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Fracture-Related Complications: What You Can Do to Prevent Infection
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HoeJeong Chung, Jin Woo Lee, Sang-Ho Lee, Hoon-Sang Sohn
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J Korean Fract Soc 2023;36(4):139-147. Published online October 31, 2023
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DOI: https://doi.org/10.12671/jkfs.2023.36.4.139
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- Fracture-related infections (FRI) can occur when bacteria enter the wound during a traumatic injury. All efforts should be made to prevent FRI-associated complications due to the complexity of treatment at the time of onset and poor treatment outcomes. The risk factors for FRIs vary and several preoperative, perioperative, and postoperative measures can be implemented to prevent infections. Preoperative measures include blood sugar control, nutritional support, discontinuation of steroids and immunosuppressants, treatment of accompanying pre-existing infections, and decolonization of pathogens, specifically Staphylococcus aureus. The perioperative and postoperative measures include the use of prophylactic antibiotics, proper surgical site preparation (hair removal, preoperative washing, skin antisepsis), suitable surgical environment (operating room ventilation system, behavioral interventions in the operating room), correct surgical techniques (debridement, irrigation, wound closure, and negative pressure wound therapy). All medical staff should pay careful attention and ensure the implementation of the correct preventive measures.
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Bisphosphonate: An Invaluable Medication or Abandoned Acid?
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HoeJeong Chung, Jin Woo Lee, Jae Woong Um, Hoon-Sang Sohn
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J Korean Fract Soc 2021;34(3):122-130. Published online July 31, 2021
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DOI: https://doi.org/10.12671/jkfs.2021.34.3.122
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- Over the last two decades, bisphosphonate has widely been applied in the treatment of osteoporosis.
We reviewed the various adverse effects, current trials involving diverse bone metabolic diseases, and the future direction of bisphosphonate. Acute phase reaction, hypocalcemia, ocular inflammation, and gastrointestinal disturbances are the well-known short-term side-effects of bisphosphonate. Long term side-effects include osteonecrosis of the jaws and atypical femur fracture. In the modern clinical setting, bisphosphonate is widely used in treatments for osteoporosis, osteopenia, osteoarthritis, rheumatoid arthritis, and metastatic bone cancer. Further studies are underway for expanding the application as a bone-targeting agent in bone-related diseases. Bisphosphonate remains useful and invaluable as the 1st line medication for osteoporosis. Considering the numerous clinical situations, including time to medication after fracture, duration of drug usage, and individual drug holiday, an optimal and proper use of bisphosphonate needs to be achieved. In the current scenario, bisphosphonate will retain a strong position due to good efficacy and effectiveness for osteoporosis treatment, and the precise ap- plication to various bone diseases. We anticipate a key role of bisphosphonate for future application in the treatment of metabolic bone diseases. Further studies and advancement are highly anticipated, considering the high potential of bisphosphonate for various uses.
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Citations
Citations to this article as recorded by  - Ocular Inflammation with Use of Oral Bisphosphonates
Jee Hyun Jeong, Kyung Tae Kang, Yu Cheol Kim
Journal of the Korean Ophthalmological Society.2025; 66(2): 128. CrossRef
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A Prospective Study of Fractures of the Tibial Shaft Treated with Intramedullary Interlocking Nail : Comparing One versus Two Distal Screws
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Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Eui Chan Jang, Jin Woo Lee
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J Korean Soc Fract 1997;10(2):303-308. Published online April 30, 1997
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DOI: https://doi.org/10.12671/jksf.1997.10.2.303
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- In non-randomized prospective study, 67 tibial fractures were treated with intramedullary inter-locking nail. Patients were divided into 2 groups based on the number of distal locking screw. Group I was consisted of 33 fractures treated with one distal locking screw Group II was consisted of 34 fractures treated with two distal locking screws. The patients were followed up for an average of 12 months. There was no statistically significant difference between group I and II with regard to total operation time, fracture union time. However fluoroscopic time was significantly longer at group II than group I. Serial radiographs of patients in both group were analyzed for change of hardware and fracture healing postoperatively. No significant difference was found between two groups in fracture union time, hardware failure and complications in proximal and middle tibial fracture. But the angulation and locking screw breakage were significant in group I in distal tibia fracture. We concluded that fracture of the proximal and middle third of the tibia that require interlocking nail can be successfully treated with a single distal locking screw. However, in fractures of the distal one third, two distal locking screws should be required to prevent of angular deformity in sagittal plane and for stablefixaton. The use of a single distal locking screw reduces operation time, radiation exposure, local soft tissue discomfort and cost without compromizing fracture union.
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Thirty-five Degree Internal Oblique Radiographs in Assessment of Tibial Fracture Healing
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Eun Woo Lee, Ki Ser Kang, Soo Yong Kang, Jin Woo Lee
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J Korean Soc Fract 1996;9(2):475-479. Published online April 30, 1996
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DOI: https://doi.org/10.12671/jksf.1996.9.2.475
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Abstract
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- For the assessment of fracture healing, tomogram, computerized sonometry, resonant frequency analysis etc. were introduced recently, but most of orthopedic surgeons depend on plain X-ray and clinical experience. The progress of tibial fracture healing may be difficult to assess through routine radiological examination(AP and lateral).
So, we intended to assess the healing of tibial fracture with 35° internal oblique view as well as AP and lateral. Five orthopedic surgeons assested the tibial fracture heating with only AP and lateral (group 1), and AP. lateral and 35° internal oblique view(group 2) in 45 tibial fractures. In the percent agreement of their assessment, Group 1 was 60% and group 2 was 76%. Group 2 was higher than group 1, especially in IM nailing and bone graft groups.The change of judgement between the two group was 18.7%, and it was higher in the distal tibial fracture, posterolateral bone graft and external device groups. In 11 Cases, the fibular fractures were overlapped with tibiai fracture in laterai view, in which cases 35° intelnal oblique view was useful for assessing the tibial fracture healing. We recommand 35° internal oblique view for assessment of tibial fracture healing before using more tophisticated and expensive procedure, especialiy in patients with posterolateral bone graft, distal libial fracture and combined fibular fracture, and probably in IM nailing and external device.
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