Fracture healing is the result of highly ordered physiological and cellular pathways to restore the structure and function of broken bones. Therefore, bone, unlike other types of tissues, heals when the damaged area of the bone is completely reshaped biochemically and biomechanically. Many effective mechanisms such as systemic biological factors, biochemical factors, hormonal factors, and biomechanical factors affect fracture healing. [1,2] A problem that occurs in this process may result in nonunion or late union. [3,4] Bone healing problems are common, particularly in fractures with bone defects. Numerous negative mechanical factors such as excess motion at the fracture site, a large interfragmentary gap and loss of blood supply affect the development of nonunion. [5] On the other hand, although the infection does not cause nonunion on its own, it creates a predisposition by creating similar factors that cause nonunion. Factors such as old age, cachexia and malnutrition, steroids or anticoagulants, Objectives: This study aims to investigate the efficacy of tetracalcium phosphate (TTCP) on fracture healing in rat femurs.Materials and methods: Forty-two female Wistar Albino rats were randomized into two groups (Group 1 and Group 2, n=21 for each). The left femur of all animals was fractured by osteotomy after deep anesthesia with ketamine. Additional procedure was not applied to the rats in Group 1. Rats in Group 2, following osteotomy, were applied to the fracture line approximately 2 mL TTCP. The animals were sacrificed at Weeks 1, 2, and 3 after surgery (seven animals were sacrificed from each group each week) and the broken femurs were removed. The femurs were examined first radiographically and second histopathologically.Results: Radiologically, callus maturity and bone union increased with time in both groups. However, no significant differences were found regarding callus maturity and bone union in weekly comparisons (anteroposterior plain: p=0.53, p=0.37, p=0.42, lateral plain: p=0.26, p=0.42, p=0.87). Histopathologically, the fractures healed normally as the weeks progressed in both groups. The histological scores of Group 2 were higher at Weeks 1, 2, and 3. In the evaluation, no significant difference was found between the groups in terms of histological scores except for the first week (p=0.024, p=104, p=462, respectively). Conclusion:Although there was no statistically significant difference in the histological evaluation of both groups, except for the first week, the histological scores of Group 2, which underwent TTCP in all weeks, were higher. According to the results of this study, we believe that TTCP may be beneficial, particularly in the early stages of fracture healing.
Background: Studies have shown that bioactive cements have beneficial bone-forming effects. Our objective in the present study is to investigate the efficacy of tetracalcium phosphate (TTCP) on fracture healing in rat femur.Materials and methods: Forty-two female Wistar Albino rats randomized into two groups (groups 1 and 2, n=21 for each). The left femur of all animals was fractured by osteotomy after deep anesthesia with ketamine. Additional procedure was not applied to the rats in group 1. Rats in Group 2, following osteotomy were applied to the fracture line approximately 2 cc TTCP. The animals were sacrificed on the 1st, 2nd and 3rd post-operative weeks (each week 7 animals were sacrificed from each group) and the broken femur were removed. The femur were examined first radiographically and second, histopathologically.Results: Radiologically, callus maturity and bone union increased with time in both groups. But no significant differences were found regarding callus maturity and bone union in weekly comparisons (Anteroposterior plain: p:0.53, p:0.37, p:0.42, Lateral plain p:0.26, p:0.42, p:0.87). Histopathologically, the fractures healed normally as the weeks progressed in both groups. In the comparison of both groups, no significant difference was found outside the 1st week, although the histological scores of group 2, who were treated for all weeks, were higher in terms of fracture healing (p:0,024, p:104,p:462).Conclusions: Although no significant difference was found in the comparison of both groups except for the first week, the histological scores of the group 2 who received TTCP in all weeks were higher in terms of fracture healing. According to the results of this study, we think that TTCP can be useful especially in the early stages of fracture healing.
Tuber kalkanei kopma kırıkları, genellikle indirekt travma sonrası oluşan ve nadir görülen kırıklardır. Osteoporoz ve diyabet, kırık gelişiminde risk faktörleridir. Bunlar, olası yara sorunları nedeniyle erken cerrahi girişim ile tedavi edilmesi gereken kırıklardır. Bu yazıda, kopma kırığı nedeni ile cerrahi tedavi uygulanan ve vida ile tespiti yapılan, takiplerinde osteoporoz, hasta uyumsuzluğu (erken yük verme), yara yeri problemleri nedeniyle sirküler alçı uygulanamaması gibi problemler nedeniyle erken dönemde implant yetmezliği ve kırık fragmanda redüksiyon kaybı gelişmesi üzerine çift düğme implantı ile revizyon cerrahisi yapılan bir olgu sunuldu.
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