Journal of orthopaedic trauma
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The purpose of this study was to determine if proximity of cannulated lag screws to the articular surface of the patella combined with the tension band technique affects resistance to fracture gap opening, and if an alternative locking nut and bolt device without a tension band behaves in a biomechanically similar fashion. ⋯ When combined with the tension band, the proximity of cannulated lag screws to the articular surface did not affect resistance to fracture gap opening. Additionally, the stand-alone CompreSURE cannulated locking nut and bolt device without tension band was able to resist fracture gap opening in transverse fractures as effectively as the cannulated screw with tension band technique.
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Comparative Study
Comparison of the antimicrobial effect of chlorhexidine and saline for irrigating a contaminated open fracture model.
The objective of this study is to compare antimicrobial effect of irrigation with chlorhexidine gluconate (CHG) to saline in an animal model. ⋯ This study does not support the use of CHG as an irrigant. This may be due to the antibacterial effect of CHG being offset by the associated host tissue toxicity. Host tissue damage from high irrigation pressures and cytotoxic solutions has been shown to allow bacteria to thrive. We believe this is due to a "rebound" of bacteria growth in a wound bed containing small quantities of necrotic tissue damaged by CHG exposure.
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Angiogenesis and osteogenesis are essential for bone growth, fracture repair, and bone remodeling. Vascular endothelial growth factor (VEGF) has an important role in bone repair by promoting angiogenesis and osteogenesis. In our previous study, endothelial progenitor cells (EPCs) promoted bone healing in a rat segmental bone defect as confirmed by radiological, histological, biomechanical, and micro-CT evaluations. Although EPCs have demonstrated effectiveness in animal models of fracture healing, the mechanism by which EPCs enhance fracture healing remains unclear. We hypothesized a possible paracrine mechanism of action, where the secretion of growth factors critical to the processes of fracture healing (such as VEGF), is responsible for the positive effects of EPC therapy. The purpose of this study was to evaluate VEGF gene expression after local EPC therapy for a rat segmental bone defect. ⋯ EPC-based therapy for a segmental bone defect results in increased VEGF expression during the early period of fracture repair. In addition, the specific VEGF isoform may be a key regulator of the bone healing process. These findings demonstrate that EPCs may promote fracture healing by increasing VEGF levels and thus stimulating angiogenesis, a process that is essential for early callus formation and bone regeneration.