• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.63-68
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• 2006

Purpose: To assess the effectiveness of the Locking compression plate (LCP) after open reduction for the treatment of the displaced clavicular shaft fracture, the clinical and radiologic outcome of the patients who were managed with the LCP for internal fixation after open reduction has been analyzed. Materials and Methods: We reviewed 26 cases with a displaced clavicular shaft fracture treated by internal fixation using Locking compression plate after open reduction between May 2003 and November 2004. The patients were followed up for at least six months period, and final postoperative outcome was evaluated using clinical results based on Kang's criteria, radiologic signs of fusion. Results: All fractures united by an average of 9.3 weeks without delayed union and showed fast recovery of motion fraction and shoulder function. In addition,24 cases without the fractures of proximal humerus recovered to normal range of shoulder notion within 2.9 weeks. Clinically, according to Kang's criteria, the outcome was good or better in 22 patients. The complications included shoulder joint dysfunction in two cases and keloid formation in one case, and no other complications were observed. Conclusion: The internal fixation using LCP for the treatment of displaced clavicular shaft fracture is a safe, reliable method of treatment, with few complications, and offers rapid recovery of shoulder joint function and bone union.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.202-208
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• 2010

Purpose: In this study we introduced minimal invasive plate osteosynthesis (MIPO) and analyzed clinical outcomes to determine the effectiveness of this intervention in proximal humerus fractures. Materials and Methods: We studied 27 patients including 16 cases with a 2-part fracture, 10 cases with a 3-part fracture, and 1 case with a 4-part fracture. Clinical outcomes were evaluated using UCLA score, KSS score and recovery of range of motion. Time to union and humerus neck-shaft angle change were estimated by radiologic assessment. The average follow up period was 19 months. Results: UCLA scores were "excellent" for 15 patients, "good" for 12 patients. The mean KSS score was 91.4 at final follow-up. The average shoulder range of motion was $167.2^{\circ}$ in forward elevation. Bone union occurred by 14.1 weeks postoperatively. Humerus neck-shaft angle recovery was "excellent" in 24 patients and "moderate" in 3 patients. There were no complications such as axillary nerve paralysis, deep infection, or subacromial impingement of the plate. Conclusion: MIPO for proximal humerus fractures is an effective procedure if performed with sufficient understanding of the anatomical structures. MIPO leads to minimized dissection of soft tissue, low complication rates and early recovery of range of motion.

• The korean journal of orthodontics
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• v.24 no.1 s.44
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• pp.37-62
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• 1994

This study was undertaken to investigate the three dimensional vascular changes of periodontal ligament following orthodontic tooth movement. Experimental tooth movement was carried out in 96 Sprague-Dawley rats with the weight of 250g. They were divided into four experimental groups (each 24 rats). The left maxillary first molar was moved mesially with 25g force in group I, and with 75g force in group II. Each three animals were sacrificed after 1, 6, 12, 24 hours, and 3, 7, 14, 21 days. In group III, 25g mesial force was applied for 3 days, and in group IV, 75g mesial force was applied for 3 days. Then the appliances were removed, and each three animals were sacrificed after 1, 6, 12, 24 hours, and 3, 7, 14, 21 days from removal of appliance. The contralateral molars were used for control group. Casting media was injected via left ventricle and polymerized in warm water. After corrosion of surrounding soft tissue, three dimensional vascular changes were examined using scanning electron microscopy. The findings of this study were as follows: 1. Pressure side of group I and II showed degenerative vascular changes such as vascular compression, reduction of vasculature, leakage of casting media. But, regenerative changes were dominant after 7 days of tooth movement. Although the degenerative vascular changes were more severe in group II, which was exposed to heavy force, the timing of these changes was not different between two groups. 2. Periodontal vasculature was reestablished by the growth of new capillaries and their differentiation and union from the remaining periodontal vessels and vessels of alveolar bone marrow. Although vascular regeneration was more rapid in group I, which was exposed to light force, the vasculature was not fully normalized in both groups even after 21 days. 3. There was no remarkable changes in tension side of group I and II, but looping of capillary, new capillary growth, dilation of vessels, redirection of vessels in the direction of tensile force were occurred. 4. In pressure side of group III and IV, in which appliance was removed after 3 days of orthodontic force, bone resorption was continued even after removal of appliance. Regeneration of vasculature was initiated after 1-6 hours, and it was more rapid in group III than group IV. In both groups, the vasculature was not fully normalized even after 21 days. 5. After removal of appliance, tension side of group III and IV showed vascular compression and loss of vasculature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.129-136
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• 1991

The fibrin sealant was first designed as an alternative to surgical suture for the purpose of surface-to-surface union especially in parenchymal organs like the liver, spleen and kidney. The clinical application of currently used fibrin sealant was first introduced in 1972. The fibrin sealant consists of principal two components; lyophilized human fibrinogen and bovine thrombin. The fibrinogen component also contains coagulation factor XIII. A solution of aprotinin, an inhibitor of fibrinolysis is used to dissolve the fibrinogen and to provide the first component, and a solution of calcium chloride is also used to provide the second component. From July to December in 1990, during 6 months, we used fibrin sealant in the 28 patients of 33 various cases, in the following ways; supportive application of fibrin sealant after free autogenouse nerve graft for the repair of inferior alveolar nerve, facial nerve or accessory nerve, treament of hemangioma or lymphangioma to thrombosize and lead to the tumor shrinking, skin grafting to stimulate the adhesion and tissue repair, bone grafting in the patients of cleft alveolus, mandibular reconstruction or orthognathic surgery to facilitate the knitting of bone chips, tissue adhesion after tumor resection, radical neck dissection or flap reconstructions, and supportive adhesion of external auditory cannal after TMJ surgery via postauricular approach. No adverse effects were observed, none of the patients developed hepatitis or other blood transmitted disease, and the wound healing were acceptable.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.31-36
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• 2007

Purpose: Recycling extracorporeal irradiated autograft is used as one of the reconstruction methods after limb salvage with malignant bone tumor. However, there were some problems such as joint instability, progressive arthritis, insufficient joint resection margin were found after intraarticular recycling autograft. Thus, we carried out a research in order to investigate the results of recycling total joint autotransplantation after extracorporeal irradiation that could resolve the problems. Materials and Methods: There were five cases of patients who were diagnosed as osteosarcom around the knee joint and underwent same operation from June 1997 to Feb 2006. All patients had been evaluated from 93 to 105 months (mean 100 months) and their mean age was 21.6. Results: The roentgenographic union of junctional sites began at 15.6 months (9~40 months) postoperatively. As regards to the orthopaedic functional results, we used the criteria of Ennecking et al. Overall mean functional result was 71.6%. Complication such as epiphyseal collapse (three cases) and joint instability (five cases) were noted respectively. In all the cases, tumor prosthesis was used to replace the knee joint. Conclusion: Because recycling total joint autotransplantation after extracorporeal irradiation does not prevent joint instability and progressive arthritis, tumor prosthesis is recommended in young adult.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.37-42
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• 2007

Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

• Journal of Korean Neurosurgical Society
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• v.48 no.5
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• pp.412-418
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• 2010

Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.130-134
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• 2013

A painful pseudoarthrosis will develop due to a delay in diagnosis and treatment, and surgical care is required. Treatment of pseudoarthrosis is really difficult because the acromion is a thin flat bone that is difficult to be fixed firmly. A 52-year-old woman with multiple trauma had an acromial fracture that was not detected until it had caused pain after ambulation. Open reduction and internal fixation with a variable angle locking compression plate for distal radius and autogenous iliac bone graft were performed. At nine months after the operation, there was partial tear in the supraspinatus tendon, and arthroscopic repair of the supraspinatus tendon was performed. At nine months after the operation, radiographs showed a complete union. At three months after tendon repair, the patient had excellent function of the shoulder. We have reported a case of a successful treatment of nonunion and pseudoarthrosis of acromial fracture that is difficult to be fixed.

• Journal of Korean Foot and Ankle Society
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• v.25 no.3
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• pp.111-116
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• 2021

Purpose: Variations in the preferred conservative and operative treatment methods for ankle arthritis may be observed in the practice of orthopedic surgeons. This study is based on the Korean Foot and Ankle Society (KFAS) member survey and aims to report the current trend and changes in the management of ankle arthritis over the last few decades. Materials and Methods: A web-based questionnaire containing 24 questions was sent to all KFAS members in July 2021. The questions were mainly related to the preferred techniques and clinical experience in osteotomy, arthrodesis, and total ankle arthroplasty (TAA) for patients with ankle arthritis. Results: Sixty-three out of 550 surgeons (11.5%) responded to the survey. The responses to 6 out of the total of 24 questions (25.0%) achieved the levels needed to reflect a tendency. Answers that showed a tendency were related to the following: a surgical approach for arthrodesis (anterior approach), use of auto-bone graft for arthrodesis (iliac bone), a nonunion rate of more than 10% following arthrodesis, main reason related to unsatisfactory results after arthrodesis (nonunion or delayed union), the main reason to change total ankle prosthesis (unstable supply of prosthesis), the unusualness of revision TAA and conversion of fusion to TAA. Diversity was found in several aspects of treatment (degree of experience and satisfaction in supramalleolar osteotomy, fixation method for arthrodesis, preferred TAA prosthesis and longevity, degree of experinece, annual number of TAA operation. Conclusion: This study proposes updated information with regard to the current trends in the management of ankle arthritis in Korea. Both consensus and variations in the approach to patients with ankle arthritis were identified through this survey. With an increasing preference for TAA, the need for the development of a prosthesis optimized for Koreans and a stable supply of prostheses were the suggestions made by the study.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.1-13
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• 1990

The main objectives of this study was to observe the effects of hyperbaric oxygen therapy on the healing processes of mandibular fracture of streptozotocin-induced diabetic rats. Author used 60 rats (Sprague-Dawley Strain) deviding into control(30) and experimental groups(30). Complete fracture was produced on the left mandibular body of 60rats, rendered hyperbaric oxygen therapy (2 hrs. daily at 2.5 atm.) on experimental group and observed effects of hyperbaric oxygen therapy by microscopically. The obtained results were as follows; 1. Infiltration of inflammatory cells was no significant differences between the control and experimental group until 3rd week, but experimental group showed decreasing tendency after 4th week. 2. Severe proliferation of fibroblasts showed rather rapider in experimental group, at 2nd week, while at 3rd week in control group. 3. Osteoclasts appeared at 1st week in experimental group while at 3rd week in control group, and experimental group showed early bone resorption pattern. 4. Osteoblasts appeared at 1st week in experimental group while at 3rd week in control group, and experimental group showed prominent osteoblastic activity. 5. Moderate proliferation of capillary blood vessels showed in initial stage of experimental group while mild proliferation at 1-2nd week in control group. 6. Formation of cartilaginous callus showed at 4th week in experimental group, while at 6th week in control group. 7. Formation of bony callus showed mildly at 5th week, and moderately at 6th week in experimental group, while no appearance in control group, but complete bony union was not observed even in experimental group throughout this experiment.