• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.27-33
• /
• 2010

Purpose: Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. Materials and Methods: We evaluated factors that have an effect on bone union and bone function after union. We evaluated age, fracture site, comminution, displacement, shortening and other factors. Among 523 clavicular midshaft fractures that presented between January 2004 and Jun 2009 at our Department of Orthopaedic Surgery, we identified 270 who had conservative treatment and 173 patients who had surgical treatment. Results: The period required for bone union increased with the degree of displacement. For the group below 12 years of age, and the group without comminution, it took half the time to achieve bone union compared with the other groups. Displacement mostly occurred within 2 weeks after conservative treatment. Conclusion: In patients with a comminuted clavicular midshaft fracture, we might, because of expected delays in bone union, delay the start of rehabilitation until patients are more than 13 years old. Because the degree of displacement may be increased within 2 weeks during conservative treatment, we can think about surgical treatments.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.4
• /
• pp.324-330
• /
• 2020

Purpose: Korean studies on the prevalence of a tarsal coalition are quite rare, and there are very few reports on the prevalence of multiple tarsal coalitions among adults in the foreign literature. Therefore, this study examined the characteristics and prevalence of tarsal coalition in the Korean population based on imaging tests. Materials and Methods: The prevalence of tarsal coalition and its anatomical location and histological classification were reviewed retrospectively among 4,711 patients (4,454 males and 257 females) with an ankle sprain or ankle fracture who underwent foot and ankle computed tomography and magnetic resonance imaging between March 2009 and February 2019 at the authors' institution. Results: Over a period of 10 years, 78 patients (1.7%) had a tarsal coalition, among whom 53 patients (67.9%) had an isolated tarsal coalition and 25 patients (32.1%) had multiple tarsal coalitions. Regarding the anatomical location, a talocalcaneal coalition was the most common type in both isolated (31 patients, 37 cases [62.7%]) and multiple (22 patients, 23 cases [45.1%]) tarsal coalitions. In the isolated coalition group, the second-most common type was calcaneonavicular coalition (10 patients, 16.9%), followed by naviculocuneiform (nine patients, 15.3%) and cuboidonavicular coalitions (three patients, 5.1%). In the multiple coalition group, the second-most common coalition type was calcaneonavicular coalition (14 patients, 14 cases [27.5%]), followed by talonavicular coalition (six patients, six cases [11.8%]). From a total of 60 cases of talocalcaneal coalition, 24 cases (40.0%) were in the posterior facet, 18 cases (30.0%) in the middle facet, and four cases (6.7%) in the anterior facet. Regarding the histological classification, cartilaginous coalition was the most common in both single (32 patients, 35 cases [59.3%]) and multiple (20 patients, 37 cases [72.5%]) coalition groups. Conclusion: The present study found that talocalcaneal coalition was the most common type of tarsal coalition. In contrast to previous reports that a talocalcaneal coalition generally occurs in the middle facet, it was usually observed in the posterior facet in the present study. In addition, although multiple tarsal coalitions have been reported to be quite rare, this study confirmed that they are not rare and can occur in a range of patterns.

• The Journal of the Korean bone and joint tumor society
• /
• v.15 no.2
• /
• pp.93-103
• /
• 2009

Purpose: We evaluated the outcomes of surgical reconstructions using recycled autograft augmented with VFG for bone defects caused by tumor resections. Materials and Methods: Ten patients with a malignant or locally aggressive bone tumor who were managed with recycled autograft augmented with VFG and followed up minimum 1 year were evaluated for bone union, functional result and complications. The influence of various factors on bone union and functional outcomes were also analyzed. Results: Bone unions were obtained at 13 of 20 junctions. Average union time was 3.7 months at metaphyseal junctions and 8 months at diaphyseal junctions (P<0.05). At diaphyseal junctions, younger aged group and intramedullary location group showed earlier bone union (P<0.05). The mean functional score was 81%. There were 3 nonunions, 4 delayed unions and 2 recycled bone resorption combined with fractures. Conclusion: To obtain excellent results, proper microvascular technique, sufficient length of VFG bridging both junctions, stable internal fixation and protection of reconstructed bone until union are necessary.

• Journal of the Korean Arthroscopy Society
• /
• v.12 no.3
• /
• pp.217-221
• /
• 2008

Coracoid impingement syndrome results from abnormal contact between the anterosuperior humerus and the coracoacromial arch. The coracoid impingement may occur from traumatic, idiopathic, or iatrogenic causes. Traumatic causes of coracoid impingement include fractures of scapular neck, coracoid process or lesser tuberosity. Coracoid impingement due to lesser tuberosity malunion is a rare disease and most of them were treated by open procedures. The authors present a case of coracoid impingement caused by malunion after isolated lesser tuberosity fracture which was treated by arthroscopic coracoplasty with percutaneous screw fixation.

• The Journal of the Korean bone and joint tumor society
• /
• v.16 no.1
• /
• pp.8-13
• /
• 2010

Purpose: This study was performed to evaluate the effi ciency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. Materials and Methods: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. Results: The mean size of lesion was 33.5 $cm^3$ (range, 2.3-181.9 $cm^3$) (29.4 $cm^3$ in PRP group and 40.2 $cm^3$ in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. Conclusion: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.

• Journal of Biomedical Engineering Research
• /
• v.25 no.5
• /
• pp.361-367
• /
• 2004

The axial compressive strength, relative 3-D stability and osteoconductive shape design of an intervertebral fusion cage are important biomechanical factors for successful intervertebral fusion. Changes in the stress distribution of the vertebral end plate and in cage stability due to changes in the spike shape of a newly contrived box-shaped fusion cage are investigated. In this investigation, the initial contact of the cage's spikes with the end plate and the penetration of the cage's spikes into the end plate are considered. The finite element analysis is conducted to study the effects of the cage's spike height, tip width and angle on the stress distribution of the vertebral end plate, and the micromigration of the cage in the A-P direction. The stress distribution in the end plate is examined when a normal load of 1700N is applied to the vertebra after inserting 2 cages. The micromigration of the cage is examined when a pull out load of l00N is applied in the A-P direction. The analysis results reveal that the spike tip width significantly influences the stress concentration in the end plate, but the spike height and angle do not significantly influence the stress distribution in the end plate touching the cage's spikes. In addition, the analysis results show that the micromigration of the cage can be reduced by adjusting the spike angle and spike arrangement in the A-P direction. This study proposes the optimal shape of an intervertebral fusion cage, which promotes bone fusion, reduces the stress concentration in a vertebral end plate, and increases mechanical stability.

• The Journal of the Korean bone and joint tumor society
• /
• v.11 no.1
• /
• pp.62-70
• /
• 2005

Purpose: We compared the time how much time spent until the bone unions, when we grafted fresh frozen allograft during therapy of benign bone tumor depends on the degrees of bony unions. Materials and Methods: This study selected 29 cases, in which a curettage on the benign bone tumors was conducted and a fresh frozen allograft was transplanted. The area of the focus, the new bone formation, the recurrence of the focus and complications in the plain radiographs were observed. Results: The average time when we could find out bony unions in the radiographs is eleven weeks. The time when we could observe the unions in the radiographs are 11.4 weeks in allograft group, 10.7 weeks in allograft and autograft groups and 13.6 weeks in allograft and bone substitute. On radiologic findings, the average lesion size is 40 cm3. The time when we could find bony unions are 9.3 weeks in less than 40 $cm^3$ and 12.9 weeks in more than 40 $cm^3$. We could observe recurrences in two cases. Conclusion: The authors could get the similar results between fresh frozen allograft, allograft and autograft after curettage of benign bone tumor. We can think the ideal method which is the transplantation of autograft, but if we can’t get autograft enough, the best way which heal the defects is the transplantation of fresh frozen allograft.

• Journal of Yeungnam Medical Science
• /
• v.7 no.1
• /
• pp.203-210
• /
• 1990

This is a case report of correction of malunioned maxilla after traffic accident by Le Fort I osteotomy and posterior segmental osteotomy. By this procedure, authors obtained the following results. 1. The malinioned maxilla after traffic accident which had anterior crossbite, posterior open bite and scissor's bite were corrected by Le Fort I osteotomy and posterior segmental osteotomy. 2. No postoperative infection and specific complication were seen in this case. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. And then, the patient could open his mouth in normal range after a week of intermaxillary fixation removal. 4. For rigid fixation and reducing relapse, the osteotomized maxilla was fixed with miniplates.

• Journal of Biomedical Engineering Research
• /
• v.25 no.6
• /
• pp.525-530
• /
• 2004

Three dimensional finite element models of lumbar interbody fusion using rage and screws were constructed for the simulation of stress distribution and maximum displacement. It is also performed to investigate the efforts of osteoporosis and the location of cage on the stress distribution. It is known from the results that the increase of the strength of trabecular bone causes to decrease the stress of cortical bone and to increase the stress of trabecular bone. And it is found that the trend of stress distribution is changed by the change of location of cage and proper location of cage enhances the rate of operational success.

• The Journal of the Korean bone and joint tumor society
• /
• v.9 no.2
• /
• pp.139-147
• /
• 2003

Purpose: The purpose of this study was to determine if bony union can be obtained when a bone graft substitute is transplanted in order to treat a benign bone tumor and if there is a difference between calcium sulfate and hydroxyapatite in the healing procedure when the degree of the bony union after the bone graft are compared. Materials and Methods: This study selected 20 cases, in which a curettage on the benign bone tumors was conducted and a bone graft substitute was transplanted. The area of the focus, the new bone formation, the recurrence of the focus in the plain radiographs and histological findings were observed. Results: Twenty cases (13 males, 7 females) were evaluated. Their mean age at surgery was 15.8 years (2~45), and the mean follow-up period was 3 years. The mean area of focus was 30.7 $cm^3$ in the radiographs, and 19 cases showed successful results in the ultimate visit, while 1 case has a recurrence of the focus. Conclusion: Calcium sulfate has osteoconduction and superior bioavailability, and is absorbed in vivo in proportion to the new bone formation. On the other hand, hydroxyapatite has good osteoconduction. It can result in better bone formation when it is combined with an autologous bone graft, autologous bone marrow, and an allogenic bone graft, but is absorbed in vivo more slowly than the former.