We treated 3 cases of fracture and 1 case of avascular necrosis of femoral head using autologous cultured osteoblasts injection. The stromal cells from the bone marrow were cultured to differentiate to osteoblasts for 4 weeks. The fracture sites of each patients were right ulnar shaft, left radial shaft, and left 5th metatarsal base. All of the fractures showed callus formations after 1 week of osteoblasts injection to the fracture site. After 4 weeks, callus formations were progressed. Avascular necrosis of femoral head was bilateral and both were Ficat stage II. Core decompression and allograft impaction were performed to the left, and core decompression and autologous cultured osteoblasts injection percutaneously after 4 weeks of the decompression operation were done to the right femoral head. CT images of 1 year from the operations showed trabecular bone formation and well maintained femoral head contour of the right femur, but resorption of the grafted bone for the left.
Comminuted fractures of distal humerus are difficult fracures to treat because of their rarity and associated significant comminution. The results of managing theses fractures non-operatively are limited by failure to get anantomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudoarthrosis. The goals of open reduction are to preserve articular surface and restore elbow function. Hence an operative management with anatomical reduction of fragments becomes the treatment of choice for these fractures. Authors analyzed 17 patients, with 30 months follow-up on an average, who were treated with open reduction and rigid internal fixation followed early mobilization during the period from jan. 1991 to Dec. 1996. Following results were obtained. 1. According to the Muller's classification, type A was 4 cases(23.5%), type B was 4 (23.5%), and type C was 9(53%) 2. Excellent or good results were obtained in 12 cases(71%) by the criteria of Aitken and Rorabeck. 3. There were limitation of full extension over 5degreein all cases and no other severe complications causing disability of elbow.
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Treatment for the Supracondylar Fractures of the Distal Humerus with Cannulated Screw Jin Soo Park, Young Khee Chung, Jung Han Yoo, Kyu Cheol Noh, Kook Jin Chung, Dong Nyoung Lee Journal of the Korean Fracture Society.2007; 20(1): 58. CrossRef
Several treatment methods for complete acromioclavicular(AC) joint dislocation have been recommended. This study was performed to evaluate the results of the injuries that had been treated operatively with Bosworth technique combined with coracoclavicular ligament reconstruction using coiacoacromial ligament. Between September 1992 and October 1995, 19 cases were treated with this method. We made an assessment of the results suggested by Taft. Subjectively, fifteen patients had no pain or stiffness. 17 patients had normal strength and full range of motion objectively. On the roentgenographic bases, 16 cases showed normal findings and one showed the subluxation of the AC joint. The overall Taft score was 10.8 points and 84 % of the patients showed good or excellent results. The advantages of this method include anatomical reduction of the AC joint and early motion of shoulder. Ligament reconstruction enables early removal of the lag screw which precludes joint stiffness and metal problems. We conluded that this method was a good surgical method for complete AC joint dislocation.