Soft tissue related complications are quite frequent in limb lengthening. Muscle fibers may proliferate or regenerate after stretching injury over 10-20% of their original length. However, the cells which are engaged in this phenomenon are not confirmed yet. We chased the S-phase cells (phase for DNA replication) in the posterior leg muscle during limb lengthening by immunohistochemical technique. We lengthened the tibiae of fifteen New Zealand white rabbits. We divided them into three groups and each group is consisted of five rabbits. In group 1, we lengthened the left tibiae by 10% of their original length, in Group 2, 20%, and in group, 3, 25%, respectively, At the end of lengthening posterior muscles of lengthened left side and of controlled right side were fixed and processed for Immunohistochemical staining which could detect the incorporation of bromodeoxyuridine(BDU). Labelling index(LI:% of positively stained S-phase nuclei) of group 1 was zero. LI of groups for more than 20% lengthening (sum of group 2 and 3) was statistically significant. In conclusion, nuclei around or within the muscle tissue are in S-phase during limb lengthening which means proliferation of the muscle fivers or of the certain cells that abut muscle fibers.
Bromodeoxyuridine ; DNA ; Extremities ; Immunohistochemistry ; Leg ; Muscles ; Rabbits ; Tibia

Ilizarov technique has been successfully applied to limb lengthening for several decade, one of its main drawback is, however, long application of external fixator over 6 months. To lessen this time, simultaneous intramedullary fixation which convert later to static fixation by insertion of interlocking screws has been proposed. The indication for surgical limb lengthening includes familial short stature below the 3rd percentile. We compared the results of thirteen tibial lengthening with Ilizarov method to that of eleven hybrid methods. The hybrid system is composed of an unreamed AO intramedullary nail (IM) and ring fixator. Once the lengthening is completed, distal interlocking screws were inserted. In the group who were treated by hybrid system, the mean lengthening of tibia was 7.1cm (range, 6.3-9.5), the mean of external fixation period 7 months (range, 5-9), the mean healing index 1.2 month/cm (range, 1.1-1.4). On the other hand, the mean lengthening of tibia was 7.5cm (range, 5-10.3), the mean of external fixation period 9.8 months (range, 6-15), the mean healing index 1.4 month/cm (range, 1.1-1.8) in the group treated by Ilizarov method. Mean follow-up period was 23 months (range 14-47). There was no rotational or angular deformities and no loss of lengthening in the hybrid group. However we experienced three cases of angular deformity at the distraction site during lengthening in Ilizarov group. There was no deep infection in both groups. In the hybrid group we found several advantages such as no deformity, no loss of lengthening, and less scar by early removal of fixator, but some disadvantages such as need of subsequent procedures and limitation in intramedullary nailing.
Cicatrix ; Congenital Abnormalities ; External Fixators ; Extremities ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Hand ; Ilizarov Technique* ; Tibia

No abstract available.
Foot* ; Tarsal Bones*

No abstract available.
Extremities* ; Osteogenesis* ; Ultrasonography*

The authors report two cases of successful reconstruction in infected nonunion of the femur involving marked shortening by compression and gradual distraction at the nonunion site using Ilizarov external fixator. At first, infection was controlled by radical excision & the administration of systemic antibiotics for four weeks and we also started compression at the nonunion site 3 days after operation. Autogenous iliac bone graft was added to strengthen the site of new bone formation lastly. In this report, the role of the compression seems to provide a good environment for distraction osteogenesis by focal necrosis and triggering inflammation. Compression and gradual distraction may be one of the treatment mordalities for nonunion of a long bone with massive bone loss or shortening, even infected.
Anti-Bacterial Agents ; External Fixators ; Femur* ; Inflammation ; Necrosis ; Osteogenesis ; Osteogenesis, Distraction ; Transplants

The back pain is increasingly becoming a major problem in the elderly people. The cause of back pain in the elderly patient is quite different from in the young subject. And relationship of the occurrence of osteoporosis with the incidence of fractures in general is currently regarded as a major factor. The authors performed clinical observation on 194 elderly patients who were treated for back pain during 5 years period from April, 1983 to April, 1988 at the Department of Orthopaedic Surgery, Severance Hospital and relationship between osteoporosis and compression fracture of spine was reviewed. The results were as follows : l. Among the 194 cases of back pain(28.3% of total admission cases), whose age were over 50: 142 cases were female and 52 cases were male, being more common in female. 2. Most common cause of back pain was the compression fracture of spine : 86 cases(44.3 %). Osteoporosis was associated with 66 cases(76.7%) out of 86 cases. 3. The number of compression fracture in same patient was more frequent in osteoporotic patient and thoracolumber junction (T12, Ll) was the major site of fracture (45.6%). Compression fracture of spine caused by osteoporosis occured at multiple level in 60.6%. 4. Twenty three cases(34.8%) of compression fracture of spine with osteoporosis were found to have previous history of fractures of spine and/or extremities by radiological examination. Regarding this results, compression fractures of spine was not infrequent cause of back pain in the elderly. It was thought that re-fracture of spine should be prevented by vigorous approach against osteoporosis along with the treatment of presenting fracture in these patients.
Aged ; Back Pain ; Clinical Study ; Extremities ; Female ; Fractures, Compression ; Humans ; Incidence ; Male ; Osteoporosis ; Spine

Since 1952, Ilizarov external fixator has been developed and used for more than 30 years in Russia and world-wide interest on it has been prevalent during last 2-3 years. The fixation of the tension applied thin wires to the metal frame resist flexional and translational deformity just like other extenal fixators. But, it allows cyclic axial micro-motion at the fracture site without loss of reduction so that it can provide good environment for the fracture healing biologically and biomechanically. Another advantage of Ilizarov external fixator is that it permits mobilization of the adjacent joints and weight bearing of the fractured limb during the application of it and shortens the duration of administration. Since 1988, We applied the Ilizarov external fixator for the treatment of diffcult tibial fractures (open comminuted, segmented and comminuted fractures, nonunion, maunion) and obtained good results in 7 cases. So we report our results even if we had limited cases and experiences.
Congenital Abnormalities ; External Fixators ; Extremities ; Fracture Healing ; Fractures, Comminuted ; Joints ; Russia ; Tibia ; Tibial Fractures ; Weight-Bearing

We experienced two cases of irreducible fracture dislocation and one case of neglected dislocation of the interphalangeal joint of great toe. The cause of irreducibility of fracture dislocation were an interposition of the flexor hallucis longus tendon entrapped within undisplaced longitudinal fracture of the condyle of proximal phalanx and an entrapment of the osteochondral fragment which was avulsed from the distal insertion of lateral collateral ligament.
Dislocations ; Joints ; Lateral Ligament, Ankle ; Tendons ; Toes

PURPOSE: Cardiotoxicity following cancer chemotherapy or radiotherapy is an emerging issue for breast cancer patients. The purpose of this study was to analyze the current domestic research trends for exercise intervention for Korean breast cancer patients under chemotherapy or radiotherapy, focused on cardiovascular indices as study outcome measures and to make suggestions for future nursing studies. METHODS: A literature search was done using PubMed, CINAHL and two Korean databases to identify experimental studies reported in Korean or English between 2,000 and 2015. We identified five studies independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed by RoBANS criteria. RESULTS: Tai-chi exercise was used in three studies and aerobic exercise programs or yoga and walking exercise in the remaining studies. Two studies evaluated cardiovascular outcomes and showed positive findings for breast cancer patients. For cardiovascular indices, heart rate and blood pressure were used. CONCLUSION: This study showed the need for conducting well-designed experimental studies including clinical cardiovascular outcomes to generate evidence on exercise intervention for cancer therapy-induced cardiotoxicity prevention. Additional studies are warranted to accelerate the potential use of exercise as a nursing intervention for cancer patients under chemotherapy or radiotherapy.
Bias (Epidemiology) ; Blood Pressure ; Breast Neoplasms* ; Breast* ; Cardiovascular System ; Drug Therapy* ; Exercise ; Heart Rate ; Humans ; Nursing ; Outcome Assessment (Health Care) ; Radiotherapy* ; Walking ; Yoga

Twenty four patients with gap nonunions of the tibia were treated with the Ilizarov intercalary bone transport method. The purpose of this retrospective study is to evaluate the results and complications in gap nonunions of the tibia treated using the Ilizarov method. There were 22 males and two females with an average age of the 35.8 years(range, 23-63 years). The mean follow up period was 30.2 months(range, 17-70 months). Ten of the 24 patients had no external shortening with bone gap, 13 external shortening with gap and one hemicircumferential defect. On average, the size of bone loss measured 8.2 cm(range, 3-18 cm). Twenty-one of 24 patients were treated by whole segment internal transport(fifteen were proximal fragment transport, five were distal fragment transport, one was proximal and distal fragment transport), one patient by anterior hemicircumferential corticotomy and partial bone fragment internal transport and tow patients by fibula transfer. All patients healed with solid bony union, although twelve patients required bone grafts, eleven at the docking site and one at the distraction site. On average, the healing index was 49 days/cm(range, 18-82 days/cm). There was on relationship between the percentage transport(size of the distraction gap/the transporting fragment length x 100) and healing index. Numerous complications were encountered, most commonly delayed union and pin site infection, Conclusively, the application of Ilizarov techniques to gap nonunions of the tibia was very effective, but required correct technique and careful follow-up examination.
Female ; Fibula ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Male ; Methods ; Retrospective Studies ; Tibia ; Transplants