Salvage Masquelet Technique for Insufficient Bone Regeneration Following Chipping and Lengthening in Tibial Nonunion: A Case Report.

BACKGROUND The treatment of nonunion with deformity and shortening remains a significant challenge in orthopedic surgery. The chipping and lengthening technique is used for bone reconstruction and new bone formation, without the need for bone grafting. However, inadequate bone regeneration can require additional treatment.

Investigation of 222-nm ultraviolet C irradiation bactericidal effect on the surgical field in a rabbit model.

Ultraviolet C (UV-C) not only has a bactericidal effect, but is also cytotoxic; however, UV-C at a wavelength of 222 nm with a high absorption coefficient for proteins is considered safe. We have previously reported the safety of 222-nm UV-C irradiation in humans and rabbits. This study evaluated the bactericidal effect of 222-nm UV-C irradiation on exposed surgical fields.

Successful Correction of Lower-Limb Malunions Using Intramedullary Nailing and Chipping Osteotomy: A Case Series.

BACKGROUND Lower-limb fracture malunion can result in angular deformity that requires surgical correction. Chipping corrective osteotomy (CCO) is a novel method that involves a chipping technique at the center of rotation of angulation, followed by single-stage internal fixation. This case series describes 3 cases of correction of fracture malunion of the lower limb managed using combined CCO and intramedullary nail stabilization.

Innovative Management of Brodie's Abscess: Continuous Local Antibiotic Perfusion in a 14-Year-Old Patient.

BACKGROUND Brodie's abscess is a rare form of subacute osteomyelitis that primarily affects the metaphyseal regions of long bones. Conventional treatment involves thorough curettage and systemic antibiotic therapy for ≥6 weeks, with bone grafting required for abscess sizes >3 cm. Continuous local antibiotic perfusion (CLAP) delivers high concentrations of antibiotics directly to the infection site and facilitates preservation of biologically active bone tissue.

Bactericidal effect of far ultraviolet-C irradiation at 222 nm against bacterial peritonitis.

Far ultraviolet-C irradiation at 222 nm has potent bactericidal effects against severe infections such as peritonitis, with minimal cytotoxicity. Bacterial peritonitis due to bowel perforation is a serious condition with high mortality despite current treatments. This study investigated the safety and efficacy of intraperitoneal far ultraviolet-C irradiation at 222 nm.

Management of Infected Tibial Nonunion: Combining Synthetic Bone Grafting with Continuous Local Antibiotic Perfusion (CLAP).

BACKGROUND Infection control and reconstruction of bone and soft tissue are essential for treating infected nonunion. Continuous local antibiotic perfusion (CLAP) is a drug delivery system that continuously delivers antibiotics at the required concentration, area, and duration. This case report describes the instance of infected nonunion in which infection eradication and bone union were achieved using CLAP and synthetic bone grafting while retaining the implant.

Three-dimensional printed calcium phosphate scaffolds emulate bone microstructure to promote bone regrowth and repair.

The interconnected structures in a 3D scaffold allows the movement of cells and nutrients. Therefore, this study aimed to investigate the in-vivo bioactivity of 3D-printed β-tricalcium phosphate (β-TCP) and hydroxyapatite (HAP) scaffolds that replicate biological bone. This study included 24-week-old male New Zealand white rabbits.

Phase III clinical trial of autologous CD34 + cell transplantation to accelerate fracture nonunion repair.

Background: We previously demonstrated that CD34 + cell transplantation in animals healed intractable fractures via osteogenesis and vasculogenesis; we also demonstrated the safety and efficacy of this cell therapy in an earlier phase I/II clinical trial conducted on seven patients with fracture nonunion. Herein, we present the results of a phase III clinical trial conducted to confirm the results of the previous phase studies using a larger cohort of patients.

Methods: CD34 + cells were mobilized via administration of granulocyte colony-stimulating factor, harvested using leukapheresis, and isolated using magnetic cell sorting.

Multicenter study on atypical femoral fractures in patients with bone metastases taking bone- modifying agents.

Bone-modifying agents (BMAs), with bone-resorptive inhibitory effects, such as zoledronic acid and denosumab, are widely used at higher doses for bone-related events caused by bone metastasis of malignant tumors. These drugs have been suggested to be associated with atypical femoral fractures (AFFs), and the relationship between BMAs and AFFs has attracted attention. To investigate the clinical features including bone union time of AFFs in patients administered BMA for bone metastasis, we conducted a retrospective multicenter study.

Osteomyelitis of the Pubis Treated by Masquelet Technique in a Football Player: A Case Report.

Introduction: Osteomyelitis pubis is a rare disease that presents with fever, pubic or hip pain, pain during hip movement, and claudication to avoid pain. It most frequently affects young athletes involved in sports that require twisting and cutting, but its exact cause is unknown and no definite treatment has been established. We report a case of pubic osteomyelitis in a young football player who was treated using the Masquelet technique and antibiotics with a good clinical course.

Nonunion of Hoffa Fracture Successfully Treated by Total Knee Arthroplasty: A Case Report.

A Hoffa fracture is a rare type of femoral fracture that is difficult to treat. Nonoperative treatments usually result in failure; hence, in most cases, surgical treatments are essential. Nonunion following Hoffa fracture appears to be relatively uncommon, and there are limited reports in the literature about this type of nonunion.

Continuous local antibiotic perfusion: A treatment strategy that allows implant retention in fracture-related infections.

Purpose: Fracture-related infections are difficult to treat because of the formation of biofilms around implants. Systemic antibiotics are notoriously ineffective against biofilms due to their insufficient penetration of tissues with poor vascularity. The goal of treating fracture-related infections is to achieve bone union while retaining the implant.

A Case of Nonunion with Ballooning Deformity after Periprosthetic Humeral Fracture.

Introduction: We report a very rare case of nonunion with ballooning deformity of the humeral bone after a periprosthetic humeral fracture nonunion.

Case Report: A 79-year-old woman underwent hemiarthroplasty 19 years ago for her proximal humerus fracture. She injured her right humeral diaphysis (stem distal end fracture) 6 years ago.

Treatment of Chronic Osteomyelitis of the Femur by Intramedullary Antibiotic Perfusion (iMAP): A Case Report.

Introduction: Chronic osteomyelitis is difficult to cure definitively, because local areas are often covered with sequestrum and scar tissues with a poor blood flow; these may render systemic antibiotic administration ineffective. We present a case of chronic osteomyelitis that was successfully treated with continuous local antibiotic perfusion (CLAP) through an intramedullary antibiotic perfusion (iMAP) pin.

Case Presentation: A 65-year-old man who suffered an episode of the right femoral osteomyelitis at the age of 15 years experienced a relapse at the age of 63 years.

Combined treatment using cross-leg free flap and the Masquelet technique: a report of two cases.

We introduce a treatment that combines the cross-leg free flap with the Masquelet technique and describe two cases using this method for bone and soft tissue reconstruction. Both patients were successfully treated and ambulatory. This novel method can be safely performed using the delay technique, indocyanine-green angiography and near-infrared spectroscopy.

Safety of 222 nm UVC Irradiation to the Surgical Site in a Rabbit Model.

For the prevention of surgical site infection (SSI), continuous disinfection could be helpful. Short wavelength ultraviolet radiation C (UVC) is highly bactericidal but shows cytotoxicity. Radiation of UVC with a wavelength of 222 nm to the skin is considered to be safe because it only reaches the stratum corneum.

A Piezo1/KLF15/IL-6 axis mediates immobilization-induced muscle atrophy.

Although immobility is a common cause of muscle atrophy, the mechanism underlying this causality is unclear. We here show that Krüppel-like factor 15 (KLF15) and IL-6 are upregulated in skeletal muscle of limb-immobilized mice and that mice with KLF15 deficiency in skeletal muscle or with systemic IL-6 deficiency are protected from immobility-induced muscle atrophy. A newly developed Ca2+ bioimaging revealed that the cytosolic Ca2+ concentration ([Ca2+]i) of skeletal muscle is reduced to below the basal level by immobilization, which is associated with the downregulation of Piezo1.

Immunohistochemical analysis revealed the expression of bone morphogenetic proteins-4, 6, 7, and 9 in human induced membrane samples treated with the Masquelet technique.

Background: Induced membrane (IM) is the key component of Masquelet reconstruction surgery for the treatment of bone defects. IM is formed around the cement spacer and is known to secrete growth factors and osteoinductive factors. However, there is limited evidence available concerning the presence of osteoinductive factors in IM.