• Journal of Korean Orthopaedic Sports Medicine
• /
• v.11 no.1
• /
• pp.62-65
• /
• 2012

Avulsion fractures of the intercondylar eminence of the tibia are uncommon. This kind of fracture is most commonly found in adolescents, with an increasing incidence for those involved in competitive athletics. Recently, an arthroscopic procedure is preferred to reduce the operation-related morbidity. Screws, K-wires, Suture anchor have been described as fixation devices. Cannulated screw fixation is a simple method, but this instrument has the risk of causing damage to the growth plate. The authors report good results using cannulated screw in arthroscopic treatment for pediatric anterior cruciate ligament avulsion fracture.

• Journal of Korean Foot and Ankle Society
• /
• v.13 no.2
• /
• pp.118-123
• /
• 2009

Purpose: We wanted to evaluate the relating factors for deformities of the foot after tibial fracture and the outcome of respective surgical treatment. Materials and Methods: We studied thirty-two patients (thirty-five feet) who had foot deformities after tibia fracture. The age, gender, shape, location, concurrent soft tissue injury and operative treatment of tibial fracture were analysed and outcome of the surgical treatment was investigated. Results: Deformities of the foot mostly occurred in open fractures of Gustilo type 3 or closed fracture with severe soft tissue injury. Variable surgical treatments such as simple release, lengthening, Z-plasty and osteotomy were performed. The AOFAS ankle-hind foot scale was improved from average of 37.3 points preoperatively to an average of 77.2 points at the last follow up. The Maryland foot score was from 42.9 to 90.2 and AOFAS Lesser Toe Metatarso-phalangeal interphalangeal scale was from 42.9 to 90.5. Radiological correction was also improved from 21.9 degrees to 7.9 degrees (Meary angle), from 112.2 to 138.5 (Hibb's angle) and from 33.8 to 25.9 (Calcaneal pitch). Conclusion: We proposed that great care should be taken of treatment for the tibial fracture and early detection and proper management of the foot deformities are crucial.

• Archives of Reconstructive Microsurgery
• /
• v.15 no.2
• /
• pp.58-64
• /
• 2006

Purpose: Management of soft-tissue defect after open tibial fractures includes immediate and repeated debridement, skeletal stabilization, and early soft-tissue coverage with muscle flaps. The purpose of this study was to evaluate the outcome of the free rectus abdominis muscle flap (RA flap) for treatment of open fractures of the tibia and to discuss its advantages compared with the latissimus dorsi muscle flap (LD flap) in poly trauma patients. Materials and Methods: We performed a retrospective review of 5 patients who had a severe (Gustilo IIIb or IIIc) open fracture of the tibia treated with RA flap from May 2003 to March 2006. All were men, and the mean age was 46.6 years (range, $28{\sim}68$). Three patients had combined injuries such as pelvic bone fractures, multiple rib fractures with hemothorax, and contralateral tibial fracture. All patients received RA flap within 7 days after trauma except two with established chronic osteomyelitis. Results: All flaps survived, and there was no marginal flap necrosis. During the follow-up period, there was no evidence of persistent or recurrent osteomyelitis. The size of RA flap ranged from $8{\sim}20\;cm$ in length and $6{\sim}10\;cm$ in width. The average time required for RA flap elevation was 32 minutes, which is shorter than LD flap. Flap elevation could be done in supine position which is essential in poly trauma patients. Conclusion: Although a wide variety of options are available, RA flap is regarded as an optimal method for coverage of soft-tissue defect of the open tibial fracture in poly trauma patients. LD flap is reserved for large sized soft-tissue defect which cannot be covered by RA flap.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.39 no.6
• /
• pp.257-262
• /
• 2013

Objectives: Oral and maxillofacial defects often require bone grafts to restore missing tissues. Well-recognized donor sites include the anterior and posterior iliac crest, rib, and intercalvarial diploic bone. The proximal tibia has also been explored as an alternative donor site. The use of the tibia for bone graft has many benefits, such as procedural ease, adequate volume of cancellous and cortical bone, and minimal complications. Although patients rarely complain of pain, swelling, discomfort, or dysfunction, such as gait disturbance, both patients and surgeons should pay close attention to such after effects due to the possibility of tibial fracture. The purpose of this study is to analyze tibial fractures that occurring after osteotomy for a medioproximal tibial graft. Materials and Methods: An analysis was intended for patients who underwent medioproximal tibial graft between March 2004 and December 2011 in Inha University Hospital. A total of 105 subjects, 30 females and 75 males, ranged in age from 17 to 78 years. We investigated the age, weight, circumstance, and graft timing in relation to tibial fracture. Results: Tibial fractures occurred in four of 105 patients. There were no significant differences in graft region, shape, or scale between the fractured and non-fractured patients. Conclusion: Patients who undergo tibial grafts must be careful of excessive external force after the operation.

• Journal of Trauma and Injury
• /
• v.29 no.3
• /
• pp.76-81
• /
• 2016

Purpose: The purpose of this study was to compare the data comprehensively including not only the clinical and radiographic outcomes but some parameters related to operation between the minimally invasive plate osteosynthesis (MIPO) technique and intramedullary nailing (IMN) for treatment of segmental tibia shaft fractures. Methods: We conducted a retrospective study of 31 patients (mean age, 49.3 years, range, 27-74 years), with a mean follow-up of 14.1 months (range, 12-19 months) with acute segmental tibial fractures (AO 42-C2) who underwent either surgical treatment of MIPO or IMN. In accordance with the Gustilo-Anderson classification, 11 were type I, 5 were type II, and 15 were type III. Initial compartment syndrome was confirmed in 2 cases. Results: There were no statistically significant differences in terms of the patient demographic data between the two groups. The time to definitive fixation was longer in the MIPO group (mean $13.7{\pm}10.9days$; range, 2-27) than in the intramedullary group (mean $5.4{\pm}9.6days$; range, 0-35) with statistically significant difference (p=0.002). Bony union was observed in most of cases but except 5 cases of nonunion were diagnosed (3 in the MIPO vs 2 in IMN, p=0.188). The average bone healing time was 27.1 weeks (10 to 56 weeks) in MIPO group and 23.2 weeks (13 to 66 weeks) in IMN group, respectively (p=0.056). Overall complications were 5 cases in MIPO group and 2 cases in the IMN group. Difference in LEFS was not statistically significant between both groups (p=0.824). Conclusion: This study showed that segmental tibia shaft fractures treated with both MIPO and intramadullary nailing was challenging with relatively high complication rate. A well planned sequential strategy with keeping the soft tissue and personality of fracture in mind is utmost significant as much as the choice of surgical modalities.

• Journal of Korean Foot and Ankle Society
• /
• v.27 no.3
• /
• pp.87-92
• /
• 2023

Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

• Journal of the Korean Society for Precision Engineering
• /
• v.21 no.6
• /
• pp.188-196
• /
• 2004

The objective of this paper is to propose a new technology of the orthopaedic surgery using the combination of reverse engineering (RE) based on CT data and rapid prototyping (RP). The proposed technology utilizes symmetrical characteristics of the human body and capability of the combination of RE and RP, which rapidly manufactures three-dimensional parts from CT data. The original .stl data of injured extents are generated from the mirror transformation of .stl file fur uninjured extents. The physical shape before injuring is manufactured from RP using the original .stl data. Subsequently, pre-operative planning, such as a selection of proper implants, preforming of the implant, a decision of fixation locations and an insert position for the implant, an estimation of the invasive size, and pre-education of operators are performed using the physical shape. In order to examine the applicability and the efficiency of the proposed surgical technology, various case studies, such as a distal tibia commented fracture, a proximal tibia plateau fracture and an iliac wing fracture of pelvis, are carried out. From the results of case studies, it has been shown that the proposed technology is an effective surgical tool of the orthopaedic surgery reducing the operational time, the operational cost, the radiation exposure of the patient and operators, and morbidity. In addition, the proposed technology could improve the accuracy of operation and the speed of rehabilitation.

• Composites Research
• /
• v.22 no.3
• /
• pp.29-34
• /
• 2009

In this paper, finite element analyses were used to estimate the strain distribution at the fracture site of a tibia bone. A stainless steel bone plate and various composite bone plates were considered to find out the best conditions for callus generation while bone fracture was cured for 16 weeks. Through this research, the appropriate load condition which makes the strains between the appropriate range($2{\sim}10%$) was sought. From this analysis, it was found that lower level of external load is needed for the appropriate strain for the case of composite bone plate application and it was also found that the composite bone plate had potential advantages for effective bone fracture healing relieved stress shielding effect.

• Journal of Veterinary Clinics
• /
• v.29 no.2
• /
• pp.198-201
• /
• 2012

A one-month-old, male Hanwoo calf was presented to Chonbuk Animal Medical Center with non-weight bearing lameness on its right hindlimb. The radiograph and CT scan showed a Salter-Harris III fracture at the distal tibia. Following open reduction, the fracture was stabilized by cross-pins. A temporal external skeletal fixator was used as an additional support for 5 weeks. 5 weeks after surgery, bone fracture had successfully healed with no complication. At 2 years after surgery, the calf could walk almost normally although intermittent weight-bearing lameness after active exercise. This is a rare case that the combined use of temporal external fixation and cross-pins fixation was sufficiently effective for treating a distal tibial physeal fracture in a calf.

• Journal of Korean Medicine Rehabilitation
• /
• v.30 no.4
• /
• pp.1-16
• /
• 2020

Objectives The main purpose of this study was to evaluate the bone healing effect of Pahyeolsandong-tang (PHT)(Poxiesanteng-tang) extract in tibia fracture-induced mice. Methods PHT was extracted using a solution of 35% ethanol in 60℃ for 8 hours. Mice were randomly divided into 4 groups (normal, control, PHT 50 and PHT 100). Mice of experimental groups were medicated with PHT 50 or 100 mg/kg for 7 to 21 days. To clarify the effect of bone fracture healing, relative messenger RNA (mRNA) expressions of osteocalcin (OCN), runt-related transcription factor 2 (Runx2), osterix (OSX), Sox9, collagen type II alpha 1 chain (Col2a1), receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG) were examined. Results In in vitro experiment, relative mRNA expression of OCN, Runx2, Col2a1 was significantly increased in PHT treated group to compare with control differentiation group. In in vivo experiment, relative mRNA expression of OCN, Runx2, OSX, Sox9, Col2a1, RANKL, OPG was significantly increased in PHT treated group. Conclusions This study showed that PHT accelerates bone fracture healing through the activation of osteoclasts and osteoblasts. It was showed that PHT significantly promotes osteoblasts differentiation by osteoblast differentiation markers such as OCN, Runx2, Col1a2. Also it was investigated that PHT had stimulatory effect on osteoblasts function through enhancing OCN, Runx2, OSX, Sox9, Col2a1 and, osteoclasts function through enhancing RANKL and OPG markers. PHT effectively promotes bone fracture healing process through activation of osteoblasts and osteoclasts.