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Complex carpal dissociation with open, complete, and divergent trapezium, capitate, and hamate dislocation: a case report
We report a patient with a unique complex carpal dissociation involving complete and divergent dislocation of the hamate, capitate, and trapezium with total ligamentous disruption of the distal carpal row and midcarpal joint, associated with a transverse shaft fracture of the fifth metacarpal. The mechanism of injury was a sustained torsional force resulting in a simultaneous distraction and bidirectional dorsopalmar (ulnar)-palmodorsal (radial) crushing force at the carpus
Angiogenic activity mediates bone repair from human pluripotent stem cell-derived osteogenic cells
Human pluripotent stem cells provide a standardized resource for bone repair. However, criteria to determine which exogenous cells best heal orthopedic injuries remain poorly defined. We evaluated osteogenic progenitor cells derived from both human embryonic stem cells (hESCs) and induced pluripotent stem cells (hiPSCs). Phenotypic and genotypic analyses demonstrated that these hESCs/hiPSCs are similar in their osteogenic differentiation efficiency and they generate osteogenic cells comparable to osteogenic cells derived from mesenchymal stromal cells (BM-MSCs). However, expression of angiogenic factors, such as vascular endothelial growth factor and basic fibroblast growth factor in these osteogenic progenitor cells are markedly different, suggesting distinct pro-angiogenic potential of these stem cell derivatives. Studies to repair a femur non-union fracture demonstrate only osteogenic progenitor cells with higher pro-angiogenic potential significantly enhance bone repair in vivo. Together, these studies highlight a key role of pro-angiogenic potential of transplanted osteogenic cells for effective cell-mediated bone repair