Management of posttraumatic long bone defects in the national orthopedic practice (literature review)

Shastov, A. L.; Кононович, Н. А.; Горбач, Е. Н.

doi:10.18019/1028-4427-2018-24-2-252-257

Cited by 9 publications

(1 citation statement)

References 5 publications

(6 reference statements)

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“…In modern traumatology and orthopedics, disorders of the consolidation processes in bone fractures are a serious problem [1][2][3][4]. Many factors, both local and general [1,5], lead to impairment of reparative osteogenesis [6][7][8]. Not only does this complicate the treatment of patients with fractures, but also increases the cost of the treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of local stimulation methods of reparative osteogenesis

Mukhanov

Blazhenko

Богданов

et al. 2021

Innovacionnaâ medicina Kubani

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Objective To determine the ratio of the main growth factors when using various methods of local stimulation of reparative osteogenesis.Material and methods The study consisted of two parts: in the first part a comparative analysis of the content of growth factors by ELISA was carried out (PDGF – platelet derived growth factor, TGF – transforming growth factor, VEGF – vascular endothelial growth factor, IGF – insulin-like growth factor, BMP6 and BMP7 – morphogenetic proteins 6 and 7), capable of stimulating reparative osteogenesis in blood plasma, plateletrich plasma, red bone marrow and bone autoregenerate. The second part presented the results of approbation of the autoregenerate obtained according to the original method in the framework of an acute experiment on animals.Results The most important cytokines affecting the process of reparative osteogenesis are fibroblast growth factor – FGF1 and bone morphogenetic protein 7 – BMP7. Based on the results of a comparative enzymelinked immunosorbent assay, it has been established that the autoregenerate, obtained by the original method, and a bone marrow aspirate concentrate have the highest osteogenic potential.Conclusion Autoregenerate is an effective and promising means of local stimulation of reparative osteogenesis, and its transplantation is a simple and highly effective procedure.

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Section: Introductionmentioning

confidence: 99%

Comparative analysis of local stimulation methods of reparative osteogenesis

Mukhanov

Blazhenko

Богданов

et al. 2021

Innovacionnaâ medicina Kubani

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Lower leg shortening technique in treatment of the wounded with gunshot tibial fractures

Artemev,

Kerimov,

Nelin

et al. 2024

Traumatology and Orthopedics of Russia

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Background. The severity of gunshot wounds to the extremities is due to the formation of bone and soft tissue defects. The relevance of this publication is determined by the need to introduce simple and effective methods into the practice of providing assistance to the wounded. The technique under consideration fully satisfies these requirements. The aims of the study: 1) to optimize the lower leg shortening technique and analyze the short-term results of its application in treatment of the wounded with gunshot tibial fractures; 2) to assess the indications for surgical restoration of the lower leg length after its shortening. Methods. The study enrolled 45 wounded patients with gunshot fractures of the lower leg bones. Reconstructive interventions were performed on 51 segments. In the absence of purulent-necrotic lesions of the fragments ends, closed reduction and convergence to tight contact without resection were performed (13 cases, group I). In the case of necrosis of the fragments ends, resection and convergence were performed with significant shortening of the segment (38 cases, group II). Results. The amount of shortening accounted for 4 cm [3; 6] in group I and 8 cm [7; 10] in group II (p0.001). Due to the convergence of the fragments, the reduction of the soft tissue defect was 25 cm2 [11; 41] and 38 cm2 [20; 81] in group I and II respectively. In 2 (15.4%) patients in group I and 4 (10.5%) patients in group II no fusion occurred. In the remaining cases the fusion occurred, the consolidation period was 50 [45; 59] weeks in group I and 36.5 [29; 43] weeks in group II (p0.001). Conclusions. Depending on the condition of fragments ends, there are two possible options of the shortening technique: without resection and with resection of the fragments ends. Shortening without resection is possible in the absence of signs of fragment necrosis. The disadvantage is the risk of delayed fusion, the advantage is the ability to avoid traumatic intervention in the form of resection of the fragments ends. In case of the fragments ends necrosis, their transverse resection and convergence with the elimination of diastasis between them is necessary. The advantage of this shortening technique is the optimization of conditions and reduction of fusion time, the disadvantage is the formation of significant bone defects. The need for lengthening of the shortened segment does not always arise. Lengthening as a second stage after conducting rehabilitation is considered as an optimal choice.

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Deproteinized Bone Tissue as a Matrix for Tissue-Engineered Construction: Experimental Study

Anastasieva

Черданцева

Толстикова

et al. 2023

Traumatology and Orthopedics of Russia

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Background. At present, for a number of reasons the complete bone defect replacement with autogenous bone is not always possible. Bone substitute materials are used as an alternative to autogenous bone tissue and can be of either biological or non-biological origin. One of the ways of development of reconstructive technologies is the use of tissue-engineered constructs that fully imitate autogenous bone tissue in the required volume. Aim of study to define in vivo the possibility of using deproteinized human cancellous bone tissue as a matrix for creating tissue-engineered constructs. Methods. An in vivo study was carried out on NZW rabbits. To create a construct, we used the fragments of deproteinized cancellous bone tissue of the human femoral head and stromal vascular fraction of rabbit adipose tissue as a matrix. Bone defect modeling with its subsequent replacement was performed to evaluate the efficacy of reparative osteogenesis during bone defects reconstruction. Study groups were defined: group 1 (control) surgical modeling of a bone defect of the femur without its reconstruction; group 2 surgical modeling of a bone defect of the femur with its reconstruction using fragments of deproteinized cancellous bone matrix; group 3 surgical modeling of a bone defect of the femur with its reconstruction using fragments of deproteinized cancellous bone matrix in combination with stromal vascular fraction of adipose tissue (according to ACP SVF technology). Results. Comparative analysis of reparative processes in case of applying tissue-engineered constructs based on deproteinized human cancellous bone matrix in combination with adipose tissue-derived stromal vascular fraction on in vivo experimental model revealed that the use of these bone substitute materials contributes not only to an early activation of reparative regeneration of main structural elements of the bone tissue in the area of the bone defect replacement, but also to its well-timed differentiation. This determines the restoration of structural and functional viability of the bone tissue at the damage site without developing discernible reactive inflammation. Moreover, the effect of the selected tissue-engineered construct with the combined influence of several factors (ACP SVF) in its composition turned out to be more effective in stimulating bone tissue repair and differentiation. Conclusion. Combination of SVF and deproteinized bone matrix for creating tissue-engineered constructs enables to engage several regeneration mechanisms and accelerate the process of bone defect replacement in comparison with isolated deproteinized bone matrix without bone defect reconstruction.

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Management of posttraumatic long bone defects in the national orthopedic practice (literature review)

Cited by 9 publications

References 5 publications

Comparative analysis of local stimulation methods of reparative osteogenesis

Comparative analysis of local stimulation methods of reparative osteogenesis

Lower leg shortening technique in treatment of the wounded with gunshot tibial fractures

Deproteinized Bone Tissue as a Matrix for Tissue-Engineered Construction: Experimental Study

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