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Zou B. Pedicle ossification after fibular flap reconstruction of maxillary defects: A case report and literature review. Clin Case Rep 2024; 12:e8810. [PMID: 38698875 PMCID: PMC11063610 DOI: 10.1002/ccr3.8810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/30/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Key Clinical Message The phenomenon of vessel pedicle ossification is a noteworthy aspect of the repair and reconstruction of maxillofacial defects. Imaging findings typically reveal high-density shadows within the vascular pedicle pathway, which may be managed through conservative observation or surgical intervention as deemed appropriate. Abstract Vessel pedicle ossification is a relatively uncommon complication associated with the reconstruction of oral and maxillofacial tissue defects using free tissue flap repair. In this paper, we report a case of pedicle ossification and conduct a comprehensive review of previous literature. A 39-year-old man presented with a limited ability to open his mouth 6 months after fibular flap reconstruction of the mandible. Plain film X-ray and computed tomography (CT) indicated pedicle ossification. Two years after the initial operation, the restriction in the patient's ability to open his mouth had not worsened, although there were more pronounced radiographic abnormalities.
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Affiliation(s)
- Bo Zou
- Department of Oral and Maxillofacial SurgeryLiaocheng People's Hospital, Medical School of Liaocheng UniversityLiaochengShandongChina
- Department of Oral and Maxillofacial SurgeryPeking University School and Hospital of StomatologyBeijingChina
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Bernstein M, Little MTM, Marecek G. Current Management of Acute and Posttraumatic Critical Bone Defects. J Orthop Trauma 2024; 38:S1-S8. [PMID: 38502596 DOI: 10.1097/bot.0000000000002762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 03/21/2024]
Abstract
SUMMARY Limb reconstruction in patients with critical-sized bone defects remains a challenge due to the availability of various technically demanding treatment options and a lack of standardized decision algorithms. Although no consensus exists, it is apparent from the literature that the combination of patient, surgeon, and institutional collaborations is effective in providing the most efficient care pathway for these patients. Success relies on choosing a particular surgical approach that manages infection, soft tissue defects, stability, and alignment. Recent systematic reviews demonstrate high success rates with the following management options: Ilizarov bone transport, Masquelet (induced membrane) technique, cancellous bone grafting, and vascularized bone grafts.
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Affiliation(s)
- Mitchell Bernstein
- Department of Surgery, McGill University Health Center, Montreal QC, Canada
- Department of Pediatric Surgery, McGill University Health Center, Montreal QC, Canada; and
| | - Milton T M Little
- Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Beverly Hills, CA
| | - Geoffrey Marecek
- Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Beverly Hills, CA
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Cai Y, Zhang X, Chen X, Dai X, Chai S, Li G, Mei Z, Ho J, Chen J, Li L, Xiong N. Autologous bone fragments for skull reconstruction after microvascular decompression. BMC Surg 2022; 22:395. [PMCID: PMC9673364 DOI: 10.1186/s12893-022-01820-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background Various methods are used to reconstruct the skull after microvascular decompression, giving their own advantages and disadvantages. The objective of this study was to evaluate the efficacy of using autologous bone fragments for skull reconstruction after microvascular decompression. Methods The clinical and follow-up data of 145 patients who underwent microvascular decompression and skull reconstruction using autologous bone fragments in our hospital from September 2020 to September 2021 were retrospectively analyzed. Results Three patients (2.06%) had delayed wound healing after surgery and were discharged after wound cleaning. No patient developed postoperative cerebrospinal fluid leakage, incisional dehiscence, or intracranial infection. Eighty-five (58.62%) patients underwent follow-up cranial computed tomography at 1 year postoperatively, showed excellent skull reconstruction. And, the longer the follow-up period, the more satisfactory the cranial repair. Two patients underwent re-operation for recurrence of hemifacial spasm, and intraoperative observation revealed that the initial skull defect was filled with new skull bone. Conclusion The use of autologous bone fragments for skull reconstruction after microvascular decompression is safe and feasible, with few postoperative wound complications and excellent long-term repair results.
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Affiliation(s)
- Yuankun Cai
- grid.413247.70000 0004 1808 0969Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei China
| | - Xiuling Zhang
- grid.508021.eDepartment of Neurology, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Xiaogan, Hubei China
| | - Xiaobin Chen
- Department of Neurosurgery, Wuhan NO. 1 Hospital, Wuhan, Hubei China
| | - Xuan Dai
- grid.413247.70000 0004 1808 0969Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei China
| | - Songshan Chai
- grid.413247.70000 0004 1808 0969Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei China
| | - Guo Li
- grid.413247.70000 0004 1808 0969Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei China
| | - Zhimin Mei
- grid.413247.70000 0004 1808 0969Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei China
| | - Joshua Ho
- grid.194645.b0000000121742757School of Biomedical Sciences, LKS Faculty of Medicine, Hongkong University, Hongkong, China
| | - Jincao Chen
- grid.413247.70000 0004 1808 0969Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei China
| | - Luoqing Li
- Department of Neurology, Yueyang Central Hospital, Yueyang, Hunan China
| | - Nanxiang Xiong
- grid.413247.70000 0004 1808 0969Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei China
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Mastrolia I, Giorgini A, Murgia A, Loschi P, Petrachi T, Rasini V, Pinelli M, Pinto V, Lolli F, Chiavelli C, Grisendi G, Baschieri MC, Santis GD, Catani F, Dominici M, Veronesi E. Autologous Marrow Mesenchymal Stem Cell Driving Bone Regeneration in a Rabbit Model of Femoral Head Osteonecrosis. Pharmaceutics 2022; 14:pharmaceutics14102127. [PMID: 36297562 PMCID: PMC9610232 DOI: 10.3390/pharmaceutics14102127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Osteonecrosis of the femoral head (ONFH) is a progressive degenerative disease that ultimately requires a total hip replacement. Mesenchymal stromal/stem cells (MSCs), particularly the ones isolated from bone marrow (BM), could be promising tools to restore bone tissue in ONFH. Here, we established a rabbit model to mimic the pathogenic features of human ONFH and to challenge an autologous MSC-based treatment. ON has been originally induced by the synergic combination of surgery and steroid administration. Autologous BM-MSCs were then implanted in the FH, aiming to restore the damaged tissue. Histological analyses confirmed bone formation in the BM-MSC treated rabbit femurs but not in the controls. In addition, the model also allowed investigations on BM-MSCs isolated before (ON-BM-MSCs) and after (ON+BM-MSCs) ON induction to dissect the impact of ON damage on MSC behavior in an affected microenvironment, accounting for those clinical approaches foreseeing MSCs generally isolated from affected patients. BM-MSCs, isolated before and after ON induction, revealed similar growth rates, immunophenotypic profiles, and differentiation abilities regardless of the ON. Our data support the use of ON+BM-MSCs as a promising autologous therapeutic tool to treat ON, paving the way for a more consolidated use into the clinical settings.
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Affiliation(s)
- Ilenia Mastrolia
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Correspondence:
| | - Andrea Giorgini
- Division of Orthopedics, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Alba Murgia
- Technopole of Mirandola TPM, Mirandola, 41037 Modena, Italy
| | | | | | - Valeria Rasini
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Massimo Pinelli
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Valentina Pinto
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Francesca Lolli
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Chiara Chiavelli
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Giulia Grisendi
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Maria Cristina Baschieri
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Giorgio De Santis
- Division of Plastic Surgery, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Fabio Catani
- Division of Orthopedics, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Massimo Dominici
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Technopole of Mirandola TPM, Mirandola, 41037 Modena, Italy
| | - Elena Veronesi
- Laboratory of Cellular Therapy, Division of Oncology, Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- Technopole of Mirandola TPM, Mirandola, 41037 Modena, Italy
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Abstract
PURPOSE OF REVIEW The periosteum, the outer layer of bone, is a major source of skeletal stem/progenitor cells (SSPCs) for bone repair. Here, we discuss recent findings on the characterization, role, and regulation of periosteal SSPCs (pSSPCs) during bone regeneration. RECENT FINDINGS Several markers have been described for pSSPCs but lack tissue specificity. In vivo lineage tracing and transcriptomic analyses have improved our understanding of pSSPC functions during bone regeneration. Bone injury activates pSSPCs that migrate, proliferate, and have the unique potential to form both bone and cartilage. The injury response of pSSPCs is controlled by many signaling pathways including BMP, FGF, Notch, and Wnt, their metabolic state, and their interactions with the blood clot, nerve fibers, blood vessels, and macrophages in the fracture environment. Periosteal SSPCs are essential for bone regeneration. Despite recent advances, further studies are required to elucidate pSSPC heterogeneity and plasticity that make them a central component of the fracture healing process and a prime target for clinical applications.
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Affiliation(s)
- Simon Perrin
- Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France
| | - Céline Colnot
- Univ Paris Est Creteil, INSERM, IMRB, F-94010, Creteil, France.
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