• Title/Summary/Keyword: 비 외상성 골괴사

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The Short Term Clinical Results of Hemiarthroplasty to Treat Humeral Head Osteonecrosis (상완골 두 비 외상성 골괴사에 시행한 견관절 반 치환술의 단기 추시 결과)

  • Sohn, Kang-Min;Sung, Chang-Meen;Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.183-189
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    • 2007
  • Introduction: While uncommon, humeral head osteonecrosis is an indication for arthroplasty when the humeral head collapse is advanced. The current authors report the short-term clinical results of 7 hemiarthroplasties to treat humeral head osteonecrosis. Materials and Methods: This study focused on 7 reconstructed shoulders of 5 patients whose humeral head osteonecrosis was treated with hemiarthroplasty. The postulated causes were alcohol-induced (4 cases) and steroidinduced (3 cases). The minimum follow-up was 12 months. This study compared the preoperative and postoperative shoulder pain, range of motion, and ASES scores. The postoperative patient satisfaction was assessed. Results: The level of pain during exercise was reduced from a preoperative average of 7.6 to a postoperative average of 1.9. The range of motion, in terms of forward flexion, abduction, and external rotation, improved from preoperative averages of $105.7^{\circ}$, $80^{\circ}$, and $22.1^{\circ}$ to postoperative averages of $146.6^{\circ}$, $139.3^{\circ}$, and $44.3^{\circ}$, respectively. The ASES scores increased from a preoperative mean of 39.0 to a postoperative mean of 84.1. The patients' ratings of the outcomes were excellent (5 cases) and good (2 cases). Conclusions: These short-term results indicate that hemiarthroplasty is a reliable treatment method for humeral head osteonecrosis improving shoulder pain, range of motion, and patient satisfaction.

Total Hip Arthroplasty in Patients with Avascular Necrosis of the Entire Femur (전체 대퇴골에 발생한 골괴사 환자에서 인공 고관절 전치환술)

  • Yi, Seung Rim;Im, Se Hyuk;Park, Sang Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.281-286
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    • 2019
  • Avascular necrosis (AVN) is defined as the cellular death of bone and bone marrow components due to the loss of blood supply, and associated with post-traumatic or non-traumatic events. AVN usually involves the epiphysis of a long bone, such as the femoral and humeral heads, which are susceptible to osteonecrosis. Many studies have been conducted but they were restricted to investigations of femoral head avascular necrosis. The presence of osteonecrosis in the proximal femur may impair biological fixation after total hip arthroplasty. We report a 56-year-old male patient with avascular necrosis located not only at the femoral head, but also in the entire femur, including the medullary cavity, who underwent total hip arthroplasty 2 years earlier along with a review of the relevant literature.

Review of Myositis Ossificans (골화성 근염에 대한 고찰)

  • Bae Sung-Soo;Park Rae-Joon;Han Dong-Uk
    • The Journal of Korean Physical Therapy
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    • v.12 no.2
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    • pp.255-265
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    • 2000
  • The term 'myositis ossificans' encompasses four categories of clinicopathological disorders. The first, myositis ossificans progressive(fibrodysplasia ossificans progressive), is a rare genetic disease characterized by progressive heterotopic ossification involving skeletal muscle, tendon, ligaments, and fascia, with congenital malformation of the great toes, and usually microdactyly, monophalangism, and mal formed proximal phalanges. with valgus deformity of metatarsophalangeal joint. The ossification begins shortly after birth and may contribute to the patient's death. The second, heterotopic ossificans, can occur in patients with neuromuscular and chronic diseases such as paraplegia, poliomyelitis, polymyositis, bum, tetanus, and infection. But the lesions in these cases often lack the typical histologic features of myositis ossificans. The third, myositis ossificans traumatica, is the most common; it develops in response to soft tissue trauma such as a single severe injury, minor repetitive injures, fracture, joint dislocation, stab wound, or surgical incision. The forth, nontraumatic myositis ossificans, also designated :pseudomalignant osseous tumors of extraskeletal soft tissues' and 'psedomalignant myositis ossificans', occurs in persons repeated small mechanical injures or nonmechanical soft tissue injuries due to local ischemia, inflammation. or other factors cannot be ruled out in such cases.

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ORTHODONTIC TRACTION OF TRAUMATICALLY INTRUDED TEETH : CASE REPORT (외상에 의해 함입된 치아의 교정적 견인을 통한 치험례)

  • Kim, Hae-Ri;Oh, So-Hee;Kim, Young-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.506-512
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    • 2007
  • Traumatic injury of tooth in children is commonly occurred problem. It is classified into tooth, periodontal tissue, supporting bone, soft tissue injury by it's area and extent. Among the periodontal tissue injuries, traumatically intruded teeth are common in anterior maxillary area, though the occurrence rate is rather low, the pulp and supporting tissue injury is possible by vertical impact. The treatment method of traumatically intruded teeth is various. Observation on the spontaneous reeruption for 3-4 weeks is recommended if the traumatized teeth are deciduous teeth or slightly intruded immature permanent anterior teeth. If this did not occur because the extent of intrusion is severe or the traumatized teeth are mature permanent anterior teeth, orthodontic traction is applied by fixed/removable appliances. At this time, light and continuous force is applied for the extrusive movement of the intruded teeth. When above procedures are impossible, surgical repositioning and fixation is recommended. In these cases, we performed conventional endodontic therapy for pulp necrosis and orthodontic traction with fixed appliance. We obtained satisfactory results and will report that.

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ORTHODONTIC TRACTION AFTER THE TRAUMATIC INTRUSION OF UPPER CENTRAL INCISOR (외상에 의하여 함입된 상악 중절치의 교정적 견인)

  • Han, Yoon-Beum;Lee, Jae-Ho;Choi, Hyung-Jun;Sohn, Hyung-Kyu;Kim, Seong-Oh;Song, Je-Seon;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.293-297
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    • 2009
  • Traumatic intrusion is a type of injury that involves axial displacement of a tooth toward the alveolar bone. Its occurance is relatively rare compared to other types of luxation in permanent dentition. It is more common in boys than in girls, and most common etiology of intrusion is fallen down. Various complication may occur following traumatic intrusion, such as pulp necrosis, root resorption, pulp obliteration and marginal bone loss. In addition, traumatic intrusion is commonly combined with hard or soft tissue injuries. Therefore, it is difficult to establish proper treatment plan. Choice of treatment for an intruded tooth by trauma include waiting for spontaneous re-eruption, orthodontic repositioning, and surgical repositioning. In this case, we repositioned the intruded central incisor using orthodontic traction, in a six-year old girl, which failed to re-erupt spontaneously.

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Clinical Study of Acute Pyogenic Osteomyelitis in Children (소아 급성 화농성 골수염의 임상적 고찰)

  • Park, Ji Sook;Yeom, Jeong Suk;Hwang, Sun Chul;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.731-736
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    • 2005
  • Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

Slipped Capital Femoral Epiphysis(SCFE) (대퇴골두 골단분리증의 치험례)

  • Dan, Jin-Myoung;Kim, Se-Dong
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.245-261
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    • 1997
  • Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

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