence of facial nerve injury may be higher in this select population.

Adolescent↗

Temporal bone fractures: longitudinal or oblique? The case for oblique temporal bone fractures.

Classical descriptions and illustrations of temporal bone fractures are misleading. Both oblique and longitudinal fractures produce a similar fracture line in the middle cranial fossa; however, externally, they are different. Oblique fractures cross the petrotympanic fissure while longitudinal fractures run within it. In a study of 150 temporal bone fractures, the majority were oblique. An array of fracture planes accounts for most of the fractures observed. Depending on the direction of trauma, fracture planes rotate around an anteroposterior axis. When they approach the horizontal (axial) plane, they result in oblique fractures. True longitudinal fractures are rare. They are vertical and perpendicular to the oblique planes.

Adolescent↗

[The healing of bone fractures in rats during the readaptation after a 14-day head-down suspension].

Histological, histochemical and histomorphometric methods have been used to study an effect of a 14-day head-down suspension on healing the fractured fibular diaphysis in the rats traumatized immediately after suspension. The study of the fibulae on Days 11 and 17 following an operative fracture indicated that both in control and experimental rats the ends of fractured bones were tightly interconnected by the calluses. A comparative study of the calluses and their structural components as well as detailed investigation of histological structure of calluses on the 11th and 17th post-traumatic days did not reveal significant differences between control and experimental animals. Furthermore, the rate of cartilage replacement by spongy bone tissue in calluses of experimental animals was even somewhat higher than that in control rats. Thus the data obtained give ground to believe that in a readaptation period after 14-day suspension resulting in the osteoporotic changes of weight-bearing bones a repair process in the bones is rapidly normalized and in some parameters exceeds it in control animals.

Adaptation, Physiological↗

Temporal bone fractures.

Temporal bone fractures represent a frequent source of morbidity and are often associated with fatal injuries in the head trauma patient. The initial care of these patients may be the responsibility of the emergency room physician or the neurosurgeon. The treatment of temporal bone fractures is often postponed because more pressing injuries may exist. However, it should be stressed that an otolaryngologist be consulted as soon as feasible because future rehabilitation is dependent on the initial examination.

Humans↗