Journal of Musculoskeletal Trauma

Jihyo Hwang

3 Articles

Current Concepts of Vitamin D and Calcium in the Healing of Fractures: Jihyo Hwang; J Korean Fract Soc 2021;34(3):117-121. Published online July 31, 2021; DOI: https://doi.org/10.12671/jkfs.2021.34.3.117

Abstract PDF: Fragile fractures, also known as osteoporosis fractures, insufficiency fractures, and senile fractures are a significant problem encountered by orthopedic surgeons. Calcium and vitamin D are essential for maintaining bone health and deficiencies in calcium and vitamin D are major risk factors for the development of osteoporosis. Sufficient amounts of calcium are also required for fracture-callus mineralization. Hence, compromised bone repair that is frequently observed in osteoporotic patients might be attributed to calcium and vitamin D deficiencies. Consequently, calcium and vitamin D supplementation represents a potential strategy for treating compromised fracture healing in osteoporotic patients. There is some clinical evidence of the positive effect of supplementation in fracture healing and posttraumatic bone turnover, but research in this area is ongoing. Calcium and vitamin D should be the primary treatment of choice in osteopenic patients with an insufficiency of calcium and vitamin D and for the prevention of secondary osteoporotic fractures. Calcium and vitamin D can also be used as addition to other primary osteoporotic medications such as antiresorptive or bone-forming agents. The role of calcium and vitamin D in fracture healing and the therapeutic potential of calcium and vitamin D supplementation is summarized in this context.

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Simulation for Reduction of Transverse Acetabular Fractures in Sawbones Models: Seongeun Byun, Cyril Mauffrey, Jehyun Yoo, Changwon Park, Jihyo Hwang; J Korean Fract Soc 2019;32(4):196-203. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.196

PURPOSE
The transversely oriented fracture lines are very difficult to reduce during operations, even after clear exposure of the fracture site, in acetabular fractures. The purpose of this study is to verify the quality of reduction between the different subtypes (transtectal, juxtatectal, and infratectal) of transverse fractures. This study also determined the proper type of clamps to use and the proper zone for achieving accurate reductions in Sawbones models.
MATERIALS AND METHODS
Six fractures in 3 different subtypes of transverse fractures were artificially created. Ten different reduction clamps were applied for reduction of the fractures. Twelve holes around the fracture were drilled for the maintenance of the clamps. The fracture displacements were measured at the extra-articular area and the intra-articular joint portion. The pictures of the intra-articular fracture displacements were taken by a camera and these were uploaded and analyzed by the TraumaCadÂ® computer program (Brainlab).
RESULTS
The reduction quality was poor in order of transtectal, juxtatectal and infratectal. The intraarticular opening was more prominent in the transtectal subtype. The safe zone, when giving consideration of the neurovascular bundles, was a quadrilateral surface of the ilium. Drill holes are useful for maintenance of the reduction clamps. Reduction clamps with points (Weber clamp) were the best for maintenance and accurate reduction. Regarding the concerns of placement of clamps, the middle to posterior combination was the best. The upper hole among the posterior holes in the ilium was the most likely to well reduce the intra-articular opening.
CONCLUSION
Transtectal was the more complicated subtype in the aspect of reduction quality. The Weber type reduction clamp was the best for reduction by centrally located holes in the quadrilateral surface and posteriorly located iliac holes in transverse acetabular fractures. The upper hole, among the posterior holes in the ilium, was the best for reduction of the fracture displacements in the intraarticular portion of acetabulum.

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Surgical outcomes of transverse acetabular fractures and risk factors for poor outcomes
Jae Hoon Jang, Nam Hoon Moon, Seung Joon Rhee, Seok Jin Jung, Tae Young Ahn
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef

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Extracorporeal shockwave therapy for acute fractures: a narrative review of bone healing and soft-tissue recovery: Yonghyun Yoon, Jihyo Hwang, Jungyoun Kim, Hyeongjik Kim, Jonghyeok Lee; Received August 2, 2026 Accepted August 31, 2026 Published online September 14, 2026; DOI: https://doi.org/10.12671/jmt.2026.00262

Abstract: Extracorporeal shockwave therapy (ESWT) is well established for delayed union and nonunion of fractures, but its role in acute-fracture care remains comparatively underexplored. This narrative review synthesizes mechanistic, preclinical, and clinical evidence on ESWT for bone healing and soft-tissue recovery during the acute post-fracture period, including several studies published between 2023 and 2026 that have not previously been discussed together in a single review. ESWT may promote fracture repair through mechanotransduction-mediated activation of osteogenic signaling, including bone morphogenetic protein-2, transforming growth factor-beta, and runt-related transcription factor 2; angiogenic signaling mediated by vascular endothelial growth factor; modulation of the inflammatory phase; and acceleration of endochondral ossification. Human clinical evidence remains limited to a small number of trials, most notably a 56-patient quasi-randomized controlled trial that suggested a lower risk of nonunion, although the estimate was imprecise. The 2023 Cochrane Review rated the certainty of evidence as very low, and a 2026 systematic review similarly emphasized limitations related to small sample sizes and heterogeneous protocols. Evidence for acute soft-tissue and muscle injury is comparatively more developed and has been extended by a 2023 systematic review of muscle injuries, a 2021 case series on return to play in elite athletes, and a 2025 randomized controlled trial evaluating ESWT for periarticular soft-tissue injury after hip fracture surgery. Open fractures, in which bone and soft-tissue healing are biologically interdependent, represent the strongest candidate indication for future dual-outcome research. Adequately powered randomized trials using standardized protocols remain the principal unmet need before ESWT can be recommended for routine use in acute fractures.

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