The potential for nerve regeneration and recovery of its function exists in the presence of a suitable pathway for regenerating axon and endoneurial tube can serve as nerve conduit for regenerating axon in fresh nerve graft. But value of degenerated nerve as donor nerve has not been established till now. This experiment assessed the chronologic influence of fresh and degenerated nerve graft on axonal growth for 10mm gap of sciatic nerve in rabbit and how long degenerated nerve was ahle to serve as a nerve conduit microscopically. Electromicroscopically, the regenerating axons which were ohserved in the degenerated nerve graft had more abundant unmyelinated fibers and revealed abundant collagen fibers in the endoneurium. And these regenerating axons became gradually surrounded with newly developed basal lamina and decreased the collagen fibers at l2 week of degenerated nerve graft. Histologically, myelinated axons which were observed in central area of the degenerated nerve graft at 8 week of degenerated nerve graft were relatively thinner, but a definite structural difference of regenerating axons was not found except reduction of number compared with those of tresh nerve graft. The numher of myelinated axons was 6,072+/-l42 in normal sciatic nerve, 4,479+/- 157 in fresh nerve graft group, and 2,968+/-168 in the degenerated nerve graft group. Difference of the number of myelinated axons between fresh and degenerated nerve graft group was significant stati stically(P<0.05). These results showed that the ability of a degenerated nerve graft as a passage for the regenerating axons and it can be employed as one of the favorable nerve conduits.
Axons ; Basement Membrane ; Collagen ; Humans ; Myelin Sheath ; Nerve Regeneration ; Peripheral Nerves ; Sciatic Nerve* ; Tissue Donors ; Transplants*

Interleukin 1(IL-1), a 17.5 KD glycoprotein, is known to be associated with local bone resorption. In the present study, we examined the effects of IL-1, compared with insulin and parathyroid hormone (PTH), on DNA, protein and collagen synthesis in UMR-106-01 rat osteoblastic osteosarcoma cells. When 200 units/mL IL-1 was administered to UMR-106-01 cells, [3H]-thymidine uptake increased to 119% of the untreated control. But when 10 nM insulin was added to the cells, [3H]- thymidine uptake increased to 130% and when 1 nM PTH was added, the uptake decreased to 89% of the control. On the other hand, protein and collagen synthesis, measured by [3H]-leucine and [3H]-proline incorporation respectively, were not affected by IL-1 administration compared to the other hormones. These results indicate that IL-1 effects osteoblast-like cells, stimulating DNA synthesis via a different mechanism to the well-known cell growth factor, insulin.
Animals ; Bone Resorption ; Cell Proliferation* ; Collagen ; DNA ; Glycoproteins ; Hand ; Insulin ; Interleukin-1* ; Interleukins ; Osteoblasts ; Osteosarcoma ; Parathyroid Hormone ; Rats ; Thymidine

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

Authors reviewed 28 cases of displaced acetabular fracture treated operatively from Februay 1991 to January 1996 and followed up more than 1 year. The clinical results were retrospectively analyzed with consideration of surgical problems and complications. The results were as follows; 1. According to Letournels classification, we had 16 elementary fractures(57%) and 12 associated fractures(43%). 2. Kocher-Langenbeck approach in 16 cases, ilioinguinal in 9 cases, extended iliofemoral 2 cases and combined approach in 1 case were used. 3. The devices for internal fixation were as follows: screw only in 12 cases(elementary fracture 9cases, associated fracture 3 cases), plate and screw in 16 cases(elementary fracture 7 cases, as-sociated fracture 9 cases). 4. There were complications such as 3 degenerative arthritis, 2 superficial wound infection, 1 iatrog-enic sciatic nerve palsy and 1 avascular necrosis of femoral head and no postoperative heterotro-phic ossification. 5. Satisfactory reduction by radiologic criteria was gained in 23 cases(82%). Satisfactory results by clinical criteria(by dAubigne & Postels) was gained in 21 cases(75%). Only 2 patient with a satisfactory radiologic reduction was clinically unsatisfactory. It seems that the satisfactory operative reduction of the fracture is the factor that correlates best with a satisfact-ory clinical result.
Acetabulum* ; Classification ; Head ; Humans ; Necrosis ; Osteoarthritis ; Retrospective Studies ; Sciatic Neuropathy ; Wound Infection

Nine scaphoid non-unions, which were treated by through curettage of the scar tissue on pseudarthrosis, iliac bone grafts between the fragments and Herbert screws fixation, were analysed. The average follow up period from operation was 16.9 months. The interval between the fracture and the time of the operation ranged from 10 months to 48 months(average 21.6 months). Average union time was 14 weeks after operation. The initial radiologic cystic changes disappeared and overall clinical results were improved. Mean postoperative range of motion of the wrist was flexion 55 and extension 45°. Three of them had DISI deformity preoperatively which their scapholunate angles (mean 104°) has been corrected after reduction (mean 75°). In one case among three DISI deformities, partial radial styloidectomy and triscaphe fusion were added (to bone graft and Herbert screw fixation). A case of incorrect positioning of the screw and a case of neuroma were complicated. Treatment of scaphoid nonunion with curettage of the scar tissue and iliac bone graft and Herbert screw fixation seems to be encouraging to regain the normal anatomy of scaphoid and function of the wrist.
Cicatrix ; Congenital Abnormalities ; Curettage ; Follow-Up Studies ; Neuroma ; Pseudarthrosis ; Range of Motion, Articular ; Transplants ; Wrist

Purpose: To evaluate the value of an open wedge high tibial osteotomy (HTO) using a Locking Compression Plate(R) (LCP(R)) as a surgical technique. Materials and Methods: From May, 2003 to January, 2005, eleven open wedge HTO using LCP(R) were performed and the average follow-up period was 17.8 months. The knee score and function score for the clinical results, and the degree of varus deformity, the size of the joint space, the posterior tibial slope and the medial instability for radiography results were evaluated. Results: The knee score improved from 54.8 points to 95.9 points, and the function score improved from 57.3 points to 88.2 points. The femorotibial angle was corrected from 4.1degrees varus to 9.9degrees valgus. The posterior tibial slope did not show any significant change. The size of the joint space increased from 3.3 mm to 4.3 mm. No medial instability was observed. Conclusion: An open wedge HTO using LCP(R) achieved a corrected angle, reduced loss of the corrected angle, and an improved knee function. The surgical technique prevented the posterior tibial slope from increasing.
Congenital Abnormalities ; Follow-Up Studies* ; Joints ; Knee ; Osteotomy ; Radiography

PURPOSE: To evaluate prognostic factors for arthritis and usefulness of bone SPECT in reconstructed joint. MATERIAL AND METHOD: ACL reconstruction using bone-patellar tendon-bone graft was performed in fourteen patients from March 1996 to March 1997, and follow-up bone SPECT was done. The mean duration from ACL reconstruction to SPECT was 23 months. The knee was defined to be unstable when the difference of displacement measured using KT-2000 arthrometer was greater than 3 mm. Lesions were evaluated in sub-divided five compartments ; patello-femoral joint, anteromedial, anterolateral, postero-medial and posterolateral compartment of tibio-femoral joint. RESULT: Geographic bone bruise was found in 9 cases(15 compartments) of 14 patients and bone SPECT revealed increased uptake in all the compartments. Reticular type bone bruise was found in 6 cases(7 compartments) and no compartment revealed increased uptake. Partial meniscectomy was done in 9 cases(16 compartments), and 8 cases(13 compartments) of them revealed increased uptake. Six cases were unstable and four of them revealed increased uptake in the patello-femoral joint. Activity level was not correlated with hot uptake. CONCLUSIONS: Bone SPECT is a useful method to predict osteoarthritis after ACL reconstruction. Geo-graphic bone bruises at injury, meniscectomy and instability are important factors for prognosis after ACL reconstruction.
Arthritis* ; Bone-Patellar Tendon-Bone Grafts ; Contusions ; Follow-Up Studies ; Humans ; Joints ; Knee ; Osteoarthritis ; Prognosis ; Tomography, Emission-Computed, Single-Photon*

Posterior cruciate ligament (PCL) injuries associated with multiple ligament injuries can be easily diagnosed, but isolated PCL tears are less symptomatic, very difficult to diagnose, and frequently misdiagnosed. If a detailed investigation of the history of illness suggests a PCL injury, careful physical examinations including the posterior drawer test, dial test, varus and valgus test should be done especially if the patient complains of severe posterior knee pain in >90degrees of flexion. Vascular assessment and treatment should be done to avoid critical complications. An individualized treatment plan should be established after consideration of the type of tear, time after injury, associated collateral ligament injuries, bony alignment, and status of remnant. The rehabilitation should be carried out slower than that after anterior cruciate ligament reconstruction.
Anterior Cruciate Ligament Reconstruction ; Collateral Ligaments ; Humans ; Knee ; Ligaments ; Physical Examination ; Posterior Cruciate Ligament ; Rupture

Purpose: The purpose of this study was to evaluate the incidence of deep vein thrombosis (DVT) after various types of knee surgery and to identify patients at high risk. Materials and Methods: This retrospective was conducted using the medical records of knee surgeries conducted by one surgeon at Gachon University Gil Medical Center between May 2019 and December 2020. The occurrence of DVT was determined by venous ultrasonography 4 to 6 days after surgery, and the incidence of DVT was determined for arthroscopic ligament surgery, arthroscopic meniscus surgery, arthroplasty, and osteotomy. Patients diagnosed with DVT were treated with a pharmacological agent for 3 months, and DVT was reevaluated by Doppler sonography at 3 months postoperatively. Results: Among a total of 221 cases, 75 cases (33.9%) were diagnosed with DVT. The incidence of DVT was significantly dependent on type of surgery, that is, anterior cruciate ligament surgery (ACL) 29.4%, meniscus surgery 30.2%, artroplasty 33.3%, and osteotomy 52.4%. In 60 of the 75 cases, DVT was successfully managed without complication by pharmacologic treatment. On the other hand, in 3 cases, pharmacologic treatment was stopped due to side effects. The other 15 cases were managed conservatively. A significant correlation was found between tourniquet application and incidence of DVT, and in the arthroplasty group, age and DVT were significantly correlated. However, surgical time was not correlated with DVT. Conclusion The incidence of DVT after knee surgery is significantly dependent on type of surgery. We believe that the absence of any severe complication, such as systemic or pulmonary embolism, related to DVT was due to early detection and adequate pharmaceutical management. Furthermore, we recommend that tourniquet not to be applied to patients at high risk of DVT.

PURPOSE: This goal of this study is to evaluate the clinical and radiological outcomes of proximal tibial comminuted fractures treated with medial minimally invasive percutaneous plate osteosynthesis (MIPPO). MATERIALS AND METHODS: We evaluated 43 patients who underwent medial MIPPO from February 2008 to February 2012 and were followed up for more than one year. According to the AO/OTA classification, there were 30 patients of 41-A3 and 13 patients of 41-C2. Thirty-six patients had closed fractures and seven patients had open fractures. We assessed clinical outcomes, radiologic results and postoperative complications. RESULTS: All fractures were united at an average of 18.3+/-8.1 weeks except three patients with nonunion. According to Schatzker and Lambert assessment, excellent results were achieved for 22 patients and good results were achieved for 21 patients. The average tibial plateau angle was 89.1degrees+/-2.7degrees and the average posterior tibial slope angle was 10.5degrees+/-4.6degrees. In assessment of lower limb alignment, the average femorotibial angle was 175.1degrees+/-2.9degrees and the mean deviation of mechanical axis was 46.5%+/-12.7%. In terms of complications, three patients had nonunion, but complete bony union was achieved by autogenous cancellous bone grafting. Seven patients complained of skin irritation around the plate. However, there was no skin necrosis, infection, or limited range of motion in seven patients with skin irritation. CONCLUSION: Medial MIPPO for proximal tibial comminuted fractures provides favorable clinical outcomes and good radiological alignments.
Axis, Cervical Vertebra ; Bone Transplantation ; Classification ; Fractures, Closed ; Fractures, Comminuted* ; Fractures, Open ; Humans ; Lower Extremity ; Necrosis ; Postoperative Complications ; Range of Motion, Articular ; Skin ; Tibia