In the limb lengthening by gradual distraction techniques, permanent tissue damage and joint contracture or subluxation can occur if the bone is lengthened beyond a certain safety limit. The main cause of those problems seems to be the difference in the reaction to distraction between bone and muscle. The purpose of this study was to investigate the difference between the tibialis anterior, a monarticular muscle and extensor of ankle joint, and gastrocnemius, a biarticular muscle and flexor of knee and ankle joint, in their response to bone lengthening in relation to the percentage of lengthening of the tibia by callotasis. Fifteen growing rabbits were divided into three lengthening groups; group I (10% lengthening), group II (20% lengthening), and group III (30% lengthening). The lengthening was done on the left tibiae and the right tibiae were used as a control. Length of the muscle belly, length of the tendon, and weight of the muscle were measured. Histopathologic studies by hematoxylin eosin and Masson trichrome stain were done on the mid-portion of muscle belly and distal musculotendinous junction of each muscle. Scoring system based on five parameters (atrophy of muscle fibers, the internalization of nuclei of muscle fibers, the degeneration of muscle fibers, the regeneration of muscle fibers, and the endomysial fibrosis of muscle fibers) was utilized for semi-quantitative analysis of histopathologic study. The following results were obtained.; 1. The length of muscle belly significantly increased in the experimental side compared to the control in group II, group III of tibialis anterior and in group III of gastrocnemius (P<0.05). 2. The length of tendon did not significantly increase in the experimental side compared to the control in any group of tibialis anterior and gastrocnemius (P>0.05). 3. The weight of muscle did not significantly increase in the experimental side compared to the control in any group of tibialis anterior and gastrocnemius (P>0.05). 4. The score of any 5 parameters did not significantly increase in the experimental side compared to the control in the mid-portion of muscle belly and musculotendinous junction of tibialis anterior and gastrocnemius (P>0.05). 5. The sum of 5 parameters did not significantly increase in the experimental side compared to the control in the mid-portion of muscle belly and musculotendinous junction of group I of either tibialis anterior or gastrocnemius (P>0.05), but significantly increased in the mid-portion of muscle belly and musculotendinous junction in group I and group II of both tibialis anterior and gastrocnemius (P<0.05). The results suggest that significant histopathologic changes can occur beyond 20% lengthening in tibialis anterior and gastrocnemius, and that gastrocnemius is less compliant to distraction than tibialis anterior.
Ankle Joint ; Bone Lengthening ; Contracture ; Eosine Yellowish-(YS) ; Extremities ; Fibrosis ; Hematoxylin ; Joints ; Knee ; Muscle, Skeletal* ; Osteogenesis, Distraction ; Rabbits ; Regeneration ; Tendons ; Tibia

Intraosseous ganglion is an uncommon benign tumor thought to be caused by an intramedullary metaplastic event. We recently experienced a case of intraosseous ganglion that occurred on the femoral head of a 65-year old man who complained of intermittent hip pain. Complete evaluation including bone scan, CT, MRI was done. His pain disappeared after curettage and bone graft was done on the lesion.
Aged ; Bone Cysts* ; Curettage ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging ; Transplants

Orthopaedic medicine has developed and benefited from the advancement of related basic science. Current technologies such as joint replacement and internal fixation of fractures started from research on biocompatible biomaterials and on the understanding of body biomechanics. As ongoing research on life science may dramatically change the appearance of future orthopaedic medicine, it is very important to keep abreast with recent trends of related basic science. This review introduces the realm of basic sciences related to orthopaedic medicine along with comments on future perspectives.
Biocompatible Materials ; Biological Science Disciplines ; Biomechanics ; Joints ; Orthopedics

Much attention has been paid to the relationship between atypical femoral fractures (AFF) and use of bisphosphonates (BPs). While a significant cause-effect relationship was not established in earlier studies, more recent data shows a growing relationship between AFF and BPs use. The definition of an 'AFF' has also undergone significant changes. This review briefly summarizes the definition, pathogenesis, and management of AFF.
Bone Remodeling ; Diphosphonates ; Femoral Fractures*

Mesenchymal stem cells (MSCs) exist in bone marrow and other musculoskeletal tissues. These cells contribute to the homeostasis of musculoskeletal tissue as well as support for the growth and differentiation of primitive hemopoietic cells. Recent advancements in tissue engineering and regeneratve medicine have brought MSCs to high attention as a potential source of cells which would differentiate to a variety of tissue, tailored to individual needs. In this review is briefly outlined the current status of MSCs, particularly focused on their biological characteristics and clinical applications.
Bone Marrow ; Homeostasis ; Mesenchymal Stromal Cells* ; Population Characteristics ; Regenerative Medicine* ; Tissue Engineering*

BACKGROUND: Bisphosphonates (BPs) are the most commonly used anti-osteoporotic drugs, which have been proven to reduce the risk of osteoporotic fractures. However, use of BPs, particularly for long periods of time, is associated with an increased risk of atypical femoral fracture (AFF). Healing of BP-associated AFF is usually delayed because of suppressed bone turnover. Teriparatide (TPTD), a recombinant form of parathyroid hormone (PTH), enhances bone healing in patients with delayed healing or non-union. METHODS: In this study, we summarized and performed a systemic review of the published literature on treatment of AFF using TPTD. RESULTS: Although there is a lack of level 1 studies on the evidence of TPTD in promoting bone union in AFFs, this systemic review of the available literature revealed that TPTD works positively in AFFs, and we put together the evidence that TPTD is a viable treatment option for enhancing fracture healing in AFFs. CONCLUSIONS: While anecdotal evidence of beneficial effects of TPTD on fracture healing offer limited guidance for clinical decision making, a better understanding of the role of TPTD in fracture healing may be elucidated with future prospective trials.
Decision Making ; Diphosphonates ; Femoral Fractures* ; Fracture Healing ; Humans ; Osteoporotic Fractures ; Parathyroid Hormone ; Prospective Studies ; Teriparatide*

PURPOSE: To retrospectively analyze and compare the results of proximal femoral nail (PFN) and dynamic hip screw (DHS) in the treatment of A22, 23 AO/OTA intertrochanteric fractures. MATERIALS AND METHODS: Out of 100 patients who had an A22,23 unstable intertrochantericfractures, 50 patients were treated with DHS (Group I) and 50 patients were treated with PFN (Group II). The age, gender, preoperative morbidity, intraoperative data (type of anesthesia, duration of surgery, the amount of blood transfusion, the position of implant) and postoperative functional status and complications of both groups were compared. RESULTS: The mean surgical duration was shorter in the PFN group than in the DHS group (P=0.03) but the amount of transfusion was comparable. The intraoperative complications encountered were a femoral shaft fracture in the PFN group, cut-through of the lag screws in one patient from each group, and a loss of reduction in one hip in the DHS group. There were no significant differences in the union time, postoperative morbidity or mortality. The mobility score was higher in the PFN group than in the DHS group (P=0.02) even though the social function score was similar. CONCLUSION: The use of PFN has the advantage of a shorter operative time and a better mobility of patients without altering the overall course of patients' recovery.
Anesthesia ; Blood Transfusion ; Hip Fractures* ; Hip* ; Humans ; Intraoperative Complications ; Mortality ; Operative Time ; Retrospective Studies

Although the risk of incurring factures of the upper extremity that are associated with in-line skating is well known, the incidence of low extremity injuries was reported to be low and so this has not yet been highlighted so far. We have experienced two cases of intertrochanteric fractures that occurred to active, middle-aged adults during in-line skating and we report on these cases along with a review of the relevant literatures.
Adult ; Athletic Injuries ; Extremities ; Hip Fractures* ; Humans ; Incidence ; Skating* ; Upper Extremity

No abstract available.
Head ; Osteonecrosis ; Stem Cells

No abstract available.