• Clinics in Shoulder and Elbow
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• v.23 no.3
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• pp.156-158
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• 2020

PHILOS plate fixation in osteoporotic proximal humerus fracture of old age is well-known for high complication rate, especially metal failure, providing various augmentation techniques, such as calcium phosphate cement, allogenous or autologous bone graft. We report a case of polymethyl methacrylate augmentation to provide appropriate reduction with a significant mechanical support. This can be a treatment option for displaced unstable osteoporotic proximal humerus fracture with marked bony defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.491-497
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• 2001

Polymethylmethacrylate(PMMA) is currently commonly used material for the reconstruction of bone defects and fixation of joint prosthetics following congenital and acquired causes. Although PMMA has widespread use, it does not possess the ideal mechanical characteristics with osteoconductivity and osteoinductivity required. In order to overcome these problem, addition of bovine bone drived defatting demineralized bone(BDB) powders to a PMMA bone cement was done for improvement of physical property and bone forming characteristics of composite. In order to investigate the influence of BDB reinforcement on the PMMA, we measured physical property of compressive, tensile, flexural strength, and scanning electron microscopic examinations. The results were obtained as follows: 1. The PMMA forms a solid cellular matrix with open cells about $100{\mu}m$ in variable size and incorporating BDB. BDB aggregates inside the cells form a porous network that is accessible from the outer surface. 2. The physical properties were compressive strength of mean $22.74{\pm}1.69MPa$, tensile strength of mean $22.74{\pm}1.69MPa$, flexural strength of mean $77.53{\pm}6.93MPa$. Scanning electron microscopic examinations were revealed that there was DBD particles form a highly porous agglomerates. BDB can be added PMMA in the form of dried powders, the composites are applicable as bone substitutes. BDB and PMMA mixture is shown to produce a class of composites that due to their microstructure and improved mechanical properties may be suitable for application as bone subsitutes. The mechanical and material properties of the BDB-PMMA bone substitute composites are competitive with those properties of a porous ceramic matrix of other hydroxyapatite and with those of natural bones.

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.42-45
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• 2017

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.

• Journal of Korean Neurosurgical Society
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• v.65 no.5
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• pp.730-740
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• 2022

Objective : Although several commercialized bone cements are used during percutaneous vertebroplasty (PVP) for patients with osteoporotic vertebral compression fracture (OVCF), there are no reports using domestic products from South Korea. In this study, we investigated the safety and efficacy of Spinofill^® (Injecta Inc., Gunpo, Korea), a new polymethyl methacrylate product. Methods : A prospective, single-center, and single-arm clinical trial of 30 participants who underwent PVP using Spinofill^® for painful thoracolumbar OVCF was performed with 6-months follow-up. Clinical and surgical outcomes included the Visual analog scale (VAS), Korean-Oswestry disability index (K-ODI), and Odom's criteria, complication rate, and recurrence rate. Radiological outcomes were evaluated by measuring the findings of postoperative computed tomography and simple radiograph. Results : The pain of VAS (from 8.95±1.05 to 4.65±2.06, p<0.001) and the life quality based on K-ODI (from 33.95±5.84 to 25.65±4.79, p<0.001) improved significantly, and successful patient satisfaction were achieved in 20 patients (66.7%) 1 day after surgery. These immediate improvements were maintained or more improved during the follow-up. There was no surgery- or product-related complications, but OVCF recurred in two patients (6.7%). Favorable cement interdigitation was reported in 24 patients (80.0%), and extra-vertebral cement leakage was reported in 13 patients (43.0%). The mean vertebral height ratio (from 60.49%±21.97% to 80.07%±13.16%, p<0.001) and segmental kyphotic angle (from 11.46°±8.50° to 7.79°±6.08°, p=0.002) improved one day after surgery. However, these short-term radiological findings somewhat regressed at the end. Conclusion : The overall outcomes of PVP using Spinofill^® were as favorable as those of other conventionally used products.

• Hip & pelvis
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• v.30 no.4
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• pp.269-275
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• 2018

Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson's scoring system. Results: More patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be $-2.506{\pm}0.22$ (mean${\pm}$standard deviation); all patients were within the range of -2.0 to -2.8. The duration of radiological union was $13.67{\pm}1.77$ weeks. Salvati and Wilson's scoring at 12 months of follow up was $30.96{\pm}4.97$. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out. Conclusion: Bone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.

• Journal of Veterinary Clinics
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• v.39 no.4
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• pp.185-191
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• 2022

An Amur softshell turtle with multiple shell injuries was admitted to the Seoul Wildlife Center on 19 May 2021. The most severe lesion was a puncture wound requiring urgent closure. In addition to routine supportive therapy, the damaged shell was patched with biocompatible polymethyl methacrylate (PMMA) materials (bone cement and dental acrylic) and fiberglass. Despite a few methods to repair the carapace or plastron of hard-shelled turtles, shell repair in the Amur softshell turtle has rarely been reported. This paper reports the repair process of a puncture wound in the carapace of a softshell turtle using polymethyl methacrylate (PMMA). PMMA is a biocompatible acrylic polymer that forms a tight structure that holds the implant against tissue defects, such as skin, bones, and dentures. Fiberglass, a preferred fiber in various medical fields, was used with PMMA to provide extra strength and waterproof capability. After the procedure, there were no signs of edema, inflammation, bleeding, skin discoloration, or any other complications. Accordingly, this can be a method of choice in softshell turtles using biocompatible materials to cover the lesion in the carapace and provide appropriate wound management, supportive therapy, and a suitable course of antibiotics considering all other circumstances.

• Journal of Veterinary Clinics
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• v.26 no.4
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• pp.359-361
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• 2009

A sexually intact female Alaskan Malamute, 5-year-old weighing 25.2 kg presented to the Hangang Animal Hospital, following hit-by-car. On initial presentation, the dog had severe salivation and the right canine tooth luxation. Radiographs revealed fractures of the right rostral hemimandible with the right canine tooth luxation and symphyseal separation. Surgical repair of fractures was performed by use of an interdental wiring technique and external fixation technique that included pins, an acrylic connecting bar, and polymethyl methacrylate bone cement. Post-operative radiographs revealed that bridging callus was well formed over cortices of the fracture area. Pins and an acrylic connecting bar were removed 7 weeks post-operatively. The dog exhibited evidence of normal mastication.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.700-706
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• 2018

Objective : Percutaneous vertebroplasty (PV) is a minimally invasive procedure designed to treat various spinal pathologies. The maximum number of levels to be injected at one setting is still debatable. This study was done to evaluate the usefulness and safety of multilevel PV (more than three vertebrae) in management of osteoporotic fractures. Methods : This prospective study was carried out on consecutive 40 patients with osteoporotic fractures who had been operated for multilevel PV (more than three levels). There were 28 females and 12 males and their ages ranged from 60 to 85 years with mean age of 72.5 years. We had injected 194 vertebrae in those 40 patients (four levels in 16 patients, five levels in 14 patients, and six levels in 10 patients). Visual analogue scale (VAS) was used for pain intensity measurement and plain X-ray films and computed tomography scan were used for radiological assessment. The mean follow-up period was 21.7 months (range, 12-40). Results : Asymptomatic bone cement leakage has occurred in 12 patients (30%) in the present study. Symptomatic pulmonary embolism was observed in one patient. Significant improvement of pain was recorded immediate postoperative in 36 patients (90%). Conclusion : Multilevel PV for the treatment of osteoporotic fractures is a safe and successful procedure that can significantly reduce pain and improve patient's condition without a significant morbidity. It is considered a cost effective procedure allowing a rapid restoration of patient mobility.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.672-676
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• 2000

One of the current treatment methods for chronic osteomyelitis is removal of the infected and necrotic tissue to reduce the bacterial concentration as much as possible. This is performed concomitantly with antibiotic therapy. Chronic osteomyelitis(C.O.) implies chronic ischemia of the diseased bone. Thus, the treatment for C.O. requires high systemic level of antibiotics. In some cases, however, inherent undesirable adverse effects(for example, nephrotoxicity, ototoxicity, and others) may render this course of treatment difficult. Knowing that residual monomers are released from hardened bone cement, installation of antibiotic-impregnated PMMA(polymethyl-methacrylate) beads in situ have been one of treatment methods of C.O. When introduced into the wound, they established an exceedingly high level of local antibiotics for prolonged period without high systemic level of antibiotics. We experienced favorable results with vancomycin-impregnated PMMA beads for the treatment of C.O. of the mandible. So, we report it with literature reviews.