BACKGROUND:Delayed healing and nonunion of fractures are common clinical issues.Clinical observations have shown that patients with limb fractures combined with traumatic brain injury experience significantly faster fracture healing compared with those without brain injury.The potential mechanisms behind this phenomenon have become a crucial focus of current research.Recent studies indicate that traumatic brain injury significantly accelerates callus formation and fracture healing processes by regulating cytokines,hormones,neural signals,and stem cell mechanisms.OBJECTIVE:To summarize the latest research progress in the mechanisms by which traumatic brain injury promotes callus formation and fracture healing,thereby providing a theoretical basis for clinical applications.METHODS:The first author conducted a search of CNKI,WanFang,VIP,PubMed,Embase,Web of Science,and Cochrane Library databases for literature published from January 2013 to October 2024,with some references traced back up to 20 years.The search terms used were"traumatic brain injury,callus,fracture healing,inflammatory response,cytokines,hormones,neuropeptides,genes,stem cells"in Chinese and English.A total of 83 articles meeting the inclusion criteria were ultimately selected.RESULTS AND CONCLUSION:The mechanism by which traumatic brain injury promotes callus formation and fracture healing is highly complex,involving multiple regulatory pathways such as cytokines,hormones,the nervous system,and stem cells.However,the precise mechanisms are still not fully understood and require further investigation.Current research suggests that traumatic brain injury accelerates bone callus formation and bone tissue regeneration by promoting the release of cytokines(e.g.,insulin-like growth factor-1)and hormones(e.g.,growth hormone and leptin),regulating the nervous system,and promoting stem cell proliferation and differentiation.Additionally,traumatic brain injury triggers a series of immune responses,including the release of inflammatory factors and activation of immune cells,which modulate fracture healing.These responses improve local blood flow,cell migration,and fibroblast activation,supporting various stages of bone healing.Stem cell activation induced by traumatic brain injury is also crucial,as activated stem cells differentiate into osteoblasts,chondrocytes,and adipocytes,facilitating bone tissue regeneration and repair.Therefore,traumatic brain injury-induced immune responses and stem cell activation work together to accelerate fracture healing,providing essential support for the process.These mechanisms significantly shorten the healing time and improve patient outcomes.In conclusion,traumatic brain injury promotes callus formation and fracture healing through multiple mechanisms,highlighting its importance in bone repair.Future research should focus on the signaling pathways and regulatory factors influenced by traumatic brain injury to further understand its mechanisms.These findings will provide a foundation for developing targeted therapies,stem cell treatments,and neural regulation therapies,with potential clinical value in shortening healing time,optimizing recovery protocols,and improving prognosis.Exploring traumatic brain injury-induced biological effects will open new avenues for fracture treatment.

Objective:To investigate the effects of pulsed electromagnetic fields(PEMFs)combined with iron oxide nanoparticle paramagnetic gel on muscle strength,mass,and function in elderly patients with degenerative muscle atrophy.Methods:The clinical data of 40 patients with degenerative muscle atrophy who were treated in our hospital from Sep 2024 to Mar 2025 were retrospectively analyzed.According to the treatment method,patients were divided into the PEMFs group and the combined treatment group,with 20 cases in each group.The intervention sites in both groups were the bilateral quadriceps femoris.The PEMFs group received low-frequency alternating PEMFs therapy,while an iron oxide nanoparticle paramagnetic gel was applied locally to the target area prior to each PEMFs session in the combined treatment group.Muscle strength,mass,and functional indicators were assessed in both groups before and after the intervention.Results:After 12 weeks of intervention,the combined treatment group showed greater improvements in maximum voluntary contraction,rectus femoris thickness,and cross-sectional area compared to the PEMFs group(P＜0.05).Additionally,the combined treatment group showed further reductions in timed up and go test(TUGT)and five-repetition sit-to-stand test(5STS)durations,as well as increased walking distance in the 6-minute walk test(6MWT),all of which were better than those observed in the PEMFs group(P＜0.05).The combined therapy also resulted in superior improvements in skeletal muscle mass index and Berg Balance Scale score(P＜0.05).Conclusions:PEMFs have a promotive effect on muscle strength,mass,and functional performance.The combination with iron oxide nanoparticle paramagnetic gel can further enhance its therapeutic efficacy.

Objective:To investigate the effects of pulsed electromagnetic fields(PEMFs)combined with iron oxide nanoparticle paramagnetic gel on muscle strength,mass,and function in elderly patients with degenerative muscle atrophy.Methods:The clinical data of 40 patients with degenerative muscle atrophy who were treated in our hospital from Sep 2024 to Mar 2025 were retrospectively analyzed.According to the treatment method,patients were divided into the PEMFs group and the combined treatment group,with 20 cases in each group.The intervention sites in both groups were the bilateral quadriceps femoris.The PEMFs group received low-frequency alternating PEMFs therapy,while an iron oxide nanoparticle paramagnetic gel was applied locally to the target area prior to each PEMFs session in the combined treatment group.Muscle strength,mass,and functional indicators were assessed in both groups before and after the intervention.Results:After 12 weeks of intervention,the combined treatment group showed greater improvements in maximum voluntary contraction,rectus femoris thickness,and cross-sectional area compared to the PEMFs group(P＜0.05).Additionally,the combined treatment group showed further reductions in timed up and go test(TUGT)and five-repetition sit-to-stand test(5STS)durations,as well as increased walking distance in the 6-minute walk test(6MWT),all of which were better than those observed in the PEMFs group(P＜0.05).The combined therapy also resulted in superior improvements in skeletal muscle mass index and Berg Balance Scale score(P＜0.05).Conclusions:PEMFs have a promotive effect on muscle strength,mass,and functional performance.The combination with iron oxide nanoparticle paramagnetic gel can further enhance its therapeutic efficacy.

BACKGROUND:Delayed healing and nonunion of fractures are common clinical issues.Clinical observations have shown that patients with limb fractures combined with traumatic brain injury experience significantly faster fracture healing compared with those without brain injury.The potential mechanisms behind this phenomenon have become a crucial focus of current research.Recent studies indicate that traumatic brain injury significantly accelerates callus formation and fracture healing processes by regulating cytokines,hormones,neural signals,and stem cell mechanisms.OBJECTIVE:To summarize the latest research progress in the mechanisms by which traumatic brain injury promotes callus formation and fracture healing,thereby providing a theoretical basis for clinical applications.METHODS:The first author conducted a search of CNKI,WanFang,VIP,PubMed,Embase,Web of Science,and Cochrane Library databases for literature published from January 2013 to October 2024,with some references traced back up to 20 years.The search terms used were"traumatic brain injury,callus,fracture healing,inflammatory response,cytokines,hormones,neuropeptides,genes,stem cells"in Chinese and English.A total of 83 articles meeting the inclusion criteria were ultimately selected.RESULTS AND CONCLUSION:The mechanism by which traumatic brain injury promotes callus formation and fracture healing is highly complex,involving multiple regulatory pathways such as cytokines,hormones,the nervous system,and stem cells.However,the precise mechanisms are still not fully understood and require further investigation.Current research suggests that traumatic brain injury accelerates bone callus formation and bone tissue regeneration by promoting the release of cytokines(e.g.,insulin-like growth factor-1)and hormones(e.g.,growth hormone and leptin),regulating the nervous system,and promoting stem cell proliferation and differentiation.Additionally,traumatic brain injury triggers a series of immune responses,including the release of inflammatory factors and activation of immune cells,which modulate fracture healing.These responses improve local blood flow,cell migration,and fibroblast activation,supporting various stages of bone healing.Stem cell activation induced by traumatic brain injury is also crucial,as activated stem cells differentiate into osteoblasts,chondrocytes,and adipocytes,facilitating bone tissue regeneration and repair.Therefore,traumatic brain injury-induced immune responses and stem cell activation work together to accelerate fracture healing,providing essential support for the process.These mechanisms significantly shorten the healing time and improve patient outcomes.In conclusion,traumatic brain injury promotes callus formation and fracture healing through multiple mechanisms,highlighting its importance in bone repair.Future research should focus on the signaling pathways and regulatory factors influenced by traumatic brain injury to further understand its mechanisms.These findings will provide a foundation for developing targeted therapies,stem cell treatments,and neural regulation therapies,with potential clinical value in shortening healing time,optimizing recovery protocols,and improving prognosis.Exploring traumatic brain injury-induced biological effects will open new avenues for fracture treatment.

BACKGROUND:Pulsed electromagnetic field is a non-invasive and non-radiative treatment method.Clinical use of pulsed electromagnetic fields in the treatment of orthopedic diseases has achieved certain results. OBJECTIVE:To review the current clinical application of the pulsed electromagnetic field in the treatment of orthopedic diseases,providing a scientific theoretical basis for the clinical treatment of orthopedic diseases. METHODS:The first author used a computer to search PubMed,CBM,Cochrane Library,CNKI,and WanFang Data for related studies on the pulsed electromagnetic field in the treatment of orthopedic diseases,using the keywords of"pulsed electromagnetic field,orthopedics,osteoarthritis,osteoporosis,bone healing,electromagnetic navigation"in English and Chinese.For the literature related to the same content,recent publications were selected.A total of 69 articles were selected from the search results for review. RESULTS AND CONCLUSION:Pulsed electromagnetic field has a definite curative effect on fracture healing.It can be used in the treatment of osteomyelitis by antibacterial,bactericidal,anti-inflammatory and promoting bone healing,and can inhibit osteoporosis and its progress.In addition,the treatment of early osteoarthritis,femoral head necrosis and postoperative rehabilitation of late joint replacement through various ways can become a treatment for orthopedic diseases.However,the therapeutic mechanism of the pulsed electromagnetic field for a variety of orthopedic diseases is still unclear,and most of the research is still in the primary stage.In the future,it is still necessary to obtain more reliable evidence from high-quality research and clinical trials to provide a more perfect basis for the clinical treatment of orthopedic diseases.

Objective: To evaluate the clinical efficacy of proximal femoral nail antirotation (PFNA) in treatment of elderly incompleted inner wall type intertrochanteric fracture. Methods:The medical records of 33 patients with incompleted inner wall type intertrochanteric fractures were analyzed retrospectively. The incision length,blood loss,operative time,volume of drainage,start standing time,fracture healing time,abnormal rate of femur and complications were summarized,and the clinical effects were also evaluated according to Harris standard. Results:A total of 31 patients achieved complete follow-up data. The fracture healing time and clinical excellent rates were (12.5 ± 3.5) weeks and 90.3%. The abnormal rate of femur operative time, incision length, blood loss, operative time, volume of drainage, and start standing time were 12.9%,(4.3 ± 2.7) cm,(50.2 ± 35.0) ml,(40.3 ± 12.7) min,(30.5 ± 9.6) ml and (10.3 ± 5.7) d. Conclusion:PFNA fixation is an ideal method for treatment of elderly incompleted inner wall type intertrochanteric fractures, with small incision, shorter operative time, shorter fracture healing time, shorter bed rest time and less complications.

BACKGROUND:Bone marrow mesenchymal stem cels play an osteogenic role under the assistance of scaffold materials. The scaffold cannot only deliver the cels to the bone defect area, but also act as a new bone growth framework. Colagen-chitosan composite is one of ideal scaffold materials in bone tissue engineering, which has osteoinductive ability and better osteogenic ability than conventional scaffolds. Bone transport technology has been widely used in the clinical repair of long bone defects, but it has some deficiencies, such as slow osteogenesis, long time for external fixation and nonunion. How to further accelerate bone formation and reduce complications has become the current problem to be solved. Here, it is hypothesized that bone marrow mesenchymal stem cels/ colagen/chitosan composite scaffold can increase the therapeutic effect of bone transport in the repair of tibial bone defects.
METHODS/DESIGN:This study is a randomized controled animal experiment, includingin vitro andin vivo tests.In vitro test: Bone marrow mesenchymal stem cels are isolated from the bone marrow of New Zealand rabbits aged 1-2 months, and passaged to the third generation. Then, cel suspension is added onto the colagen-chitosan scaffold to construct the bone marrow mesenchymal stem cels/colagen/chitosan composite scaffold.In vivo test: Twenty-four New Zealand rabbits at 3-4 months are selected and randomly assigned to receive bone transport, scaffold implantation, bone transport+scaffold implantation, respectively. The primary outcome measures are the growth of implant materials and bone defect interface, X-ray detection of bone defect repair, hematoxylin-eosin staining and scanning electron microscope observation of bone formation in the bone defect region, immunohistochemical detection of type I colage expression in the osteogenic region, scanning electron microscope observation of interface bonding between implant materials and host bone, ultrastructure and bone formation.
DISCUSSION:The results from this animal experiment wil help to determine the feasibility of bone marrow mesenchymal stem cels/colagen/chitosan composite scaffold to accelerate bone repair during bone defect repair using bone transport technology.

[Objective]To evaluate long term curative effect on treatment of developmental dislocation of hip(DDH) in children between 18~36 months old by combined close-reduction method of adductor-cut,close-reduction and frog type plaster fixation.[Method]One hundred and fifty-six children(232 hips) treated by combined close-reduction method in 1993 to 2001 were followed-up with mean follow-up time of 9.2(5.5~14.5) years.There were 77 hips of grade Ⅰ dislocation,95 hips of grade Ⅱ,and 60 hips of grade Ⅲ according to Zhou Yongde grading criteria.Periodical imaginological and hip joint function examinations were evaluated and analyzed.[Result]One hundred and ninety-five hips obtained satisfactory concentric reduction with excellent and good rate of 84.05% according to Zhou Yongde criteria.There were 9 hips with femoral head necrosis at follow-up.Mean preoperative acetabular index(AI) of successful reduction hips was(35.34?5.96)%,and that of failure reduction hips was(44.51?5.32)%.The excellent and good rate were 84.41% in cases of grade Ⅰ hips,85.21% in grade Ⅱ hips,and 81.67% in grade Ⅲ hips.[Conclusion]Combined method of adductor-cut,close-reduction and frog type plaster fixation is an effective way for treatment of DDH of children between 18~36 months old.Preoperative AI but not degree of dislocation is the criteria to determine whether close-reduction is necessary or not.