New treatment lets patients use broken bones immediately

Jewelry designer Eve Alfille, 72, sought medical attention for a wrist fracture just 10 days before she was to show a new collection of work at her gallery in Evanston.

She thought her show would be ruined because she would be unable to finish hand-crafting her jewelry with a clunky cast on her wrist.

She went to one doctor who told her he wouldn’t perform surgery – the wrist would just have to heal on its own. Without the surgery she faced permanent displacement, and might not have been able to twist her wrist ever again, she said.

“They weren’t really interested in my needs,” Alfille said. “I am a jewelry designer and there is a certain use of my hand that I just need – I wouldn’t be able to work.”

She was devastated and sought a second opinion. That’s when Dr. Mark Cohen, an orthopedic surgeon at Rush University Medical Center who specializes in hand, wrist and elbow surgery, told her that using the latest technology he could fix her wrist and have her back to work in just a few days.

“It was remarkable,” Alfille said. “There was no pain, before or after, and I was able to do work that same day.”

Alfille is but one of many patients who will find wrists fractures less of an inconvenience than in years past. New technology, which attaches small plates to the bone, has been tested over the past five years and has now had enough trials to be proved very effective at getting patients up and running months faster than before without risk of reinjuring the bone, Cohen said.

Wrist fractures are the most common type of broken bones, which means many people could potentially be incapacitated by the injury. Cohen said in the winter with slippery sidewalk and ice-crusted parking lots he treats three to four broken wrists a week. In addition to being of use on the wrist, the plates can also be used in ankle, leg, hip and other types of fractures.

“These small little locking plates have revolutionized the way we treat broken wrists,” Cohen said. “Patients experience less pain, fewer problems after surgery, recover quicker and rapidly recover their mobility and function.”

The small locking plates are secured internally with small screws placed directly into the bone. Once in place the plates are extremely secure and permanent. The patient can almost immediately enter rehabilitation therapy and start to return to normal activities, Cohen said. Using old technology, including casts, to set the wrist -- or external screws fixed into place with metal bars -- the patient would not enter therapy until about two months after the fracture occurred.

The process is much faster because the body is essentially tricked into thinking it is healed because it has been bolted back together internally, said Dr. John Fernandez, Cohen’s partner in orthopedics at Rush University Medical Center.

“We have a couple of students who were treated the old way versus the new way and the difference is dramatic,” Fernandez said. “Patients are able to use the hand immediately rather than waiting for the fracture to heal.”

This surgery will be most influential for seniors who are the most common victims of falls that result in broken or fractured bones, Cohen said.

“Many older people live alone and their independence is very important to them,” Cohen said. “To be able to make somebody independent within a few days is a huge difference than having someone rely on only one hand for all of their activities.”

Source: http://news.medill.northwestern.edu/chicago/news.aspx?id=76077

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Drug helps re-grow injured bone

BIRMINGHAM, Ala., Jan. 11 (UPI) -- A drug designed to treat iron poisoning can help boost the body's ability to re-grow injured bone, U.S. researchers said.

In a study published online, in advance of the print edition of the journal Proceedings of the National Academy of Sciences, researchers said deferoxamine activates a cell pathway that helps the body respond to low oxygen levels that often accompany fractures, by triggering the growth of new blood vessels, which in turn causes bone to regenerate and heal.

"With deferoxamine activating this pathway, we've proven a significant point -- it is possible to explore new, safe and more affordable ways to kick-start bone repair," study co-author Dr. Shawn Gilbert of the University of Alabama at Birmingham said in a statement. "Current treatments use complex proteins, which are expensive to make and cost thousands of dollars per dose. The type of agent used in this study is a simple, small molecule drug that costs hundreds, not thousands."

In the study, the bone density of broken mouse bones injected with deferoxamine more than doubled to 2.6 cubic millimeters, compared to 1.2 cubic millimeters in untreated bones. There were also significant increases in the number of new blood vessels, and excellent connectivity between those vessels, the study found.

Source: http://www.upi.com/NewsTrack/Health/2008/01/11/drug_helps_re-grow_injured_bone/3872/

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Healing Old Broken Bones without Operations

Cartilage, even if it is old, promotes inosculation of broken old bones. Specialists of the Chelyabinsk State Institute of Laser Surgery (Russian Academy of Medical Sciences) and the St. Petersburg Institute of Bioregulation and Gerontology (North-West Branch, Russian Academy of Medical Sciences) have developed a treatment for fractures.

The aging organism’s metabolism differs from the one in young days. Young bones are constantly renewed: old cells die off and they are replaced by new ones. These processes are slower in old bone tissue, therefore, if the bone breaks it is difficult to repair – the restorative potential is not as good as it was before. And bone strength is different as there are less mineral salts in aging bones.

Russian researchers have investigated methods of healing bones without extensive operations, long-term bone fixation or expensive stimulating drugs, using tests on animal subjects.

The experiments involved eighteen rabbits aged five to six years, divided into two groups. Researchers took part of the cranium parietal bone and ablated it under anaesthetic, observing how the hole on the bone healed up. In one group, the cartilage was placed into the wound, with the other group had the wound covered by a skin flap.

Researchers found that separated cartilage fragments in the bone gradually join with trabeculas of bone and pull collagen fibers with young fibroblasts towards them. Three weeks after the operation, a callus was formed and new blood vessels actively grew, with the wound healed by the end of the fourth week, with young conjunctive tissue beginning to ossify. As for the reference group animals, their bones did not heal by this stage. Researchers concluded that osteoplasty using the patient’s own cartilage stimulates the healing process of old bone fibres knitting together.

Source: http://www.azom.com/details.asp?newsID=10056

Do broken hearts lead to broken bones?

OBJECTIVE: Mental distress may entail increased risk of hip fracture, but it is uncertain whether the effect consists solely of an indirect effect through use of medication, or whether it is also mediated through other mechanism. The purpose of this study was to examine the association between mental distress and risk of hip fracture in women, adjusted for medication (that is, use of tranquillisers/sedatives or hypnotics).

DESIGN: A three year follow up of hip fracture was conducted on 18,612 women, consisting of 92.5% of all women aged 50 years or older in a Norwegian county. Three hundred and twenty nine suffered a hip fracture. A mental distress index was based on questions about life dissatisfaction, nervousness, loneliness, sleep disorders, troubled and uneasy feelings, depression and impairment attributable to psychological complaints. Relative risk with 95% confidence intervals (CI) of hip fracture with respect to mental distress were controlled for medication, age, body mass index (BMI), smoking, physical inactivity, and physical illness by means of Cox regression.

RESULTS: The 10% of women with the highest mental distress had more than twofold increased risk of hip fracture compared with the 10% of women with the lowest mental distress, after adjustment for age and medication. The relative risk was 1.95 (95% CI 1.2, 3.3) after additional control for BMI, smoking, physical inactivity, and physical illness. The relative risk of hip fracture for daily users of medication compared with never users was 2.1 (95% CI 1.6, 2.9). After adjusting for mental distress it was 1.5 (95% CI 1.0, 2.2).

CONCLUSIONS: Risk of hip fracture was positively related to mental distress, also after adjustment for medication use. The effect of tranquillisers/sedatives or hypnotics on hip fracture risk may be overestimated in studies with no adjustments for mental distress.

Source: http://jech.bmj.com/cgi/content/abstract/53/6/343