• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.87-93
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• 2005

Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.57-61
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• 2012

Pretibial cyst formation is a rare complication after anterior cruciate ligament (ACL) reconstruction and there are only few cases reported. Pretibial cyst can be caused by variable reasons. Foreign body reaction due to breakdown of bio-absorbable screw for fixation, graft necrosis at tibial site, joint fluid leakage to tunnel and incomplete incorporation of graft to bony tunnel. The authors experienced one case of massive pretibial cyst after arthroscopic ACL reconstruction using bio-absorbable interference screw in 38-year-old male patient. Thus, authors report this rare case with literature view.

• Hip & pelvis
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• v.35 no.1
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• pp.47-53
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• 2023

Purpose: The purpose of this study is to compare the radiological results of fixation using the femoral neck system (FNS) and cannulated screw (CS) for treatment of femoral neck fractures. Materials and Methods: A retrospective study of patients with femoral neck fractures who underwent internal fixation and had follow-up of more than six months from 2010 to 2020 was conducted. A total of 87 patients were enrolled in the study. The FNS group included 20 patients and the CS group included 67 patients. Classification of fractures was performed according to Garden and Pauwels classification. Operation time, intraoperative blood loss, sliding distance of the implant, lateral soft tissue irritation caused by implants, and complications were evaluated. Results: The mean operation time was 40.30 minutes in the FNS group and 46.84 minutes in the CS group. The mean intraoperative bleeding volume was 51.25 mL in the FNS group and 72.16 mL in the CS group. Bone union was achieved in 18 patients in the FNS group (90.0%) and in 61 patients in the CS group (91.0%). The mean sliding distance of the implant was 4.06 mm in the FNS group and 3.92 mm in the CS group. No patients in the FNS group and 12 patients in the CS group complained of soft tissue irritation. Conclusion: A shorter operative time, less intraoperative bleeding, and less irritation of soft tissue were observed in the FNS group. FNS could be an alternative to CS for fixation of femoral neck fractures.

• Journal of Korean Neurosurgical Society
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• v.42 no.1
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• pp.6-10
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• 2007

Objective : The purpose of this study was to determine the effect of bone cement augmentation of pedicular screwing in severe osteoporotic spondylolisthetic patients. Methods : Twenty patients with spondylolisthesis (8 : spondylolytic spondylolisthesis 12 : degenerative spondylolisthesis) who had undergone pedicular screwing and interbody fusion for osteoporotic lumbar spine (T-score on bone mineral density<-3.0) from 2002 to 2005 were reviewed. Mean age was 62.3 years with 3 male and 17 female patients. Average follow-up period was 14 months. Average T-score on bone mineral density (BMD) was -3.62. After decompression of neural elements, about 6cc of polymethylmethacrylate (PMMA) was injected into the each vertebral body through transpedicular route. All patients underwent one level interbody fusion and pedicular screw fixation. Clinical outcome was assessed using Oswestry Disability Index (ODI) on the last clinical follow-up. In addition, a modified MacNab's grading criteria was used to objectively assess patient's outcome postoperatively. Radiographic analysis of sagittal contour was assessed preoperatively, immediately postoperatively, and at final follow-up including fusion rate. Results : Eighteen of 20 patients were graded as excellent or good according to the modified MacNab's criteria. An significant improvement of ODI was achieved in both groups. Mean sagittal angle at the preoperative state, postoperative state and at the last follow-up state was $11.0^{\circ},\;20.1^{\circ}$ and $18.3^{\circ}$, respectively, with mean sagittal angle correction gain $7.3^{\circ}$. Firm fusion was achieved in all patients. There were one compression fracture above the fused segment after 6 months follow-up and one case of seroma. But there were no postoperative complications related to bone cement leakage and pedicular screwings such as screw pullout or screw cut-up. Conclusion : Bone cement augmentation of pedicular screwing can be an effective procedure for osteoporotic lumbar spine in spondylolisthetic patients.

• Archives of Craniofacial Surgery
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• v.17 no.4
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• pp.211-217
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• 2016

Background: Nonsyndromic craniosynostosis is a relatively common craniofacial anomaly and various techniques were introduced to achieve its operative goals. Authors found that by using smaller bone fragments than that used in conventional cranioplasty, sufficiently rigid bone union and effective regeneration capacity could be achieved with better postoperative outcome, only if their stable fixation was ensured. Methods: Through bicoronal incisional approach, involved synostotic cranial bone together with its surrounding areas were removed. The resected bone flap was split into as many pieces as possible. The extent of this 'multi-split osteotomy' depends on the degree of dysmorphology, expectative volume increment after surgery and probable dead space caused by bony gap between bone segments. Rigid interosseous fixation was performed with variable types of absorbable plate and screw. In all cases, the pre-operational three-dimensional computed tomography (3D CT) was checked and brain CT was taken immediately after the surgery. Also about 12 months after the operation, 3D CT was checked again to see postoperative morphology improvement, bone union, regeneration and intracranial volume change. Results: The bony gaps seen in the immediate postoperative brain CT were all improved as seen in the 3D CT after 12 months from the surgery. No small bone fragment resorption was observed. Brain volume increase was found to be made gradually, leaving no case of remaining epidural dead space. Conclusion: We conclude that it is meaningful in presenting a new possibility to be applied to not only nonsyndromic craniosynostosis but also other reconstructive cranial vault surgeries.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.397-402
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• 2013

Background Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relatively common injury. Various treatments for fracture-dislocation of the PIP joint have been reported. In the present study, we performed open reduction through a midlateral incision using absorbable sutures to reduce the small bone fragments and performed volar plate repair. Methods We treated nine patients with fracture-dislocation of the PIP joint with small fractured bone fragments too small for pinning or screw fixation. Patients with volar plate injury were treated with open reduction and volar plate repair at the periosteum of the middle phalangeal bone base by the modified Kessler method using absorbable sutures. All patients were placed in a dorsal aluminum extension block splint, which maintained the PIP joint in approximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate. Results At a mean final follow-up of postoperative 9 months, all patients were evaluated radiographically and had adequate alignment of the PIP joint and reduction of the displaced bone fragments. Range of motion was improved and there were no complications. Conclusions This technique is an excellent alternative to the current method of treating patients with fracture-dislocations that include small fragments that are too small for pinning or screw fixation. It is a less invasive surgical method and enables stable reduction and early exercise without noticeable complications.

• Journal of Trauma and Injury
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• v.27 no.3
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• pp.57-62
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• 2014

Purpose: A hamate body coronal fracture is well known as a very rare fracture in the carpal bones and is also hard to diagnose in initial stage due to the bone's architecture. We report our experience in treatment of such a fracture, and we present a review of the relevant literatures. Methods: Four patients who experienced hamate body coronal fractures from October 2006 to October 2013 were enrolled in this study. One patient also had an associated Capitate fracture, and two patients had associated dislocations of the $4^{th}$ metacarpal joint. We performed open reduction and mini-screw fixation on the four patients. In addition, a K-wire was fixed for the two patients with dislocations. Results: The average follow-up period was 24.5 months after surgery, and bone union was observed at the $8^{th}$ week after surgery. We confirmed that bone union had been completed for all the patients, and functional tests showed that joint motion was in the normal range without complications. Conclusion: When a patient has consistent pain on the ulnar side of the wrist, a hamate fracture should be suspected. Computer tomography is better than a simple X-ray scan for confirming the diagnosis of a hamate body coronal fracture. An open reduction and mini-screw fixation led to a good result.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.33-37
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• 2009

Purpose: To evaluate the results of the compression plate fixation and autogenous bone graft in the management of humerus shaft nonunion. Materials and Methods: Eighteen cases were treated for humerus shaft nonunion using compression plate fixation and an autogenous iliac bone graft. The mean follow-up period was 28 months. Bony union was confirmed from the serial radiographs and the clinical outcomes were assessed according to ASES scoring system. Results: In 12 cases of initial plate fixation, the causes of nonunion were 6 cases of inadequate plate length, 2 with a broken plate, 2 with screw loosening, 1 infection and 1 noncompliance of a psychiatric patient. In 3 cases of initial intramedullary fixation, the cause of nonunion was a distraction of the fracture site. In 3 cases of external fixation, the cause of nonunion was inadequate fixation. All cases showed bony union after an average of 24 weeks. The clinical outcomes were 11 excellent, 6 good and 1 fair. Conclusion: In the treatment for nonunion, compression plate fixation with autogeneous bone graft after complete removal of the fibrous and necrotic tissue is believed to give satisfactory results.

• Corrosion Science and Technology
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• v.7 no.3
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• pp.162-167
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• 2008

Degradable implants have been in use for bone surgery for decades. However, degradable metal implants are one of the new research areas of biomaterials science. Magnesium has good biocompatibility due to its low toxicity, and it is a corroding, i.e. dissolvable, metal. Furthermore, magnesium is needed in human body, and naturally found in bone tissue. There have been some published reports also asserting the potential bone cell activation or bone healing effect of high magnesium ion concentrations. The classic method for achieving intertransverse process fusion involves autogenous iliac crest bone graft. Several investigations have been performed to enhance this type of autograft fusion. However, there is no research which has been undertaken to investigate the efficiency of pure magnesium particles in posterolateral spinal fusion. In this study, corrosion behavior of magnesium metal at the bone interface, the possibility of new bone cell formation and the degree of effectiveness in producing intertransverse process lumbar fusion in a sheep model have been investigated. Cortical bone screws were machined from magnesium alloy AZ31 extruded rod and implanted to hip-bones of sheep via surgery. Three months after surgery, the bone segments carrying these screws were removed from the sacrificed animals. Samples were sectioned to reveal Mg/bone interfaces and investigated using optical microscope, SEM-EDS and radiography. Optical and SEM images showed that there was a significant amount of corrosion on the magnesium screw. The elemental mapping results indicate, due to the presence of calcium and phosphorus elements, that there exists new bone formation at the interface. Furthermore, sixteen sheep were subjected to intertransverse process spinal fusions with pedicle screw fixation at various locations along their spines. Each animal was treated with 5cc autograft bone at one fusion level and 1cc magnesium+5cc autograft bone at the other. Six months after surgery, bone formation was evaluated by gross inspection and palpation, and radiological, histological, scanning electron microscopic and x-ray diffraction analyses. It may be stated that the potential for using useful corrosion of magnesium alloys in medical applications is expected to be significant.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.2
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• pp.81-87
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• 1998

Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.