Osteopathien und Knochenstoffwechselerkrankungen

Abstract

Pathological and metabolic bone diseases are common and relevant occurrences in orthopedics and trauma surgery; however, fractures are often treated as being the illness itself and not seen as the symptom of an underlying bone disease. This is why further diagnostics and systemic treatment options are often insufficiently considered in the routine treatment of fractures. This review focuses on osteoporosis, osteopetrosis, hypophosphatasia and Paget's disease of bone.In patients with osteoporotic vertebral or proximal femur fractures, pharmaceutical treatment to prevent subsequent fractures is an integral part of fracture therapy together with surgical treatment. Osteopetrosis is caused by compromised osteoclastic bone resorption; therefore, even in the face of an elevated bone mass, vitamin D3 supplementation is crucial to avoid clinically relevant hypocalcemia. Unspecific symptoms of the musculoskeletal system, especially together with stress fractures, are typically found in patients suffering from hypophosphatasia. In these patients measurement of alkaline phosphatase shows reduced enzyme activity. Elevated levels of alkaline phosphatase are found in Paget's disease of bone where bisphosphonates are still the treatment of choice.

An adaptive biodegradable zinc alloy with bidirectional regulation of bone homeostasis for treating fractures and aged bone defects

“…Factors causing aberrant bone metabolism, including co-infections, severe trauma, advanced age, postmenopausal osteoporosis, bone metastases, use of certain medications (e.g., glucocorticoids, diuretics, etc. ), autoimmune disease (e.g., rheumatoid arthritis), renal insufficiency, hyperparathyroidism function, hereditary bone disease, and diabetes mellitus affect the bone conversion process through varied and complex pathways [ [3] , [4] , [5] ]. However, they all lead to increased osteoclast bone resorption and decreased osteoblast bone formation, resulting in a metabolic imbalance in the systemic or local skeletal microenvironment [ 6 ].…”