Functional training is put a very high position in the treatment of fractures by Western Medicine and Traditional Chinese Medicine. The influences of functional training during fracture healing are very important. Functional training will begin after reduction and fixation and it represents the principle of the combination of functional training and fixation in the fracture treatment by TCM. Functional training makes kinds of favourable stress, which can accelerate the healing of fracture, but the incorrect functional training makes shear strength or torsion and so on, which may make interfere fracture healing. So, the biomechanical studies on functional training of the fracture are becoming a focus of fracture treatment.
Biomechanical Phenomena ; Fracture Healing ; Fractures, Bone ; physiopathology ; surgery ; Humans

Acetabulum, as the important factor for weight bearing of the upper body, has its unique anatomic features and complicated physiological function. The integrity and stability of the lunata articular surface in the dome region of acetabulum, is the important base to bear the physiological function of acetabulum. The fracture related to this part will cause relation change of contact area and stress between head of femur and acetabulum. Furthermore, the deep anatomical position of the dome region, the complicated surrounding anatomical relation, and the irregular bony structure will also increase the difficulty of surgical treatment. Especially for some complicated comminuted or compressed fracture, even with good explosions, it is hard to get satisfied anatomical reduction. Consequently,forward traumatic arthritis has greater probability of occurrence. Therefore, the clinical research on the fracture in the dome region of acetabulum was getting more and more attention worldly. This paper intended to review the relation of fracture classifications and anatomic features, physiological function,diagnostic criteria,and also its clinical treating countermeasure.
Acetabulum ; injuries ; physiopathology ; surgery ; Fractures, Bone ; diagnosis ; physiopathology ; surgery ; Humans ; Prognosis ; Weight-Bearing

Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations. It may be associated with fractures of the adjacent bones and neurovascular compromise. It should be treated immediately by close reduction. The associated neuropraxia usually recovers with time. Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks. Here, we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.
Adult ; Fractures, Bone ; physiopathology ; therapy ; Humans ; Male ; Shoulder Dislocation ; complications ; physiopathology ; therapy

The purpose of this study was to compare the biomechanical stability obtained by using our technique featured an anatomical plate and compression bolts versus that of the conventional anatomic plate and cancellous screws in the fixation of intraarticular calcaneal fractures. Eighteen fresh frozen lower limbs of cadavers were used to create a reproductive Sanders type-III calcaneal fracture model by using osteotomy. The calcaneus fractures were randomly selected to be fixed either using our anatomical plate and compression bolts or conventional anatomic plate and cancellous screws. Reduction of fracture was evaluated through X radiographs. Each calcaneus was successively loaded at a frequency of 1 Hz for 1000 cycles through the talus using an increasing axial force 20 N to 200 N and 20 N to 700 N, representing the partial weight bearing and full weight bearing, respectively, and then the specimens were loaded to failure. Data extracted from the mechanical testing machine were recorded and used to test for difference in the results with the Wilcoxon signed rank test. No significant difference was found between our fixation technique and conventional technique in displacement during 20-200 N cyclic loading (P=0.06), while the anatomical plate and compression bolts showed a great lower irreversible deformation during 20-700 N cyclic loading (P=0.008). The load achieved at loss of fixation of the constructs for the two groups had significant difference: anatomic plate and compression bolts at 3839.6±152.4 N and anatomic plate and cancellous screws at 3087.3±58.9 N (P=0.008). There was no significant difference between the ultimate displacements. Our technique featured anatomical plate and compression bolts for calcaneus fracture fixation was demonstrated to provide biomechanical stability as good as or better than the conventional anatomic plate and cancellous screws under the axial loading. The study supports the mechanical viability of using our plate and compression bolts for the fixation of calcaneal fracture.
Biomechanical Phenomena ; physiology ; Bone Plates ; Fracture Fixation ; methods ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo summarize the experience of percutaneous fixation of scaphoid fractures with Herbert screws through volar approach, and provide a reliable and efficient treatment method for scaphoid fractures.

METHODSFrom April 2008 to September 2012,15 patients with scaphoid fractures were treated by percutaneous fixation with Herbert cannulated screws through volar approach including 14 males and 1 female with an average age of 35 years ranging from 25 to 45 years old. Among them, 10 cases were on left side and 5 cases were on right side. Durations from injury to operation ranged from 3 to 10 days with an average of 5 days. All these cases were identified as B2 type according to the Herbert classification based on X-ray and CT scan. In order to assess the function of wrist, all patients were calculated according to Krimmer's score postoperatively.

RESULTSThe follow-up period were from 5 to 18 months with an average of 10 months. At 3 months after operation,X-ray was re-checked every month. All the patients achieved bone union with a mean time of 10 weeks (ranged from 7 to 14 weeks) postoperatively. According to Krimmer's score, 14 cases gained 100 scores as perfect and one case got 90 scores as good. The small volar incision of all patients were union at the first period. No operation complications such as infection and nonunion occurred.

CONCLUSIONPercutaneous fixation with Herbert cannulated screws through volar approach is a reliable and efficient treatment method for scaphoid fractures with small invasion, high bone union rate, and fewer complications.

Adult ; Bone Screws ; utilization ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; physiopathology ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery

BACKGROUND: To determine relative fixation strengths of a single lateral locking plate, a double construct of a locking plate, and a tibial nail used in treatment of proximal tibial extra-articular fractures. METHODS: Three groups of composite tibial synthetic bones consisting of 5 specimens per group were included: lateral plating (LP) using a locking compression plate-proximal lateral tibia (LCP-PLT), double plating (DP) using a LCP-PLT and a locking compression plate-medial proximal tibia, and intramedullary nailing (IN) using an expert tibial nail. To simulate a comminuted fracture model, a gap osteotomy measuring 1 cm was created 8 cm below the knee joint. For each tibia, a minimal preload of 100 N was applied before loading to failure. A vertical load was applied at 25 mm/min until tibial failure. RESULTS: Under axial loading, fixation strength of DP (14,387.3 N; standard deviation [SD], 1,852.1) was 17.5% greater than that of LP (12,249.3 N; SD, 1,371.6), and 60% less than that of IN (22,879.6 N; SD, 1,578.8; p < 0.001, Kruskal-Wallis test). For ultimate displacement under axial loading, similar results were observed for LP (5.74 mm; SD, 1.01) and DP (4.45 mm; SD, 0.96), with a larger displacement for IN (5.84 mm; SD, 0.99). The median stiffness values were 2,308.7 N/mm (range, 2,147.5 to 2,521.4 N/mm; SD, 165.42) for the LP group, 4,128.2 N/mm (range, 3,028.1 to 4,831.0 N/mm; SD, 832.88) for the DP group, and 5,517.5 N/mm (range, 3,933.1 to 7,078.2 N/mm; SD, 1,296.19) for the IN group. CONCLUSIONS: During biomechanical testing of a simulated comminuted proximal tibial fracture model, the DP proved to be stronger than the LP in terms of ultimate strength. IN proved to be the strongest; however, for minimally invasive osteosynthesis, which may be technically difficult to perform using a nail, the performance of the DP construct may lend credence to the additional use of a medial locking plate.
Biomechanical Phenomena ; Bone Nails ; Bone Plates ; Fracture Fixation, Internal/*instrumentation ; Fractures, Comminuted/physiopathology/*surgery ; Humans ; Models, Anatomic ; Tibial Fractures/physiopathology/*surgery

OBJECTIVETo observe the long-term effect of tissue engineering-based repair of large weight-bearing bone defect in goats, and the final outcome of the scaffold material coral hydroxyapatite (CHAP) in vivo.

METHODSFifteen Chinese goats were subjected to operations to induce a 2-cm left tibial diaphyseal defect, which was filled subsequently with CHAP and bone marrow stromal stem cells (BMSCs). The repaired defects were evaluated by ECT, X-ray and histology in the early stage and at 6, 12, 18, and 24 months postoperatively.

RESULTSECT showed good bone regeneration and revascularization within 2 months postoperatively. X-ray and histology displayed eccentric and gradual bone regeneration in the early stage, and the tissue-engineered bone graft was firmly healed with the goat tibia. X-ray and histological examination at 6, 12, 18, 24 months postoperatively revealed moulding of the new bones and medullary cavity recanalization, and the structure of CHAP disappeared and gradually integrated into the new bones.

CONCLUSIONTissue-engineered bone is capable of total repair of large bone defect in goats by forming normal functional new bones. CHAP can be eventually degraded completely and become the component of the newly generated bones.

Animals ; Bone Marrow Transplantation ; Bone Regeneration ; Bone Substitutes ; Cells, Cultured ; Goats ; Prostheses and Implants ; Tibial Fractures ; physiopathology ; surgery ; Tissue Engineering ; methods

We performed endoscopic bone grafting for eight patients of delayed union and nonunion which developed after femoral and humeral shaft fractures. The mean interval from initial intervention to endoscopic bone grafting was 7.3 months. Six patients of delayed union and nonunion healed at 4.1 months on average. Two patients had unsatisfactory healing and eventually underwent non-endoscopic revisional surgery. There was no intraoperative on postoperative complication. Endoscopic bone grafting can be a less invasive alternative, obtaining rapid bone union in cases of compromised healing of the diaphyseal fracture.
Adult ; Bone Transplantation* ; Case Report ; Endoscopy* ; Female ; Femoral Fractures/surgery* ; Femoral Fractures/radiography ; Femoral Fractures/physiopathology ; Human ; Humeral Fractures/surgery* ; Humeral Fractures/radiography ; Humeral Fractures/physiopathology ; Male ; Middle Age ; Time Factors ; Wound Healing*

Mast cell(MC) takes an important role in trauma and the process of wound healing, and the pathophysiology reaction has a relationship to the time since trauma, which is helpful to determine the post-trauma and postmortem interval, and to distinguish the wound shaped whether before or after death. In this paper, the role of MC and its chemic medium in the process of wound healing, scar shaping, postburns inflammatory response, healing of bone fracture, as well as the signification for forensic medicine and the progress of researching in this field were reviewed.
Burns/physiopathology* ; Forensic Medicine/methods* ; Fractures, Bone/physiopathology* ; Humans ; Inflammation/physiopathology* ; Keloid/physiopathology* ; Mast Cells/physiology* ; Wound Healing/physiology* ; Wounds and Injuries/physiopathology*

Bone is a load-bearing organ in human body. Fatigue damage occurs readily at the modest loads to which bone is subjected during its habitual physiological usage. Even bone fracture may occur during vigorous activity. The nature of fatigue damage is that in bone there are very fine microcracks which are smaller than typical microcracks, and may occur at the level of hydroxyapatite crystals. But bone can repair microdamage by bone remodeling. Osteocytes play an important role of signaling during bone remodeling. Some researchers attempted to describe the process of bone fatigue damage and repair by mathematic, mechanical models in order to understand it well and to apply it well in clinical practice.
Animals ; Bone Remodeling ; physiology ; Bone Resorption ; pathology ; physiopathology ; Bone and Bones ; cytology ; injuries ; physiology ; Fractures, Stress ; pathology ; physiopathology ; Humans ; Models, Biological ; Stress, Mechanical