Determination of Radiographic Healing

Litrenta, Jody; Tornetta, Paul; Mehta, Samir; Jones, Clifford B.; O’Toole, Robert V.; Bhandari, Mohit; Kottmeier, Stephen; Ostrum, Robert F.; Egol, Kenneth A.; Ricci, William M.; Schemitsch, Emil H.; Horwitz, Daniel S.

doi:10.1097/bot.0000000000000390

Cited by 206 publications

(157 citation statements)

References 10 publications

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“…In fact Kim et al [36] revealed that the 16-year rate of survival of the components was 91% with bone allograft strut and the mean Harris Hip Score was 39 ± 10 points before revision and improved to 86 ± 14 points at 16-year follow-up ( p = 0.02) and the mean preoperative WOMAC score was 62 ± 29 (41–91) points and improved to 22 ± 19 (11–51) points at 16-year follow-up ( p = 0.003). Fractures treated with plate fixation are more rigid and do not form the same robust callus as those treated with intramedullary nails [37]. Furthermore, the presence of the plate with or without the bone allograft strut obscures the evaluation of the lateral cortex, and many reviewers commented on the difficulty in its scoring.…”

Section: Discussionmentioning

confidence: 99%

“…This difficulty is reported in experimental work, where the intraclass correlation coefficient (between RUST and modified RUST) values of individual cortices that demonstrated the lowest agreement for the lateral cortex in plate fixation are seen. The goal of the modified RUST or RUS score described in many articles is to gain a greater range of scores during the crucial time of healing when callus was bridging [37]. …”

Section: Discussionmentioning

confidence: 99%

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The Biological Metallic versus Metallic Solution in Treating Periprosthetic Femoral Fractures: Outcome Assessment

Carta

Fortina

Riva

et al. 2016

Advances in Medicine

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Introduction. The periprosthetic fracture of the femur is, in order of frequency, the fourth leading cause (5.9%) of surgical revision. Our study aims to demonstrate how the grafting of bone splint betters the outcomes. Materials. We treated 15 periprosthetic femoral fractures divided into two groups: PS composed of 8 patients treated with plates and splints and PSS involving 7 patients treated only with plates. The evaluation criteria for the two groups during the clinical and radiological follow-up were the quality of life measured by the Short Form (36) Health Survey (SF-36), Harris Hip Score (HHS), Modified Cincinnati Rating System Questionnaire (MCRSQ), bone healing measured by the Radiographic Union Score (RUS), postoperative complications, and mortality. The evaluation endpoint was set at 24 months for both groups (p < 0.05). Results. The surgery lasted an average of 124.5 minutes for the PS group and 112.6 minutes for the PSS. At 24 months all clinical and radiographic scores were p < 0.05 for the PS group. During follow-up 4 patients (2 in each group) died of causes not related to surgery. Conclusions. The use of the metal plate as opposed to cortical allogenic splint should be taken into consideration as a noteworthy point for periprosthetic femoral fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Biological Metallic versus Metallic Solution in Treating Periprosthetic Femoral Fractures: Outcome Assessment

Carta

Fortina

Riva

et al. 2016

Advances in Medicine

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show abstract

“…Each callus, on the four cortices (two from antero-posterior and two from lateral views), was evaluated by four orthopedic surgeons blinded to the group. A bony union was defined when three of the four cortices were bridged and/or fracture lines disappeared completely [ 25 , 26 ]. Nonunion was defined if neither side of the callus was bridged in these views [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

Triweekly administration of parathyroid hormone (1–34) accelerates bone healing in a rat refractory fracture model

Kumabe

Lee

Waki

et al. 2017

BMC Musculoskelet Disord

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BackgroundSome reports have shown that intermittent parathyroid hormone (PTH) (1–34) treatment for patients with delayed union or nonunion have led to successful healing. In this study, we investigated whether systemic intermittent administration of PTH (1–34) has a beneficial effect on bone healing in a rat refractory fracture model.MethodsWe created a refractory femoral fracture model in 32 rats with periosteal cauterization that leads to atrophic nonunion at 8 weeks after surgery. Half the rats received subcutaneous intermittent human PTH (1–34) injections at a dosage of 100 μg/kg, thrice a week for 8 weeks. The other half received the vehicle only. At 8 weeks after fracture, radiographic, histological and mechanical assessments were performed.ResultsRadiographic assessments showed that the union rate was significantly higher in the PTH group than in the control group (P < 0.05). The degree of fracture repair as scored using the Allen grading system in histological assessment was significantly greater in the PTH group than in the control group (P < 0.05). The ultimate stress and stiffness measurements were significantly greater in the PTH group than in the control group (p < 0.05).ConclusionsWe demonstrated that triweekly administration of PTH (1–34) increased union rate and accelerated bone healing in a rat refractory fracture model, suggesting that systemic administration of PTH (1–34) could become a novel and useful therapy for accelerating fracture healing in patients at high risk of delayed union or nonunion.Electronic supplementary materialThe online version of this article (10.1186/s12891-017-1917-2) contains supplementary material, which is available to authorized users.

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“…There have been several types of methods for assessing the union rate while there is still no gold standard method. [ 9 , 10 ] In this study, we aimed to investigate the effects of associated factors like age, fracture level, accompanying fibular fractures and wound condition on healing by determining and comparing union scores of PTF.…”

Section: Introductionmentioning

confidence: 99%