• Title/Summary/Keyword: non-union fracture

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The Changes of Osteocalcin and Procollagen Carboxy-terminal Propeptide on Healing in Canine Fracture Models (개의 골절 모델에서 골절치유에 따른 Osteocalcin 및 Procollagen Carboxy-terminal Propeptide의 변화)

  • 김남수;김수미;강창원;최은경;최인혁
    • Journal of Veterinary Clinics
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    • v.19 no.4
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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.

Hemiarthroplasty for Fractures or Fracture-Dislocations of the Proximal Humerus (상완골 근위부 골절 또는 골절 및 탈구에서의 상완골 두 치환술)

  • Kim Young Kyu;Eom Gi Serk
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.20-25
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    • 2000
  • Purpose : To evaluate functional results and study factors influencing results after humeral hemiarthroplasty for comminuted fractures of the proximal humerus. Materials and Methods: We reviewed 12 patients with average follow-up period of 23 months(12 to 42). The proximal humeral fractures consisted of one anatomical neck fracture, five three-part and six four-part fractures or fracture-dislocations. Constant score and Compito et al' evaluation system were used for clinical assessment. Statistical analysis was done with the Wilcoxon test. Results: Six cases of anatomical neck, three-part fractures or fracture-dislocations showed 61 points on the average Constant score and three unsatisfactory results on the Compito et al' evaluation; Six of four-part fractures or fracture-dislocations showed 51 points and three unsatisfactory results. There were 59(two unsatisfactory) for five non-associated dislocation and 53(four unsatistactory) for seven associated dislocation; 66(one unsatisfactory) for three under 60 years and 41(five unsatisfactory) for nine over 60 years; 67(two unsatisfactory) for seven tuberosity union and 41(four unsatisfactory) for five tuberosity non-union or resorption; 58(four unsatisfactory) for ten early operation within two weeks and 43(all unsatisfactory) for two delayed operation; and 18(unsatisfactory) for one case of a accompanied rotator cuff tear. Conclusion: We concluded that tuberosity union was important factor influencing the results. Also, we thought that age, timing of operation and accompanied rotator cuff tear could be influenced to results.

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Stress Analysis of Plate Augumentation for Distal Femur Fracture (대퇴부 원위부 골절에 관한 금속판 보강술의 응력 해석)

  • 김지숙;범현규;양영수
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 1997.10a
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    • pp.816-819
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    • 1997
  • The operation of femoral non-union after IM(Intramedullary) nailing in distally femoral fractures is considered. Augmentive plate fixation is the management of femoral non-union after IM nailing. The purpose of this study is to compare the bending, torsional stiffness and stress distribution of the two operations by the FEM(Finite Element Method). Augmentive plate fixation is better than IM nail fixation. These results conclude that plate augmentation is a useful method for the unstable femoral non-union after interlocking IM nailing.

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Studies on the application of bone alkaline phosphatase and percentage of BALP values to total alkaline phosphatase as a marker of bone formation (골혈성 지표로써 bone alkaline phosphatase(BALP)와 TALP치에 대한 BALP치 비율(B/T)의 응용)

  • Kim, Nam-soo;Choi, In-hyuk
    • Korean Journal of Veterinary Research
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    • v.39 no.6
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    • pp.1197-1209
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    • 1999
  • Twenty-one dogs(male 11 heads, female 10 heads) which were about 16 months ($16.3{\pm}3.5$) old and 10kg($10.1{\pm}2.0$) body weight, were allotted randomly into four groups as follows. Group I consisted of five dogs whose muscles were operated for sham muscle injuries. Group II consisted of seven dogs treated for cystic duct obstruction. Group III consisted of five dogs treated for the union fracture model. Group IV consisted of five dogs treated for the non-union fracture model. Radiographical and histological observations were carried out to determine bone alkaline phosphatase(BALP) and total alkaline phosphatase(TALP) values of each group for 20 weeks after the treatments with the condition of new bone formation. And also the applicability of percentage of BALP values to TALP (B/T) was studied after BALP was compared respectively with TALP. The level of TALP was increased without any relation to bone formation in group II, and all levels of BALP and B/T were increased in group III. The mean of B/T was high in statistical significance, due to varied levels of B/T and BALP. The changes of rates of B/T were significantly increased only in the case of the active new bone formation in group III, union fracture model. It was recognized that the mean values of B/T were statistical significant of the high applicability of the B/T ratio as an index of bone formation.

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Effectiveness of freeze-dried bone grafts on the non-union fracture model of dogs (개의 비유합(非癒合) 골절(骨折) model에 있어서 동결건조골이식(凍結乾燥骨移植)의 효과(效果))

  • Choi, In-hyuk;Kim, Hyeon-gyeong;Kim, Nam-soo;Sasaki, Nobuo
    • Korean Journal of Veterinary Research
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    • v.36 no.2
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    • pp.495-511
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    • 1996
  • To investigate the effectiveness of the freeze-dried allografts and fibrin glue in bone grafts, the status of new bone formation and union of the grafted bone were observed in three types of grafting bones; autogenic bone(AT), allogenic bone(AL), and allogenic bone particles mixed with fibrin glue(FG). These were transplanted into non-union fracture model of 7 adult dogs with 2cm defect made in the proximal metaphysis of both fibulae. The autogenic and allogenic grafting bones had been treated by a modified freeze-dried method. The serial radiogram were observed the repair process of grafted bones biweekly until 17 or 21 weeks after transplantation and the observation of histological aspects, tetracycline double labeling and microradiography in the grafted bones were undertaken at 17 or 21 weeks after transplantation. The incorporation of bone minerals to the non-union fracture models were accomplished in 4 of 5 cases grafted with AL and in 2 of 4 cases grafted with AT. None of 5 cases grafted with FG were incorporated. The process of new bone formation and resorption in the grafted bones were observed three types; resorption of the grafted bones after newbone formation(type A) in 4 cases, new bone formation after resorption(type B) in 2 cases and complete or incomplete resorption without new bone formation(type C) in 8 cases. The modified freeze-dried method used in this study contributed to inhibite the rejection in allogenic grafts but the union period of the grafted freeze-dried bone was more prolonged than that of fresh autografts. Fibrin glue did not contribute to induce a new bone formation ofbone grafts.

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The Effect of a Multi-component Smoking Cessation Program on Bone Union in Adult Patients with Fracture (다요소 금연 프로그램이 성인골절 환자의 금연 및 골유합에 미치는 효과 분석)

  • Kim, In Sook;Lee, Hanju;Lee, Seon Heui
    • Journal of muscle and joint health
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    • v.27 no.1
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    • pp.31-40
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    • 2020
  • Purpose: This study was done to examine the effect of a multi-component cessation program on bone union by comparing the union time between the experimental group and the control group. Methods: A non-equivalent control group posttest design was used. The subjects were 33 patients in the experimental group and 33 patients in the control group, 66 patients in total. The subjects of the experimental group were provided with a face-to-face multi-component smoking cessation program. After the discharge, telephone consultation was provided once a week for 10 weeks. Results: Bone union time was 51.6±10.9 days in the experimental group and 60.9±13.83 days in the control group (p=.003). Among 33 subjects who participated in the smoking cessation program, the average union period of the participants who succeeded in quitting smoking was 44.56 days, the participants who reduced smoking were 50.67 days, and failed to quit smoking group was 60.11 days (p=.006). Conclusion: This study indicated the importance of smoking cessation in patients with fracture and the decrease in the union time by providing smoking cessation education. If the multi-component smoking cessation program is used as a nursing intervention in clinical practice, it will be effective for bone union by increasing the smoking cessation rate of patients with fracture.

Delayed union of a pediatric lunate fracture in the United Kingdom: a case report and a review of current concepts of non-scaphoid pediatric carpal fractures

  • Timothy P. Davis;Elizabeth Headon;Rebecca Morgan;Ashley I. Simpson
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.315-321
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    • 2023
  • Pediatric carpal fractures are rare and often difficult to detect. This paper reviews the current literature on pediatric non-scaphoid carpal fractures, with a case report of a lunate fracture associated with a distal radius and ulnar styloid fracture, managed nonoperatively in a 12-year-old boy. There is lack of consensus regarding the management of these fractures due to the low number of reported cases. A frequent lack of long-term follow-up limits our understanding of the outcomes, but good outcomes have been reported for both nonoperative and operative management. This case report brings attention to the current time period for the definition of delayed union in pediatric carpal fractures, and emphasizes the need for prolonged follow-up for the detection of delayed complications leading to functional impairment.

Antegrade Interlocking Intramedullary Nailing in Humeral Shaft Fractures (상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Kim, Sin-Ki
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.1-6
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    • 2010
  • Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.

Refracture of Proximal 5th Metatarsal Stress Fracture in Athletes Treated Operatively (운동 선수군의 제 5중족골 피로골절의 수술적 치료 후 발생한 재골절)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, Jae-Young;Bang, Yu-Sun;Lee, Sang-Joon
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.95-100
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    • 2003
  • Purpose: To evaluate the incidence, contributing factors, and clinical results of refracture of proximal 5th metatarsal stress fracture treated operatively in athletes Materials and Methods: This study included 8 patients who had been treated for refracture of proximal 5th metatarsal stress fracture with operaton. Their charts & radiologic findings were evaluated retrospectively. Results: The overall incidence of refracture was 13%. Main contributing factors were time of return to sports activity and associated deformities such as cavus foot or flat foot. Seven cases were managed with nonoperative treatment, and we added percutaneous pin fixation under local anesthesia in one case. Bony union was seen at average 8. 5 weeks in 7 cases except 1 nonunion and all of 8 patient returned to athletics at average 16 weeks. Conclusion: The incidence of refracture of proximal 5th metatarsal stress fracture treated operatively in athletes was relatively high. Time of rerum to sports activity must be decided very carefully on individual situation and further imaging study may be helpful for bony union evaluation. The non-operative treatment may have a good result if bone graft was done initially.

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A Case Report of Femoral Neck Fracture in an Elderly Patient Managed by Non-operative Korean Medical Treatment : 42 Months Follow-up

  • Kim, Ju-ran;Gong, Han Mi;Jun, Seungah;Lee, Jung Hee;Lee, Bong Hyo;Lee, Hyun-Jong;Kim, Jae Soo
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.252-258
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    • 2018
  • This report showed the clinical outcome of an elderly patient with a femoral neck fracture who was treated non-operatively with Korean medical treatment. The patient had acupuncture, herbal medication, moxibustion, and participated in physical rehabilitation for 3 months. The effects of Korean medical treatment were measured every 2 weeks using the numeric rating scale (NRS) and the Harris hip score (HHS). After treatments, the NRS score for hip pain decreased from 8 to 2, and the HHS increased from 0 to 43. A 42-month follow-up showed the patient's NRS score was 0 and the HHS was 61. Furthermore, an X-ray showed complete union of the femoral neck fracture with no suspicion of avascular necrosis. These results suggest that Korean medical treatment can effectively reduce pain and aid rehabilitation in patient with femoral neck fractures with no surgery, resulting in complete union of the fracture.