Osteology, Volume 4, Issue 3 (September 2024) – 4 articles

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration and quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of the NewClip narrow locking plate system with early weight-bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with the NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation. Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and a final follow-up at twelve months revealed complete osseous healing without complications. Conclusions: The use of this type of plate in treating isolated fibular fractures with early weight-bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes, warranting further investigation with larger cohorts. Full article

This paper aims to review the various surgical techniques for gastrocnemius–soleus recession and Achilles tendon lengthening, with a special focus on the treatment of clubfoot and cerebral palsy (CP) equinus contracture. This descriptive review article comprehensively explores different techniques for gastrocnemius recession, including the Hoke percutaneous triple hemisection, Baker’s method (Tongue-in-Groove Gastrocnemius–Soleus Recession), the Vulpius method, the Baumann procedure, and the Strayer procedure (Gastrocnemius Recession). The objective is to present a detailed analysis of these methods, covering their indications, procedural nuances, relevance in clinical practice, and outcomes. Full article

Advanced laboratory methods play a crucial role in bone research, allowing researchers and scientists to study the complex biology and nature of the skeleton. Dual-energy X-ray absorptiometry (DXA) is a non-invasive method of measuring bone mass, which is an important parameter for the diagnosis and treatment of several bone diseases. Micro-computed tomography (μCT) is a very high-resolution technique that can be used to investigate the 3D microstructure of trabecular bone. Dynamic bone histomorphometry is used to assess histological indices of bone formation and resorption using fluorochromes embedded into newly formed bone. Mechanical testing is used to measure bone strength and stiffness, providing important information about bone quality and fracture risk. All these methods are widely used in preclinical in vivo studies using rodents and in most clinical studies. Therefore, it is important for both researchers and scientists within the field of bone biology, and those in neighboring fields, to be familiar with their use, strengths, limitations, and important technical aspects. Several guidelines and protocols about the topic have been published, but are very exhaustive. The present review aimed to provide instructions for early-career researchers and outline important concepts and technical aspects of DXA, μCT, dynamic bone histomorphometry, and mechanical testing in bone research. Full article

Weight-bearing physical activity is considered beneficial to bone health throughout the course of life, with the most marked benefits for bone health often considered to be high levels of activity around the time of peak bone mass (PBM) acquisition. To date, the research focus has been on the benefits of recreational weight-bearing sporting activity. Participation in elite sport is associated with enhanced sporting activity but is often also associated with low body weight, menstrual disturbance in females, and rest periods following injury. The benefit of sporting activity may, therefore, be attenuated in these groups. Here, we undertook a systematic review to consider what evidence is available regarding whether elite sporting activity in young adulthood has lasting benefits for bone health. Studies of retired athletes aged >50 years, who participated in elite sport from 15 to 30 years, were considered for inclusion. Elite sport was defined as participation at the national level or above. Following protocol development, the search strategy was applied to PubMed, Medline, Embase, and Web of Science. The selection was managed with Rayyan software, and the bias was assessed using the Newcastle–Ottawa scale. Two reviewers independently identified papers; a third adjudicated and screened the final selection for consideration. The protocol was registered with PROSPERO (CRD42021293644). Two reviewers screened 951 articles, of which 4 papers met the inclusion criteria. One paper reported findings in women and three in men; no paper included both sexes. The sample sizes varied from 24 to 193 and considered football, endurance running, weightlifting, and swimming. Bone density was measured at the femoral neck, trochanter, and lumbar spine. All studies reported higher density in former athletes than non-elite controls, though the information available regarding confounding lifestyle factors was variable. A meta-analysis was not possible as studies were too heterogenous. In conclusion, from the limited available evidence, our study suggests elite sporting activity in young adulthood may have lasting benefits for bone health. However, given the paucity of available data, we highlight an urgent need for future research, especially in female athletes. Full article