• 한방재활의학과학회지
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• 제29권4호
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• pp.1-14
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• 2019

Objectives The object of this study was to assess the effect of Gyejibokryunghwan (GBH) on anti-oxidant and anti-inflammatory activities in RAW 264.7 cells and on factors associated with fracture union in tibia-fractured rats. Methods The 1,1-diphenyl-2-picryl-hydrazyl (DPPH) radical scavenging activity was measured to assess anti-oxidant activity. The production of nitric oxide (NO), interleukin-6 (IL-6), interleukin-$1{\beta}$ ($IL-1{\beta}$) and tumor necrosis factor-${\alpha}$ ($TNF-{\alpha}$) in the RAW 264.7 cells were measured to assess anti-inflammatory activity. The production of osteocalcin, calcitonin, carboxy-terminal telepeptides of type II collagen (CTXII), transforming growth factor-${\beta}$ ($TGF-{\beta}$), bone morphogenetic protein-2 (BMP-2) in serum of tibia-fractured rats were measured to assess the effects of fracture union. X-rays were taken every two weeks from 0 to 4th week to assess fracture union effect. Results DPPH radical scavenging activity of GBH was increased according to concentration of GBH in RAW 264.7 cell. NO, prostaglandin $E_2$ ($PGE_2$), IL-6, $IL-1{\beta}$ and $TNF-{\alpha}$ were significantly decreased, indicating anti-inflammatory effect. Osteocalcin, calcitonin, $TGF-{\beta}$ were significantly increased in the experimental groups. CTXII was significantly decreased in the experimental groups. BMP-2 was not significantly changed in the experimental groups. The X-ray showed that the experimental group has better healing effects on tibia-fractured rats than control group. Conclusions From above result, GBH has an effect on anti-oxidant, anti-inflammatory activities in RAW 264.7 cells. GBH showed significant results in factors related with fracture union and radiologic examination. In conclusion, GBH can help fracture union and it well be expected to be used actively in clinics.

• PNF and Movement
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• 제16권3호
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• pp.317-332
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• 2018

Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

• 대한족부족관절학회지
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• 제12권1호
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• pp.86-92
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• 2008

Purpose: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. Materials and Methods: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. Results: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. Conclusion: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2011년도 춘계학술대회 논문집
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• pp.1453-1454
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• 2011

• 대한족부족관절학회지
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• 제15권1호
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• pp.32-35
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• 2011

Fibrous dysplasia is a benign disease that causes replacement of the medullary bone with fibrous tissue in one or more bones. Long bone like femur, tibia and fibular are often affected and occurring under 30 years old. We report a case of two solitary lesions of fibrous dysplasia with pathologic fracture treated with bone curettage, bone graft, plate fixation, who complains of lower leg pain.

• 한방재활의학과학회지
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• 제30권3호
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• pp.141-149
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• 2020

Objectives The purpose of this study is to find the effect of Korean medicine treatments on pain reduction and range of motion recovery in patients with proximal tibia fractures. Methods We studied 15 patients who had been diagnosed as proximal tibia fracture. This study was conducted as retrospective observational study which analyzed patient's medical records with IBM SPSS statistics 25 program. We used numeric rating scale to evaluate pain reduction and range of motion to observe the patient's recovery. Results The average of numeric rating scale reduced statistically significantly from 5.26±1.38 to 2.73±1.17 (p<0.001). The average of knee flexion range of motion increased statistically significantly from 81.11±34.34 to 117.66±19.01 (p<0.01). Conclusions We found that Korean medicine treatments have a positive effect on pain reduction and knee rom improvement in patients with proximal tibia fractures.

• 대한족부족관절학회지
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• 제19권3호
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• pp.86-90
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• 2015

Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

• 대한족부족관절학회지
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• 제23권3호
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• pp.110-115
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• 2019

Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2009년도 춘계 종합학술대회 논문집
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• pp.1124-1129
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• 2009

골절 후 골 유합에 대한 미세직류전류 자극의 효과를 관찰하기 위하여 체중 2.5~3 ㎏내외의 6개월 령 뉴질랜드 웅성토끼 24마리를 대상으로 경골 골절 후 미세전류 자극을 적용한 실험군과 비적용군인 대조군으로 나누어 3일, 7일, 14일 및 28일 후 BMP-4에 대한 면역조직화학적 염색을 실행하여 다음과 같은 결론을 얻었다. BMP-4의 발현은 비침습식 미세전류를 적용한 실험군과 자연치유군인 대조군 모두 시간이 경과함에 따라 통계학적으로 유의하게 증가하다가 감소되었다. 그러나 실험군에서 경골 골절 3일 후 대조군은 하버씨계의 간질층판을 중심으로 약한 갈색의 면역양성반응(+)을 보였으나 실험군의 경우 중등도의 면역양성반응(++)을 보였다. 경골 골절 7일 후 대조군은 하버씨계의 동심원과 간질층판을 중심으로 중등도의 갈색의 면역양성반응(++)을 보였으나 실험군의 경우 바깥층판을 포함하여 매우 강한 갈색의 면역양성반응(++++)을 보였다. 경골 골절 14일 후 대조군은 하버씨계의 간질층판과 동심원을 중심으로 강한 갈색의 면역양성반응(+++)을 보였으며 실험군 또한 강한 면역양성반응(+++)을 보였다. 그 후 점차 감소하여 경골 골절 28일 후 대조군은 하버씨계의 간질층판을 중심으로 약한 갈색의 면역양성반응(+)을 보였으나 실험군의 경우 중등도의 면역양성반응(++)을 보였다. 위의 결과로 보면 골절 후 미세전류를 비침습적으로 적용할 때 치유과정 초기에 골형성단백질인 BMP-4의 발현을 증가시켜 골절 치유를 촉진시킴을 알 수 있다.

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.388-399
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• 1993

1983년 2월부터 1993년 5월까지 저자들이 interlocking IM nail정을 이용하여 치료한 경골 골절을 평균 14개월 추시하여 다음과 같은 결론을 얻었다. 1. 총 38례 중 37례에서 골유합을 이루어 97.3%의 골유합율은 보였으며 평균골유합기간은 18.7주였다. 2. 금속정의 사용 범위는 경골 간부 및 근위부나 원위부 골절에서 만족할 만한 결과를 얻었다. 3. interlocking nail은 심한 분쇄성 골절, 개방성 골절, 골소실이 있는 개방성 골절 동에서 견고한 고정을 얻을 수 있었다. 4. 불유합 및 지연유합된 경우 모두 골유합을 이루어 나사못 맞물림을 이용한 금속정 고정법은 경골 간부 골절에서 훌륭한 치료법으로 생각된다. 5. 가장 중요한 합병증은 Valgus 각형성 2례 및 varus 1례와 심부감염 1례 등이었다. 6. 금속정은 고정력이 견고하여 조기 관절운동 및 보행이 가능하여 관절 강직이나 근위축을 방지할 수 있었다.