Evidence map›Paper›PMID 28176273›Full record

ReviewJournal of experimental orthopaedics2017

The haematoma and its role in bone healing.

H Schell, G N Duda, A Peters, S Tsitsilonis, K A Johnson, K Schmidt-Bleek

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of experimental orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 107 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
107citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

107 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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47 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

H SchellJulius Wolff Institut and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin, Berlin, Germany.
G N DudaJulius Wolff Institut and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin, Berlin, Germany.
A PetersJulius Wolff Institut and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin, Berlin, Germany.
S TsitsilonisJulius Wolff Institut and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin, Berlin, Germany.
K A JohnsonFaculty of Veterinary Science, University of Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0001-6207-3924
K Schmidt-BleekJulius Wolff Institut and Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin, Berlin, Germany. katharina.schmidt-bleek@charite.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fracture treatment is an old endeavour intended to promote bone healing and to also enable early loading and regain of function in the injured limb. However, in today's clinical routine the healing potential of the initial fracture haematoma is still not fully recognized. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) formed in Switzerland in 1956 formulated four AO principles of fracture treatment which are still valid today. Fracture treatment strategies have continued to evolve further, as for example the relatively new concept of minimally invasive plate osteosynthesis (MIPO). This MIPO treatment strategy harbours the benefit of an undisturbed original fracture haematoma that supports the healing process. The extent of the supportive effect of this haematoma for the bone healing process has not been considered in clinical practice so far. The rising importance of osteoimmunological aspects in bone healing supports the essential role of the initial haematoma as a source for inflammatory cells that release the cytokine pattern that directs cell recruitment towards the injured tissue. In reviewing the potential benefits of the fracture haematoma, the early development of angiogenic and osteogenic potentials within the haematoma are striking. Removing the haematoma during surgery could negatively influence the fracture healing process. In an ovine open tibial fracture model the haematoma was removed 4 or 7 days after injury and the bone that formed during the first two weeks of healing was significantly reduced in comparison with an undisturbed control. These findings indicate that whenever possible the original haematoma formed upon injury should be conserved during clinical fracture treatment to benefit from the inherent healing potential.

Indexed as

Bone healingFracture treatmentHaematomaRegeneration

Identifiers

PMID28176273
PMCPMC5296258

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.