Bone Stress Injuries at the Ankle and Foot.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: None declared. 10. Microvasc Res. 2017 Mar;110:5-13. doi: 10.1016/j.mvr.2016.11.005. Epub 2016 Nov 23. The periosteal microcirculation in health and disease: An update on clinical significance. Szabó A(1), Janovszky Á(2), Pócs L(3), Boros M(4). Author information: (1)Institute of Surgical Research, University of Szeged, Szeged, Hungary. Electronic address: szabo.andrea.exp@med.u-szeged.hu. (2)Department of Oral and Maxillofacial Surgery, University of Szeged, Szeged, Hungary. (3)Department of Traumatology and Hand Surgery, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary. (4)Institute of Surgical Research, University of Szeged, Szeged, Hungary. Apart from its nutritive functions, the periosteum critically affects bone regeneration via its stem/osteoprogenitor cell content. Normal healing after bone fractures, trauma-orthopedic interventions and invasive dental procedures is critically linked to the reestablishment of the periosteal microcirculation, but the reconstruction, replacement or repair of lost tissues may also be performed with autologous periosteum. Besides the initiation of cell differentiation during bone repair and remodeling processes, the periosteum together with the endosteum plays significant roles in the pathogenesis of both hormone-related and trauma-induced osteoporotic alterations in the bone metabolism. Nevertheless, the axial bones, and in particular the jawbones, and the appendicular bones display differences not only in their blood supply and fracture healing characteristics, but also in respect of the development of osteoporosis and their reactions to treatment modalities (i.e. bisphosphonates). These reactions may also be linked to the differences in periosteal microcirculatory reactions. The present overview summarizes the relevant data of microcirculatory studies focusing on the periosteal reactions in different anatomical locations together with the optimal background methodologies, study models and the most significant observations. Copyright © 2016 Elsevier Inc. All rights reserved. DOI: 10.1016/j.mvr.2016.11.005