The role of the resorption phase of remodeling process of bone in development of nonunion after osteosynthesis of the femoral neck medial fracture (review)

Authors

  • Evgeny Pirogov
  • Olexiy Tyazhelov

DOI:

https://doi.org/10.15674/0030-598720153116-125

Keywords:

remodeling, bone tissue resorp¬tion, pseudartrosis, femoral neck

Abstract

We presented an analytical review of scientific information on the mechanisms of local bone resorption within a remodeling process of bone fragments in cases of medial femoral neck fractures. Mar­ginal resorbtion of fragments should be considered during osteo­synthesis as a result of this process because result of this process is partial loss of bone material in fracture area, reducing of the geometric parameters of bone fragments, changing of structural and mechanical properties of bone tissue in the vicinity of the zone of fracture and, consequently, violations of tension-deformed state of materials on the verge of «lock – bone» reached in the process of surgery. Most researchers recognize that certain fragments resorption always occurs mostly after fractures of epimetaphiseal bone areas. However there were not described any its possible mechanisms and chronological relationship with stages of repara­tive regeneration, and an idea of marginal resorption in the initial phase of consolidation of bone fragments is rather vague. In most mechanical or mathematical model process of marginal resorbtion is not taken into consideration which inevitably leads to errors in biomechanical grounding of application of different fixateurs. The authors highlighted information on local and systemic factors that affect the extent and dynamics of local bone resorption and its role in the development of early complications after osteosynthesis of medial femoral neck unstable fractures. We described some typical processes of bone tissue loosing and their relationship to the level of blood circulation. Recognizing the marginal resorption as a typi­cal process of remodeling bone fragments and further study of its mechanisms will help to resolve a problem of treatment of medial femoral neck fractures and to create some novel biomechanically substantiated fixateurs.

References

  1. Avrunin A.S. The hierarchy of structural and functional organization of the skeleton / A. S. Avrunin, I. I. Shubnikov // Osteopathy as a system of diagnosis and treatment. International conference. — SPb., 2007. — P. 29–34.
  2. Avrunin A. S. Osteocyte remodeling: background, current knowledge and clinical assessment / A. S. Avrunin // Traumatology and orthopedics of Russia.- 2012. — № 1. — P. 128–134.
  3. Adaptive model for cancellous bone loss during aging / A. S. Avrunin, R. M. Tihilov, L. K. Parshin, I. I. Shubnikov // Genius orthopedics. — 2007. — No. 1. — P. 100–111.
  4. Afshin F. N. Metalosteosynthesis and metalocement osteosynthesis of fractures of the proximal femur in patients of elderly and senile age: synopsis dis. ... cand. of medical sciences:. — D., 2007. — 27 p.
  5. Bykov V. L. Cytology and general histology (Functional morphology of cells and tissues) / V. L. Bykov. — SPb.: SOTIS, 2000. — 520 p.
  6. Influence "Bivalos" on reparative bone regeneration: experimental data and clinical studies / V. V. Povoroznyuk, N. A. Korzh, N. V. Grigorieva, F. V. Klimovickiy // Orthopedics, traumatology and prosthetics.— 2012.— No. 1.— P. 5–11, doi: http://dx.doi.org/10.15674/0030-5987201215-11.
  7. Dedova I. I. Endocrinology. / I. I. Dedova, G. A. Melnichenko. — M.: GEOTAR-Media, 2013. — 752 p.
  8. Zhilaev R. O. Topographic-anatomical aspects of ways to improve the surgical treatment of patients with fractures of the femur. synopsis dis. ... cand. of medical sciences: 14.01.21 / R. O. Zhilaev — Donetsk, 2009. — 24 p.
  9. Investigation and assessment of the biomechanical design “fragments-detent” that is generated in the surgical treatment of femoral neck fractures / A. K. Popsuishapka, E. A. Pobel, M. A. Shevtsova, L. S. Belogurova // Orthopedics, traumatology and prosthetics. — 2006. — No. 4. — P. 55–62.
  10. Intra-articular fractures of the femoral neck in patients under the age of 50 years (especially methanogenesis and treatment) / V. G. Klimovickiy, M. A. Kaszuba, A. I. Kaszuba // Trauma. — 2007. — No. 3. — P. 304–309.
  11. Klimovickiy V. G. Possible ways of optimization of reparative processes in patients with fractures of long bones of extremities / V. G. Klimovickiy, V. N. Pasternak, V. M. Oximes // Orthopedics, traumatology and prosthetics. — 2006. — No. 1. P. 90–99.
  12. Komov V. P. Biochemistry / V. P. Komov, V. N. Shvedova. — 3-rd edition. — M.: Drofa, 2008. — 638 p.
  13. Korzh N. A. Reparative regeneration of the bone: a modern view on the problem. The regeneration stage / N. A. Korzh, N. V. Dedukh // Orthopedics, traumatology and prosthetics. — 2006. — No. 1. — P. 77–84.
  14. Korzh N. A. Reparative bone regeneration: a modern view on the problem. Systemic factors affecting fracture healing / N. A. Korzh, N. V. Dedukh, O. A. Nikolchenko // Orthopedics, traumatology and prosthetics. — 2006. — No. 2. — P. 93–99.
  15. Korzh N. A., Reparative bone regeneration: a modern view on the problem. Violation bone regeneration / N. A. Korzh, K. K. Romanenko, L. D. Goridova // Orthopedics, traumatology and prosthetics. — 2006. — No. 1. — P. 84–90.
  16. Lavrishcheva G. I. Morphological and clinical aspects of reparative regeneration of the supporting tissues and organs / G. I. Lavrishcheva, G. A. Onoprienko. — M.: Medicine, 1996. — 208 p.
  17. Mueller M. E. Manual internal osteosynthesis / M. E. Mueller, M. Allgower, R. Schneider. — Berlin; Heidelberg; New York: Springer-Verlag, 1996. — 750 p.
  18. On the choice of fixator for osteosynthesis of the femoral neck / N.V. Novikov, P. N. Golik, N. A. Vasilyev, V. E. Pavlovsky // Orthopedics, traumatology and prosthetics. — 1986. — No. 4. — P. 41–43.
  19. Pat. 1074511 A SU, IPC A 61 B 17/18. Apparatus for the treatment of femoral neck fractures / Ilizarov G. A., Chigarev V. M. and others; applicant and patentee of the Kurgan of the order "Badge of honor" scientific research Institute of experimental and clinical Orthopaedics and traumatology. — Appl. 14.07.1982.
  20. Pat. 2074669(13) C1 Russian Federation, IPC A 61 B 17/78. Device for osteosynthesis of the proximal end of the femur / Reshetnikov A. N., Ivanov V. M. and others; applicant and patentee of the Saratov research Institute of traumatology and orthopedics. — Appl. 24.06.1994.
  21. Pat. 2214192(13) C2 Russian Federation, IPC A 61 B 17/68. Spiceboy fixator for osteosynthesis / Staryh V. S.; applicant and patentee of the Kemerovo city clinical hospital №3 them. M. A. Podgorbunskogo. — Appl. 04.12.2000.
  22. Pat. 22283(13) C2 Ukraine, IPC A 61 B 17/68, A 61 B 17/74. The divice for the osteosynthesis fractures of the proximal end of the femur / Bilinski P. I. — Appl. 24.03.1997.
  23. Pat. 2280416(13) C2 Russian Federation, IPC A 61 B 17/74. Device for fixation of femoral neck fractures / Shugol G. B., Demakov S. L. and others; applicant and patentee of Shugol G. B.— Appl. 24.03.2004.
  24. Pat. 2306111(13) C2 Russian Federation, IPC A 61 B 17/56. Fixator for osteosynthesis of the femoral neck / Shagivaleev N. A.; the applicant and the patentee Shagivaleev N. A.— Appl. 20.06.2005.
  25. Pat. 80152(13) C2 Ukraine, IPC A 61 B 17/74. The divice for osteosynthesis of the femoral neck fractures / Loskutov O. E., Vishnevskii V. O. and others; Savnik and patentblatt Sabsai O. V. — Appl. 04.04.2005.
  26. Femoral neck fractures in patients of elderly and senile age / G. I. Herzen, A. I. Protsyk, M. P. Ostapchuk, Malkavi Amir.- K., 2003. — 170 p.
  27. Reinberg S. A. X-ray diagnosis of diseases of bones and joints / S. A. Reinberg. — M.: Medicine, 1964. — 530 p.
  28. Rolik A. V. Reconstructive intervention in intra-articular fractures of the femoral neck in patients of elderly and senile age / A. V. Rolik, P. M. Vorontsov // Orthopedics, traumatology and prosthetics.— 2001.— No. 1.— P. 76–77.
  29. Semenkin O. M. Remedy post-traumatic deformity of the distal metapelite radius / O. M. Semenkin, S. N. Izmalkov // Traumatology and orthopedics of Russia. — 4 (58) — M., 2010. — P. 78–83.
  30. Soloviev V. A. The origin, differentiation and morpho-functional characteristics of cells of bone / V. A. Soloviev, T. V. Shynkarenko // Verhnevolzhskiy medical journal. — 2011. — Vol. 9. Vol. 3 No. 11 — P. 49–54.
  31. Timoshenko S. V. Surgical treatment of unstable fractures of the distal radius metaepiphysis and their consequences: synopsis dis. ... cand. of medical sciences / S. V. Timoshenko. — K., 2010. — 24 p.
  32. Trubnikov V. F. Diseases and injuries of the musculoskeletal system / V. F. Trubnikov — K.: Zdorovya, 1984. — 328 p.
  33. Tyazhelov A. A. Rationale stable functional osteosynthesis in fractures of the femoral neck / Tyazhelov A. A., E. N. Pirogov. // Orthopedics, traumatology and prosthetics. — 2014. — No. 1. — P. 22–27, doi: http://dx.doi.org/10.15674/0030-59872014122-27.
  34. Watson-Jones R. Fractures and joint damage / R. Watson-Jones. — M.: Medicine, 1972. — 672 p.
  35. Fedorov V. G. Classification and treatment of fractures of the periarticular area of the bones spongy structure / V. G. Fedorov // Information letter for doctors, traumatologists and surgeons of practical health care. — Izhevsk, 2012.
  36. Bonewald L. F. Mechanosensation and transduction in osteo¬cytes / L. F. Bonewald // Bonekey Osteovision. — 2006. — Vol. 3 (10). — P. 7–15.
  37. Cowin S. C. Mechanosensation and fl uid transport in living bone // J. Musculorscelet. Neuron Interact. — 2002. — Vol. 2 (3). — P. 256–260.
  38. Do bone cell behave like a neuronal network? / C. N. Turner, A. C. Robling, R. I. Duncan, D. B. Burr // Calcif. Tissue Int. — 2002. — Vol. 70 (6). — P. 435–442.
  39. Frost H. M. Defining osteopenias and osteoporoses: another view (with insights from a new paradigm) / H. M. Frost // Bone. — 1997. — Vol. 20. — P. 385–391.
  40. Internal fixation versus hemiarthroplasty for displaced fractures of the femoral neck in elderly patients with severe cognitive impairment / R. Blomfeldt, H. Tornkvist, S. Ponzer [et al.] // J. Bone Joint Surg. Br. — 2005. — Vol. 87 (4). — P. 523–529.
  41. Signal transduc-tion pathways involved in mecanotransduction in bone cells / A. Leidert, D. Kaspar, R. Blakytny [et al.] // Biochem. Biophys. Res. Comm. — 2006. — Vol. 349 (1). — P. 1–5.
  42. Silver F. H. Membranosensing and membra-nochemical transduction: how is mechanical mechanical energy sensed and converted into chemical energy in an extracellular matrix? / F. H. Silver, L. M. Siperko // Crit. Rev. Biomed. Eng. — 2003. — Vol. 31 (4). — P. 255–331.

Downloads

How to Cite

Pirogov, E., & Tyazhelov, O. (2015). The role of the resorption phase of remodeling process of bone in development of nonunion after osteosynthesis of the femoral neck medial fracture (review). ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 116–125. https://doi.org/10.15674/0030-598720153116-125

Issue

No. 3 (2015)

Section

DIGESTS AND REVIEWS

License

Copyright (c) 2015 Evgeny Pirogov, Olexiy Tyazhelov

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).