• Journal of Korean Medicine Rehabilitation
• /
• v.30 no.2
• /
• pp.47-66
• /
• 2020

Objectives The purpose of this study is to evaluate the bone healing effect of Dohongsamul-tang (Taohongsiwu-tang; DH) on femur fractured mice. Methods Mice were randomly divided into 4 groups (naive, control, positive control and DH). All groups except naive group were subjected to bone fracture on both hind limb femurs. Naive group received no treatment at all. Control group was fed with normal saline, and positive control group was orally medicated with tramadol. DH-treated group was orally medicated with DH. We analysed the levels of BMP2, COX2, Col2a1, Sox9, Runx2, and Osterix genes on 3, 7 and 14 days after fracture. Alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, total cholesterol, and triglyceride levels were measured for safety assessment. Results In morphological, histological analysis, callus formation process of DH-treated group was faster than the control group. BMP2, Sox9 gene expression were significantly increased at 7 days after fracture compared to the control group. COX2, Col2a1 gene expression were significantly increased at 14 days after fracture compared to the control group. Total cholesterol was significantly increased by DH at 3 days. Triglyceride was significantly decreased by DH at 3, 7 days after fracture compared to the control group. Conclusions Dohongsamul-tang promoted bone healing process after fracture by stimulating the bone regeneration factors. And DH shows no hepatotoxicity, nephrotoxicity and serum lipid abnormality. In conclusion, it seems that DH helps to promote fracture regeneration after bone fracture by regulating gene expressions related to bone repair.

• Journal of Veterinary Clinics
• /
• v.35 no.6
• /
• pp.269-272
• /
• 2018

A 4-year-old, 6.1 kg intact female dachshund was referred to the Animal Medical Center with acute right hind limb lameness. Radiographs revealed fractures of iliac body and tibia in the right limb. In addition, the dog exhibited tricuspid valve regurgitation and moderate heartworm infection in the right ventricle and main pulmonary artery on echocardiogram. To obtain stable anesthetic conditions for operation, an adult heartworm removal procedure was previously followed by repair of the complex fractures. All surgical procedures were done without complication and with stable patient conditions. At a one month postoperative follow-up, the dog was doing well with normal ambulation and no tricuspid valve regurgitation as well.

• Journal of Veterinary Clinics
• /
• v.25 no.5
• /
• pp.408-410
• /
• 2008

A four months old, 3.6 kg intact female Miniature Dachshund dog was referred for non-weight bearing lameness at right hind limb due to car accident. On physical examination, the patient was non-weight bearing on the right hind leg and had moderate swelling in the proximal to middle tibia region. There was palpable crepitus. Radiographs revealed a slightly displaced, spiral, oblique fracture involving the proximal diaphyseal region of the right tibia. Fibular fracture was also noted. Internal fixation was performed to repair the fracture. Due to bowed shape of fractured tibia, it was not possible to apply K-wire, containing appropriate diameter ($60{\sim}80%$ of bone marrow diameter) for intramedullary fixation. We fixed the bowed tibia fracture using a smaller diameter (30% of bone marrow diameter) K-wire with cross pins and cerclage wires. Four weeks after the operation, radiographs demonstrated healing of the tibia fracture as well as the fibular fracture.

• Journal of Korean Foot and Ankle Society
• /
• v.14 no.2
• /
• pp.165-168
• /
• 2010

Purpose: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. Materials and Methods: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. Results: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p <0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p <0.05). Conclusion: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.

• Journal of Veterinary Clinics
• /
• v.28 no.1
• /
• pp.179-182
• /
• 2011

Two day-old male and 1 month-old female Hanwoo calves presented to Chonbuk Animal Medical Center in Chonbuk National University. Two calves were stepped by mother cow and had right (2 day-old male) and left (1 month-old female) forelimb lameness. The male calf was diagnosed as right radius-ulnar fracture through physical and radiographic examination. The other female calf was diagnosed as left third and fourth metacarpal bone fracture by the same examinations as male calf. Acrylic frame external fixator was used to reduce the fractures. Arcrylic frame external fixator in two calves lasted for 5~6 weeks. After removing the acrylic frame external fixator, radiographic evaluation and physical examination were performed. Fractured radius-ulnar and metacarpal bones were unionized and the calves were able to stand and bear weight. In these two calves, application of acrylic frame external fixator in calf fracture was effective. Acrylic frame external fixator should be considered for the repair of radius-ulnar and metacarpal bone fracture in calf.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.7 no.1
• /
• pp.8-14
• /
• 2008

Elbow joint injuries during exercise mostly occur by repeated stress to the joint than direct trauma. A pitcher who uses his arm above his head is most likely to be injured. So learning the right way to exercise and gaining the strength by maturating the body are essential for diminishing the chance of injury. On lateral ulnar tendon injury, which is most commonly injured area on elbow joint, pitchers generally complain of pain in arm movement above head and reduction of velocity, accuracy, and number of pitching. When there is pain on upper arm in harsh using, the stress fracture must be thought and epicondylar physis fracture of medial arm can occur by repeated abduction stress and contraction of flexors on forearm on children with immature skeleton. Osteochondritis dissecans of capitullum occur in young athletes who use there upper limb continuously lifting weights and gym work. And stress of abduction-extension includes damage of soft tissue and bone components, post medial crush syndrome, lateral ulnar ligament injury, extensor-abductor injury, stress of radius- capitullum are in this category.

• Journal of Veterinary Clinics
• /
• v.31 no.6
• /
• pp.523-526
• /
• 2014

Three dogs were admitted for repair of bone fracture. Case 1 (Maltese, 1.8 kg, intact female, 5-month-old) and case 2 (poodle, 3.0 kg, intact female, 6-month-old) had non-weight bearing lameness in the left pelvic limb, and case 3 (mixed, 3.3 kg, intact female, age unknown) had non-weight-bearing lameness in the left thoracic limb. On orthopedic examination, there was pain, crepitus, palpable instability and substantial soft tissue swelling on the affected side. No neurological deficits were identified. Radiographs revealed left proximal metaphyseal tibial and fibular fractures in cases 1 and 2, and left proximal metaphyseal radial and ulnar fractures in case 3. All cases had closed long-bone fractures with short juxta-articular fracture segments. Under fluoroscopic guidance, proper placement of the ring fixation elements was confirmed during surgery. Two or three rings were used to stabilize fractures with traditional circular external skeletal fixators (CESF). Postoperative radiographs showed acceptable alignment and apposition of the previously identified fracture. Time to radiographic union ranged from 5 to 14 weeks and there were no signs of implant failure or pin tract infection. Functional outcomes were excellent in all cases. CESF can be successfully used to reduce short juxta-articular fractures in which bone plates or external skeletal fixation cannot be applied.

• PNF and Movement
• /
• v.16 no.1
• /
• pp.151-159
• /
• 2018

Purpose: The aim of this study was to examine the activation of the contralateral upper and lower extremities and trunk muscle during ipsilateral upper extremity diagonal isokinetic exercise. Methods: Twenty-one healthy male subjects with no history of shoulder injury undertook ipsilateral diagonal isokinetic exercise at 60, 120, and $180^{\circ}/sec$, utilizing a standard Biodex protocol. Muscle activation amplitudes were measured in the upper trapezius, pectoralis major, biceps brachii, rectus abdominis, external oblique, rectus femoris, adductor longus, and biceps femoris muscles using electromyography. A one-way analysis of variance and paired t-tests were conducted, and the data were analyzed using SPSS, version 21.0. Results: The results revealed no statistically significant interaction between motion and angular velocity and no statistically significant contralateral muscle activation according to angular velocity (p>0.05). However, they revealed statistically significant contralateral muscle activation according to motion (p<0.05). Conclusion: These results suggest that the movements involved in contralateral upper extremity diagonal isokinetic exercise can enhance muscle strength in patients affected by stroke, fracture, burns, or arthritis.

• The Journal of the Korean bone and joint tumor society
• /
• v.20 no.1
• /
• pp.7-13
• /
• 2014

Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

• The Journal of the Korean bone and joint tumor society
• /
• v.1 no.2
• /
• pp.154-163
• /
• 1995

With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.