Injury
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Review
Application of scaffolds for bone regeneration strategies: current trends and future directions.
Scaffolds are extensively used in surgery to replace missing bone and to achieve bony union and fusion. An ideal scaffold should not only maintain, induce, and restore biological functions where cells, extracellular matrix, and growth factors are needed, but also have the right properties with respect to degradation, cell binding, cellular uptake, non-immunogenicity, mechanical strength, and flexibility. Here we examine both the basic science behind the development of scaffolds and comprehensively and systematically review the clinical applications.
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Comparative Study
Fresh osteochondral allograft is a suitable alternative for wide cartilage defect in the knee.
There are several surgical options to restore a wide osteochondral defect in the knee. Fresh osteochondral allografts are usually considered a poor alternative due to their difficulties in surgical application. The aim of this work is first to present our experience including the surgical technique and the functional results of patients receiving fresh osteochondral allograft to restore major knee lesions, then, to compare our results with other results presented in literature. ⋯ Therapeutic study, Level IV.
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Comparative Study
Clinical strategies at the docking site of distraction osteogenesis: are open procedures superior to the simple compression of Ilizarov?
This retrospective review reports on forty-five tibial non-unions who underwent docking site treatment for non-union using closed versus open and endoscopic strategies. In this cohort of patients, all but twelve were infected non-unions. Sixteen patients initially treated with single compression were compared to twenty-three patients treated with open revision of the docking site, and six endoscopic procedures. ⋯ Conclusive evidence of superiority of one modality of treatment over the other cannot be drawn from our data. The simple compression procedure requires less invasive surgery and is probably less demanding and more cost-effective in short transports, although the two cases of failure due to recurrence of sepsis were observed after this procedure. Further studies are desirable to investigate the effectiveness of open docking site grating procedures.
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Comparative Study
Monotherapy vs. polytherapy in the treatment of forearm non-unions and bone defects.
To determinate the efficacy of "polytherapy", a surgical technique that utilize all the components of the diamond concept (mesenchymal stem cells, bone morphogenetic proteins and scaffold) versus a "monotherapy", a surgical technique that utilize only one component of the diamond conceptin the treatment of severe forearm non-unions. ⋯ The polytherapy technique with the use of recombinant morphogenetic proteins, autologous MSCs and scaffold in the same surgical time appears to be an effective treatment for patients with severe forearm non-unions.
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Comparative Study
Comparing ICD-9 and ICD-10: the impact on intentional and unintentional injury mortality statistics in Italy and Norway.
The international classification of diseases (ICD) provides guidelines for the collection, classification and dissemination of official cause-of-death statistics. New revisions of the ICD can potentially disrupt time trends of cause-of-death statistics and affect between-country comparisons. The aim of this study was to measure how switching from ICD-9 to ICD-10 affected mortality statistics for external causes of death, i.e. intentional and unintentional injuries, in Italy and Norway. ⋯ Switching to ICD-10 did not change the overall trends for accidents, homicides and suicides in either country. However, the number of records in some injury subcategories e.g. accidental falls and traffic accidents, decreased. Changing classification can thus affect the ranking of causes of injury mortality, with consequences for public health policy.