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Bone Healing in Hand Transplantation

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Hand Transplantation

Abstract

Various bone disorders can affect the ability of bone cells to structure organic and inorganic components. Avascularity can cause osteonecrosis, with death of haematopoietic cells, lipocytes and endothelial cells. Repair of osteonecrosis is the time needed for the process to replace necrotic bone. Callous fracture healing is a regenerative process consisting of three stages of inflammation: development of soft callus, of hard callus and remodelling [1, 2]. During inflammation, new blood vessels are induced, enhancing angiogenesis, which can be investigated by Doppler ultrasound. Following inflammation, fibrous and cartilaginous tissue known as soft callus develops, which can be observed by grey-scale ultrasound. In the hard callus stage, cartilaginous tissue converts to woven bone, which will finally be remodelled to lamellar bone.

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References

  1. Burchardt H (1983) The biology of bone graft repair. Clin Orthop 174:28–42

    PubMed  Google Scholar 

  2. Ostrum RF, Chao EY, Bassett CA et al (1994) Bone injury, regeneration and repair. In: Sheldon RS (ed) Orthopaedic Basis. Science. American Academy of Orthopedic Surgeons, pp 277–324

    Google Scholar 

  3. Enneking WF, Eady JL, Burchardt H (1980) Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 62:1039–1058

    PubMed  CAS  Google Scholar 

  4. Schafer D, Jager K, Fricker R et al (1997) Quantitative monitoring of blood supply to knee joint transplants in dogs. Eur Surg Res 29:455–464

    PubMed  CAS  Google Scholar 

  5. Bensusan JS, Davy DT, Goldberg VM et al (1991) The effects of vascularity and cyclosporin A on the mechanical properties of canine fibular autografts. J Biomech 25:415–420

    Article  Google Scholar 

  6. Innis PC, Randolph MA, Paskert JP et al (1991) Related articles. Vascularized bone allografts: in vitro assessment of cell-mediated and humoral responses. Plast Reconstr Surg 87:315–325

    Article  PubMed  CAS  Google Scholar 

  7. Doi K, DeSantis G, Singer DI et al (1989) The effect of immunosuppression on vascularised allografts. A preliminary report. J Bone Joint Surg Br 71:576–582

    PubMed  CAS  Google Scholar 

  8. Mathes DW, Randolph MA, Bourget JL et al (2002) Recipient bone marrow engraftment in donor tissue after long-term tolerance to a composite tissue allograft. Transplantation 73:1880–1885

    Article  PubMed  Google Scholar 

  9. Kirschner MH, Brauns L, Gonschorek O et al (2000) Vascularised knee joint transplantation in man: the first two years experience. Eur J Surg 166:320–327

    Article  PubMed  CAS  Google Scholar 

  10. Thompson RC Jr, Pickvance EA, Garry D (1993) Fractures in large-segment allografts. J Bone Joint Surg Am 75:1663–1673

    PubMed  Google Scholar 

  11. Lee WP, Yaremchuk MJ, Pan YC et al (1991) Relative antigenicity of components of a vascularized limb allograft. Plast Reconstr Surg 87:401–411

    Article  PubMed  CAS  Google Scholar 

  12. Muramatsu K, Doi K, Akino T et al (1997) Longer survival of rat limb allograft. Combined immunosuppression of FK-506 and 15-deoxyspergualin. Acta Orthop Scand 68:581–585

    Article  PubMed  CAS  Google Scholar 

  13. Gabl M, Pechlaner S, Lutz M et al (2004) Bilateral hand transplantation: bone healing under immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone. J Hand Surg [Am] 29:1020–1027

    Article  Google Scholar 

  14. Margreiter R, Brandacher G, Ninkovic M et al (2002) A double-hand transplant can be worth the effort! Transplantation 74:85–90

    Article  PubMed  Google Scholar 

  15. Menck J, Schreiber HW, Hertz T, Burgel N (1994) Angioarchitecture of the ulna and radius and their practical relevance. Langenbecks Arch Chir 379:70–75

    Article  PubMed  CAS  Google Scholar 

  16. Giebel GD, Meyer C, Koebke J, Giebel G (1997) Arterial supply of forearm bones and its importance for the operative treatment of fractures. Surg Radiol Anat 19:149–153

    PubMed  CAS  Google Scholar 

  17. Wright TW, Glowczewskie F (1998) Vascular anatomy of the ulna. J Hand Surg [Am] 23:800–804

    Article  CAS  Google Scholar 

  18. Dubernard JM, Owen E, Herzberg G et al (1999) Human hand allograft report on first 6 months. Lancet 17:1315–1320

    Article  Google Scholar 

  19. Petruzzo P, Revillard JP, Kanitakis J et al (2003) First human double hand transplantation efficacy of a conventional immunosuppressive protocol. Clin Transplant 17:455–460

    Article  PubMed  Google Scholar 

  20. Jones JW, Gruber SA, Barker JH, Breidenbach WC (2002) Successful hand transplantation. One-year follow up. N Engl J Med 7:468–472

    Google Scholar 

  21. Piza-Katzer H, Ninkovic N, Pechlaner S et al (2002) Double hand transplantation functional outcome after 18 months. J Hand Surg [Br] 27:385–390

    Article  CAS  Google Scholar 

  22. Tang L, Ebara S, Kawasaki S et al (2002) FK506 enhanced osteoblastic differentiation in mesenchymal cells. Cell Biol Int 26:75–84

    Article  PubMed  CAS  Google Scholar 

  23. Monegal A, Navasa M, Guanabens N et al (2001) Bone mass and mineral metabolism in liver transplant patients treated with FK506 or cyclosporine A. Calcif Tissue Int 68:83–86

    PubMed  CAS  Google Scholar 

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© 2007 Springer-Verlag Italia

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Gabl, M. et al. (2007). Bone Healing in Hand Transplantation. In: Lanzetta, M., Dubernard, JM., Petruzzo, P. (eds) Hand Transplantation. Springer, Milano. https://doi.org/10.1007/978-88-470-0374-3_35

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  • DOI: https://doi.org/10.1007/978-88-470-0374-3_35

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0373-6

  • Online ISBN: 978-88-470-0374-3

  • eBook Packages: MedicineMedicine (R0)

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