• 한국임상수의학회지
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• 제34권3호
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• pp.200-203
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• 2017

The objective of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) method for treatment of tibial shaft fractures in dogs by comparing MIPO radiographic and fracture healing time results with those from the popular open reduction and internal fixation (ORIF) technique. In this clinical study at the Royal Animal Medical Center, five consecutive dogs with diagnoses of comminuted tibial shaft fractures were treated with the MIPO surgical approach. For comparison, an additional five breed-, age-, and weight-matched dogs with comminuted tibial shaft fractures were treated with the ORIF technique. Mean healing time was $75.6{\pm}12.5$ days in the MIPO group and $131.8{\pm}18.6$ days in the ORIF group (p < 0.01). The mean surgery time in the MIPO group ($36.4{\pm}3.5$ minutes) was significantly shorter (p < 0.01) than that for the ORIF group ($47.0{\pm}2.2$ minutes). Based on the short surgical and healing times, the MIPO approach is clinically superior to the ORIF approach and should be the preferred approach in tibial fracture cases.

• 대한족부족관절학회지
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• 제10권2호
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• pp.184-189
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• 2006

Purpose: To evaluate surgical treatment using two-staged MIPO technique in tibial pilon fractures involving tibial shaft. Materials and Methods: Twelve patients, who underwent two-staged MIPO technique for pilon fractures involving tibial shaft between January 2003 and May 2005, were followed for more than one year. Radiographs were graded by the criteria of Anglen and ankle functions were graded by the criteria of Mast and Teipner. Ankle function, union time and postoperative complications were also analysed. Results: Clinically there were eight (67%) good results, three (25%) fair results and one (8%) poor result. At the last follow-up, the radiographic results showed seven (58%) excellent results, three (25%) good results, and two (17%) fair results. During the follow up, There was one case of nonunion Conclusion: Two-staged MIPO techinque is one of the good methods for the treatment of pilon fractures invloving tibial shaft.

• 대한족부족관절학회지
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• 제27권3호
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• pp.87-92
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• 2023

Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.61-67
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• 1988

1. 저자들은 1986년 11월부터 1988년 2월까지 경골간부 골절 8례를 나사못 맞물림법을 이용한 골수강내 금속정을 사용하여 치료하였다. 2. 술 후 방사선 소견상 골유합 기간은 평균 약 15주였다. 3. 환자의 입원기간은 평균 5.5주로서 비교적 짧은 입원기간을 보여주었으며 아울러 사회복귀 및 적응이 빨랐다. 4. 술 후 조기운동이 가능하였고 평균 4.3주 경과 후 목발보행을 시작하였다. 5. 술 후 관절강직, 근위축등의 합병증은 거의 없었다. Hamza등에 의한 술후 평가방법에 따르면 Excellent 7례, Good 1례로 결과는 만족스러웠다.

• Journal of Veterinary Science
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• 제21권1호
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• pp.10.1-10.12
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• 2020

Blood perfusion of skeletal muscle and callus was evaluated using contrast-enhanced ultrasonography (CEUS) in a canine osteotomy model to determine the applicability of CEUS in the assessment of neovascularization during fracture healing and to compare the vascular signals on CEUS between external skeletal fixation and cast-applied dogs. In 6 Beagle dogs, a simple transverse osteotomy was performed at the left tibial shaft and external skeletal fixation (n = 3) or a cast (n = 3) was applied. Radiography, power Doppler ultrasonography (power Doppler), and CEUS were performed until complete union was achieved. On CEUS, vascular changes were quantitatively evaluated by measuring peak intensity (PI) and time to PI in the soft tissue and callus and by counting the vascular signals. Vascular signals from the soft tissue were detected on power Doppler and CEUS on day 2. Significantly more vascular signals were detected by CEUS than by power Doppler. On CEUS, PI in the surrounding soft tissue was markedly increased after the fracture line appeared indistinctively changed on radiography in all dogs. In the cast-applied dogs, vascular signals from the periosteal and endosteal callus were detected on CEUS before mineralized callus was observed on radiography. CEUS was useful in assessing the vascularity of soft tissue and callus, particularly in indirect fracture healing, and provided indications of a normally healing fracture.

• Journal of Yeungnam Medical Science
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• 제9권1호
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• pp.130-136
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• 1992

본 영남대학교 의과대학 부속병원 정형외과에서는 1986년 12월에서 1991년 11월까지 경부 간부 골절 31례에 대하여 Ender nail을 시행하여 다음과 같은 결과를 얻었다. 1. 환자의 평균연령은 37.3세였고, 남자에게서 3배가 많았으며, 교통사고가 가장 많은 원인이었다(67%). 2. 폐쇄성 골절이 20례, 개방성 골절이 11례였으며, 분쇄골절과 분절골절이 18례(57.7%)였고, 중간부 골절이 16례로 가장 많았다. 3. 동반손상이 19례에서 있었고, 수상후 수술까지의 기간은 평균 7.6일이었다. 4. 평균 골유합 기간은 18.9주였으며, 2례에서 지연유합을 보였다. 5. 합병증으로 하지 단축이 2례, 각형성 변형이 3례, 관절 운동 제한 2례, 감염이 연부조직에 1례 있었다. 이상 경골 간부골절 치료에 사용한 Ender nail은 시술의 간편성, 적절한 고정성과 운동성, 비교적 폭넓은 적용 범위등으로 좋은 치료 결과를 기대할 수 있는 방법으로 사료된다.

• Journal of Trauma and Injury
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• 제29권3호
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• pp.76-81
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• 2016

Purpose: The purpose of this study was to compare the data comprehensively including not only the clinical and radiographic outcomes but some parameters related to operation between the minimally invasive plate osteosynthesis (MIPO) technique and intramedullary nailing (IMN) for treatment of segmental tibia shaft fractures. Methods: We conducted a retrospective study of 31 patients (mean age, 49.3 years, range, 27-74 years), with a mean follow-up of 14.1 months (range, 12-19 months) with acute segmental tibial fractures (AO 42-C2) who underwent either surgical treatment of MIPO or IMN. In accordance with the Gustilo-Anderson classification, 11 were type I, 5 were type II, and 15 were type III. Initial compartment syndrome was confirmed in 2 cases. Results: There were no statistically significant differences in terms of the patient demographic data between the two groups. The time to definitive fixation was longer in the MIPO group (mean $13.7{\pm}10.9days$; range, 2-27) than in the intramedullary group (mean $5.4{\pm}9.6days$; range, 0-35) with statistically significant difference (p=0.002). Bony union was observed in most of cases but except 5 cases of nonunion were diagnosed (3 in the MIPO vs 2 in IMN, p=0.188). The average bone healing time was 27.1 weeks (10 to 56 weeks) in MIPO group and 23.2 weeks (13 to 66 weeks) in IMN group, respectively (p=0.056). Overall complications were 5 cases in MIPO group and 2 cases in the IMN group. Difference in LEFS was not statistically significant between both groups (p=0.824). Conclusion: This study showed that segmental tibia shaft fractures treated with both MIPO and intramadullary nailing was challenging with relatively high complication rate. A well planned sequential strategy with keeping the soft tissue and personality of fracture in mind is utmost significant as much as the choice of surgical modalities.

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.388-399
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• 1993

1983년 2월부터 1993년 5월까지 저자들이 interlocking IM nail정을 이용하여 치료한 경골 골절을 평균 14개월 추시하여 다음과 같은 결론을 얻었다. 1. 총 38례 중 37례에서 골유합을 이루어 97.3%의 골유합율은 보였으며 평균골유합기간은 18.7주였다. 2. 금속정의 사용 범위는 경골 간부 및 근위부나 원위부 골절에서 만족할 만한 결과를 얻었다. 3. interlocking nail은 심한 분쇄성 골절, 개방성 골절, 골소실이 있는 개방성 골절 동에서 견고한 고정을 얻을 수 있었다. 4. 불유합 및 지연유합된 경우 모두 골유합을 이루어 나사못 맞물림을 이용한 금속정 고정법은 경골 간부 골절에서 훌륭한 치료법으로 생각된다. 5. 가장 중요한 합병증은 Valgus 각형성 2례 및 varus 1례와 심부감염 1례 등이었다. 6. 금속정은 고정력이 견고하여 조기 관절운동 및 보행이 가능하여 관절 강직이나 근위축을 방지할 수 있었다.

• Archives of Reconstructive Microsurgery
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• 제7권1호
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• pp.54-61
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• 1998

Free vascularized fibular is the most usuful bony donor of the long bone reconstruction in reconstructive microsurgical field. It has many benifits such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter with long pedicle, minimal donor site morbity too. In that situations of the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transfered. The bony circulation of the fibula has two ways, one from nutrient artery via peroneal artery through nutrient foramen which makes endosteal arterial network inside of the fibula, another way is periosteal network through outside encircling vascular network of the bone which distributed in muscle sleeves of the fibular diaphysis. Authors modified free vascularized fibular bone graft with transverse osteotomy is made from the anterolateral aspect of the fibular shaft just distal to entry of the nutrient artery. This produces two vascularized bone struts that may be folded pararell to each other but that remain connected by the periosteum and muscle cuff surrounding the peroneal artery and veins. The proximal strut is vascularized by both a periosteal and endosteal blood supply, whereas the distal strut is vascularized by a periosteal blood supply alone. This procedure can call "doule barrel" free vascularized fibular graft. We performed 7 cases of doule barrel fashined fibular transplantation on distal femur and proximal tibial large defects. Average bone union time takes 7 months from that procedure. There were no significant bone union time differences between both proximal and distal struts. After solid union of the transfered double barrel fibular graft, there were no stress fracture in our series. We can propose double barrel free vascualized fibular graft is usuful method in that cases with very large bone defect on large long bones especially metaphyseal defects.

• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.176-183
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• 1999

전북대학교병원 정형외과에서 1993년 12월부터 1998년 9월까지 하지의 만성 골수염 7례에 대하여 유리 근 피판 이식술을 시행하고 최소 1년 2개월부터 최장 5년 3개월까지 추시하여 다음과 같은 임상적 결과를 얻었다. 1. 만성 골수염의 발생 부위는 경골이 4례, 종골 2례 그리고 대퇴골이 1례였다. 2. 만성 골수염의 지속 기간은 평균 31.6년이었다. 3. 전체 7례 중 1례에서 편평 상피암이 발병되었다. 4. 만성 골수염은 4례에서 혈행성 감염으로 초래되었고, 3례는 외상력이 있었는데 2례는 교통사고 그리고 1례는 경미한 외상이었다. 5. 치료는 부골 제거술과 유리 근 이식술을 시행하였던 예가 2례, 부골 제거술없이 유리 근 이식술을 시행한 예가 5례였다. 6. 전체 7례 중 6례에서 유리 근 이식술을 시행하였고 1례에서 유리 근피판 이식술을 시행하였는데 복직 근이 4례였고, 광배 피판, 광배 근피판 그리고 박근이 각각 1례씩이었으며 7례 중 6례(85.7%)에서 생존하였다. 7. 대퇴부에 시행하였던 광배 근피판 1례는 정맥이식술을 통한 단측 문합술을 시행하였으나 술 후 2일째부터 허혈성 변화를 일으켜 실패하였으며, 외상으로 인한 종골 1례에서는 복직근 이식술이 성공하였으나, 술 후 심한 외상성 족관절염으로 인한 극심한 통증으로 슬관절 하부 절단술이 시행되었다.