Early Metabolic Responses of Bone to Immobilization

Hardt, Alfred B.

doi:10.2106/00004623-197254010-00011

Cited by 30 publications

(6 citation statements)

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“…Several investigators have suggested that transient responses may occur during bone adaptation (Frost, 1989;Heaney, 1994;Weinans and Prendergast, 1996;Weinhold et al, 1994). Although most histomorpho metric studies are inconclusive regarding this issue, some suggest the existence of transient, oscillatory responses when disuse is imposed (Hardt, 1972;Jaworski et al, 1978;Uhthoff and Jaworski, 1978;Uhthoff et al, 1985). Despite these intriguing results, there are no clear experimental data to support the existence of oscilla tions similar to those shown in Fig.…”

Section: Discussionmentioning

confidence: 96%

A mechanistic model for internal bone remodeling exhibits different dynamic responses in disuse and overload

Hazelwood

Martin

Rashid

et al. 2001

Journal of Biomechanics

116

169

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Bone is a dynamic tissue which, through the process of bone remodeling in the mature skeleton, renews itself during normal function and adapts to mechanical loads. It is, therefore, important to understand the effect of remodeling on the mechanical function of bone, as well as the effect of the inherent time lag in the remodeling process. In this study, we develop a constitutive model for bone remodeling which includes a number of relevant mechanical and biological processes and use this model to address differences in the remodeling behavior as a volume element of bone is placed in disuse or overload. The remodeling parameters exhibited damped oscillatory behavior as the element was placed in disuse, with the amplitude of the oscillations increasing as the severity of disuse increased. In overload situations, the remodeling parameters exhibited critically sensitive behavior for loads beyond a threshold value. These results bear some correspondence to experimental findings, suggesting that the model may be useful when examining the importance of transient responses for bone in disuse, and for investigating the role fatigue damage removal plays in preventing or causing stress fractures. In addition, the constitutive algorithm is currently being employed in finite element simulations of bone adaptation to predict important features of the internal structure of the normal femur, as well as to study bone diseases and their treatment.

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Section: Discussionmentioning

confidence: 96%

A mechanistic model for internal bone remodeling exhibits different dynamic responses in disuse and overload

Hazelwood

Martin

Rashid

et al. 2001

Journal of Biomechanics

116

169

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“…13 Bone healing may also be a complication secondary to osteopenia and changes in local venous pH. 14 Furthermore, prolonged fixation may lead to weakness and atrophy of the masseter and temporalis. 15 While this study had a large sample size (n = 413 fractures), it was limited by its retrospective nature.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Maxillomandibular Fixation After Open Reduction of Mandible Fractures

Saman

Kadakia

Ducic

2014

JAMA Facial Plast Surg

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IMPORTANCE Patients are placed in maxillomandibular fixation (MMF) to restore premorbid occlusion prior to open reduction-internal fixation (ORIF) of mandibular fractures. Maintaining MMF for these patients for several weeks postoperatively is a widely accepted dictum. OBJECTIVE We compare postoperative ORIF outcomes in dentate patients with noncomminuted symphyseal, parasymphyseal, or angle fractures of the mandible between those who underwent postoperative MMF and those who did not. DESIGN, SETTING, AND PARTICIPANTS Retrospective review of medical records for 311 patients with 413 mandibular fractures treated at a level 1 public trauma center in the Fort Worth, Texas, metropolitan area. All patients were treated from August 1997 to August 2012 and had a minimum follow-up of 6 weeks. INTERVENTIONS Of the 413 symphyseal, parasymphyseal, and angle fractures, 78, 63, and 83 patients were treated with postoperative MMF respectively. The group without postoperative MMF included 56 symphyseal fractures, 49 parasymphyseal fractures, and 84 angle fractures. MAIN OUTCOMES AND MEASURES Rates of wound dehiscence, infection, plate removal, nonunion, malunion, and malocclusion were compared.RESULTS Using an unpaired t test and α value of .05 for significance, the difference between the 2 groups' outcomes was not statistically significant for any of the complications evaluated. In the groups with vs without postoperative MMF, the mean numbers of complications were as follows: wound dehiscence, 4.7 vs 2.5 (95% CI, -1.7 to 6.0) (P = .16); infection, 6.7 vs 4.0 (95% CI, -1.7 to 7.0) (P = .14); plate removal, 2.3 vs 2.5 (95% CI, -7.9 to 7.6) (P = .94); nonunion, 1.0 vs 0.5 (95% CI, -2.2 to 3.2) (P = .59); malunion, 0.7 vs 1.0 (95% CI, -3.1 to 2.4) (P = .72); and malocclusion, 1.3 vs 1.0 (95% CI, -4.0 to 4.7) (P = .82). CONCLUSIONS AND RELEVANCEThe surgical dictum of maintaining postoperative MMF for all trauma patients after ORIF of the mandible may not be of advantage in the treatment of dentate patients with noncomminuted symphyseal, parasymphyseal, or angle fractures.LEVEL OF EVIDENCE 3.

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“…[11] These changes are reversible to varying degrees, depending on when function is reinstituted. Only one case has been reported regarding allergy to material used for IMF.…”

Section: Discussionmentioning

confidence: 99%

“…IMF can lead to osteoporosis, hypercapnia, hypoxia and decreased Ph in the nutrient veins of immobilized bones. [ 11 ] These changes are reversible to varying degrees, depending on when function is reinstituted. Only one case has been reported regarding allergy to material used for IMF.…”

Section: Discussionmentioning

confidence: 99%

A questionnaire survey on postoperative intermaxillary fixation in mandibular trauma: Is its use based on evidence?

Shenoy

Shah

2011

Natl J Maxillofac Surg

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Context:This questionnaire survey was conducted to ascertain if the practice of the routine use of postoperative intermaxillary fixation (IMF) in mandibular trauma (of the dentate segments only) was based on evidence available in the literature.Settings and Design:This study was designed as a questionnaire survey that would be conducted among surgeons operating on mandibular fractures in the state of Gujarat.Materials and Methods:A typed questionnaire was sent to oral maxillofacial surgeons and plastic surgeons of Gujarat state for their feedback by post. Approval of the ethical committee of the university was obtained. All the feedback forms received back were included for this survey which included 25 oral and maxillofacial surgeons and 25 plastic surgeons.Results:Although majority of the surgeons use open reduction and internal fixation (ORIF), 25% of the surgeons still prefer using only IMF as the sole modality of treatment for the said group of mandibular fractures. According to our survey, the majority of surgeons use IMF routinely in the postoperative setting even after using ORIF. Occlusion seems to be the critical factor among 72% of surgeons in deciding on the use of IMF as an adjunct after ORIF. Seventy-eight percent of surgeons vary their period of IMF based on the site of fracture.Conclusion:The routine use of postoperative IMF in cases of mandibular fractures seems to find favor among surgeons despite lack of sound scientific evidence supporting its use. There is also no evidence to suggest that if IMF is not used, it would have deleterious effects on occlusion or otherwise.

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Early Metabolic Responses of Bone to Immobilization

Cited by 30 publications

References 0 publications

A mechanistic model for internal bone remodeling exhibits different dynamic responses in disuse and overload

A mechanistic model for internal bone remodeling exhibits different dynamic responses in disuse and overload

Postoperative Maxillomandibular Fixation After Open Reduction of Mandible Fractures

A questionnaire survey on postoperative intermaxillary fixation in mandibular trauma: Is its use based on evidence?

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