超越最初的影响:创伤后骨损失及其机制的系统审查
Adibeh Rahmani1,2, Ulrike Weichelt1,2, Denise Jahn1,2
1Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, corporate member of, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
概括
像TBI和SCI这样的重大创伤损伤会导致严重的骨损失并增加骨折风险. 了解复杂的机制是制定有效的预防和治疗策略的关键.
科学领域:
- 整形外科 整形外科 整形外科
- 创伤外科 手术 创伤外科
- 代谢性骨疾病 代谢性骨疾病
背景情况:
- 系统性骨损失是重大创伤的已知并发症,包括创伤性脑损伤 (TBI),脊髓损伤 (SCI),烧伤和骨折.
- 虽然SCI诱导的骨损失得到了充分记录,但TBI,烧伤和骨折对骨代谢的影响需要进一步调查.
研究的目的:
- 系统地审查各种伤害类型中创伤后骨损失的临床和临床前证据.
- 确定导致骨损失的关键机制及其对骨折风险的影响.
- 引导未来的研究和预防和治疗的临床策略.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 搜索了PubMed,科学网,Scopus和科学直播直到2025年1月.
- 包括关于创伤和骨损失的临床和临床前研究,合成提取的数据.
主要成果:
- 包括TBI,SCI,烧伤和骨折的165项研究.
- 观察到显著的骨矿物质密度 (BMD) 减少 (SCI高达50%,烧伤高达8%) 和骨质疏松症风险增加.
- 确定了有助于发生的机制:机械卸载,炎症,神经调节,代谢/激素失衡.
结论:
- 创伤后骨损失是机械,炎症,神经,营养和荷尔蒙因素的多因素相互作用的结果.
- 了解这些机制对于开发缓解骨损失和降低骨折风险的干预措施至关重要.
- 有针对性的策略对于改善创伤患者的长期结果至关重要.
相关概念视频
01:40Bone Remodeling
40.2K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
40.2K
01:29Bone Disorders
5.0K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
5.0K
01:27Fractures: Bone Repair
5.0K
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
5.0K
01:31Osteoclasts in Bone Remodeling
3.9K
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
3.9K