Fracture healing

Oral corrosion of metallic restorations does not, per se, generally result in serious damage to the structure. Corrosion can result, however, in various local and systemic effects, notably the hypersensitivity and allergic reactions reported by many workers. Galvanic cells created by mixed metal couples can delay fracture healing and induce oral lesions and cancer. 

Once bone loss is sufficient to result in a compression fracture, pharmacological therapy is much less effective. However, even after fractures have occurred, the use of the bisphosphonates and rPTH has been shown to increase bone densities and reduce the rate of subsequent fractures. Nasal calcitonin (200 units daily) is effective in promoting fracture healing and also exhibits an analgesic effect by reducing pain in persons with acute lumbar compression fractures. Whatever compound is used for prophylaxis or treatment of osteoporosis, calcium and Ds supplementation are required for maximum benefit. 

Metallic biomaterials (metals such as Ti or its alloys and others) are used for the manufacture of orthopaedic implants due to their excellent biocompatibility with respect to electrical and thermal conductivity and their mechanical properties, e.g., for hard tissue replacement such as total hip and knee joints, for fracture healing aids such as bone plates and screws or dental implants. For example, Co-Cr-Mo alloys are employed for metal-on-metal hip bearings in total joint replacements. Problems with implants occur because of ion release in patients with metal implants. To control this ion release, the ultratrace determination of Co, Cr and Mo in the blood (or serum) and urine of patients with Co-Cr-Mo alloy hip implants is carried out routinely in the author s laboratory. The trace metal determination of Co, Cr and Mo in complex matrices such as urine and blood by ICP-MS is not trivial due to the low concentrations expected in the sub-ngmF1 range, the possible danger of contamination during sample collection, sample preparation and the... 

Brown KM, Saunders MM, Kirsch T, Donahue HJ, Reid JS. Effect of COX-2-specific inhibition on fracture-healing in the rat femur. J Bone Joint Surg Am. 2004 86-A l 16-123. 

Wheeler P, Batt ME. Do non-steroidal antiinflammatory drugs adversely affect stress fracture healing A short review. Hr] Sports Med. 2005 39 65-69. 

Ouyang, H, Sherman, P. J., Paschalis, E. P., Boskey, A. L. and Mendelsohn, R. (2004) Fourier transform infrared microscopic imaging effects of estrogen and estrogen deficiency on fracture healing in rat femurs. Appl. Spectrosc. 58, 1-9. 

Trippel, S. B., Potential role of insulinlike growth factors in fracture healing. Clinical Orthopaedics 355S, S301-313 (1998). 

Bone diseases with osteoblast activity (Paget s disease, rachitis, osteomalacia, bone tumours, aseptic bone necrosis, fracture healing)... 

In Wistar rats treated with ciprofloxacin, there was poor healing of experimental fractures during the early stages of repair, suggesting that fluoroquinolones may compromise the clinical course of fracture healing (95). 

Huddleston PM, Steckelberg JM, Hanssen AD, Rouse MS, Bolander ME, Patel R. Ciprofloxacin inhibition of experimental fracture healing. J Bone Joint Surg Am 2000 82(2) 161-73. 

Altman RD, Latta LL, Keer R, Renfree K, Hornicek FJ, Banovac K. Effect of nonsteroidal antiinflammatory drugs on fracture healing a laboratory study in rats. J Orthop Trauma 1995 9(5) 392-400. 

El-Zawawy HB, Gill CS, Wright RW, Sandell LJ. Smoking delays chondro genesis in a mouse model of closed tibial fracture healing. J Orthop Res 2006 24(12) 2150—8. 

Hulth, A. 1989. Current concepts of fracture healing. Clin. Orthop. 249 265. 

O Slullivan, M.E., Chao, E.Y.S., and Kelly, P.J. 1989. Current concepts review. The effects of fixation on fracture healing. J. Bone Joint Surg. 71A 306. 

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