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Asset-light fee-oriented (ALFO) is a hospitality industry model that enhances the firm's growth with minimal capital investment and reduces the risk of collateral loss. This analysis aims to examine and provide a comprehensive bibliometric analysis of the ALFO strategy in social and management sciences.The authors reviewed 60 research articles on ALFO from 2003 to 2022 using the "bibliometrix 3.0" package of R studio. International journal of hospitality and management was a core journal that mainly targeted Asset light fee-oriented strategy publications. Purdue University is the primary affiliation. Brazil, United States, and France are significant countries for literary research in the stated field. Sohn. J is the core author for developing a contemporary ALFO strategy. The study suggests two research themes and streams using co-citation and bibliometric coupling; "Application of ALFO strategy in the hospitality industry" and "Role of ALFO in behavioural finance of the hospitality industry". The study's main areas and themes will help us generate future research directions regarding the ALFO strategy. The study provides strong influential and theoretical implications for policymakers, researchers, the tourism sector, and hospitality stakeholders.

Purpose The organizational success to achieve and maintain its competitiveness is ascribed in the effectiveness of its knowledge management (KM) system, which depends on its employees’ impetus to exhibit knowledge sharing behavior. When an employee hides knowledge, an organization somewhat loses its part of knowledge, which causes loss to the organization eventually. This study aims to examine the impact of personality traits and one’s ethnicity on knowledge hiding behavior (KHB) by focusing on mediating role of team member exchange (TMX). Design/methodology/approach A total 308 questionnaires are collected from the public sector organizations (Livestock and Dairy Development Department, Punjab, Pakistan), out of them 300 are used in the analysis. Through Google e-survey form, cross-sectional data using convenience sampling are collected from the Gazetted officers (managerial level) of the department. Findings The paper provides empirical insights about three personality traits, i.e. openness, conscientiousness and neuroticism, and ethnicity have positive relation with KHB, whereas TMX as a mediator converts this positive relation into negative. Remaining two personality traits, i.e. extraversion and agreeableness, have negative relation with KHB, whereas TMX as a mediator strengthens this negative relationship with KHB. Research limitations/implications The broad context of research and large number of items made it difficult to collect the responses. In future studies, 50 items of big five should be replaced with mini scale. Empirical explanation of the relation between ethnicity and knowledge hiding is an addition to body of knowledge in general, particularly in context of Pakistan. Practical implications This study has the power to help managers in managing their team members and to understand what kind of personality and social group involvements promote knowledge sharing culture within the organization. Originality/value To broaden the understanding of KM domain, this study adds value in the relationship between big five personality traits, ethnicity and KHB of employees by finding the mediating effect of TMX in the context of Pakistani organizations.

Work engagement is a valuable organizational resource, and it has many positive outcomes. In today’s dynamic and competitive business environment, organizations can only be successful when they have an engaged workforce. The current study examines how supervisors support and fairness is important for employee’s work engagement and how the role of perceived organizational support is significant in an employee's workplace. In line with Organizational Support Theory (OST) and Conservation of Resource Theory (CRT), the current study is an empirical attempt to explain antecedents that could increase work engagement and resultantly fetch productivity and profit in the context of South Asia (the case of Pakistan) by considering the outcomes. This cross-sectional study draws data through structured questionnaires from 310 employees of eight mega retail stores by using simple random sampling. The outcomes of Structural Equation Modeling (SEM) analysis revealed a positive effect of supervisors’ support and organizational fairness on work engagement through the mediation of Perceived Organizational Support (POS) and explained the impact of work engagement on task performance and career satisfaction of employees. The current study tested the model for work engagement; future research might test the model using other employee factors (employee sustainability or motivation) in order to test continuous employee behaviors in their workplaces.

Diaphyseal forearm fractures represent a spectrum of injury patterns that include isolated radial shaft fractures, isolated ulnar shaft fractures, both-bone forearm fractures, Galeazzi fracture-dislocations, and Monteggia fracture-dislocations. Although less common than distal radius fractures, diaphyseal forearm fractures are still a frequently encountered clinical entity seen by orthopaedic surgeons, both as isolated injuries and in the patient with polytrauma. It is important to review the epidemiology of diaphyseal forearm fractures and the classification systems used to describe them, as well as to discuss the principles of the initial evaluation and management of these fractures. It is important to know the indications for nonsurgical and surgical management, along with the goals of surgical management, options for internal fixation, and surgical approaches to the forearm.

The COVID-19 pandemic that began in 2019 has created an acute fear of economic crisis, and people have experienced the state of perceived job insecurity. Several measures were taken to control this deadly pandemic, but it still affected the majority of global operational activities. This study addresses the United Nation’s Sustainable Development Goal (SDG) number 8 that relates to decent work and economic growth. This quantitative study examines the impact of fear associated with economic crisis and perceived job insecurity on mental health with the moderating effect of surface and deep acting. Surface acting is displaying fake emotions, and deep acting is modifying inner feelings according to the required emotions. This study used sample data from private-sector employees and applied SmartPLS for structural model assessment. As many organizations took more challenging decisions to sustain their business operations, the study therefore analyzes the impact of the pandemic on private sector employees. The two main findings of the study are: (i) surface acting moderates the relationships of fear of economic crisis and perceived job insecurity with mental health and declines the impact of both on mental health, (ii) while deep acting negatively moderates the relationships of fear of economic crisis and perceived job insecurity with mental health and improved mental health even in the presence of both. The study highlighted the importance of deep acting at workplaces to sustain employees’ mental and psychological stability. Organizations could introduce emotional labor strategies and strengthen the mental health of their employees against the underlying fear of economic crisis and perceived job insecurity.

Most orthopedic residents carry significant debt and may enter their practice with little knowledge of business management, minimal retirement savings, and overall poor financial literacy. This study aimed to gauge financial literacy, debt, and retirement planning in United States orthopedic surgery residents. Willingness to participate in formalized financial education was also assessed. Eighty-five allopathic orthopedic surgery residents in the United States completed a 14-question anonymous online survey in 2016. The survey assessed demographic data, self-assessed financial knowledge, amount of credit card debt and loans, preparation for retirement, and willingness to participate in formal didactic education on these topics. Most respondents derive their financial knowledge from personal research (51%), whereas only 4 per cent have a formal curriculum. Despite most respondents reporting more than $200,000 in outstanding loans, only 31 per cent create and stick to a budget. Few programs offer retirement advice, and 48 per cent of respondents save $0 toward retirement. Eighty-five per cent of residents expressed interest in learning about personal investment, savings, and retirement planning. Orthopedic surgery residents carry significant debt and do not achieve their high-income potential until disproportionately later in life. Only 4 per cent of residents have formal training in investing, personal finance, or retirement despite a majority who desire such a curriculum. In fact, almost 75 per cent of those surveyed felt less prepared for retirement than their peers outside of medical training. This study suggests a role for formal financial education in the orthopedic curriculum to prepare residents for retirement, improve financial literacy, and enhance debt management.

Importance Despite the widespread use of systemic antibiotics to prevent infections in surgically treated patients with fracture, high rates of surgical site infection persist. Objective To examine the effect of intrawound vancomycin powder in reducing deep surgical site infections. Design, Setting, and Participants This open-label randomized clinical trial enrolled adult patients with an operatively treated tibial plateau or pilon fracture who met the criteria for a high risk of infection from January 1, 2015, through June 30, 2017, with 12 months of follow-up (final follow-up assessments completed in April 2018) at 36 US trauma centers. Interventions A standard infection prevention protocol with (n = 481) or without (n = 499) 1000 mg of intrawound vancomycin powder. Main Outcomes and Measures The primary outcome was a deep surgical site infection within 182 days of definitive fracture fixation. A post hoc comparison assessed the treatment effect on gram-positive and gram-negative-only infections. Other secondary outcomes included superficial surgical site infection, nonunion, and wound dehiscence. Results The analysis included 980 patients (mean [SD] age, 45.7 [13.7] years; 617 [63.0%] male) with 91% of the expected person-time of follow-up for the primary outcome. Within 182 days, deep surgical site infection was observed in 29 of 481 patients in the treatment group and 46 of 499 patients in the control group. The time-to-event estimated probability of deep infection by 182 days was 6.4% in the treatment group and 9.8% in the control group (risk difference, –3.4%; 95% CI, –6.9% to 0.1%;P = .06). A post hoc analysis of the effect of treatment on gram-positive (risk difference, –3.7%; 95% CI, –6.7% to –0.8%;P = .02) and gram-negative-only (risk difference, 0.3%; 95% CI, –1.6% to 2.1%;P = .78) infections found that the effect of vancomycin powder was a result of its reduction in gram-positive infections. Conclusions and Relevance Among patients with operatively treated tibial articular fractures at a high risk of infection, intrawound vancomycin powder at the time of definitive fracture fixation reduced the risk of a gram-positive deep surgical site infection, consistent with the activity of vancomycin. Trial Registration ClinicalTrials.gov Identifier:NCT02227446

Hospitality industry always looks for the exhibition of positive emotions from employees’ side and employees display it through suppressing negative emotions (surface acting) or expressing positive emotions (deep acting). The aim of this study is to examine the impact of emotional labor strategies on emotional exhaustion of employees through moderating effect of perceived organizational support. The study uses a sample of 190 employees of chain hotels situated in Lahore, Pakistan. Results concludes that hotels in hospitality sector should value the emotions of frontline employees to prevent them from getting emotionally exhausted, so they could serve the customers’ productively. Similarly, if organizations develop a mechanism and system that enhance the positive perception of organizational support among employees, it will decrease the adverse consequences of emotional labor. This research could be carried out in other service sectors like education, health, banking, airlines etc. where frontline employees matter a lot for organizational image.

The aim of this study is to investigate the association among work-life balance, intrinsic motivation, subjective well-being and job satisfaction among the healthcare professionals of Pakistan. Utilizing a sample of 301 Health Care Professionals, the authors tested the proposed relationships. Findings were constant with the hypothesized theoretical scheme, and mediated association between work-life balance and subjective well-being through job satisfaction was stronger when intrinsic motivation was high rather than low. Based on the findings, we suggest that the association between work-life balance and subjective well-being in Health Care Professionals is more complicated than was previously believed&mdash, thus yielding a pattern of moderated mediation. In brief, it was found that work-life balance enhances subjective well-being through job satisfaction when intrinsic motivation is low. We also discuss the theoretical contributions and practical implications of the research and directions for future studies.

In light of the recent uptrend in the prescription of opioids, this study seeks to identify patterns of opioid misuse among orthopaedic post-operative patients and principal external sources in obtaining these medications. Ten-month survey based study. Two Level-I trauma centers (urban and suburban). 207 patients between the ages of 18 to 89 years who underwent surgical fixation of fractures involving the pelvis, long bones or peri-articular regions of the knee, ankle, elbow and wrist. Patients who believed they were under-medicated, used prescribed opioids at higher than recommended doses, and took extra opioids in addition to their prescribed analgesics were analyzed by age, employment, income, education, controlled substance use, pain interference with activities of daily living, and anatomical surgical site. 182 patients completed the survey. 19.2% of patients (n=35) felt under-medicated [unemployed (p

Most orthopedic residents carry significant debt and may enter their practice with little knowledge of business management, minimal retirement savings, and overall poor financial literacy. This study aimed to gauge financial literacy, debt, and retirement planning in United States orthopedic surgery residents. Willingness to participate in formalized financial education was also assessed. Eighty-five allopathic orthopedic surgery residents in the United States completed a 14-question anonymous online survey in 2016. The survey assessed demographic data, self-assessed financial knowledge, amount of credit card debt and loans, preparation for retirement, and willingness to participate in formal didactic education on these topics. Most respondents derive their financial knowledge from personal research (51%), whereas only 4 per cent have a formal curriculum. Despite most respondents reporting more than $200,000 in outstanding loans, only 31 per cent create and stick to a budget. Few programs offer retirement advice, and 48 per cent of respondents save $0 toward retirement. Eighty-five per cent of residents expressed interest in learning about personal investment, savings, and retirement planning. Orthopedic surgery residents carry significant debt and do not achieve their high-income potential until disproportionately later in life. Only 4 per cent of residents have formal training in investing, personal finance, or retirement despite a majority who desire such a curriculum. In fact, almost 75 per cent of those surveyed felt less prepared for retirement than their peers outside of medical training. This study suggests a role for formal financial education in the orthopedic curriculum to prepare residents for retirement, improve financial literacy, and enhance debt management.

Morel-Lavallée lesions are closed degloving injuries sustained during violent soft tissue shear that separate the subdermal fat from its strong underlying fascia. Lesions most often occur in the peritrochanteric region, and patients may have concomitant polytrauma. As a result, a hematoma develops that has a high rate of acute bacterial colonization and chronic recurrence. Conservative treatment outcomes are best for those managed acutely. However, diagnosis is often delayed or missed. Furthermore, there is no universally accepted treatment algorithm. Diagnosis and treatment depend on a surgeon's thorough understanding of the cause, pathophysiology, imaging characteristics, and treatment options of Morel-Lavallée lesions.

Traumatic upper extremity amputation is a life-altering event, and recovery of function depends on proper surgical management and postoperative rehabilitation. Many injuries require revision amputation and postoperative prosthesis fitting. Care should be taken to preserve maximal length of the limb and motion of the remaining joints. Skin grafting or free tissue transfer may be necessary for coverage to allow preservation of length. Early prosthetic fitting within 30 days of surgery should be performed so the amputee can start rehabilitation while the wound is healing and the stump is maturing. Multidisciplinary care is essential for the overall care of the patient following a traumatic amputation of the upper limb.

Percutaneous sacroiliac (SI) screw fixation is indicated for unstable posterior pelvic ring injuries, sacral fractures, and SI joint dislocations. This article provides a review of indications and contraindications, preoperative planning, imaging techniques and relevant anatomy, surgical technique, complications and their management, and outcomes after SI screw insertion.

Knee dislocations are catastrophic injuries that demand emergent evaluation and often require a multidisciplinary approach. Long-term outcome studies are relatively scarce secondary to the variability in any given study population and the wide variety of injury patterns between knee dislocations. Multiple controversies exist with regard to outcomes using various treatment methods (early vs late intervention, graft selection, repair vs reconstruction of medial and lateral structures, rehabilitation regimens). Careful clinical evaluation is essential when knee dislocation is suspected.

Metatarsal fractures are common injuries encountered by orthopedic surgeons. Although many metatarsal fractures can be treated nonoperatively, there are some relative indications for operative fixation. In this chapter, a case study is presented to demonstrate fixation techniques of a metatarsal shaft fracture. The patient has fractures in two metatarsals—one is fixed with plating and the other is fixed with pinning. Preoperative planning for these patients, operative techniques, and subsequent postoperative care are discussed. In addition, the chapter highlights several key technical points which the reader could apply to one’s surgical repertoire.

This study aims to determine the groups of patients who are at risk for noncompliance and misunderstanding of their pain regimen.Survey-based cohort study.Suburban Level-I trauma center.A total of 171 patients between the ages of 18-89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist.Patients who cannot accurately reproduce their prescribed pain medication list and patients who modify this pain medication regimen were analyzed by age, employment status, income level, education level, time between surgery and follow-up, and whether pain interfered with activities of daily living.Overall, 147 patients completed the survey. Seventy percent (n = 114) of patients could not accurately reproduce their pain medication regimen, regardless of age, employment status, income level, education level, time between surgery and follow-up, and whether pain interfered with activities of daily living. Patients (61.2%; n = 90), regardless of the 6 aforementioned demographic factors, also admitted to modifying their pain medication regimen with non-prescribed medications, with 55.8% (n = 82) of patients adding over-the-counter medications to surgeon-prescribed narcotic medications.Misunderstanding and noncompliance of surgeon-prescribed pain regimens are prevalent across all patient demographics. Knowledge of the potential effects these augmentative medications can have on fracture healing and any drug-drug interactions that may arise is an important aspect of patient postoperative care. Surgeons must be wary of these trends and screen for any unintended side effects a patient's pain regimen may have.Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Pelvic ring fractures are common in the elderly population and are usually a result of low-energy trauma, such as falls from standing. In most cases, low-energy pelvic ring injuries can be treated with appropriate analgesia and early mobilization. Arterial injury resulting in hemodynamic instability from a low-energy pelvic ring injury is rare but, given the poor compliance of vessels in the elderly population, possible. These patients must be carefully monitored after the initial injury. The purpose of this report is to describe an elderly patient who sustained a superior pubic ramus fracture and arterial injury following a low-energy fall from standing that required angiographic intervention. Elderly patients who sustain low-energy or pelvic insufficiency fractures are unlike the younger population with high-energy pelvic fractures and hemodynamic collapse. Elderly patients can have a delayed presentation of arterial injury and require careful physical examination and close monitoring. Additionally, the authors provide a review of the literature for low-energy pelvic fractures. [ Orthopedics. 2017; 40(3):e546–e548.]

Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study. Exclusion criteria included polytrauma, gunshot injuries, periprosthetic fractures, and non-operative management. Primary endpoint was hemoglobin (Hgb) drop from admission to day of surgery (DOS); secondary endpoint was need for pre-op transfusion and discharge location. Results: 304 patients were analyzed who sustained a proximal femur fracture. Median IC Hgb drop was 0.6g/dL; median EC Hgb drop was 1.1g/dL from admission to DOS ( p = 0.0272). Rate of pre-operative transfusions was higher in EC (36/194 = 18.6%) than IC fractures (5/105 = 4.5%) ( p = 0.0006), and overall transfusion rates remained higher throughout hospital stay (55.7% EC vs. 32.7% IC; p = 0.0001). Breakdown of bleeding rate and tranfusion rates between IT and ST fractures were not significant ( p = 0.07; p = 0.4483). Extracapsular hip fractures were more likely to be discharged to a skilled nursing facility (SNF) (84.4% EC vs. 73.8% IC; p = 0.027). Conclusion: Intracapsular hip fractures have significantly less pre-operative blood loss and fewer pre-operative transfusions than their extracapsular counterparts. These findings can be used to establish appropriate pre-operative resuscitative efforts, ensuring that hip fracture protocols account for the increased likelihood of blood loss in extracapsular fractures.

Segmental bone loss represents a difficult clinical entity for the treating orthopedic surgeon. This article discusses the various treatment modalities available for limb reconstruction, with a focus on the indications, potential complications, and the outcomes of available treatment options.

Objective Biomechanical comparison between locked plating and retrograde nailing of supracondylar femur fractures with simulated postoperative weight-bearing. Methods The Locking Condylar Plate (LCP) and Retrograde/Antegrade EX Femoral Nail (RAFN) were tested using 10 paired elderly cadaveric femurs, divided into Normal and Low Bone Mineral Density (BMD) groups, with a simulated AO/OTA type 33-A3 supracondylar femur fracture. Each specimen was subjected to 200,000 loading cycles in an attempt to simulate six weeks of postoperative recovery with full weight-bearing for an average individual. The construct's subsidence due to cyclic loading, and axial stiffness before and after the cyclic loading were measured and their correlation with BMD was studied. The two implants were compared in a paired study within each BMD group. Results LCP constructs showed higher axial stiffness compared to RAFN for both Normal and Low BMD groups (80% and 57%, respectively). After cyclic loading, axial stiffness of both constructs decreased by 20% and RAFN constructs resulted in twice as much subsidence (1.9 ± 0.6 mm). Two RAFN constructs with Low BMD failed after a few cycles whereas the matched pairs fixed with LCP failed after 70,000 cycles. Conclusions The RAFN constructs experienced greater subsidence and reduced axial stiffness compared to the LCP constructs. In Low BMD specimens, the RAFN constructs had a higher risk of failure.

This article discusses contemporary management strategies for gunshot-related fractures with special attention paid to the initial evaluation, role of debridement, principles of fixation, need and duration of antibiotic therapy, and management of sequelae. Pertinent sequelae detailed are fractures associated with vascular injury, compartment syndrome, massive loss of soft tissue and bone, nerve injury, and lead toxicity. Language: en

In animal studies, continuous passive motion (CPM) has been shown to improve cartilage healing after injury compared with immobilization. Human studies have also shown the improved rate of hemarthrosis clearance with CPM compared with immobilization. Clinical studies of CPM have mostly come from the total knee replacement literature. However, its use in joint replacement (which does not rely on cartilage repair) only partially shows the potential benefits of CPM. CPM has been used extensively in the postoperative care of articular fractures treated with open reduction and internal fixation, a natural extension of the purported clinical use of early basic science studies. It is believed to help improve cartilage repair, range of motion, and clearance of hemarthrosis. However, little attention has been paid specifically to CPM as a treatment modality. Better clinical studies of CPM as a treatment modality for articular fracture management are warranted to determine its potential benefits and to more clearly specify parameters for its use in specific clinical scenarios.

The patient is an 18-year-old female with no past medical history other than borderline mental retardation who presents after an urban all-terrain vehicle (ATV) accident where she was thrown from the vehicle. On initial evaluation in the trauma bay, she was noted to have a 15 × 6 cm wound over her anteromedial leg, with significant degloving over the tibia. She was found to have a Schatzker VI tibial plateau fracture with large (Gustilo Anderson IIIB) metadiaphyseal butterfly fragment (Fig. 6.1). She also was found to have a nondisplaced medial malleolus fracture on the ipsilateral side.

OBJECTIVE: To retrospectively investigate the experience at one urban level one trauma center with gunshot femoral fractures with vascular injury and to examine the implication of surgical sequence with regards to short-term complications and ischaemia time. METHODS: We performed a retrospective study of 24 patients treated at an urban level one trauma center over a 10-year period with low velocity gunshot wounds resulting in femur fractures and major vascular injury. Data were stratified according to sequence of surgical intervention. RESULTS: The mean age was 31.3 years. Mean time to revascularization was highest in patients undergoing definitive orthopaedic fixation first (660 min) and lowest in patient undergoing shunting first (210 min). Most complications in patients undergoing vascular repair first, included two disrupted repairs requiring immediate revision after subsequent orthopaedic fixation. Other complications included compartment syndrome and one amputation. CONCLUSION: Surgical sequence did not appear to impact the outcome with regard to limb loss, compartment syndrome, or mortality. Orthopaedic repair following vascular repair, however, is a risk for disruption of the vascular repair. We suggest that close and early direct communication between the orthopaedic and vascular surgeons take place in order to facilitate a satisfactory outcome. Language: en

Background A recent review of the literature found worse outcomes and longer length of stay for minorities undergoing TKAs and THAs when compared with whites. It is unclear if this association exists for the operative treatment of tibia fractures.

Elbow fracture dislocations are complicated injuries that are difficult to manage and fraught with complications. A complete series of radiographs is typically complemented with CT scan to evaluate the elbow and assist preoperative planning. Typically, operative intervention is necessary and a systematic approach to the elbow injuries should be chosen. This article addresses the coronoid and proceeds to the radial head, lateral soft tissues, and finally the medial ligaments if elbow instability persists. With a focused, systematic surgical approach, improved outcomes have been demonstrated and patients may recover full function and range of motion in the affected elbow.

Objective: To verify the hypothesis that neurologic injuries are less prevalent in civilian gunshot injuries than that reported in the military literature, and are more likely to occur with concomitant fracture. Methods: In order to investigate the incidence and patient variables of gunshot injury with neurologic injury, a retrospective chart review was performed at a single urban trauma center over a five-year period. Results: One thousand eight hundred and fifty-one patients with gunshot injuries were treated at our center over the five year study period. Of these, 895 patients (48%) had involvement of at least one extremity and 382 (21%) had concomitant fractures. Seventy-four had concomitant neurologic injury. There was a statistically significant difference of 14% (53/382) and 4% (21/513) (P Language: en

Plate fixation remains the primary surgical treatment option for most adult forearm fractures. However, intramedullary nailing can be successful and might be preferable in cases of massive soft-tissue injury and burns, certain segmental fractures, pathologic fractures, and skeletally immature adolescent patients. Furthermore, the risk for refracture after plate removal is decreased with fixation by intramedullary nailing. The history, indications, surgical technique, and results of intramedullary fixation of forearm fractures are described in this article.

We previously identified osteoactivin (OA) as a novel secreted osteogenic factor with high expression in developing long bones and calvaria, and that stimulates osteoblast differentiation and matrix mineralization in vitro. In this study, we report on OA mRNA and protein expression in intact long bone and growth plate, and in fracture calluses collected at several time points up to 21 days post-fracture (PF). OA mRNA and protein were highly expressed in osteoblasts localized in the metaphysis of intact tibia, and in hypertrophic chondrocytes localized in growth plate, findings assessed by in situ hybridization and immunohistochemistry, respectively. Using a rat fracture model, Northern blot analysis showed that expression of OA mRNA was significantly higher in day-3 and day-10 PF calluses than in intact rat femurs. Using in situ hybridization, we examined OA mRNA expression during fracture healing and found that OA was temporally regulated, with positive signals seen as early as day-3 PF, reaching a maximal intensity at day-10 PF, and finally declining at day-21 PF. At day-5 PF, which correlates with chondrogenesis, OA mRNA levels were significantly higher in the soft callus than in intact femurs. Similarly, we detected high OA protein immunoexpression throughout the reparative phase of the hard callus compared to intact femurs. Interestingly, the secreted OA protein was also detected within the newly made cartilage matrix and osteoid tissue. Taken together, these results suggest the possibility that OA plays an important role in bone formation and serves as a positive regulator of fracture healing.