• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2006년도 제4차 연수강좌
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• pp.175-186
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• 2006

$\cdot$ Many authors have advocated surgical tx. for type II because of high risk of nonunion.$\cdot$ But, in a few reports, no correlations between the nonunion and functional disability.$\cdot$ Reconstruction of integrity of the CC lig. (encircling suture) is important for rapid fracture healing.

• Archives of Reconstructive Microsurgery
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• 제16권1호
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• pp.6-13
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• 2007

Purpose: To report the clinical results of the vascularized fibular graft in the treatment of intractable infected nonunion of femur. Materials and Methods: We reviewed 3 patients who were performed vascularized fibular graft in treated for intractable infected nonunion of femur. They had received an average of 5.6 times($4{\sim}8\;times$) surgical treatment at different hospitals. 1 case was of a infected nonunion in a fracture treated with internal fixation, the fracture having occurred after resection of a malignant tumor and transplantation of pasteurized autologous bone. 2 cases occurred after internal fixation in closed fractures. Surgical treatment was performed an average of 4 times($3{\sim}5\;times$) at our hospital and in all of the cases debridement of necrotic tissue and sequestrectomy. And vascularized fibular graft was performed. In all cases unilateral external fixation devices were used, of these, 1 case was changed into internal fixation. The final conclusion was made by assessment of functional outcomes and complications according to the standards of Paley. Results: As a result, in all of the cases bone union was achieved, and in the last follow up the functional results were excellent in 2 cases and good in 1 case. There were not presented leg length discrepancy of more than 2 cm, and further loss of knee joint motion. After previous treatment, average 23.3 months($16{\sim}30\;months$) was taken to eliminate infection and achieve complete bone union via vascularized fibular graft in our hospital. Conclusion: In treatment of intractable infected nonunion of femur, fairly good results can be expected after firm fixation, through debridement and vascularized fibular graft.

• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.87-91
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• 2012

족무지 종자골의 불유합은 주로 스트레스 골절의 후유증으로 나타나며 보존적인 치료에도 증상이 지속되는 경우 수술이 시도될 수 있다. 저자들은 과사용 후에 족무지의 내측 이분 종자골 및 외측 종자골에 동시에 발생한 스트레스 골절의 드문 예를 경험하였으며, 석고 고정에 치료되지 않은 내측 종자골의 불유합에 대해서는 소파 및 골이식술을 이용하여 만족할 만한 결과를 얻었기에 그 결과를 보고하는 바이다.

• 대한관절경학회지
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• 제10권2호
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• pp.192-198
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• 2006

소아에 있어서 경골 극 골절은 좋은 예후를 보인다. 하지만 드물게 증상이 있는 불유합이 발생하며, 골절의 정복과 골이식으로 치료한 경우가 보고되고 있다. 저자들은 8세 소아의 경골 극 골절 Mckeever 제 2형을 장하지 석고 고정을 이용한 보존적 치료를 하였으나, 불유합된 2 례를 관절경하 정복술 및 내고정술로 치료하여 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.

• 대한정형외과 초음파학회지
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• 제4권2호
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• pp.66-71
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• 2011

목적: 보존적인 치료를 시행 받은 쇄골 골절 환자 중 단순 방사선학적 검사에서 가골 형성이 관찰 되지 않아 지연유합이나 불유합이 의심되는 경우 초음파 검사가 가골 형성여부를 확인하는 검사로서 유용한 가를 알아보고자 하였다. 대상 및 방법: 쇄골 골절로 진단되어 보존적인 치료를 시행 받았으나, 불유합 또는 지연 유합이 의심되는 여섯 명의 남자와 한 명의 여자 환자(평균 38.3세; 범위: 7~70세)를 대상으로 초음파를 시행하였다. 초음파 검사상 가골 형성이 관찰된 경우는 보존적 치료를 지속하였고, 가골 형성이 관찰 되지 않은 경우는 수술적 치료를 시행하였다. 결과: 초음파 검사상 가골 형성을 관찰 할 수 있었던 6예는 보존적인 치료를 지속하여 최종 추시 단순 방사선 검사상 골유합을 확인 할 수 있었다. 초음파 검사상 가골 형성이 관찰되지 않았던 1예는 수술적 치료를 시행하였으며, 수술소견상 골유합 소견을 관찰할 수 없었다. 결론: 초음파 검사는 보존적 치료를 받는 쇄골 골절 환자에서 임상적 및 방사선학적으로 불유합 또는 지연 유합이 의심되는 경우 가골 형성을 평가하는데 있어 유용한 검사 방법으로 불필요한 수술을 피하는 데 기여할 수 있을 것으로 생각한다.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.65-69
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• 2023

The surgical approach for humeral implant failure can be challenging due to neurovascular anatomy and the possible necessity of osteosynthesis removal. We present a rare case of humeral nail bending after secondary trauma in a patient with preexistent nonunion of the humerus after intramedullary nailing. During revision surgery, the nail was sawed in half and the distal part was removed, followed by plate osteosynthesis with cable fixation to achieve absolute stability. The patient regained a full range of motion 1 year after surgery, and complete healing of the fracture was seen on imaging.

• Clinics in Shoulder and Elbow
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• 제8권1호
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• pp.19-22
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• 2005

Purpose: The causes of twelve cases of the mid-shaft clavicle nonunion and the results of internal fixation with plate and bone graft were investigated. Materials and method: From August 1997 to March 2003, twelve cases of the mid-shaft clavicle nonunion were operated with internal fixation with plate and bone graft. The duration of follow-up was average 13 months. Results: The causes of the mid-shaft clavicle nonunion included severe associated injury, severe initial displacement of the fracture fragments and insecure fixation. All cases were operated with internal fixation with plate and bone graft. According to the factor for evaluations of results, using a rating scale of excellent (no apparent factors), good (one factor), fair (two factors), poor (more than three factors), the results showed 10 excellent, 1 good and 1 poor. Screw loosening was developed in only one case . Conclusion: The internal fixation with plate and bone graft of the mid-shaft clavicle nonunion after failed conservative treatment achieved excellent results and seemed to be the procedure of choice for mid-shaft clavicle nonunion.

• Molecules and Cells
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• 제43권6호
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• pp.517-529
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• 2020

Carboxyl-terminal binding proteins (CtBPs) are transcription regulators that control gene expression in multiple cellular processes. Our recent findings indicated that overexpression of CtBP2 caused the repression of multiple bone development and differentiation genes, resulting in atrophic nonunion. Therefore, disrupting the CtBP2-associated transcriptional complex with small molecules may be an effective strategy to prevent nonunion. In the present study, we developed an in vitro screening system in yeast cells to identify small molecules capable of disrupting the CtBP2-p300 interaction. Herein, we focus our studies on revealing the in vitro and in vivo effects of a small molecule NSM00158, which showed the strongest inhibition of the CtBP2-p300 interaction in vitro. Our results indicated that NSM00158 could specifically disrupt CtBP2 function and cause the disassociation of the CtBP2-p300-Runx2 complex. The impairment of this complex led to failed binding of Runx2 to its downstream targets, causing their upregulation. Using a mouse fracture model, we evaluated the in vivo effect of NSM00158 on preventing nonunion. Consistent with the in vitro results, the NSM00158 treatment resulted in the upregulation of Runx2 downstream targets. Importantly, we found that the administration of NSM00158 could prevent the occurrence of nonunion. Our results suggest that NSM00158 represents a new potential compound to prevent the occurrence of nonunion by disrupting CtBP2 function and impairing the assembly of the CtBP2-p300-Runx2 transcriptional complex.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.289-289
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• 2009

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.18-22
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• 2001

Purpose : The purpose of this study was to evaluate stress fracture of vascularized fibular grafts(VFG) by analyzing factors associated with stress fracture and the treatment results. Materials and Methods : From June 1985 to May 1998, 7 patients with stress fractures in the 38 patients with long bone defect who had vascularized fibular graft were evaluated with clinical and radiologic methods including grafted fibular length and hypertrophic index of de Boer. The average age of the patients was 35 years(range, $14{\sim}60$ years). The mean follow-up period was 20 months(range, $16{\sim}32$ months). Results: 7(18.4%) stress fractures occurred in 38 patients. Characteristics of the fractures were (1) all occurred at lower extremity of male patients treated with VFG for long bone defected caused by infected nonunion; (2) all occurred 10 months at the average(range, $4{\sim}17$ months) after VFG; and (3) the length and hypertrophic index of grafted fibula had no influence on the incidence of stress fracture. Union was obtained in 3 patients by conservative treatment. 4 patients obtained union by internal fixation; one at immediately onset of fracture; and three after failure of conservative treatment who had fracture around the knee joint. Conclusion : Stress fracture may occur during the first one year after vascularized fibular graft and more attention must be paid for prevention of it, especially in the cases of infected nonunion. Stress fracture around the knee joint was expected to lead to a good result of early union by operative treatment.