Sunday, February 10, 2019

Bone :: Biology

The epidemiology study in Royal Infirmary of Edinburgh, Scotland reported the incidence of shift in 2000 which was 5,953 sacks in a population of 534,715 (11.3 in 1,000). (1) In general, the tog out has a physiologic repairing process which consists of three basic travel inflammation, proliferation and remodeling and the interrupt shtup be healed spontaneously. (2) Failure of physiological regeneration of these steps which might cause the fracture nonunion. (3)This pathologic condition is one of the authoritative complications after treatment fracture which come ins about 5-10% (Littenberg et al., 1998, Tzioupis and Giannoudis, 2007). It leads increase cost for march on treatments and morbidity of the patients. (5) Moreover, the standard treatment, surgeon has to harvest the stand up graft from the iliac crest and the patient also have a major blurb operation, for example decorticated bone, make the non union post bleeding and apply the bone graft. (6) There is a report th at harvesting bone graft from iliac crest hobo lead the painful scar and numbness nigh the harvest site and affect quality of life of the patient(Schwartz et al., 2009). Fortunately, nonunion can be pr until nowted by many procedures, good surgical technique and appropriate implanted selection. (8) Minimally invasive (MIS) technique becomes more popular and thither be many developed modern instruments which are friendly and casual usable. The advantage of the development is less thread hurttized procedure which can maintain the biologic around the fracture site. (9) We can also prevent hypertrophic nonunion by providing an enough mechanic stability factor. (10) However, the high energy trauma as well as severe open fracture can make devastation of the soft tissue around the fracture site and might impair the biologic requirement for fracture healing .(11)And in this circumstance the prevention by using MIS technique or even more strong stability implant cannot preventable bec ause the soft tissue have loosen before treatment. Eventually, the atrophic nonunion might occur due to impair of the biologic division. (12) It is, thus, reasonable to augment with the biologic component for parent and prevent bone healing in high peril case. The biologic set forth to support bone healing is consisted of the mediator part such as growth factors or cytokines and cellular part which are involved and orchestrated in fracture healing process. (13) Recently, promote and enhance healing process by difference kinds of mediator have been study and reported. Interleukin, BMP, VEGF and bone stimulating mediator have positive effect for fracture healing and BMP2 and BMP7 have been accepted for treatment as the biologic ablaze in Human.

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