This is a progress report (Year 3) for the development of a novel therapeutic drug (salubrinal and guanabenz) for skeletal diseases, focusing on potential treatment of osteoporosis and bone fracture. The study in the third year was focused on the subtasks in Tasks 3, 4, and 5, using animal models and in vitro cell cultures. In vivo data supported efficacy of salubrinal and guanabenz on strengthening bone in bone necrosis (Task 3) and bone fracture (Task 4). In vitro data showed genome-wide mRNA...
Topics: DTIC Archive, INDIANA UNIV INDIANAPOLIS, *BONE FRACTURES, *HEALING, *OSTEOPOROSIS, DRUGS
We build on our earlier findings of three potential contributing genetic factors (ADRB2, TLR4, CFH)in the development of heterotopic ossification (HO). HO development in long bone fractures correlated with all of these variables but was inversely associated with head injury scores. With more recent data we have determined that the ADRB2 minor allele is associated with HO formation in our patient population however, TLR4 and CFH no longer demonstrate significance.
Topics: DTIC Archive, VANDERBILT UNIV MEDICAL CENTER NASHVILLE TN, *BONE FRACTURES, *GENETICS, *TRAUMA,...
Because aging can lower the fracture resistance of bone in ways that are independent of bone mass, the present project investigated the possibility that transforming growth factor (TGF)-Beta inhibition could improve multiple measurements of fracture resistance in growing, mature adult, and old rodents. TGF-Beta inhibition was achieved with a neutralizing antibody known as 1D11. When administered to growing mice for 4 weeks (13 to 17 weeks of age), 1D11 substantially increased trabecular bone...
Topics: DTIC Archive, VANDERBILT UNIV NASHVILLE TN, *BONE FRACTURES, *BONES, ADULTS, AGING(PHYSIOLOGY),...
The primary objective of this project is to develop a novel large animal survival model of intra-articular fracture (IAF) in which all major pathophysiological attributes corresponding to human injuries are realistically replicated, and in which post-traumatic osteoarthritis (PTOA) predictably develops. This final report summarizes all project activities. Initial work included development of hardware to reliably induce a highly repeatable fracture of the Yucatan minipig hock and development of...
Topics: DTIC Archive, IOWA UNIV IOWA CITY, *BONE FRACTURES, CARTILAGE, DEGENERATION(PHYSIOLOGY),...
This is a progress report (year 1) for developing a novel therapeutic drug for skeletal diseases, in particular focusing on administration of salubrinal for treatment of osteoporosis and bone fracture. A formulation for salubrinal was determined and an effective dosage was identified. Using ovariectomized mice, administration of salubrinal was shown to reduce body weight and fat weight, and to prevent reduction in uterus weight and BMD/BMC. Salubrinal was also shown to inhibit osteoclast...
Topics: DTIC Archive, INDIANA UNIV INDIANAPOLIS, *BONE FRACTURES, *OSTEOPOROSIS, CANCER, HEALING, LIPID...
Long bone fractures resulting from high impact trauma can result in delayed healing. In spite of currently available treatments to enhance bone healing, these fractures can take up to a year to fully heal. Photodynamic therapy (PDT) is a minimally invasive local treatment currently used to treat cancer and skin diseases. Surprisingly, recent findings from studying the effect of PDT on vertebrae when treating spinal metastases have shown that PDT improved the strength and stiffness of the...
Topics: DTIC Archive, SUNNYBROOK AND WOMENS COLL HEALTH SCIENCES CENTER TORONTO (ONTARIO), *BONE FRACTURES,...
Our hypothesis was that a degradable, thermally-responsive bone graft substitute, made from renewable sources, that effectively and simultaneously delivers osteogenic and angiogenic growth factors directly to the bone defect site can enhance repair of non-union fractures. In this study, a new chitosan/xylan composite hydrogel was studied as an improved bone graft substitute able to accurately deliver a combination of proven growth factors in a manner that is compatible with current surgical...
Topics: DTIC Archive, VIRGINIA UNIV CHARLOTTESVILLE, *BONES, *SKIN GRAFTS, BONE FRACTURES,...
The subject of our research is development of the urodele salamander Ambystoma mexicanum (axolotl), as a model to find the optimum set of growth factors that will enable regeneration of a cartilage template across a CSD in the long bones of the extremities across a critical size defect (CSD). Unlike most models that attempt to regenerate bone directly, with less than optimum filling, regeneration of a cartilage template mimics the initial step of both the normal development of a long bone and...
Topics: DTIC Archive, INDIANA UNIV INDIANAPOLIS, *MEDICINE, *WOUNDS AND INJURIES, BONE FRACTURES, FIBULA,...
External fixators are the first choice for severe fractures in long bones on the battlefield. The applied fixators of different medical services in NATO are mostly bulky in shape, difficult to mount, unstable or too complex to understand. It was the intent of the NATO working group STANAG 2469 to improve the standards for the external fixation of long bones. The Italian proposal for a general fixation system was opposed by the US and German delegates in terms of lack of reducibility after...
Topics: DTIC Archive, Gerngross, H, MILITARY HOSPITAL ULM (GERMANY), *COMBAT FORCES, *CLAMPS, *BONE...
We build on our earlier findings of three potential contributing genetic factors (ADRB2, TLR4, CFH)in the development of heterotopic ossification (HO). Demographic and environmental data for 1313 patients were compiled in addition to radiographic findings of HO in the same cohort. Statistical analyses were performed to determine associations between ISS, head AIS, ICU days, days on ventilator support, race and gender on the development of HO. In addition, we have begun extraction on another...
Topics: DTIC Archive, VANDERBILT UNIV MEDICAL CENTER NASHVILLE TN, *BONE FRACTURES, *GENETICS, *TRAUMA,...
The hypothesis of these studies is that genetic processes that lead to the variations in both structural and material properties of bone development will be recapitulated in the developmental mechanisms that control the bone quality during fracture healing. Two goals were set out in this proposal to test this hypothesis. the First was to determine how variations in basic bone quality in the three in bred strains of mice were expressed during fracture healing. MicroCT and mechanical testing of...
Topics: DTIC Archive, Gerstenfeld, Louis C, TRUSTEES OF BOSTON UNIV MA, *HEALING, *BONE FRACTURES, MICE,...
The primary objective of this project is to develop a novel large animal survival model of intra-articular fracture (IAF) in which all major pathophysiological attributes of corresponding human clinical injuries are realistically replicated, and in which post-traumatic osteoarthritis (OA) predictively develops. Work during the reporting period (Year 1) has yielded definitive protocols to create a large animal survival IAF model and to document/analyze the natural course of fractured...
Topics: DTIC Archive, IOWA UNIV IOWA CITY, *ARTHRITIS, *OSTEOPOROSIS, BONE FRACTURES, JOINTS(ANATOMY),...
The purpose of this study is to test the efficacy of thrombopoietin (TPO) to heal a segmental bone defect (SBD) in a large animal model, the minipig. The scope of the research comprises the following specific aims (i) to determine the union rate of tibial midshaft defects in minipigs treated with BMP-2, TPO, or saline control; and (ii) to evaluate the safety and side effects of treating tibial midshaft defects in minipigs treated with BMP-2, TPO, or saline control. In the previous research...
Topics: DTIC Archive, Kacena,Melissa, Indiana University Indianapolis United States, proteins, bone...
The purpose of this research is to investigate a novel therapeutic approach to preventing PTOA by addressing mitochondrial dysfunction and oxidative damage in cartilage. Thus far we have tested a number of compounds for therapeutic activity in a chondral injury model that involves a high energy impact to the medial femoral condyle of rabbits. The selection of compounds included an oxidant scavenger, (N-Acetylcysteine), a drug that reduces mitochondrial superoxide production by blocking electron...
Topics: DTIC Archive, IOWA UNIV IOWA CITY, *ARTHRITIS, *BONE FRACTURES, *MITOCHONDRIA, CARTILAGE, CYSTEINE,...
This report covers the second year of a three-year project that examines the hypothesis that the healing of critical size femoral defects in the rat in response to recombinant, human bone morphogenetic protein-2 (BMP-2) is enhanced by reverse dynamization . In reverse dynamization, the defect is initially fixed loosely. Once healing has commenced, stiffness is increased. This is the opposite of current clinical practice of fixing osseous defects as stiffly as possible. When dynamization is used...
Topics: DTIC Archive, BETH ISRAEL DEACONESS MEDICAL CENTER BOSTON MA, *BONES, BONE FRACTURES, DEFECT...
ESWT is used in treatment of pseudoarthrosis and may be considered for callus lengthening operations. In this study, effects of ESWT on the forming callus were studied. Transverse femoral osteotomy at mid diaphysis, internally fixated with Kirschner wires were performed on 20 male, ten-week-old white Wistar rats. In the third week, animals underwent ESWT with 1500 (Group I) and 500 (Group II) shockwaves/treatment at a generating voltage of 10 kV on their right femurs; left femurs were used as...
Topics: DTIC Archive, Utku, F S, BOGAZICI UNIV ISTANBUL (TURKEY), *SHOCK WAVES, *THERAPY, TURKEY, HEALING,...
Osteoblastic bone metastasis is a common complication of advanced prostate cancer, resulting in pain and pathologic fracture. Dickkopf homolog 1 (DKK1) is a secreted inhibitor of osteoblast Wnt signaling pathway and hypothesized to be a central regulator of prostate cancer osteoblastic bone metastasis. The purpose of this proposal is to examine mechanisms of DKK1 regulation by prostate cancer cells and determine whether DKK1 overexpression in bone blocks the formation of osteoblastic bone...
Topics: DTIC Archive, ALABAMA UNIV IN BIRMINGHAM, *BONE FRACTURES, *BONES, *METASTASIS, *PROSTATE CANCER,...
The overall aim of this research is to gain insight into the etiology of tibial stress fractures. Three dimensional motion analysis data along with structural data will be collected from 400 subjects (200 at each site) over a 3-year period. 30 of the subjects will have sustained a tibial stress fracture prior to the study and the other 370 will have not. Subjects will be recruited primarily from track teams, running clubs, and physicians local to the University of Delaware and University of...
Topics: DTIC Archive, McClay, Irene S, DELAWARE UNIV NEWARK, *BONE FRACTURES, *TIBIA, ADHESION,...
It has been assumed that chondrocytes killed by mechanical injury to articular cartilage are never replaced and that the resulting hypocellularity contributes to post-traumatic osteoarthritis. However, we found that nonviable areas in an explant injury model were repopulated within 7-14 days by cells that appeared to migrate from the surrounding matrix. We hypothesized that the migrating population included chondrogenic progenitor cells drawn to injured cartilage by alarmins released from dead...
Topics: DTIC Archive, IOWA UNIV IOWA CITY, *BONE FRACTURES, *CARTILAGE, *STEM CELLS, CHEMOTAXIS, CYSTEINE,...
Introduction/relevance to the Symposium: Lower limb stress fracture injuries (SFx) account for a high number of working days lost during initial UK military training, cause considerable morbidity to recruits and contribute significantly to the high attrition from training. Rationale: Recent evidence from the assessment of circulating biochemical markers suggests that changes in bone turnover, a process in which old bone is removed (bone resorption) and new bone formed in its place might be...
Topics: DTIC Archive, QINETIQ LTD FARNBOROUGH (UNITED KINGDOM), *BONES, BONE FRACTURES, COLLAGEN,...
Severe bone loss commonly occurs in individuals with chronic spinal cord injury who are non weight-bearing and leads to an increased risk of lower extremity fractures. This 12 month multi-side, double-blind, randomized, placebo-controlled study evaluates the efficacy and safety of two interventions known to be anabolic to bone, parathyroid horomone and mechanical loading (provided as teriparatide and vibration respectively). In 60 SCI individuals with low bone mass. At the end of the third year...
Topics: DTIC Archive, NORTHWESTERN UNIV EVANSTON IL, *SPINAL CORD, *WOUNDS AND INJURIES, ARCHITECTURE, BONE...
Objectives: Delayed and nonunion of the tibia are not uncommon in orthopaedic practice. Multiple methods of treatment have been developed with variable results. The objective of this study was to define disease-specific and treatment-related factors of prognostic significance in patients undergoing shock wave therapy for tibia nonunion. Design: Retrospective analysis. Patients: One hundred ninety-two patients treated with extracorporeal shock wave therapy (ESWT) at a single referral trauma...
Topics: DTIC Archive, NAVAL MEDICAL RESEARCH CENTER SILVER SPRING MD, *BONE FRACTURES, *SHOCK WAVES,...
In this project we study Heterotopic Ossification (HO) and are a potential novel therapy to cure it. HO consists of formation of extra bone within the muscles, near tendons and ligaments, inside the blood vessels and other places in the body. HO is triggered by trauma, burns, nerve damage, immobilization and other conditions and can also occur in patients undergoing large surgeries such as hip or knee replacement. Because trauma, burns and other severe wounds are regrettably common in our...
Topics: DTIC Archive, Forsberg,Jonathan, GENEVA FOUNDATION TACOMA WA TACOMA United States, wounds and...
Patients with Neurofibromatosis (NF1) exhibit deficient bone healing/ The cause of poor bone healing in NF1 is unclear, and pharmacologic approaches to improve bone repair are lacking. Beta-catenin is a protein that regulates osteoblasts during bone healing. When beta-catenin protein level is high, it prevents osteoblast differentiation, and undifferentiated fibroblast-like cells persist at the fracture site, resulting in a pseudarthrosis. Genetically engineered mice in which the Nf1 gene can...
Topics: DTIC Archive, HOSPITAL FOR SICK CHILDREN TORONTO (ONTARIO), *BONES, BONE FRACTURES, DRUGS, GENES,...
This cross-sectional clinical study aims to examine potential mechanisms contributing to stress fracture risk. In particular, in Study 1, we will perform advanced skeletal imaging along with gait-assessments in subjects with history of a single vs multiple vs no prior stress fractures. In addition, in Aim 2, we will perform advanced imaging to delineate variation in skeletal features according to sex and race/ethnic-origin that may contribute or protect from stress fracture. To date, we have...
Topics: DTIC Archive, Bouxsein, Mary, Massachusetts General Hospital Boston United States, bone fractures,...
The purpose of the project is to investigate a potential application of ALT-711 (4,5-Dimethyl-3-(2-oxo-2-phenylethyl)-thiazolium chloride) in improving both mechanical and biological quality of femoral cortical bone for the purpose of providing better allograft materials via chemically breaking down AGEs (Advanced Glycation Endproducts) in the bone matrix. AGEs are naturally accumulated with age in connective tissues and believed to have adverse effects on the biological and mechanical...
Topics: DTIC Archive, HENRY FORD HEALTH SYSTEM DETROIT MI, *BONES, BONE FRACTURES, CROSSLINKING(CHEMISTRY),...
Our study is a multi-center prospective randomized treatment trial investigating if supplemental perioperative oxygen use will reduce surgical site infection after surgery on fractures with a high risk of infection. The study utilizes the DOD-funded Major Extremity Research Consortium (METRC). The study population is calcaneus, pilon, and tibial plateau fractures. During the first year we created a protocol committee, designed and approved the protocol and CRFs, obtained IRB approval. We have...
Topics: DTIC Archive, O'Toole, Robert V, University of Maryland, Baltimore Baltimore United States,...
The objective of the proposed research is to develop new models for predicting the risk of post-traumatic osteoarthritis (PTOA) following intra-articular fracture (IAF). Aim 1, pursued this year, involves evaluating pre- and post-treatment CT data from patients with combat-related IAFs to measure fracture severity and post-reduction contact stress exposure. We first established a CRADA between the University of Iowa and the U.S. Army Institute of Surgical Research (USAISR). Then IRB approval...
Topics: DTIC Archive, Anderson,Donald D, University of Iowa Iowa City United States, bone fractures,...
Successful treatment of pathologic femur fractures can preserve a patient's independence and quality of life. The choice of implant depends on several disease and patient-specific variables; however, its durability must generally match the patient's estimated life expectancy. Failures do occur, however, it is unclear which implants are associated with greater risk of failure. We evaluated patients with femoral metastases in whom implants failed to determine (1) the rate of reoperation; (2) the...
Topics: DTIC Archive, KAROLINSKA INST STOCKHOLM (SWEDEN), *BONE FRACTURES, DISEASES, LIFE SPAN(BIOLOGY),...
The overall aim of this research is to gain insight into the etiology of tibial stress fractures. Three dimensional motion analysis data along with structural data will be collected from 40 subjects (200 at each site) over a 3-year period. 30 of the subjects will have sustained a tibial stress fracture prior to the study and the other 370 will have not. Subjects will be recruited primarily from track teams, running clubs, and physicians local to the University of Delaware and University of...
Topics: DTIC Archive, McClay, Irene S, DELAWARE UNIV NEWARK, *BONE FRACTURES, *TIBIA, ADHESION,...
The overall aim of this research is to gain insight into the etiology of tibial stress fractures. Three dimensional motion analysis data along with structural data will be collected from 400 subjects (200 at each site) over a 3-year period. 30 of the subjects will have sustained a tibial stress fracture prior to the study and the other 370 will have not. Subjects will be recruited primarily from track teams, running clubs, and physicians local to the University of Delaware and University of...
Topics: DTIC Archive, McClay, Irene S, DELAWARE UNIV NEWARK, *BONE FRACTURES, *TIBIA, STRESS(PHYSIOLOGY),...
The specific goals of this research program were to contribute to two major objectives in support of reducing the incidence of fracture: 1. The development and application of micro-imaging and testing techniques in animal models to study bone structure function properties. 2. Exploring the influence of calcium and vitamin D metabolism and physical forces on bone integrity. Using mouse models, this study demonstrated that the use of micro-imaging techniques (Micro CT, Raman Spectroscopy) and...
Topics: DTIC Archive, Goldstein, Steven A, MICHIGAN UNIV ANN ARBOR, *NUTRITION, *BONE FRACTURES,...
Stress fractures result from repetitive loading and have been regarded as a mechanical fatigue-driven process. However, a number of studies indicate implicate increased bone remodeling in the pathogenesis of stress fractures. These experiments tested the hypothesis by pharmacological inhibition of bone remodeling will diminish the severity of the stress fracture and slow the accumulation of microdamage with resulting from chronic loading. Bisphosphonate (BIS) antiresorptive therapy was used to...
Topics: DTIC Archive, Schaffler, Mitchell B, MOUNT SINAI SCHOOL OF MEDICINE NEW YORK, *STRESS(PHYSIOLOGY),...
The overall aim of this research is to gain insight into the etiology of tibial stress fractures. Three dimensional motion analysis data along with structural data will be collected from 400 subjects (200 at each site) over a 3-year period. 30 of the subjects will have sustained a tibial stress fracture prior to the study and the other 370 will have not. Subjects will be recruited primarily from track teams, running clubs, and physicians local to the University of Delaware and University of...
Topics: DTIC Archive, Davis, Irene S, DELAWARE UNIV NEWARK, *STRESS(PHYSIOLOGY), *ETIOLOGY, *TIBIA, *BONE...
Anterolateral tibial bowing is a morbid skeletal manifestation observed in 5% of children with neurofibromatosis type 1 (NF1), typically identified in infancy. The majority of NF1 individuals with tibial bowing will sustain a fracture that will not heal (i.e. pseudarthrosis) resulting in multiple surgeries, poor limb function, and amputation. Some NF1 individuals with tibial bowing, however, do not fracture and the bowing improves over time. Clinical predictors to help drive management are...
Topics: DTIC Archive, UTAH UNIV SALT LAKE CITY, *BONE FRACTURES, *BONES, *CHILDREN, *PATHOPHYSIOLOGY,...
Falls and debilitating bone fractures are a major problem for veterans, and more than 40,000 veterans suffered hip fractures from 2000-2002. Falls are the main etiological factor in more than 90% of fractures, and so treatments that can improve muscle strength while at the same time increasing bone mass will significantly reduce fracture-related morbidity and mortality. Myostatin is a factor that induces muscle wasting and suppresses bone formation. Our data collected thus far demonstrate i)...
Topics: DTIC Archive, MEDICAL COLL OF GEORGIA AUGUSTA, *BONE FRACTURES, ETIOLOGY, HIP, INHIBITORS, MUSCLES,...
It has been reported that more than 30,000 American service members have been wounded in the wars in Iraq and Afghanistan during the last six years. The majority of service members who are wounded in action sustain musculoskeletal injuries such as the orthopedic-related trauma involving the upper and lower extremities present with a significant bone defect. Bone allografts have become an accepted technology to replace bone loss. However, major complications reported for grafting procedures are...
Topics: DTIC Archive, RUSH UNIV MEDICAL CENTER CHICAGO IL, *BONE FRACTURES, LASER APPLICATIONS,...
Our study is a multi-center prospective randomized treatment trial investigating if supplemental perioperative oxygen use will reduce surgical site infection after surgery on fractures with a high risk of infection. The study utilizes the DOD-funded Major Extremity Research Consortium (METRC). The study population is calcaneus, pilon, and tibial plateau fractures. During the first year we created a protocol committee, designed and approved the protocol and CRFs, obtained IRB approval. We have...
Topics: DTIC Archive, O'Toole,Robert V, University of Maryland, Baltimore Baltimore United States, general...
Our application seeks to develop myostatin inhibitors as novel therapeutic agents for improving muscle and bone strength, and preventing falls and fractures for aging veterans. Our goals for year 1 of the project were to determine how the expression of myostatin, its receptor, and the myostatin antagonist follistatin change with age in musculoskeletal tissues from aged mice and bone marrow samples obtained from young (18-30) and older (50-70) patients in the orthopaedic clinic. Our findings so...
Topics: DTIC Archive, MEDICAL COLL OF GEORGIA AUGUSTA RESEARCH INST, *OSTEOPOROSIS, AGING(PHYSIOLOGY), BONE...
Stress fractures result from repetitive loading and have been regarded as a mechanical fatigue-driven process. However, a number of studies indicate implicate increased bone remodeling in the pathogenesis of stress fractures. Our experiments tested the hypothesis that pharmacological inhibition of bone remodeling will slow the accumulation of microdamage and diminish the severity of the stress fracture. Using a bisphosphonate (BIS) to suppress remodeling in the rabbit tibial stress fracture...
Topics: DTIC Archive, Schaffler, Mitchell B, MOUNT SINAI SCHOOL OF MEDICINE NEW YORK, *PATHOGENESIS, *BONE...
It is estimated that there have been several hundred tibia fractures that have occurred in the global war on terror. Little is known about the long-term consequences of these injuries and their treatment. Objective: Our main objective is to determine significant predictors of poor outcome following open tibia fractures so that suitable modifications can be made to treatment and rehabilitative therapy. Of particular interest is an evaluation of differences in outcomes for various algorithms for...
Topics: DTIC Archive, GENEVA FOUNDATION LAKEWOOD WA, *BONE FRACTURES, *TIBIA, ARMY PERSONNEL, CLINICAL...
The overall aim of this research is to gain insight into the etiology of tibial stress fractures. Three dimensional motion analysis data along with structural data will be collected from 400 subjects (200 at each site) over a 3-year period. 30 of the subjects will have sustained a tibial stress fracture prior to the study and the other 370 will have not. Subjects will be recruited primarily from track teams, running clubs, and physicians local to the University of Delaware and University of...
Topics: DTIC Archive, Davis, Irene M, DELAWARE UNIV NEWARK, *BONE FRACTURES, *ETIOLOGY,...
This retrospective study investigated active duty soldiers with delayed definitive fixation of combat-related talus fractures. The authors predicted a longer delay to internal fixation and a correlation between the timing of fixation and development of osteonecrosis and posttraumatic arthritis. The Joint Theater Trauma Registry was queried by ICD-9 codes for talus fractures. Soldiers, ages 18 to 40, with talus fracture between 2001 and 2008 were included. Radiographs identified the injury type,...
Topics: DTIC Archive, ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX, *BONE FRACTURES, ARTHRITIS,...
Severe bone loss commonly occurs in individuals with chronic spinal cord injury who are nonweight-bearing and leads to an increased risk of lower extremity fractures. This 12 month, multi-site, double-blind, randomized, placebo-controlled study evaluates the efficacy and safety of two interventions known to be anabolic to bone, parathyroid hormone and mechanical loading (provided as teriparatide and vibration, respectively) in 60 SCI individuals with low bone mass. At the end of the fourth year...
Topics: DTIC Archive, NORTHWESTERN UNIV EVANSTON IL, *OSTEOPOROSIS, *PARATHYROID HORMONES, *SPINAL CORD,...
Infection is a potentially devastating complication following severe lower extremity trauma, but its impact on the outcomes of combat casualties remains unclear. We hypothesize that orthopedic infectious complications will have a negative impact on holistic patient outcome as measured by return-to-duty (RTD) and disability ratings among wounded soldiers. We reviewed the medical records for 115 wounded soldiers who sustained a Type III open tibia fracture and tabulated the prevalence of...
Topics: DTIC Archive, ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX, *BONE FRACTURES, *INFECTIOUS...
The ongoing wars in Iraq and Afghanistan have provided the oral and maxillofacial surgeon unique challenges in reconstructing and restoring function to these soldiers with complex facial injuries. Indeed, injuries that were unsurvivable in previous conflicts are now commonplace because of early surgical intervention, body armor, and rapid evacuation. This article examines the history, etiology, diagnosis, classification, treatment, and complications of mandibular fractures, with emphasis on the...
Topics: DTIC Archive, ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX, *SURGERY, BONE FRACTURES,...
To determine the optimal fluid resuscitation and anesthetic regimen for swine undergoing uncontrolled hemorrhage. Methods: 1. 37 swine at 3 institutions underwent femur fracture, controlled hemorrhage, hypothermia and resuscitation with normal saline and Grade V liver injury followed by 30 minutes of hemorrhagic shock without resuscitation. Animals were then randomized to controls, shams, whole blood, 1:1 PRBC:FFP, FFP alone and Hextend. Physiologic measurements and coagulation assays were...
Topics: DTIC Archive, Schreiber, Martin A, OREGON HEALTH AND SCIENCES UNIV PORTLAND, *HEMORRHAGE, *SWINE,...
The Fracture Putty project was initiated to develop better, faster and more efficient methods to treat difficult fractures. This contract supported study of hydrogel polymers, which are polymerized under direct control of the operating surgeon, and are also designed for biologic cleavage by osteoclast specific proteases. Processes in bone growth and repair were studied in cell cultures, mice, rats, sheep, pigs, and feasibility of lymphatic imaging was demonstrated in humans. We believe this...
Topics: DTIC Archive, BAYLOR COLL OF MEDICINE HOUSTON TX, *BONES, *DEFECTS(MATERIALS), *GELS, *GENETIC...
The objective of this research is to develop new models for predicting the risk of post-traumatic osteoarthritis (PTOA) following intra-articular fracture (IAF). We have analyzed pre- and post-treatment CT data from patients with combat-related IAFs to measure fracture severity and post reduction contact stress exposure. Our partner at SAMMC continues screening the DoDTR to identify and enroll subjects. The imaging data for 57 subjects with collectively 95 fractures have been forwarded to us...
Topics: DTIC Archive, Anderson,Donald D, The University of Iowa Iowa City United States, ARTHRITIS,...
It has been assumed that chondrocytes killed by mechanical injury to articular cartilage are never replaced and that the resulting hypocellularity contributes to post-traumatic osteoarthritis. However, we found that nonviable areas in an explant injury model were repopulated within 7-14 days by cells that appeared to migrate from the surrounding matrix. We hypothesized that the migrating population included chondrogenic progenitor cells drawn to injured cartilage by alarmins released from dead...
Topics: DTIC Archive, IOWA UNIV IOWA CITY, *CARTILAGE, *JOINTS, BONE FRACTURES, CELLS(BIOLOGY),...
