Sonic Hedgehog Signaling Promotes Survival and Lineage Specific Differentiation of Transplanted Neural Precursor Cells and Improves Motor Recovery After Thoracic Spinal Cord Injury in Rats.

Large segmental bone defects of the tibia represent a major reconstructive challenge in orthopedic trauma surgery, particularly when associated with infection and soft tissue compromise. Among these injuries, tibial pilon fractures are especially problematic because they typically result from high-energy trauma and are characterized by severe articular comminution, metaphyseal bone loss, and significant soft tissue damage. In such cases, the risk of infection and nonunion is high, and repeated surgical interventions may further compromise local vascularity and soft tissue viability. Consequently, conventional reconstructive options—including vascularized fibular grafting and the induced membrane technique—may be limited or unreliable in the presence of persistent infection and poor biological conditions and compromised local vascularity.