• Clinics in Shoulder and Elbow
• /
• 제15권2호
• /
• pp.117-122
• /
• 2012

목적: 전위성 쇄골 간부 골절에서 관혈적 정복술 후 윤곽 성형된 잠김 압박 금속판(precontoured locking compression plate)을 이용하여 내고정을 시행한 환자를 대상으로 방사선학적 결과 및 임상적 결과를 분석하여 윤곽 성형된 잠김 압박 금속판의 유용성을 알아보고자 하였다. 대상 및 방법: 2009년 3월부터 2010년 2월까지 본원에서 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용하여 관혈적 정복 및 금속 고정술을 시행하고 1년 이상의 추시가 가능했던 34예를 대상으로 하였다. 수술 후 방사선학적 결과는 골유합 여부와 성별 및 나이에 따른 골유합 시기의 차이를 평가 하였으며 임상적 결과는 최종 추시 시 quick DASH Score 및 반대측과 관절 운동 범위의 차이를 평가 하여 분석하였다. 결과: 방사선학적 평가에서 모든 예에서 골유합을 얻을 수 있었으며 평균 골유합 기간은 12.3주였으며 성별 및 나이에 따른 골유합 기간은 통계학적으로 유의한 차이를 보이지 않았다(p=0.87). 임상적 평가에서 최종 quick DASH Score는 평균 23.5점 (12~42)이었으며, 최종 추시시 견관절의 운동은 건측과 비교 시 통계학적으로 유의한 차이를 보이지 않았다 (p=0.69). 결론: 전위성 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용한 내고정술은 정확한 해부학적 정복과 견고한 내고정을 유지 할 수 있어 조기 운동이 가능하여 견관절 운동의 회복과 함께 전례에서 골유합을 얻을 수 있어 쇄골 간부 골절 치료에서 유용하게 사용될 수 있다고 사료된다.

• Clinics in Shoulder and Elbow
• /
• 제13권1호
• /
• pp.1-6
• /
• 2010

목적: 상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술의 치료 결과 및 합병증에 대하여 알아 보고자 한다. 대상 및 방법: 2002년부터 2008년까지 상완골 간부 골절로 전향적 교합성 골수강내 금속정 고정술을 시행하고 골유합 기간까지 추시 관찰이 가능하였던 47예를 대상으로 임상적, 방사선학적 결과 및 술 후 합병증을 분석하였다. 술 후 추시 단순 방사선 검사로 골유합을 확인하였고, ASES 점수 평가법을 이용하여 임상적 평가를 시행하였다. 결과: 총 47예 중 41예 (87.2%)에서 골유합을 보였고, 평균 유합 시기는 14.5주였다. 주요 합병증으로 불유합이 6예, 지연 유합이 3예, 술 중 원위 상완골 후방 피질 골절이 2예, 견관절 유착성 관절막염이 1예를 포함한 영구적 견관절 동통이 2예 있었다. 임상적 결과는 우수가 29예, 양호가 11예, 보통이 4예, 불량이 3예로, 40예 (85.1%)에서 만족할 만한 결과를 보였다. 결론: 상완골 간부 골절에서의 전향적 교합성 골수강내 금속정 고정술은 만족할만한 골유합율 및 임상적 결과를 나타내었으며, 특히 다발성 골절 등의 동반 손상이 있는 경우 또는 분절 골절에서 유용한 하나의 치료 방법이라 사료된다.

• 한방재활의학과학회지
• /
• 제30권1호
• /
• pp.13-29
• /
• 2020

Objectives This study was performed to decide the bone union effect of Hwaweo-jeon on tibia fractured mice. Methods In this study, laboratory experiments were implemented by the stage of in vitro and in vivo. In in vitro, MC3T3-E1 cells were treated with various concentration of Hwaweo-jeon extract (HWJ). To investigate effect of HWJ for osteoblast, relative mRNA expression of 5 substances (alkaline phosphatase [ALP], runt-related transcription factor 2 [Runx2], osteocalcin [OCN], osterix [OSX] and collagen type II alpha 1 chain [Col2a1]) was used as a marker of osteogenesis. In order to determine HWJ's effect for fracture healing, relative gene expression level of ALP, Runx2, OCN, OSX and Col2a1 were used to find out the influence to osteoblast. Furthermore, receptor activator of nuclear factor kappa-B ligand and osteoprotegerin relative mRNA expression were used to estimate the impact to osteoclast. Also, X-ray was used for the purpose of identifying bone union in tibia-fracture mouse model. Results In in vitro experiment, most part of relative mRNA expression were increased compared to control group. In in vivo and in vitro experiment, HWJ induced osteoblast activitation by verifying relative mRNA expression of 5 substances. And in vivo experiment, we can also identify that HWJ triggered osteoclast activation during early stage of tibia fracture. Furthermore, X-ray pictures show noticeable recovery of tibia fracture. Conclusions HWJ extract promotes bone union by facilitating the osteoblast. But, HWJ may occur liver & kidney toxicity over specific concentration. Therefore, when HWJ is applied to human body, doctors have to follow up the liver function test & renal function test of patient.

• 대한족부족관절학회지
• /
• 제11권1호
• /
• pp.67-71
• /
• 2007

Purpose: To evaluate clinical results of the 5th proximal metatarsal intraarticular fracture (Zone I) with displacement treated operatively and to evaluate predisposing factors of the 5th proximal metatarsal fracture (Zone I). Materials and Methods: 11 patients treated for the 5th proximal metatarsal fracture (Zone I) operatively and 10 patients treated conservatively between Jan 2003 and Dec 2005, were followed for more than one year. Functions were graded by AOFAS foot scoring system and union time and postoperative complications were also evaluated. Calcaneal pitch angle was also evaluated. Results: Clinically there were no much difference in results. Clinical points were 94.5 in the operative group and 92.3 in the conservative group. At the last follow-up, the radiographic results showed union in all cases. During the follow-up period, there were no significant complications. But in the conservative group, displaced fracture with calcaneal pitch angle over 30 degree tends to show delayed union and time to loss of pain tends to be prolonged. Conclusion: Calcaneal pitch angle is thought to predisposing factor for 5th metatarsal base fracture. Operative treatment is viable option for the 5th proximal metatarsal intraarticular fracture with displacement and with calcaneal pitch angle over 30 degree. In cases of cavovarus foot deformity, we think operative treatment should be considered with deliberation and long term follow-up study for peroneal tendinopathy should be needed.

• Clinics in Shoulder and Elbow
• /
• 제19권4호
• /
• pp.209-215
• /
• 2016

Background: The purpose of this study was to identify the clinical and radiological outcomes of hook plate fixation for lateral end fracture of the clavicle and acromioclavicular dislocation. Methods: There were a total of 20 cases with lateral end fracture of the clavicle and 16 cases with acromioclavicular dislocation. All patients were evaluated for range of motion, functional score by using Constant score, and American Shoulder and Elbow Surgeons shoulder index at just before implant removal and at final follow-up. Coracoclavicular distance was measured in acromioclavicular dislocation and bony union was evaluated in the lateral end fracture of the clavicle. Results: The clinical outcomes and range of motion were increased at the final follow-up compared with just before implant removal in both the lateral end fracture of the clavicle and acromioclavicular dislocation. In acromioclavicular dislocation, all cases-except one-showed maintenance of reduction after implant removal. Moreover, in the lateral end fracture of the clavicle, all cases-except one-showed bony union. Conclusions: Hook plate fixation in the lateral end fracture of the clavicle and acromioclavicular dislocation resulted in good clinical and radiological results.

• Clinics in Shoulder and Elbow
• /
• 제24권2호
• /
• pp.72-79
• /
• 2021

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group. Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6-210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

• 한국임상수의학회지
• /
• 제29권5호
• /
• pp.412-415
• /
• 2012

1년령의 중성화된 수컷 요크셔테리어와 7년령의 암컷 푸들이 골절의 지연유합으로 내원하였다. 요크셔테리어의 경우 오른쪽 요골과 척골의 원위부가 골절되었고, 푸들의 경우 왼쪽 경골과 비골의 원위부가 골절되었다. 두 환자에서 신체검사 및 방사선검사를 통해 골절의 유합이 지연되고 있음을 확인하였다. 골절부는 금속판 및 나사못으로 고정시키고 자가해면질골을 골절 틈새에 이식하였다. 또한 빠른 골유합을 위해 $20{\mu}g$의 rh-BMP 2 가 포함된 matrigel을 골절부에 주입하였다. 수술 후 방사선검사를 통해 골절부의 치유 상태를 확인하였다. 장기간의 방사선검사에서 두 마리 모두 빠른 골유합을 보였다. 첫 증례에서는 방사선사진상에서 2주째에 요골과 척골 골절 틈새에 골밀도가 증가하였다. 20주째에는 골절선이 더 이상 관찰되지 않았으며, 정상 외관을 회복하였다. 두 번째 증례에서는 방사선사진상에서 11주째에 골절 치유가 진행되고 있음이 확인되었다. 이 두 증례 모두 예상한 것보다 골절의 치유가 빠르게 일어났다. 따라서 rh-BMP 2와 matrigel은 지연유합된 골절의 치유를 촉진하는데 효과가 있다고 생각된다.

• 대한수의학회지
• /
• 제36권2호
• /
• pp.495-511
• /
• 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.

• Clinics in Shoulder and Elbow
• /
• 제20권1호
• /
• pp.37-41
• /
• 2017

Background: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. Methods: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. Results: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7-18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0-17 mm). The average UCLA score and Constant score were 33.6 (range: 25-35) and 92.5 (range: 65-100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. Conclusions: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 1997년도 추계학술대회 논문집
• /
• pp.816-819
• /
• 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.