Current Concepts of Fracture Healing

Hulth, Anders

doi:10.1097/00003086-198912000-00028

Cited by 190 publications

(127 citation statements)

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“…Since the expression of c-fos is caused mostly by external signals [16-l S], it is conceivable that the sustained c-fos expression in osteoblasts in the fracture calluses is elicited by some external signals transferred via fracture-triggered liberation of cytokine(s) such as bone morphogenetic proteins (BMPs) [19,&) [21], and insulin-like growth factors (IGFs) [22-251. BMPs refer to an activity derived from bone that induces formation of cartilage and bone in vivo [20]. BMPs are also likely to play an important role in fracture healing processes [26,27]. We and others recently showed that BMPs are involved not only in the differentiation of uncommitted mesenchymal cells to cells of chondrocytic and osteoblastic lineage but also in the differentiation of immature osteoblasts into mature osteoblasts [28-321. In the present study we examined the effects of purifiqd BMPs and other cytokines on the expression of c-fis and osteoblastic marker genes in the murine osteoblastic MC3T3-El cells in vitro.…”

Section: Introductlonmentioning

confidence: 99%

Bone morphogenetic proteins (BMP‐2 and BMP‐3) induce the late phase expression of the proto‐oncogene c‐fos in murine osteoblastic MC3T3‐E1 cells

et al. 1992

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Here we report that bone morphogenetic proteins 2 and 3 (BMP‐2 and BMP‐3) induced marked expression of c‐fos mRNA in a biphasic manner, i.e. the late phase (48 to 60 h) as well as the immediate‐early phase (0.5 h), in murine osteoblastic MC3T3‐El cells in vitro. The BMP‐induced late phase c‐fos gene expression was temporally associated with the onset of marked expression of the genes for osteocalcin and alkaline phosphatase, differentiation markers of mature osteoblasts. In contrast, none of TGF‐β1, 10% FBS, IGF‐I and IGF‐II, which induced only the immediate‐early c‐fos mRNA expression, stimulated the expression of osteocalcin and alkaline phosphatase genes. These data suggest that in osteoblasts BMP‐2 and BMP‐3 induce the late phase expression of c‐fos, which may play a role in transcriptional activation of the genes involved in differentiation of osteoblasts.

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Section: Introductlonmentioning

confidence: 99%

Bone morphogenetic proteins (BMP‐2 and BMP‐3) induce the late phase expression of the proto‐oncogene c‐fos in murine osteoblastic MC3T3‐E1 cells

et al. 1992

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“…It is the responsibility of the physician, through the use of fixation, to assist in the healing process and ensure a functional result. Hulth (1989) , points out that in Index Medicus, fracture healing does not have a search word of its own but is included in wound healing because the basic mechanism for the initiation of wound healing and bone regeneration is the same, namely haematoma.…”

Section: Current Concepts In Bone Healing and Influencingmentioning

confidence: 99%

“…The controversy between the old principle of complete immobilization of the joint above and below the fracture, and the newer methods of functional bracing which allows movement of the joints, is postulated by Hulth's (1989) theory that the purpose of the immobilization, whether it be traction or bracing, is to maintain the external shape of the extremity and prevent the soft tissue from moving too much. The bone ends, on the contrary, are permitted to move within the soft-tissue package and even rub against each other.…”

Section: Secondary Bone Healingmentioning

confidence: 99%

“…Theoretically, according to Sarmiento et al (1984), Ilizarov et al (1973), cited by Hulth (1989), discovered that daily micromanipulation of callus in a tibial lengthening procedure yielded excellent new formation of bone, impossible to achieve in any other way. Hulth therefore suggests that prolonging the time of active stimulation by the fracture exudate is probably advantageous to healing.…”

Section: Secondary Bone Healingmentioning

confidence: 99%

“…Black (1985) suggests that interference type currents should be used in the later stages of bone healing, in contrast to direct current which should be used early. However Hulth (1989) emphasised that electrical currents can be translated to biochemical mediators (PGEi, morphogens and growth factors) in the fracture exudate, to stimulate bone growth for as long as possible in the initial stages of healing. The results of this trial cannot address either of these suggestions, thus the optimal time interval between injury and application of interference currents remains unsure.…”

Section: 13mentioning

confidence: 99%

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Stimulation of bone healing in new fractures of the tibial shaft using interferential currents

Fourie

Bowerbank

1997

Physiotherapy Res Intl

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The aim of this research was to establish whether interferential currents (IFC) could significantly reduce the healing time for fractures of the tibia and thereby prevent nonunion. Males between the ages of 12 and 86, who had sustained fractures of the tibiae, were entered into this double blind clinical trial. According to strict inclusion and exclusion criteria, a final sample of 227 cases (208 subjects) were entered by block randomization into two groups; an experimental group (n=41) and placebo group (n=35). A further group was entered retrospectively – control group (n=151). IFCs were applied to the experimental group via suction electrodes for 30 minutes per day for 10 days, using a beat frequency of 10 – 25 Hz and a swing mode of 6 ∫ 6. The placebo group had only suction electrodes applied, the intermittent mode produced a rhythmical massage effect; subjects in this group commented on pain relief which resulted in the addition of the control group as a check on the possible effect of intermittent suction. The control group received no intervention. The data were analysed using analysis of covariance which resulted in a finding of no significant difference in the time taken to union for the three groups. This means that to date there is no reason to believe that IFCs (using the parameters of this trial) can reduce the healing time for new fractures of the tibia or prevent nonunion. However, further investigation is recommended. Copyright © 1997 Whurr Publishers Ltd.

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Behavior of fetal rat chondrocytes cultured on a bioactive glass-ceramic

Loty

Forest

Boulekbache

et al. 1997

J. Biomed. Mater. Res.

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We examined the behavior of fetal rat chondrocytes cultured on a bioactive glass-ceramic containing apatite and wollastonite (A.W.G.C.). Biomaterial surface topography and profiles were evaluated by bidimensional profilometry and revealed a rough surface for the glass-ceramic compared to the plastic coverslips used as controls. Chondrocyte attachment was evaluated by measuring the number of attached cells after one day of culture and by morphological observations. Chondrocytes attached in great numbers to the material surface by means of focal contacts containing vinculin and beta1-integrin. Fluorescent labeling of actin and vimentin revealed a poor spreading of chondrocytes on the bioactive glass-ceramic compared to the plastic coverslips, where the cells appeared to adhere intimately to the surface and exhibited polygonal arrays of stress fibers. During the following days of culture, chondrocytes proliferated, colonized the surface of the material, and, finally, on day 10, formed nodular structures composed of round cells separated by a dense extracellular matrix. Furthermore, these clusters of round cells were positive for type II collagen and chondroitin sulfate, both hard markers of the chondrocyte phenotype. In addition, protein synthesis, alkaline phosphatase activity, and proteoglycan production were found to increase gradually during the culture period with a pattern similar to that observed on control cultures. These results demonstrate that the bioactive glass-ceramic tested in this study appears to be a suitable substrate for in vitro chondrocyte attachment, differentiation, and matrix production.

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Current Concepts of Fracture Healing

Cited by 190 publications

References 0 publications

Bone morphogenetic proteins (BMP‐2 and BMP‐3) induce the late phase expression of the proto‐oncogene c‐fos in murine osteoblastic MC3T3‐E1 cells

Bone morphogenetic proteins (BMP‐2 and BMP‐3) induce the late phase expression of the proto‐oncogene c‐fos in murine osteoblastic MC3T3‐E1 cells

Stimulation of bone healing in new fractures of the tibial shaft using interferential currents

Behavior of fetal rat chondrocytes cultured on a bioactive glass-ceramic

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