Complication Of Bone Fractures Research Articles

Synthesis and Quality Control of Calcium Chelidonate Substance with Osteogenic Activity

Introduction. Osteogenic agents are used for pathologies associated with impaired bone formation, complications of bone fractures, the use of implants and endoprostheses, and tumor lesions of bone tissue. High osteogenic activity in vivo on the model of experimental osteomyelitis, in vitro and in situ on mesenchymal stem cells was revealed for calcium chelidonate, which is a promising substance for the production of osteogenic drugs.Aim. Development of a method for obtaining the calcium chelidonate substance by chemical synthesis and methods of its standardization.Materials and methods. The synthesis of chelidonic acid was carried out on the basis of diethyloxalate; calcium chelidonate – using synthesized chelidonic acid and anhydrous calcium chloride. The structure of the substances was confirmed by optical spectral methods, mass spectrometry, elemental and X-ray structural analysis. The quantitative content was assessed using a liquid chromatograph. Statistical processing of the results of quantitative measurements was carried out in the STATISTICA 8,0 program.Results and discussion. As a result of the synthesis, chelidonic acid (4-oxo-4H-piran-2,6-dicarboxylic acid) was obtained, which is colorless or cream-tinged crystals. The structure of the resulting compound is confirmed by spectral characteristics and elemental analysis data. A method for obtaining the calcium chelidonate substance has been worked out, while the yield of the target product was 100 ± 5 %. By X-ray structural analysis, it was found that the synthesized compound is calcium chelidonate trihydrate [Ca(ChA)(H2O)3]n with M.M. (C7H8O9Ca) 276,15. Methods for establishing authenticity, purity and quantification of the substance have been developed. The amount of impurities in the resulting substance did not exceed 0.1 %, and the content of the main component ranged from 99,2 ± 0,20 to 100,4 ± 0,35 %.Conclusion. Due to the limited resource reserves and the complexity of the process of extracting chelidonic acid from plant raw materials, a method for the chemical synthesis of calcium chelidonate substance with osteogenic activity is proposed. The obtained results provide prospects for further research in the direction of the development and introduction of synthetic calcium chelidonate as a new osteogenic drug, provided that the specific biological activity is comparable to the natural analogue.

Sr-HA-graft-Poly(γ-benzyl-l-glutamate) Nanocomposite Microcarriers: Controllable Sr2+ Release for Accelerating Osteogenenisis and Bony Nonunion Repair.

The microcarrier system offers an attractive method for cellular amplification and phenotype enhancement in the field of bone tissue engineering. However, it remains a challenge to fabricate porous microcarriers with osteoinductive activity for speedy and high-quality osseointegration in regeneration of serious complication of bone fracture, like nonunion. Here, we present a facile method for the first time manufacture microcarriers with osteogenic effects and properties based on well controlled and long-term Sr2+ release. At first, strontium-substituted hydroxyapatite was prepared (Sr-HA) and a novel Sr-HA-graft-poly(γ-benzyl-l-glutamate) (Sr-HA-PBLG) nanocomposite was synthesized. Then, the microcarriers with highly interconnected macropores were fabricated by a double emulsion method, which allowed cells to adhere and proliferate and secrete extracellular matrix. Besides, the microcarriers with a relatively uniform diameter of 271.5 ± 45.0 μm are feasible for injection. The Sr-HA-PBLG microcarriers efficiently promoted osteogenic gene expression in vitro. With injection of the Sr-HA-PBLG microcarriers loading adipose derived stem cells (ADSCs) into the nonunion sites, bone regeneration was observed at 8 weeks after injection in a mice model.

Перспективи застосування апротиніну в щелепно-лицевій хірургії та стоматології (огляд літератури)

The article adduces the current experience of using of the aprotinin (inhibitor of proteolisis and kininogenesis) in the clinical medicine. We also highlighted the mechanism of its influence on the organizm and described the indications for it use with therapeutic purposes after surgical pain syndrome. We confirmed the effectivness of drugs based on aprotinin for the treatment in various pathological conditions, because of its anti-inflammatory, antifibrinolitic, antishock action. Nowadays, the drugs which contain the main active substance as aprotinin are used for the prevention and treatment of pancreatitis, pancreonecrosis, hyperfibrinolitic bleeding, complications after thrombolytic therapy and in cardiac surgery. Injection of aprotinin before surgery helps to prevent the development of diffuse bleeding during operation. The anti-inflammatory mechanism of aprotinin has multivalent character. The ability of aprotinin to reduce the production of proinflammatory interleukines and at the same time stimulates the appearance of anti-inflammatory interleukins that allows to use it for reducing of surgery trauma and postoperative pain syndrome. In addition, we presented the results of local application of products containing aprotinin ("Gordoх", "Contrical", "Tachokomb", "Aerus"), used by the physiotherapy. In this article we analyzed recent literature data on the use of aprotinin in clinical dental practice and maxillofacial surgery (treatment of the maxillofacial area soft tissue inflammation, complications of bone fractures, impacted lower third molars surgery). The ability of the aprotinin to reduce the symptoms of inflammation, improve microcirculation, heal postoperative wounds and its positive impact on haemodynamics makes it an alternative to dexamethasone while dealing with the pain and swelling. All above mentioned serves as a base for more widespread application of aprotinin in practical of dentistry and maxillofacial surgery.

Bone Fracture Pre-Ischemic Stroke Exacerbates Ischemic Cerebral Injury in Mice.

Ischemic stroke is a devastating complication of bone fracture. Bone fracture shortly after stroke enhances stroke injury by augmenting inflammation. We hypothesize that bone fracture shortly before ischemic stroke also exacerbates ischemic cerebral injury. Tibia fracture was performed 6 or 24 hours before permanent middle cerebral artery occlusion (pMCAO) on C57BL/6J mice or Ccr2RFP/+Cx3cr1GFP/+ mice that have the RFP gene knocked into one allele of Ccr2 gene and GFP gene knocked into one allele of Cx3cr1 gene. Behavior was tested 3 days after pMCAO. Infarct volume, the number of CD68+ cells, apoptotic neurons, bone marrow-derived macrophages (RFP+), and microgila (GFP+) in the peri-infarct region were quantified. Compared to mice subjected to pMCAO only, bone fracture 6 or 24 hours before pMCAO increased behavioral deficits, the infarct volume, and the number of CD68+ cells and apoptotic neurons in the peri-infarct area. Both bone marrow-derived macrophages (CCR2+) and microglia (CX3CR1+) increased in the peri-infarct regions of mice subjected to bone fracture before pMCAO compared to stroke-only mice. The mice subjected to bone fracture 6 hours before pMCAO had more severe injury than mice that had bone fracture 24 hours before pMCAO. Our data showed that bone fracture shortly before stroke also increases neuroinflammation and exacerbates ischemic cerebral injury. Our findings suggest that inhibition of neuroinflammation or management of stroke risk factors before major bone surgery would be beneficial for patients who are likely to suffer from stroke.

Analysis of Ilizarov apparatus application in acute traumatic lesions and treatment of complications of different parts of musculosceletal system at the Department of orthopedic surgery and traumatology in Novi Sad

Introduction. For multiply traumatized or polytraumatized patients, the preservation of normal limb function with minimal complication is the highest priority. The supreme principle of the Ilizarov techique is to achieve limb stability with equality, without deformities, with sufficient muscle function and full range of joint movement with minimal risk of infection. It is also of great importance to decrease the length of immobility with the least possible number of surgical procedures. Material and Methods. We present a retrospective and partially prospective study with the analysis of the Ilizarov apparatus application for managing acute traumatic fractures, bone fracture complications and other orthopedic conditions eligible for treatment with this technique. This study covers our experiences and results gained in the period from 2003 to 2016. The analysis included a broad spectrum of orthopedic and traumatology conditions such as acute fractures, non-union fractures, malunion fractures, pseudoarthrosis, congenital and acquired bone deformities and the final treatment after total knee joint replacement failures. Results. After a long follow-up time, the long-term results were assessed by estimating the results of clinical examinations, X-ray evaluations, Association for the Study and Application of the Method of Ilizarov bone and functional scoring system and Karlstrom and Olerud functional scoring system evaluations. Conclusion. The introduction of the Ilizarov method at our Department 13 years ago has justified its application in everyday clinical practice by achieving excellent results in the treatment of the most complicated orthopedic and trauma conditions.

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures.

First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

Extrahepatische Manifestationen von Leberkrankheiten: Skelett

Since nowadays liver diseases are being diagnosed more frequently than in former years, an increasing number of patients with skeletal alterations is detected. Predominant is osteoporosis with the feared complications of bone fractures. The measurement of bone mineral density enables us to differentiate between normal, osteopenic and osteoporotic conditions. Despite the great number of data available on bone disease we are still incapable to predict which patients with liver disease will develop osteoporosis or bone fractures and when. Treatment should focus on the prevention of development of osteoporosis and fractures and rather not on the treatment of complications. We are still lacking convincing long-term treatment studies with a sufficient number of patients who are well stratified.