The influence of biomechanical stability on bone healing and fracture-related infection: the legacy of Stephan Perren

被引：95

作者：

Foster, Andrew L. ^{[1
,2
,3
,4
]}

Moriarty, T. Fintan ^{[1
]}

Zalavras, Charalampos ^{[5
]}

Morgenstern, Mario ^{[6
]}

Jaiprakash, Anjali ^{[2
]}

Crawford, Ross ^{[2
]}

Burch, Marc-Antoine ^{[1
,6
]}

Boot, Willemijn ^{[1
]}

Tetsworth, Kevin ^{[3
,4
]}

Miclau, Theodore ^{[7
]}

Ochsner, Peter ^{[8
]}

Schuetz, Michael A. ^{[1
,3
,4
]}

Richards, R. Geoff ^{[1
]}

Metsemakers, Willem-Jan ^{[9
,10
]}

机构：

[1] AO Res Inst Davos, Davos, Switzerland

[2] Queensland Univ Technol, Brisbane, Qld, Australia

[3] Royal Brisbane & Womens Hosp, Dept Orthopaed Surg, Herston, Qld, Australia

[4] Royal Brisbane & Womens Hosp, Jamieson Trauma Inst, Herston, Qld, Australia

[5] Univ Southern Calif, Keck Sch Med, Dept Orthopaed Surg, Los Angeles, CA USA

[6] Dept Orthoped & Trauma Surg, Basel, Switzerland

[7] Univ Calif San Francisco, Dept Orthopaed Surg, Orthopaed Trauma Inst, Zuckerberg San Francisco Gen Hosp, San Francisco, CA USA

[8] Med Univ Basel, Basel, Switzerland

[9] Univ Hosp Leuven, Dept Trauma Surg, Herestr 49, B-3000 Leuven, Belgium

[10] Katholieke Univ Leuven, Dept Dev & Regenerat, Leuven, Belgium

来源：

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2021年 / 52卷 / 01期

关键词：

VASCULARIZED FIBULAR GRAFTS; DYNAMIC COMPRESSION PLATE; STAPHYLOCOCCUS-AUREUS; FASCINATING CASCADE; INTERNAL-FIXATION; LIMITED CONTACT; LOCAL INFECTION; IMPLANT DESIGN; PREVENTION; RESISTANCE;

D O I：

10.1016/j.injury.2020.06.044

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Bone healing is a complicated process of tissue regeneration that is influenced by multiple biological and biomechanical processes. In a minority of cases, these physiological processes are complicated by issues such as nonunion and/or fracture-related infection (FRI). Based on a select few in vivo experimental animal studies, construct stability is considered an important factor influencing both prevention and treatment of FRI. Stephan Perren played a pivotal role in the evolution of our current understanding of the critical relationship between biomechanics, fracture healing and infection. Furthermore, his concept of strain theory and the process of fracture healing is familiar to several generations of surgeons and has influenced implant development and design for the past 50 years. In this review we describe the role of biomechanical stability on fracture healing, and provide a detailed analysis of the preclinical studies addressing this in the context of FRI. Furthermore, we demonstrate how Perren's concepts of stability are still applied to current surgical techniques to aid in the prevention and treatment of FRI. Finally, we highlight the key knowledge gaps in the underlying basic research literature that need to be addressed as we continue to optimize patient care. (C) 2020 The Author(s). Published by Elsevier Ltd.

引用

页码：43 / 52

页数：10

共 82 条

[1] Influence of the design for fixation implants on local infection: Experimental study of dynamic compression plates versus point contact fixators in rabbits [J].