Clinical and morphological stages of bone fragments fusion
Bone regeneration is a cascade of cellular and molecular phenomena leading in the fracture region to the formation of bone tissue which is identical to the original one. The process is divided into stages between which it is impossible to draw a clear line. Objective: To identify key clinical and morphological phenomena that define the staging process of fragments fusion after the bone fracture, to clarify the essence of the first stage, to set the dates of each stage in humans. Methods: Experiments were performed in 8 adult Karakul breed sheep weighing 35–40 kg underwent a closed fracture of the right femur. Plot fracture examined by histological methods after 5 hours, 1, 4 and 15 days. Near fragmental space studied in 43 patients with closed fractures of long bones which was performed open reduction of bone fragments in. Retrospectively we evaluated clinical data in 546 patients with diaphyseal fractures of the extremities accumulated over the past 30 years. Results: it is proved that the fibrin blood clot is naturally necessary structure for proliferation and differentiation of cells and for the formation of new bone tissue. After ultrasound examination it was found that the shape and location of bone regenerate conforms to the shape and location of the fibrin blood clot. Based on the study of angular mobility of bone fragments and bone regenerate formation we established terms of healing of fractures in humerus in the period from 4 to 8 weeks, in femur — from 8 to 12, and in shin bones — from 8 to 17 weeks. Conclusion: There were proposed to highlight formation of a fibrin blood clot as the first important step of bone regeneration which completely or partially fills near fragmental space. Approximate lifetime formation and stabilization of its structure is from 12 to 24 hours. There were established terms of the stages of healing of diaphyseal fractures in human long bones.
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Marks V. О. Healing of the closed fractures of the long bones in humans and experimental animals: thesis … DM / Vasisiy Oskarovich Marks. — Kharkov, 1949. — 692 p.
Zaychenko I. L. Elements to the construction of management of the development of regenerative process of bone and generally / I. L. Zaychenko. — Lviv, 1958. — 236 p.
Kaplan A. V. Injuries of bones and joints / A. V. Kaplan. — 3rd ed. — M.: Medicina, 1972. — 229 p.
Korzh А. А. Reparative regeneration of bone / А. А. Korzh, А. М. Belous, Ye. Ya. Pankov. — M.: Medicina, 1972. — 229 p.
Korzh N. A. Reparative regeneration of bone: modern approach to the problem. Stages of repair (report 1) / N. A. Korzh, N. V. Diedukh // Orthopaedics, traumatology and prosthetics. — 2006. — № 1. — P. 77-84.
Marks V. О. Closed bone fracture healing / V. О. Marks. — Minsk: Izd-vo Academy of sciences of BSSR, 1962. — 275 p.
Marsell R. The biology of fracture healing / R. Marsell, T. A. Einhorn // Injury. — 2011. — Vol. 42(6). — P. 551–555, doi: 10.1016/j.injury.2011.03.031.
Bone regeneration and repair: biology and clinical applications / eds. J. R. Lieberman, G. E. Friedlander. — Humana Press Inc., 2005. — 450 p.
European Convention for the Protection of Vertebrate Animals used for Experimental and Other Scientific Purposes [web source] / Council of Europe. — Access mode: http://conventions.coe.int/treaty/en/treaties/html/123.htm.
Popsuishapka O. K. Functional treatment of diaphyseal fractures of extremities (clinical and experimental justification): Thesis ... MD; 14.00.22 — «Traumatology and orthopaedics» // O. K. Popsuishapka. — Kharkiv, 1991. — 271 p.
Litvishko V. О. Functional treatment of diaphyseal fractures of humerus: thesis abstract … candidate of medical sciences; 14.00.22 — «Traumatology and orthopaedics» // V. О. Litvishko. — Kharkiv, 1999. — 20 p.
Litvishko V. А. Treatment of diaphyseal fractures of extremities in conditions of traumatology departments of central district highway hospitals / V. А. Litvishko, О. Е. Uzhigova // Orthopaedics, traumatology and prosthetics. — 2012. — № 2. — P. 68–73, doi: http://dx.doi.org/10.15674/0030-59872012268-73.
Borovik I. N. Treatment of diaphyseal fractures of the femur in children using rod apparatus of external fixation: thesis … candidate of medical sciences; 14.00.22 — «Traumatology and orthopaedics» / I. N. Borovik. — Kharkiv, 2010. — 172 p.
Treatment of bone fragments nonunion after dyaphiseal fracture / O. K. Popsuishapka, V. O. Litvishko, V. V. Grigoryev, N. O. Ashukina // Orthopaedics, traumatology and prosthetics. — 2014. — № 1. — P. 34–41, doi: http://dx.doi.org/10.15674/0030-59872014134-41.
McNally E. The development and clinical applications of musculoskeletal ultrasound / E. G. McNally// Skeletal Radiol. — 2011. — Vol. 40(9). — P. 1223–1231, doi: 10.1007/s00256-011-1220-5.
Shekhter А. B. Inflammation, adaptive regeneration and dysregeneration (intercellular interaction analysis) / A. B. Shekhter, V. V. Serov // Arkhiv pathologii. — 1991. — Vol. 53(7). — P. 7–14.
Lavrishcheva G. I. Morphological and clinical aspects of reparative regeneration of support organs / G. I. Lavrishcheva, G. A. Onoprienko. — M.: Medicine, 1996. — 208 p.
Danilov R. K. Experimental and histological analysis of histogenesis and tissue regeneration (some results of the 20th century and perspectives on further research / R. K. Danilov, T. G. Borovaia, N. D. Klochkov // Morfologiia. — 2000. — Vol. 117(4). — P. 7–16.
Shevtsov V. I. Ultrastructural features of angiogenesis in fracture healing / V. I. Shevtsov, Yu. М. Iriyanov // Genii optopedii. — 1999. — № 4. — P. 13–18.
Peculiarities in the formation, structural-mechanical properties of a fibrin-blood clot and its importance for bone regeneration in fractures / O. K. Popsuishapka, V. А. Litvishko, N. O. Ashukina, Z. N. Danyshchuk // Orthopaedics, traumatology and prosthetics.. — 2013. — № 4. — P. 5–12, doi: http://dx.doi.org/10.15674/0030-5987201345-12.
Krompecher S. Local tissue metabolism: biological characteristics of the regenerate bone. Mechanisms of bone regeneration / S. Krompecher: translators А. М. Belous, Ye. Ya. Pankov. — M.: Medicine, 1971. — 294 p.
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