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Atrophic non-union is a serious complication of fractures. The underlying biological mechanisms involved in its pathogenesis are not yet completely understood. MicroRNAs (miRNAs or miRs) are a type of endogenous small non-coding RNA, which participate in various physiological and pathophysiological processes. In this study, differentially expressed miRNAs were screened in patients with atrophic non-union. In total, 4 miRNAs (miR‑149*, miR‑221, miR‑628-3p and miR‑654-5p) were upregulated and 7 miRNAs (let-7b*, miR‑220b, miR‑513a-3p, miR‑551a, miR‑576-5p, miR‑1236 and kshv-miR‑K12-6-5p) were downregulated at the fracture sites in patients with atrophic non-union. Among the upregulated miRNAs, miR‑628-3p and miR‑654-5p expression was found to be persistently decreased during osteoblast differentiation, indicating their possible inhibitory effect on osteogenesis. Gain-of-function experiment demonstrated that miR‑628-3p, but not miR‑654-5p, attenuated osteoblast differentiation. Further, in silico analysis revealed that runt-related transcription factor 2 (RUNX2), the master transcript factor for osteoblast differentiation, was the target of miR-628-3p, which had two binding site-condense regions in the 3' untranslated region. The exact binding site of miR-628-3p was further identified with luciferase reporter assay. In addition, the overexpression of miR‑628-3p appeared to be associated with the suppression of RUNX2 expression at both the mRNA and protein level, suggesting that miR‑628-3p inhibits osteoblast differentiation via RUNX2. On the whole, the findings of this study provide evidence of the upregulation of miR‑628-3p in patients with atrophic non-union and that miR‑628-3p may exert an inhibitory effect on osteogenesis via the suppression of its target gene, RUNX2. The study provides valuable insight into the pathogenesis of atrophic non-union and suggests new potential therapeutic targets for the treatment of this disorder.
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http://dx.doi.org/10.3892/ijmm.2016.2839 | DOI Listing |
Cureus
June 2025
Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, IND.
Fracture of the edentulous mandible presents a significant clinical challenge due to anatomical alterations, reduced bone density, and lack of natural occlusal support, particularly in elderly patients with comorbidities. This systematic review aimed to evaluate and synthesize the available evidence on the treatment of edentulous and atrophic mandibular fractures, focusing on clinical outcomes, treatment success, and associated complications. A comprehensive search of four electronic databases was conducted to identify studies published between 1995 and 2024.
View Article and Find Full Text PDFEur J Nucl Med Mol Imaging
August 2025
Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Objective: Evaluation of bone healing potential in cases of delayed union or non-union remains a challenge. This study evaluated the use of [F]NaF PET/CT to assess bone healing and its role in guiding clinical decision-making in orthopaedic trauma surgery.
Methods: From June 2019 to December 2024, a prospective study was conducted in a level 1 trauma center.
Diseases
March 2025
Physiology Laboratory, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Pseudoarthrosis-the failure of normal fracture healing-remains a significant orthopedic challenge affecting approximately 10-15% of long bone fractures, and is associated with significant pain, prolonged disability, and repeated surgical interventions. Despite extensive research into the pathophysiological mechanisms of bone healing, diagnostic approaches remain reliant on clinical findings and radiographic evaluations, with little innovation in tools to predict or diagnose non-union. The present review evaluates the current understanding of the genetic and biological basis of pseudoarthrosis and highlights future research directions.
View Article and Find Full Text PDFBMJ Case Rep
March 2025
Orthopaedic surgery, University of Leeds, Leeds, England, UK
Distal femoral non-union presents significant challenges, often requiring complex treatment strategies to achieve bone healing. In this case, a young male patient with an open fracture of the distal femur developed an atrophic non-union, 9 months after initial fixation. The patient underwent surgical intervention with debridement, leading to a 2.
View Article and Find Full Text PDFActa Chir Belg
June 2025
Department of (Trauma) Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.
Background: Tibial fractures, with an annual incidence of 51.7 per 100.000 adults, often result in complications like non-union and infection, particularly in open fractures.
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