Bone and Fracture Healing

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- See:
     - Bone Healing w/ Plates: 
     - Bone Topics 
 
- Discussion:
    - stages of bone healing: 
         - chondrogenesis (endochondral ossification)
               - pure compression and hydrostatic pressure causes mesenchymal cells to differentiate to chondrogenesis and endochondral ossification;
         - intramembranous ossification: strain results in the formation of collagen and intramembranous ossification;
          - references:
              - The four biomechanical stages of fracture repair. 
              - Evidence for a humoral mechanism for enhanced osteogenesis after head injury.
              - The biology of fracture repair. 
              - Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology.
              - Correlation of x-ray analysis of healing frx w/ strength.  A statisical analysis of  experimental osteotomies. MM Panjabi et al.  J. Orthop. Res. Vol 3. 1985. p 212-218. 
    - bone vascular supply:
              - fracture healing depends on adequate blood supply.
              - ref: The vascular response to fracture micromovement. 
    - radiographic determinants of healing:  (non union)
           - restoration of cortical continuity (look for healing on 4 cortices - AP and lateral views);
           - loss of distinct fracture line;
           - presence of callus (w/ IM nail or external fixator);
    - age:
           - references:
                 - Aging of bone tissue: mechanical properties.
                 - Age-related changes in the tensile properties of cortical bone. The relative importance of changes in porosity, mineralization, and microstructure.
                 - Structural and cellular changes during bone growth in healthy children. 



    - negative influences on bone healing:
           - NSAIDS:
                 - Effects of short-term treatment with corticosteroids and indomethacin on bone healing. A mechanical study of osteotomies in rats.
                 - Antiinflammatory drug effects on bone repair and remodeling in rabbits.
                 - Selective and Nonselective Cyclooxygenase-2 Inhibitors and Experimental Fracture-Healing. Reversibility of Effects After Short-Term Treatment. 
 
                 - Dose and Time-Dependent Effects of Cyclooxygenase-2 Inhibition on Fracture-Healing.

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          - XRT: 
                 - Compressive mechanical properties of human cancellous bone after gamma irradiation.
                 - Effects of irradiation on cortical bone and their time-related changes. A biomechanical and
                          histomorphological study.
                 - Long-Term Changes in the Haversian Systems following High-Dose Irradiation. An Ultrastructural
                          and Quantitative Histomorphological Study. 

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- Induction of Bone Healing:
    - autograft / allografts:
    - bone morphogenic proteins:
    - electrical properties of bone:
          - bone loaded in compression will cause an electronegative field;
          - bone loaded in tension will cause an electropositive field;
          - references:
                - Treatment of recalcitrant non-union with a capacitively coupled electrical field. A preliminary report.

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Effect of intense physical activity on the bone-mineral content in the lower limbs of young adults.

Comparison of the effects of compression plates and external fixators on early bone-healing.

The effects of extraperiosteal and subperiosteal dissection. II. On fracture healing.

The effects of extraperiosteal and subperiosteal dissection. I. On blood flow in muscle.

Humeral hypertrophy in response to exercise.

The effects of antibiotic-impregnated autogeneic cancellous bone graft on bone healing.

Bone-healing patterns affected by loading, fracture fragment stability, fracture type, and fracture site compression.

Healing and Remodeling of Articular Incongruities in a Rabbit Fracture Model.

Direct modulation of osteoblastic activity with estrogen.

The Effect of Infection and Lag Screw Fixation on the Union of Membranous Bone Grafts in a Rabbit Model.

The science of fracture healing.

Ciprofloxacin Inhibition of Experimental Fracture-Healing.

Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology.








The induction of neochondrogenesis in free intra-articular periosteal autografts under the influence of continuous passive motion. An experimental investigation in the rabbit.