Journal of Musculoskeletal Trauma

Bone Substitutes and the Advancement for Enhancing Bone Healing: Dong Hyun Lee, Ji Wan Kim; J Korean Fract Soc 2017;30(2):102-109. Published online April 30, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.2.102

With an aging population and the development of surgical techniques, there is a growing demand for bone reconstruction in areas of trauma, arthroplasty, and spinal fusion Although autogenous bone grafting may be the best method for stimulating bone repair and regeneration, there are still problems and complications, including morbidity related to bone harvesting and limitation of harvest amount. Allogeneic bone grafts have a limited supply and risk of transmission of infectious diseases. Over the past several decades, the use of bone substitutes, such as calcium phosphate, has increased; however, they have limited indications. Biomedical research has suggested a possibility of stimulating the self-healing mechanism by locally transmitting the external growth factors or stimulating local production through a gene transfer. In this review, we evaluate recent advances, including bone graft, bone substitutes, and tissue engineering.

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Calcium phosphate injection technique for treatment of distal radius fracture
Dae-Geun Kim, Byung Hoon Kwack
Medicine: Case Reports and Study Protocols.2021; 2(9): e0117. CrossRef
Experimental Study ofDohongsamul-tang(Taohongsiwu-tang) on Fracture Healing
Hyun Ju Ha, Min-Seok Oh
Journal of Korean Medicine Rehabilitation.2020; 30(2): 47. CrossRef

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The Effect of Platelet-Rich Plasma (PRP) on the Healing of Allograft for the Treatment of Segmental Bone Defect of the Ulna in Rabbits: Joo Hyun Song, Jinyoung Jeong, Yong Koo Kang, Han Yong Lee, Mun Ik Son, Sang Il Seo; J Korean Soc Fract 2003;16(3):416-422. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.416

Abstract PDF

PURPOSE
The purpose of this study was to evaluate the effect of Platelet-Rich Plasma (PRP) on the healing of the allograft for the treatment of the segmental bone defect of the ulna in Rabbits.
MATERIALS AND METHODS
About 2 cm-sized segmental bone defects were created on both ulna of twenty rabbits. The rabbits were divided into two groups, even and odd number group after numbering them from 1 to 20. The segmental bone from the odd numbered animal was transplanted to the even numbered animal, and the even numbered to the odd numbered. The left side of the ulna of the animal is grafted with a segmental allograft only. The right side of the ulna was grafted with a segmental allograft and 0.7 cc of PRP. Radiographs obtained at 0, 4, 8, and 12 weeks postoperatively were graded for radiologic union.
RESULTS
The use of the combination of PRP and segmental allograft demonstrated improved healing on radiolographic study compared with that demonstrated after use of allogrft alone.
CONCLUSION
The results of the study suggests that the use of the combination of PRP and segmental allograft can be considered as an alternative method to manage the segmental defect of the long bone.

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Effect of Different Bone Substitutes on the Concentration of Growth Factors in Platelet-rich Plasma
Hee Soon Cho, So-Young Park, Sukyoung Kim, Sang Keun Bae, Duk Seop Shin, Myun-Whan Ahn
Journal of Biomaterials Applications.2008; 22(6): 545. CrossRef

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Impacted Cancellous Allograft and Quadratus Femoris Pedicle Bone Graft of Femoral Neck Fracture Nonunion: Soo Jae Yim, Seung Han Woo; J Korean Soc Fract 2002;15(4):519-525. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.519

Abstract PDF: PURPOSE
The aim of this study was attempted to evaluate the effects of impacted cancellous allograft and quadratus femoris pedicle bone graft in the management of nonunion of femur neck fracture.
MATERIALS AND METHODS
Between March 1998 and April 1999, 5 patients, rating from 36 to 45 years of age, were treated with impacted cancellous allograft and quadratus femoris pedicle bone graft and all cases were nonunion with displaced transcervical fracture whose primary treatment had been done with closed reduction and multiple pinning. The duration of follow-up was from 36 months to 48 months and the mean follow-up period was 40 months. Clinical evaluation was done according to Lunceford functional results and radiologically bone union was evaluated by 3 monthly X-ray check.
RESULTS
After follow-up from 36 months to 48 months, all cases resulted in the bone union. Four cases, radiologically bone union was progressed during 14 weeks, and the other, obtained at 6 months. All cases, at 18 months, radiologically complete bone union was obtained. Clinical result was above fair results and no one complaints pain and instability.
CONCLUSION
For patients with nonunion of femoral neck fracture, impacted cancellous allograft and quadratus femoris pedicle bone graft was provide a good result of union.

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Impacted Cancellous Allograft and Valgus Fixation of Intertrochanteric Fracture Nonunion: Soon Yong Kwon, Young Kyun Woo, Jong Min Sohn, Jin Hwa Chung, Jung Ho Lee, Yong Sik Kim; J Korean Soc Fract 2002;15(1):65-71. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.65

Abstract PDF: PURPOSE
The aim of this study was attempted to evaluate the effects of impacted cancellous allograft and valgus fixation in the management of nonunion of intertrochanteric fracture of the femur.
MATERIALS AND METHODS
Between June 1995 and October 1999, 5 patients, ranging from 38 to 75 years of age, with nonunion of femoral intertrochanteric fracture, whose primary treatment had been done with compression hip screws, were treated with impacted cancellous allograft and valgus fixation RESULTS: After follow-up from 13 months to 24 months, among the 5 cases, 4 cases resulted in the union in a mean time of 16 weeks, improvement of LLD in a mean length of 0.8cm and good function of abduction, but 1 case resulted in nonunion, followed by total hip arthroplasty.
CONCLUSION
For patients with nonunion of femoral intertrochanteric fracture, impacted cancellous allograft and valgus fixation provide a good result of union.

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Use of Cancellous Bone Allograft in the Treatment of Long bone Fractures: Keun Bae Lee, Taek Rim Yoon, Jae Yoon Chung, Sung Taek Jung, Jae Joon Lee; J Korean Soc Fract 2001;14(4):776-782. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.776

Abstract PDF

PURPOSE
The goal of our study was to evaluate the usefulness of frozen cancellous bone allograft in the treatment of long bone fractures that had bone defect and nonunion.
MATERIALS AND METHODS
22 cases of long bone fractures(femur and tibia) with severe comminution or bone defect and nonunion were treated by operation using frozen cancellous bone allograft from March 1998 through May 2000. Thirteen were male and nine were female. The average age was 55 years old (range, 17-76 years) and the mean duration of follow-up was 20.1 months(range, 10-37 months). Eleven cases were femoral fractures, 7 cases of tibial fractures, and 4 cases of nonunion. Allografts were achieved from the patients of femoral neck fracture or osteoarthritis of the hip, and cadaveric donors. The specimens were carefully evaluated based on medical history and laboratory examination about the acute or chronic infection, and bloodtransmitted diseases. The results were evaluated by clinically, such as infection, pain at fracture site, immunological rejection and by radiologically union or resorption of allografts.
RESULTS
Radiologically, bone union was obtained in 14 cases(63.6%) at 6 months after operation, in all except two cases(90.9%) at 9 months after operation. Clinically, pain at fracture site, infection, and immunologic rejection were not observed.
CONCLUSION
In the treatment of severe comminuted fracture or nonunion of long bones, cancellous allograft transplantation after strict donor selection and appropriate screening was a good substitution for autograft avoiding of donor site morbidity or limitation in quantity.

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Influence of Process Conditions on the Quality Characteristics of Beef-Bone Broth
Byung-Su Kim, Gye-Won Kim, Jae-Yong Shim
Food Engineering Progress.2014; 18(1): 15. CrossRef

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Operative Treatment of Proximal Humeral Fracture using Inlay Graft of Fibular Allograft Combined with Plating: Duck Yun Cho, Eun Sung Koh, Myong Hyoung Lee; J Korean Soc Fract 1995;8(1):84-92. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.84

Abstract PDF

Fracture of the proximal humerus occurs more frequently in older individuals who may have advancing osteoporosis, causing the bone to weaken, even with minimal force. And, most proximal humeral fractures respond satisfactory to conservative treatment. But, operative treatment is reconmended in the case that poor results are anticipated by the severe displacement and comminution. In older patient with proximal humerus fracture, there was some problem such as osteoporosis, absorption of cancellous bone, cystic formation, and weakness of the mechanical support, and it has difficulties in rigid fixation and early ROM. Four cases of displaced fracture of the proximal humerus in older patients over 50-year-old Treated by using plate & inlay fibular allograft from Apr. 1991 to Dec. 1993 were analized clinically and radiologically. The following results were obtained. 1. The results of these patients were rated by the Neers functional criteria. Of four cases, three cases had excellent results, one case had satisfactory. 2. There was no allograft related complications, such as infection & graft rejection. So, in treatment of proximal humerus fracture at old individuals, open reduction and internal fixation with plating and inlay graft using fibular allograft was very useful method, and it resulted in rigid fixation, early ROM. and good functional result.

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Allogeneic Inlay Cortical Strut Grafts for Large Cysts or Post-curettage Cavitary Bony Defects
Yang-Guk Chung, Yong-Koo Kang, Chol-Jin Kim, An-Hi Lee, Jeong-Mi Park, Won-Jong Bahk, Hyun-Ho Yoo
The Journal of the Korean Bone and Joint Tumor Society.2011; 17(2): 73. CrossRef

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The Treatment of Infected Large Defect of the Long Bone - Allograft Transplantation and Ilizarov Technique: Duck Yun Cho, Sung Bum Yang, Kwang Chang; J Korean Soc Fract 1992;5(2):400-409. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.400

Abstract PDF: Infected large defect of the long bone have had many obstacles in treatment. It is usually very difficult to obtain union and to correct coexisting infection, deformity, & leg length discrepancy, Allograft transplantation have been traditionally used to treat infected large defect of the long bone. And Ilizarov technique has recently gained popularity as a multifactorial approach to the management of infected large defect of the long bone. We performed allograft transplantation in 5 cases and Ilizarov technique in 6 cases with infected large defect of the long bone at National Medical Center from 1987 through 1991. The results were as follows; 1. In the cases of allograft transplantaton, the average size of the bone defect was 9.6cm (range from 6cm to 3cm) and the average length of leg length discrepancy was 2.4cm (range from 0cm to 4cm). 2. In the six cases of Ilizarov technique, the average size of the bone defect was 2.5cm(range from 0.5cm to 4.5cm) and the average length of leg length discrepancy was 3.7cm(range from 0cm to 7cm). 3. In the cases of allograft transplantation, the bone union was achieved in two cases. Two cases have been followed up for 19 and 26 months each and they showed complete bone union in the proximal side of host-graft junction, but not complete union in the distal side. In one case, developed the osteolysis of the grafted bone due to the infection. After operation, the average length of leg length discrepancy was 1.4cm(range from 0 cm to 2cm). 4. In the cases of Ilizarov technique, bone union was achieved in three cases. One case have been followed up for 15 menths and showed incomplete bone union. In two cases, additional operation was performed due to the nonunion and the fracture between the junction of the proximal bone fragment and the transportated bone fragment in each. So we report our results of diferent two methods of treatment even if limited cases and experiences.

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