• 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.

• Korean Journal of Veterinary Research
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• 제39권5호
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• pp.974-985
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• 1999

Osteoporosis is defined as a decrease in bone mass that leads to an increased risk of fracture. The therapeutic effect of $1{\alpha}$,25 dihydroxycholecalciferol, the hormonal form of vitamin $D_3$ that mediates calcium translation in intestine and bone, on the healing process of fracture has still been controversial. These studies were designed to understand the healing process of normal fibular fracture, the osteoporotic changes after ovariectomy, and the therapeutic effects of $1{\alpha}$,25 dihydroxycholecalciferol on the osteoporotic fracture in rats. The simple transverse fractures of rat fibulae were produced with a rotating diamond saw. The changes of the biochemical and mechanical indices of rats were investigated. The mechanical study based on bending test revealed the healing of the fibular fracture in the 5th week after simple transverse fracture. The osteoporosis impaired more the healing of osteoporotic fibular fracture than normal non-osteoporotic fibular fracture. The healing process of osteoporotic fracture was facilitated by the treatment with $1{\alpha}$,25 dihydroxycholecalciferol, however, was delayed more than the healing process of normal fracture. The bone strength based on the bending test also confirmed this tendency. The bone strengths in the 5th week after fracture of normal bone, osteoporotic bone, and $1{\alpha}$,25 dihydroxycholecalciferol-treated osteoporotic bone were 75%, 41%, and 67%, respectively, in comparison with those of intact bone. In conclusion, $1{\alpha}$,25 dihydroxycholecalciferol was effective in promoting the osteoporotic fracture healing.

• The Korean Journal of Pharmacology
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• 제7권1호
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• pp.53-65
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• 1971

It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.

• Journal of Veterinary Clinics
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• 제19권4호
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• pp.405-410
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• 2002

The purpose of this investigation was to examine the effects of osteocalcin (serum bone GLA-protein, BGP) and procollagen carboxy-terminal propeptide (PICP) on new bone formation of canine fracture models. Serum osteocalcin and PICP were measured by standard RIA. The values of osteocalcin and PICP in the non-union and delayed-union fracture models were measured biweekly for 20 weeks in 14 dogs. The unions were radiographed for fracture healing. In non-union fracture group, the activity of BGP was markedly increased at four to eight weeks and decreased at twelve to twenty weeks and the activity of PICP was markedly increased at two to six weeks and slightly decreased at sixteen to twenty weeks. In delayed-union fracture group, the activity of BGP was markedly increased at two to eight weeks after treatment and maintained for the level until twenty weeks and the activity of PICP was markedly increased at two to six weeks after treatment and maintained for the level until twenty weeks. Radiologically, non-union group was not achieved until twenty weeks after fracture, delayed-union group was successfully achieved in eighteen weeks after fracture. These results suggested that the. activities of osteocalcin and PICP are useful parameters for biochemical markers of bone formation in dogs.

• Applied Microscopy
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• 제29권3호
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• pp.315-321
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• 1999

Vitamin D is one of important factors involved in the regulation of bone metabolism. In osteoporosis, the therapeutic effect of vitamin D on the healing process of fracture has still been controversial. These studies were designed to understand the healing process of normal fibular fracture and the therapeutic effects of $1\alpha$, 25 dihydroxycholecalciferol on the osteoporotic fracture in rats. The simple transverse fractures of rat fibulae were produced with a rotating diamond saw. The histological and ultrastructural changes of rats were observed. The histological and ultrastructural studies revealed the healing of the fibular fracture in the 5th week after simple transverse fracture. The osteoporosis impaired more the healing of osteoporotic fibular fracture than normal non-osteoporotic fibular fracture. The healing process of osteoporotic fracture was facilitated by the treatment with $1\alpha$, 25 dihydroxycholecalciferol, however, was delayed more than the healing process of normal fracture. These results suggest that $1\alpha$, 25 dihydroxycholecalciferol was effective for reducing the deleterious effects of osteoporosis in fracture healing.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.751-754
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• 2008

Purpose: Delayed rupture of flexor pollicis longus as a sequelae of the plate inserted for distal radius fracture is a very rare. This is the first case reported and published in Korea. Methods: A 48 years old female patient visited hospital, complaining flexor disturbance of interphalangeal joint of left thumb, which suddenly occurred without any external wound. We found that she had received operation of fixing plate for fracture of left distal radius 10 years ago. As operational opinion, we have checked that flexor pollicis longus tendon has been ruptured with oblique ways being stimulated by extended plate to palmar side over long period. Results: Authors performed tenorrhaphy of flexor pollicis longus without tendon graft and presented a successful active flexion of the left thumb interphalangeal joint 1 year after the operation. Conclusion: If the extruded part of the end plate is observed during the operation or follow-up, it is considered to be necessary to get rid of the plate as early as possible after the fracture healing.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권3호
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• pp.250-261
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• 2006

Diabetes mellitus, as a major health problem for the elderly, is associated with an extensive list of complications involving nearly every tissue in the body and has been shown to alter the properties of bone and impair fracture healing in both human and animals. The objective of this study was to examine the healing process of a mandibular fracture in the streptozotocin-induced rats histomorphometrically and histologically. A standardized fracture model was chosen and based on blood-glucose value at the time of surgery. A total of 11-weeks old 36 rats were divided into 2 groups; One is a streptozotocin-induced diabetic group and the other is a non-diabetic group. All was fractured experimentally. Three animals from each group were killed 1, 2, 4, 6, 8 and 12 weeks after fracture and specimens were processed undecalcified for quantitative bone histomorphometric and histologic studies. The diabetic group showed a significant decrease of histomorphometry-based parameter including trabecular bone volume, trabecular thickness in comparison to the non-diabetic rat. This was confirmed histologically. In conclusion, this study suggests that in streptozotocin-induced diabetics, the healing process of bone fracture was impaired and delayed about 2-3 weeks comparing to non-diabetics.

• 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.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• 제27권1호
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• pp.123-140
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• 1997

The purpose of this study was to investigate effects of osteoporosis on fracture wound healing in the calcium deficient rat. To research the experiment some ten-week old Wistar strain rats with approximately 300 gms weight were selected. Then, the rats were divided into two groups: Normal diet group(rats given a normal diet before and after bone fracture) and Low calcium diet group(rats given a low calcium diet before and after bone fracture). Both groups had been provided with each diet for three weeks. When the rats became thirteen weeks old, the mandibular angle of rats in both groups was artificially fractured for test. The healing of fracture wounds was reviewed by using soft x-ray radiography and /sup 99m/Tc-MDP bone scan and also histopathologic examination. The obtained results were as follows : 1. The radiolucency of the fracture site for the Normal diet group started to decrease from the 14th day since the experiment was made, while the Low calcium diet group began decrease in the radiolucency from the 21st day of the experiment. The radiolucency for the Normal diet group disappeared at the 42nd day, but one for the Low calcium diet group disappeared at the 56th day of the experiment. 2. The highest uptake rate of /sup 99m/Tc-MDP stood at the 14th day of the experiment in the Normal diet group and the Low calcium diet group's maximum rate was recorded at the 21st day of the experiment. These both groups were gradually experiencing decrease in the uptake rate as the experiment time was going on. However, the uptake rate in the Low calcium diet group was lower than one in the Normal diet group. 3. For the Normal diet group, the newly formed trabeculae, which were similar to one of the surroundung bone, were seen at the 42nd day of the experiment. On the other hand, the Low calcium diet group showed at the 56th day of the experiment that the osteoporotic findings looked weak, irregular trabeculae, and also large bone marrow space were observed clearly. As a result of the above experiment, it is said that the healing of the fracture can be completed for both groups, the Normal diet group and the Low calcium diet group. However, the amount of the newly formed bone wound in the Low calcium diet group is rather decreased compared to one in the Normal diet group and at the same time the healing of the fracture is delayed in the Low calcium diet group. Consequently, for the successful healing of fracture in osteoporosis, it is considered that the management of the etiologic factors of osteoporosis must be preceded. The more study of calcium metabolism and functions of osteoblast and osteoclast needs to proceed on.