• 제목/요약/키워드: 지연유합

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The Usefulness of Ultrasonography in the Evaluation of Clavicle Fracture Healing (쇄골 골절의 골유합 평가에 있어서 초음파의 유용성)

  • Moon, Dong Kyu;Park, Hyung Bin
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • 제4권2호
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    • pp.66-71
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    • 2011
  • Purpose: This study was conducted to determine the usefulness of ultrasonography in evaluating callus formation in radiologically suspected nonunion or delayed union of clavicle fractures during conservative management. Materials and Methods: Six male patients and one female patient (average age: 38.3 years; range: 7 to 70 years), whose conservatively managed clavicle fractures were suspected of nonunion or delayed union, were examined with ultrasonography. If callus formation was detected, the patient continued to receive conservative management. If callus formation was not detected, the patient received operative management. Results: Six patients, in whom callus formation was observed ultrasonographically, continued to receive conservative management. The final simple radiographies of their fractures showed complete unions. One patient, in whom no callus formation was observed ultrasonographically, received operative management. In that patient, there was no operative finding of any fracture healing. Conclusion: Ultrasonography is a useful tool for evaluating callus formation in clavicle fractures suspected of nonunion or delayed union during conservative management. Ultrasonography can be used to avoid unnecessary surgery.

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Clinical Application of Recombinant Human Bone Morphogenetic Protein-2 for Delayed Fractures in Dogs (개에서 골절의 지연유합에 대한 rhBMP-2의 임상적 적용 2례)

  • Kim, Jae-Kyong;Kim, Se-Eun;Go, A-Ra;Kim, Seung-Hyun;Shim, Kyung-Mi;Bae, Chun-Sik;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • 제29권5호
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    • pp.412-415
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    • 2012
  • A 1-year-old, castrated male Yorkshire terrier (case 1) and a 7-year-old female Poodle (case 2) presented with delayed union fractures. In case 1, the dog had a fractured right distal radius and ulna. In case 2, the dog had a fractured left distal tibia and fibula. A physical examination and radiographs performed in both dogs revealed delayed union fractures with large gaps. The fracture sites were fixed by bone plate and screws. Autogenous cancellous bone graft was applied into the fracture gap. To encourage rapid bone union, we used matrigel containing $20{\mu}g$ of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the fracture site. Radiographs were taken postoperatively to monitor healing. Rapid bone union was noted in both dogs in long-term radiographs. In case 1, the radiographs revealed that the fracture gaps of the radius and ulna were bridged at 2 weeks. Fracture lines were not observed and normal appearance was restored at 20 weeks. In case 2, the radiographs showed that fracture repair had progressed at 11 weeks. The fractures healed faster than expected in these two cases. The results indicate that rhBMP-2 and matrigel may be effective and useful materials to enhance healing of delayed fractures.

Arthroscopic Ankle Fusion (관절경적 족관절 고정술)

  • Kim, Hak-Jun
    • 대한관절경학회:학술대회논문집
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    • 대한관절경학회 제21차 추계 학술대회
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    • pp.93-98
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    • 2009
  • 족관절 고정술은 족관절에 발생한 심한 관절염(end-stage arthritis)에서 전통적으로 시행하던 술식으로 현재 사용되고 있는 인공 족관절 치환술이 발달되기 전까지는 gold standard 로 알려져 있었으며 현재에도 심한 족관절의 변형이나 파괴, 족관절 인공 관절의 실패시에 시행되고 있다. 1897년 Albert가 처음으로 족관절 고정술을 소개한 이후로 30여가지가 넘는 방법이 행해지고 있으나 개방적 관절 고정술의 단점인 수술 후 염증, 유합 지연, 연부조직의 손상에 의한 피부 괴사 등을 극복하고 유합물을 높이기 위해 다양한 내고정 및 외고정 장치를 사용하고 있다. 관절경 술식이 발달하면서 Schnider가 1983년 최초로 관절경을 이용한 족관절 고정술을 발표한 이후로 관절경하의 족관절 고정술은 개방적 족관절 고정술 보다 높은 유합율과 적은 수술 합병증으로 인해 관심의 대상이 되었지만 족관절의 변형이 심한 경우에는 시행하기 어려운 단점이 있는 것으로 알려져 왔다.

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Result in Tibial Stress Fracture Treatment in a Elite Soccer Player -A Case Report- (축구 선수에서 발생한 경골 피로 골절 치료에 대한 결과 -1예 보고-)

  • Lee, Kyung-Tai;Kim, Ki-Chun;Park, Young-Uk;Kim, Jun-Beom
    • Journal of Korean Orthopaedic Sports Medicine
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    • 제9권2호
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    • pp.114-120
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    • 2010
  • Anterior tibial diaphyseal stress fracture have a propensity for delayed union or nonunion and have risk of complete fracture after minor trauma. So, careful evaluation and optimal management are mandatory to succeed in treatment. It is also important to decide the point of time of return to full activity. We report experience of treatment for complete fracture of the delayed union of anterior tibial diaphyseal stress fracture as an athletic injury.

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Reconstruction of Bone Defects Caused by Tumor Resection Using Recycled Autograft Augmented with VFG (재생 자가골과 생비골 이식술을 이용한 종양절제 후 골 결손의 재건)

  • Chung, Yang-Guk;Kang, Yong-Koo;Bark, Won-Jong;Rhee, Seung-Koo;Lee, An-Hi;Park, Jeong-Mi;Park, Bo-Youn
    • The Journal of the Korean bone and joint tumor society
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    • 제15권2호
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    • pp.93-103
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    • 2009
  • Purpose: We evaluated the outcomes of surgical reconstructions using recycled autograft augmented with VFG for bone defects caused by tumor resections. Materials and Methods: Ten patients with a malignant or locally aggressive bone tumor who were managed with recycled autograft augmented with VFG and followed up minimum 1 year were evaluated for bone union, functional result and complications. The influence of various factors on bone union and functional outcomes were also analyzed. Results: Bone unions were obtained at 13 of 20 junctions. Average union time was 3.7 months at metaphyseal junctions and 8 months at diaphyseal junctions (P<0.05). At diaphyseal junctions, younger aged group and intramedullary location group showed earlier bone union (P<0.05). The mean functional score was 81%. There were 3 nonunions, 4 delayed unions and 2 recycled bone resorption combined with fractures. Conclusion: To obtain excellent results, proper microvascular technique, sufficient length of VFG bridging both junctions, stable internal fixation and protection of reconstructed bone until union are necessary.

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Hardwood Cutting with Callusing in the Mulberry(Morus bombycis Koidz.) I. Effect of a Root-Promoting Substance with Different Concentrations on Root Formation (뽕나무 유합촉진 고조삽목에 관한 연구 I. 발근촉진제 농도가 발근생장에 미치는 영향)

  • 최승운;김호락
    • Journal of Sericultural and Entomological Science
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    • 제33권2호
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    • pp.63-67
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    • 1991
  • Various concentrations of ${\alpha}$-naphthalence acetic acid(NAA) as a root-promoting substance were tested in hardwood cutting of the mulberry(Morus bombycis Koidz., cultivar : Shinkwangppong) to make clear the callusing effect on the budding and root growth. Budding and shoot growth of cuttings were delayed at high concentrations of NAA within 10 days of callusing. Especially more severe is it at higher than 50ppm. More than 93% of them, however, budded in two weeks when callused at less than 100ppm NAA. Although rooting was accelerated at high concentration of NAA from the bigining of cutting, after that, rooting percentage increased to reach 100% in 35 days of cutting in any concentration except 150ppm with relatively low rooting. Root growth was utmostly accelerated at 50ppm NAA to show the highest amount in number, length and weight of roots per cutting although high concentration of it decreased mean root length.

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Evaluation of the Biocompatibility of Cuttlebone in Mouse (쥐에서 오적골 생체적합성 평가)

  • Won, Sangcheol;Lee, Joo Myoung;Cheong, Jongtae;Park, Hyunjung;Seo, Jongpil
    • Journal of Veterinary Clinics
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    • 제32권5호
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    • pp.417-421
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    • 2015
  • Bone grafting is widely used to bridge major bone defects or to promote bone union. Natural calcium carbonate (CC) has been used as a bone substitute material and used to scaffold for bone morphogenetic protein (BMP). The aims of this study is to evaluate the biocompatibility of cuttlebone (CB) and hydroxyapatite from CB (CBHA). Each material was shaped into disks (5 mm in diameter and 2 mm in thickness). To test biocompatibility, the disks were implanted into the dorsal subcutaneous tissue in mice. Fibrous capsule thickness around each disk was evaluated histologically at 2 and 4 weeks after implantation. Concerning biocompatibility, fibrous capsule thickness of CBHA was significantly thinner than that of CB and CHA (p < 0.05) at 2 and 4 weeks after implantation. Based on the clinical and histological results, CBHA would be a safe material for use inside the body and has more effective osteoconduction than CB.

Comparison of Results Between Immediate Fixation Group and Delayed Reconstruction Group in Displaced Mid-shaft Fractures of the Clavicle (쇄골 전위성 간부 골절에서 조기 고정술 군과 지연 재건술 군 간의 결과 비교)

  • Kim, Doo-Sub;Rah, Jung-Ho;Yoon, Yeo-Seung;Lee, Chang-Ho
    • Clinics in Shoulder and Elbow
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    • 제12권1호
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    • pp.61-66
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    • 2009
  • Purpose: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. Materials and Methods: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. Results: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. Conclusion: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options.

A Case Report of Delayed Healing in Femoral Shaft Fractured Child (대퇴골 간부 골절 후 골절유합이 지연된 환아의 한의치료 증례보고)

  • Sung, Hyun-Kyung;Kim, Jang-Hyun;Min, Sang-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • 제25권1호
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    • pp.63-71
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    • 2011
  • Objectives: The purpose of this study is to report the clinical effects of oriental medical treatment on delayed healing in femoral shaft fractured child. Methods: We treated the patient with herb medicine named Kamiboatang and Pyritum. Child took Kamiboatang and Pyritum for 2 months, and Kamiboatang for 1 month. After 3 months treatments, we examined the case with radiological findings. Results: The patient's delayed femoral shaft fracture was improved after 3 months oriental medical treatment. Conclusions: This case showed that oriental medical treatment on delayed healing in femoral shaft fractured child was effective. To prove the effectiveness of Kamiboatang and Pyritum, the more clinical study of Oriental medical treatment for this case might be also needed.

The Effect of Platelet-Rich Plasma on Allograft Transplantation after Curettage in Benign Bone Tumor (양성 골 종양의 소파술 후 실시한 동종골 이식에서 혈소판 풍부 혈장 투여의 효과)

  • Kim, Jae-Do;Kim, Ji-Youn;Jang, Su-Jin;Chung, So-Hak;Jung, Gu-Hee
    • The Journal of the Korean bone and joint tumor society
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    • 제16권1호
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    • pp.8-13
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    • 2010
  • Purpose: This study was performed to evaluate the effi ciency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. Materials and Methods: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. Results: The mean size of lesion was 33.5 $cm^3$ (range, 2.3-181.9 $cm^3$) (29.4 $cm^3$ in PRP group and 40.2 $cm^3$ in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. Conclusion: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.