• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.207-212
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• 2006

Purpose: To evaluate the results of ankle lateral malleolar fractures classified as Danis-Weber type B accompanying osteoporosis that were treated with lag screw. Materials and Methods: 15 cases of Danis-Weber type B ankle lateral malleolar fractures that had T score of less than -2.5 in BMD(bone mineral density) test were selected from June 2003 to December 2005. 10 cases were males and 5 cases were females with mean age of 59 years. The main injury mechanism was supination and external rotation. Mean follow-up period was 16 months. Clinical and radiologic evaluation was done according to Meyer and Kumler's criteria. Results: All cases showed satisfying result and mean radiologic bone union period was 3 months. Anatomic reduction and bone union was acquired in all cases without complications including wound infection, skin necrosis, delayed union and nonunion Conclusions: Lag screw fixation seem to be excellent treatment of Danis-Weber type B lateral malleolar fractures with osteoporosis as it can minimize soft tissue injury and enable anatomic reduction with firm fixation.

• Archives of Reconstructive Microsurgery
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• v.4 no.1
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• pp.43-51
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• 1995

In certain low-grade malignant bone tumors such as chondrosarcoma or frequent recurrent benign bone tumors as ossifying fibroma, radical treatment may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free vascularized bone graft a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defect with excellent clinical results. We tried wide excision and free vascularized fibula graft in 5 patients with ossifying fibroma and one patient with chondrosarcoma from January 1984 to December 1994 and followed for more one year. The shortest bony defect was 7cm and the longest bony defect was 20cm and mean bony defect was 13cm. All patients were evaluated clinically and roentgenographycally on basis of functional recovery and bony union. All patients showed satisfactory functional recovery with sound bony union and showed bony hypertrophy. And, local recurrence was not seen.

• Archives of Reconstructive Microsurgery
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• v.2 no.1
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• pp.20-28
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• 1993

From 1981 to 1991, twenty one vascularized bone grafts had been performed for the treatment of large bone defects of the extremities, with average follow-up of 65.4 months. Fibulae were used in 15 patients Including two cases of osteocutaneous flap, iliums in 5 including two of osteocutaneous flap, and osteocutneous rib in one. Ten of these patients were treated for segmental defects derived from trauma or infection sequelae of long bones, while eight for locally aggressive benign or malignant bone tumors ; and three for congenital pseudarthrosis of tibia. The location of the lesions were 8 cases in tibia; 7 in humerus ; 3 in forearm bone ; 2 in foot ; and 1 in femur. The length of bone defects were averaged as 10 cm, ranging from 3 to 17.5. In eighteen patients(85.7%), the operation was successful. The duration from operation to bony union was average 5.1 months on successful cases, and three of them needed additional procedures, such as bone graft and electrical stimulation to promote bony union. Local recurrence was found in one case of chondrosarcoma, resulting in AK amputation. Wound infections were noted each one case on donor or recipient site. In five cases, the fracture of grafted bone, which united with cast immobilization in four, occurred average 16.7 months after operation.

• Journal of Veterinary Science
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• v.21 no.6
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• pp.90.1-90.11
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• 2020

Background: Mandibular fractures are common in camels, leading to considerable economic losses. This study explored methods of improving mandibular fractures repair, adjuvant with interdental wire, or bone plate fixation. Autologous bone marrow (BM) injection enhances osteogenesis and rapid healing. Objectives: To investigate the effect of autologous BM aspirate as an adjuvant treatment for repairing mandibular fractures in camels with interdental wire, or bone plate fixation. Methods: Thirty dromedary camels aged 5-8 years and of both sexes were randomly divided into 4 treatment groups: group 1 (n = 10) treated with stainless steel wire fixation and BM injection at the fracture line, group 2 (n = 10) treated with plate fixation and BM injection at the fracture line, group 3 (n = 5) treated with stainless steel bone wire fixation and placebo saline injection at the fracture line, and group 4 (n = 5) treated with plate fixation and placebo injection at the fracture line. The mandibular fractures were followed weekly for 12 weeks postoperatively to assess improvement and healing based on clinical evaluation, radiographic union scale, and bone turnover markers (i.e., bone alkaline phosphatase, osteocalcin, pyridinoline, and deoxypyridinoline). Results: Compared to other groups, elevated bone turnover markers in group 1 were demonstrated (p < 0.05) on the seventh postoperative day. Likewise, compared to other groups, both clinical findings and radiographic union scale significantly improved (p < 0.05) in group 1 on the 56th postoperative day. Conclusions: BM aspirate has a promising beneficial osteogenic effect on mandibular fracture repair in camels, most notably when combined with interdental wire fixation.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.171-180
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• 1995

Recently vascularized fibular transfer has been used in the treatment of bone tumor that are more than six centimeter in length. With refinements in microsurgical techniques and understanding of the biological and biomechanical characteristics of vascularized bone graft, the success rate of this procedure was increased. Fifteen bone tumor patients, sixteen cases seen from Apr. 1979 to Jun. 1995 were managed by means of vascularized bone graft at Kyung Hee University Hospital. Ten cases were done intercalary graft and the others were done osteoarticular graft. the ratio of male and female was 6 : 9, and mean age was 20.4 years old at operation. Mean follow up period was 5 years 4 months(range 17 months to 16 years 2 months) and mean graft length was 13.8cm. Duration for union was 5.3 months(range 3 months to 1 year) and over-all rate of union at the last follow up examination was 93.8%. Sufficient hypertrophy of grafted bone was obtained in all cases at the time of last follow up as compared to initial size of grafted bone. Several complications were found such as stress fractures, recurrence. Vascularized fibular transfer for the treatment of bone tumor is a valuable procedure in appropriately selected patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.3
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• pp.94-102
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• 2014

Purpose: This study aims to validate the effect of autoclaved autogenous bone (AAB), incorporating Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2), on critical-sized, segmental radius defects in rabbits. Delivery systems using absorbable collagen sponge (ACS) and fibrin glue (FG) were also evaluated. Methods: Radius defects were made in 12 New Zealand white rabbits. After autoclaving, the resected bone was reinserted and fixed. The animals were classified into three groups: only AAB reinserted (group 1, control), and AAB and ErhBMP-2 inserted using an ACS (group 2) or FG (group 3) as a carrier. Animals were sacrificed six or 12 weeks after surgery. Specimens were evaluated using radiology and histology. Results: Micro-computed tomography images showed the best bony union in group 2 at six and 12 weeks after operation. Quantitative analysis showed all indices except trabecular thickness were the highest in group 2 and the lowest in group 1 at twelve weeks. Histologic results showed the greatest bony union between AAB and radial bone at twelve weeks, indicating the highest degree of engraftment. Conclusion: ErhBMP-2 increases bony healing when applied on AAB graft sites. In addition, the ACS was reconfirmed as a useful delivery system for ErhBMP-2.

• Archives of Reconstructive Microsurgery
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• v.3 no.1
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• pp.9-15
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• 1994

It is difficult to obtain a satisfactory bony union of large bone defect secondary to trauma, tumor resection, congenital pseudarthrosis of tibia and bony metaplasia following infection with conventional methods. Conventional nonvascularized autologous bone graft do not provide adequate large amounts of donor bone and usually undergo necrosis or nonunion due to lack of vascular nutrition. Currently, advanced in microsurgery have made it possible to provide a continuing circulation of blood in bone grafts so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. Thus, the grafted bone is achieved more rapid stabilization without sacrificing viability. We reviewed 11 cases of vascularized fibular grafts which were performed from December 1982 to January 1993 and the following results were obtained: 1. Large bone defects with chronic osteomyelitis secondary to trauma were could be successfully treated by the vascularized fibular transfer. 2. In our experience, the vascularized fibular transfer was thought to be one of good methods of treatment for congenital pseudathrosis of tibia. 3. Complete tumor resection was followed by a free vascularized fibular transfer, resulting in good functional improvement, without local recurrence. Long bone defect secondary to bony dysplasia was could be reconstructed by the vascularized fibular transfer. 4. The transferred vascularized fibula had been hypertrophied with bony union during follow-up period and there was no resorption of the grafted fibula.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.4
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• pp.17-30
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• 2020

Objectives The purpose of this study is to evaluate the healing effect of Yukmijihwang-tang (YM) on femur fractured mice. Methods Mice were randomly divided into 6 groups: normal, control, positive control, YM with low, medium, high dosage each. All groups were prepared with femur fracture and treated diffrently. In order to measure bone regeneration effects, we analysed the levels of cyclooxygenase-2 (COX2), bone morphogenetic protein-2 (BMP2), collagen type II alpha 1 chain (Col2a1), Sox9, runt-related transcription factor 2 (Runx2), and osterix genes expressed in bone. For morphological analysis, muscles were removed and femur was observed with naked eye. Results COX2 gene expression in bone marrow significantly decreased. BMP2 gene expression significantly increased. Col2a1 gene expression significantly increased. Sox9 gene expression increased as well. Runx2 gene expression in bone marrow increased, but there was no statistical significance. Osterix gene expression significantly increased. Union of the fracture site progressed more in YM group compared to the control group. The fracture union score was significantly decreased in YM group compared to the control group. Conclusions YM showed anti-inflammatory effect, promoted bone regeneration by stimulating the bone regeneration factor. In conclusion, YM can help fracture healing and it well be applied clinically to patients with fracture.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.48.1-48.10
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• 2021

Objectives: This study aimed to evaluate the effects on bone repair of different concentrations of mineral trioxide aggregate (MTA) added to AH Plus. Materials and Methods: Bone tissue reactions were evaluated in 30 rats (Rattus norvegicus) after 7 and 30 days. In the AH + MTA10, AH + MTA20, and AH + MTA30 groups, defects in the tibiae were filled with AH Plus with MTA in proportions of 10%, 20% and 30%, respectively; in the MTA-FILL group, MTA Fillapex was used; and in the control group, no sealer was used. The samples were histologically analyzed to assess bone union and maturation. The Kruskal-Wallis and Mann-Whitney tests were performed for multiple pairwise comparisons (p ≤ 0.05). Results: At the 7-day time point, AH + MTA10 was superior to MTA-FILL with respect to bone union, and AH + MTA20 was superior to MTA-FILL with respect to bone maturity (p < 0.05). At the 30-day time point, both the AH + MTA10 and AH + MTA20 experimental sealers were superior not only to MTA-FILL, but also to AH + MTA30 with respect to both parameters (p < 0.05). The results of the AH + MTA10 and AH + MTA20 groups were superior to those of the control group for both parameters and experimental time points (p < 0.05). Conclusions: The results suggest the potential benefit of using a combination of these materials in situations requiring bone repair.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.32-36
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• 2012

Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after intercalary tricortical iliac bone graft with plate fixation for the nonunion of midshaft clavicular fractures. Material and Methods: Between September 2007 and May 2011, 10 patients who were treated by the intercalary tricortical iliac bone graft, with plate fixation for clavicle nonunion, were studied. The mean follow-up period was 30.7 (12~57) months. After the sclerotic bone was excised to the bleeding cortical bone, we interposed the tricortical iliac bone to provide structural support and restore clavicle length, and then fixed the plate and screws. The radiologic outcomes on the serial plain radiographs and clinical outcomes, according to UCLA, ASES and Quick DASH scores, were analyzed. Results: Bony union was obtained in all cases (100%) and the average union time was 18.4 (14~24) weeks. The average respective UCLA and ASES scores improved from 16.7 and 52.1 preoperatively to 27.4 and 83.6 postoperatively (p<0.05). The average Quick DASH score was 40.5, at the final follow-up. Complications were 2 shoulder stiffness, and one case had removal of device and arthroscopic surgery at 11 months, postoperatively. There were no implant failure or infection. Conclusion: Intercalary tricortical iliac bone graft, with plate fixation for the nonunion of midshaft clavicular fractures, is a good option that can provide structural support and restore clavicle length, as well as high union rate.