A new bone filler material, employing an adhesive carrier system and matrix particles originating from human bone, will be developed and its safety and osteoinductive potential evaluated by means of animal trials.
To create the experimental plastic bone filler material, voluntarily donated human long bones were first prepared into decalcified bone matrix (DBM) via crushing, cleaning, and demineralization. The DBM was then converted into bone matrix gelatin (BMG) employing a warm bath method. The experimental group utilized a mixture of BMG and DBM, with DBM alone serving as the control group. Fifteen healthy male thymus-free nude mice, aged 6-9 weeks, were selected to have their intermuscular spaces between the gluteus medius and gluteus maximus muscles prepared, followed by implantation of experimental group materials into all of them. HE staining was used to determine the ectopic osteogenic effect in animals sacrificed at 1, 4, and 6 weeks after the operation. Eight 9-month-old Japanese large-ear rabbits had 6-mm diameter defects created at the condyles of their hind legs; the left side received the experimental materials, while the right side received the control group materials. The animals were sacrificed at 12 and 26 weeks post-surgery; subsequently, Micro-CT and HE staining were utilized to assess the outcome of bone defect repair.
Within the ectopic osteogenesis experiment, HE staining identified a considerable number of chondrocytes within one week, with noteworthy newly formed cartilage tissues demonstrably present at four and six weeks post-surgical intervention. AG 1879 Twelve weeks after the rabbit condyle bone filling operation, HE staining showed absorption of certain materials, accompanied by the presence of new cartilage in both the experimental and control groups. Micro-CT analysis showed that bone formation, in terms of both rate and area, was more pronounced in the experimental group than in the control group. The postoperative evaluation of bone morphometric parameters demonstrated significantly higher values in both groups at 26 weeks compared to 12 weeks.
This sentence, in its altered configuration, stands as a testament to the power of rephrasing, showcasing the creative possibilities of language. In the experimental group, twelve weeks after the operation, bone mineral density and bone volume fraction were significantly superior to those in the control group.
Regarding trabecular thickness, no substantial distinction was noted between the two cohorts.
The result is numerically higher than zero point zero zero five. AG 1879 At the 26-week postoperative timepoint, a marked difference in bone mineral density was apparent, with the experimental group exhibiting a significantly higher density than the control group.
Amidst the ever-shifting tides of time, the essence of human connection remains a constant source of wonder. Between the two groups, there was no appreciable variation in either bone volume fraction or trabecular thickness.
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Distinguished by its exceptional biosafety and osteoinductive action, the new plastic bone filler material is a truly outstanding bone-filling substance.
The new plastic bone-filler material's remarkable biosafety and potent osteoinductive properties make it an outstanding bone-filling material.
Evaluating the results of calcaneal V-shaped osteotomy, combined with subtalar arthrodesis, for the treatment of malunion in Stephens and calcaneal fractures.
A retrospective evaluation of clinical data was undertaken for 24 patients with severe calcaneal fracture malunion who had undergone calcaneal V-shaped osteotomy combined with subtalar arthrodesis between January 2017 and December 2021. A cohort of 20 males and 4 females exhibited an average age of 428 years, with ages varying from 33 to 60 years. The 19 cases of calcaneal fracture that did not respond to conservative treatment were matched by 5 cases of surgical failure. Type A, as per Stephens' classification, accounted for 14 cases of calcaneal fracture malunion, whereas 10 cases were classified as type B. A preoperative assessment of the Bohler calcaneal angle revealed a mean of 86 degrees, with values ranging from 40 to 135 degrees. Concomitantly, the Gissane angle displayed a mean of 119.3 degrees, exhibiting a range from 100 to 152 degrees. The timeframe encompassing the period between the injury and the operation extended from 6 to 14 months, having a mean of 97 months. Pre-operative and final follow-up effectiveness was assessed employing the American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and the visual analogue scale (VAS) score. In the course of observing bone healing, the time required for healing was also documented. A series of measurements were performed to assess the talocalcaneal height, the inclination of the talus, the pitch angle, the width of the calcaneus, and the angle of hindfoot alignment.
Three patients experienced necrosis of the incision's cuticle edge, with full recovery achieved through dressing changes and oral antibiotic treatment. Complete and rapid healing of the other incisions was achieved through first intention. All 24 patients were monitored for a period of 12 to 23 months, with an average follow-up duration of 171 months. The recovery of the patients' foot shapes was impressive, leading to a full return to their previous shoe size, free from any anterior ankle impingement. All patients experienced bone fusion, with recovery times spanning from 12 to 18 weeks, yielding an average healing period of 141 weeks. The final follow-up assessment revealed no cases of adjacent joint degeneration in any of the patients. Five patients experienced mild foot pain while walking, yet this pain did not impede their everyday activities or work. No patient needed revisionary surgery. Substantially improved AOFAS ankle and hindfoot scores were evident post-procedure, in contrast to the pre-operative assessment.
Subsequent analysis revealed 16 cases with excellent results, 4 with good results, and 4 cases with poor results. The combination of excellent and good outcomes represented an astonishing 833% success rate. Post-operative assessments revealed significant enhancements in the VAS score, talocalcaneal height, talus inclination angle, pitch angle, calcaneal width, and hindfoot alignment angle.
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Calcaneal V-shaped osteotomy combined with subtalar arthrodesis effectively addresses hindfoot pain, corrects talocalcaneal height issues, restores the talus' inclination, and lowers the likelihood of subtalar arthrodesis complications such as nonunion.
A calcaneal V-shaped osteotomy, in conjunction with subtalar arthrodesis, demonstrates efficacy in mitigating hindfoot pain, correcting talocalcaneal height discrepancy, restoring the talar inclination angle, and reducing the risk of nonunion after subtalar arthrodesis procedures.
This research investigated the biomechanical discrepancies among three novel internal fixation methods for treating bicondylar four-quadrant tibial plateau fractures through the lens of finite element techniques, with the primary objective of identifying the method that aligns best with established mechanical principles.
Employing finite element analysis, a bicondylar four-quadrant fracture model of the tibial plateau and three experimental internal fixation methods were developed using CT image data from a healthy male volunteer. Anatomic locking plates, inverted L-shaped, were used to secure the anterolateral tibial plateaus in groups A, B, and C. AG 1879 In group A, reconstruction plates were used to longitudinally secure the anteromedial and posteromedial plateaus, while an oblique reconstruction plate fixed the posterolateral plateau. Groups B and C shared the common method of fixing the medial proximal tibia with a T-shaped plate, with either a reconstruction plate used for longitudinal fixation of the posteromedial plateau or, in the case of the posterolateral plateau, oblique fixation with a reconstruction plate. In three distinct groups, a 1200-newton axial load simulated the walking gait of a 60-kg adult on the tibial plateau. The ensuing maximum displacement of the fracture and maximum Von-Mises stress within the tibia, implants, and fracture line were then calculated.
The finite element method analysis established that stress concentrated in the tibia at the point where the fracture line intersected the screw thread in each group, and stress concentrated in the implant at the union of screws and fracture fragments. Upon applying a 1200-newton axial load, the maximum displacement of fracture fragments in the three groups presented a similar pattern. Group A experienced the largest displacement, measuring 0.74 mm, while group B exhibited the smallest, at 0.65 mm. The implant group C registered the lowest maximum Von-Mises stress of 9549 MPa, while the highest maximum Von-Mises stress was recorded in group B, at 17796 MPa. Among the groups, group C's tibia experienced the minimum maximum Von-Mises stress, measured at 4335 MPa, while group B had the highest, reaching 12050 MPa. The fracture line's Von-Mises stress in group A was the smallest, at 4260 MPa, while the corresponding value in group B reached a maximum of 12050 MPa.
In cases of bicondylar four-quadrant tibial plateau fracture, the medial tibial plateau's fixation with a T-shaped plate is a more substantial support mechanism than employing two reconstruction plates in the anteromedial and posteromedial plateaus, where the T-plate is the primary fixation. Aiding the overall structure, the reconstruction plate, when fixed longitudinally to the posteromedial plateau, more efficiently counters gliding compared to oblique fixation in the posterolateral plateau, resulting in a more stable biomechanical construct.
For a bicondylar four-quadrant fracture of the tibial plateau, a T-shaped plate's fixation to the medial tibial plateau provides a more substantial supportive effect than employing two reconstruction plates in the anteromedial and posteromedial plateaus, which should serve as the predominant plate. An auxiliary component, the reconstruction plate's anti-glide capability is amplified when positioned longitudinally on the posteromedial plateau, compared to oblique fixation in the posterolateral plateau. This promotes the development of a more dependable and robust biomechanical structure.