• 제목/요약/키워드: Curettage and bone graft

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이식한 생비골에서 재발한 섬유성 골이형성증 -1례 보고- (Recurred Fibrous Dysplasia in the Vascularized Fibular Graft -A Case Report-)

  • 정덕환;한정수;이용걸;한수홍;이종원
    • Archives of Reconstructive Microsurgery
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    • 제5권1호
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    • pp.147-150
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    • 1996
  • 미세수술의 발달과 더불어 악성 및 양성 종양의 치료로서 병소 조직 절제후에 결손부에 혈관 부착 골이식술을 시행하는 골종양재건술이 많이 이용되고 있으나 원래 병소가 이식골에 전이되는 보고는 많지 않다. 본 교실에서는 양성 골종양인 섬유성 골이형성증에서 종양조직 절제술후에 생비골 이식술을 시행한 후, 이식골에 원래 종양이 재발한 예를 체험하였기에 적출술 후 생골이식술로서 결손부를 대치하는 수술시에 충분한 병소의 제거 및 지속적인 추시를 통하여 재발 여부를 확인하는 것이 필요하다고 제안하는 바이다.

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후족부 내시경술을 이용한 거골내 결절종의 치료 - 증례 보고 - (Treatment of Intraosseous Ganglion of the Talus with Hindfoot Endoscopy - A Case Report -)

  • 김성윤;이우천
    • 대한관절경학회지
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    • 제16권1호
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    • pp.52-55
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    • 2012
  • 골내 결절종은 일반적으로 관절에 인접한 골단이나 연골하골에 위치하며, 낭종부위를 개방한 후 소파술 단독 또는 소파술 후 골이식술을 병용하여 치료한다. 저자들은 거골의 후방에 있는 골내 결절종의 치료로 후외측 및 후내측 삽입구를 통한 내시경적 낭종 내 소파술 및 골이식술을 시행하여 양호한 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.

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중족골에 발생한 단순 골낭종 - 1예 보고 - (Simple bone cyst which occurs in the metatarsal bone)

  • 라종득;박현수;임창석;정태원
    • 대한족부족관절학회지
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    • 제7권2호
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    • pp.279-282
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    • 2003
  • Most simple bone cysts are found in the metaphysis of the long bone, such as proximal humerus or proximal femur. Appropriate treatment is aspiration of the cyst followed by instillation of methylprednisolone or curettage with bone graft. We experienced 1 case of the simple bone cyst of the metatarsal bone. This case was treated by curettage and inserting allograft into the defect.

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섬유성 골 이형성증에서 시행한 골 이식술의 결과 분석 (The Result of Bone Grafting for Fibrous Dysplasia)

  • 정원주;김태성;조환성;윤종필;박일형
    • 대한골관절종양학회지
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    • 제20권2호
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    • pp.74-79
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    • 2014
  • 목적: 섬유성 골 이형성증은 신호전달 G 단백의 alpha 소단위체 유전자 변이에 따른 양성 골격계 질환으로 다양한 임상적 양상을 보인다. 기능적 장애, 구조적 변형를 방지하기 위해 제한적으로 수술을 시행하게 되는데 종양소파술 후 발생한 공동을 메우는 골 이식술이 시행된다. 이 연구에서는 본원에서 시행한 섬유성 골 이형성증 치료로서 자가 해면골 이식술을 시행한 경우와 자가 해면골과 동종골, 동종골만을 사용한 경우를 비교 분석하고자 한다. 대상 및 방법: 1997년4월부터 2013년 10월까지 본원에서 섬유성 골이형성증으로 진단된 58 명 중 수술 후 1년이상 추시 관찰이 가능했던 34명을 대상으로 하였다. 수술 시 평균 연령은 26.7세(범위, 2-57세)이었고, 남자는 13명, 여자는 21명이었다. 자가 골이식은 모두 장골에서 채취한 망상골을 이식하였고, 동종골은 골은행에서 기증받은 뼈를 이식용으로 재처리하여 이용하였다. 자가 해면골만 이식한 경우(I군)는 5예, 자가 해면골과 동종 골, 혹은 동종골만 이식한 경우(II군)가 29예였다. 재발, 이차적 변성 같은 합병증을 확인하기 위해, 주기적인 단순 방사선 촬영으로 관찰하였으며 각 군을 비교하였다. 결과: 섬유성 골이형성의 재발이 4예(11.4%)있었으며, 자가 해면골 이식술 시행한 군(I군; 1예 20%)과 자가해면골과 동종골, 혹은 동종골만을 이식한 경우(II군; 3예, 10.3%) 간의 재발율을 Kaplan-Meier 방법으로 분석한 결과 두군간의 차이가 없었다(p=0.554). 재발한 경우는 모두 소파술 및 자가골이식술을 다시 시행하였으며 재수술 후 재발은 없었다. 낭종 같은 이차적 변성이 확인된 경우가 1예, 병적 골절을 보인 경우 1예가 있었으나, 악성변화를 일으킨 경우는 없었다. 결론: 섬유성 골 이형성증 환자들에게 골이식을 시행한 경우, 자가 해면골 또는 동종 골 이식술을 시행한 양 군에서 재발,병적 골절 같은 합병증의 결과가 의미 있는 차이를 보이지 않았다. 따라서 종양의 부피가 작고 병변의 위치가 체중이 가하지는 부위가 아닐 경우에는 자가 해면골 이식 또한 좋은 방법으로 사료되며 이에 대한 연구가 필요하다.

가토 두개골에 이식한 다양한 형태의 자가골에 의한 골성 회복 양상 비교 평가 (A COMPARATIVE STUDY OF VARIOUS TYPE OF AUTOGENEOUS BONE GRAFT ON THE RABBIT-SKULL DEFECT HEALING)

  • 최소영;이수연;김진욱;김진수;이상한;신홍인;권대근
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권4호
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    • pp.428-434
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    • 2008
  • Introduction: Piezosurgery device is one of the most commonly used instrument on the intraoral surgery such as maxillary sinus lift and autogeneous bone graft. Piezosurgery instrument also contains the tips that are manufactured especially for the convenient bone graft, which now many surgeons apply them for collecting bone graft materials in the curettage method for the restoration of skull defects. However, objective data has not been shown concerning the effects about bone graft with using Piezosurgery. Therefore we investigated the effects of Piezosurgery on the rabbit-skull defect healing. Materials & Methods: To investigate the regeneration of the bony defect with various bone graft, 10 adult New Zealand white rabbits (average weight : $2.8{\pm}0.3kg$, about 12weeks) were used. The four circular bony defects measuring 6mm in diameter were made with Piezosurgery device on each rabbit cranial bone. The harvested bone tissues during defect formation were also used for autogeneous bone graft. They were grafted into the defects in a various type; block type (Group 1), particulated type by the bone mill (Group 2), chopped type by curette shaped Piezosurgery tip (Group 3), the defect without any graft was served as control (control group). The animals were sacrificed after 6 weeks and bone regeneration capacity was evaluated histomorphometrically. Result & Conclusion: Autogeneous bone graft harvested using a Piezosurgery instrument showed satisfactory bone regeneration. There was no conspicuous difference bone prepared among by bone mill or Piezosurgery and block bone graft. Therefore, the bone harvested from the intraoral site near the operation field using the piezosurgery device can be a feasible and reliable graft for intraoral bony defects.

척추 측만증을 동반한 흉추에 발생한 동맥류성 골낭종 - 증례 보고 - (Aneurysmal Bone Cyst of the Thoracic Spine with Scoliosis - Case Report -)

  • 한정수;김기택;조창현;양형섭
    • 대한골관절종양학회지
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    • 제5권1호
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    • pp.76-81
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    • 1999
  • Aneurysmal bone cysts are uncommon bony lesions of the spine. Approximately 3-20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region, but they may occur at the any level of the spine. These lesions commonly arise from the neural arch and occasionally invade the pedicle and the vertebral body. The clinical diagnosis of a spinal lesion can be very difficult in the early stages of the disease because specific symptoms and signs are usually absent or only amount to back pain. However, depending on the level of involvement and the extent of neurological compression, a wide variety of neurological symptoms and signs may appear, ranging from mild radicular symptoms to complete paraplegia or tetraplegia. Available treatment options include complete excision or curettage of the lesion with bone graft, but where excision cannot be achieved, low dose radiation or arterial embolization may be used. We report a case of aneurysmal bone cyst in the pedicle of the T10 spine with nonstructural scoliosis of $40^{\circ}$ Cobb's angle which was treated successfully with only curettage of the lesion.

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Surgical management of idiopathic bone cavity: case series of consecutive 27 patients

  • You, Myoung-Sang;Kim, Dong-Young;Ahn, Kang-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권2호
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    • pp.94-99
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    • 2017
  • Objectives: Idiopathic bone cavity (IBC) is an uncommon intra-osseous cavity of unknown etiology. Clinical features of IBC are not well known and treatment modalities of IBC are controversial. The purpose of this study was to investigate the clinical characteristics of 27 IBC patients who underwent surgical exploration. Materials and Methods: A total of 27 consecutive patients who underwent surgery due to a jaw bone cavity from April 2006 to February 2016 were included in this study. Nine male and 18 female patients were enrolled. Patients were examined retrospectively regarding primary site, history of trauma, graft material, radiographic size of the lesion, presence of interdental scalloping, erosion of the inferior border of the mandible, complications, results of bone graft, and recurrence. Results: Female dominance was found. Maxillary lesion was found in one patient, and bilateral posterior mandibular lesions were found in two patients. The other patients showed a single mandibular lesion. The posterior mandible (24 cases) was the most common site of IBC, followed by the anterior mandible (5 cases). Two patients with anterior mandibular lesion reported history of trauma due to car accident, while the others denied any trauma history. Radiographic cystic cavity length over 30 mm was found in 10 patients. Seven patients showed erosion of the mandibular inferior border. The operations performed were surgical exploration, curettage, and bone or collagen graft. One bilateral IBC patient showed recurrence of the lesion during follow-up. Grafted bone was integrated into the native mandibular bone without infection. One patient reported necrosis of the mandibular incisor pulp after operation. Conclusion: Differential diagnosis of IBC is difficult, and IBC is often confused with periapical cyst. Surgical exploration and bone graft are recommended for treating IBC. Endodontic treatment of involved teeth should be evaluated before operation. Bone graft is recommended to reduce the healing period.

삼피질골의 분절성형 골이식을 통한 거골 거대 동맥류성 골낭종의 치료 1예: 증례 보고 (Treatment of a Huge Aneurysmal Bone Cyst of the Talus through a Segmental Bone Graft of the Tricortical Bone: A Case Report)

  • 이승진;이효범;김갑래;김동현
    • 대한족부족관절학회지
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    • 제25권4호
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    • pp.185-189
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    • 2021
  • An aneurysmal bone cyst (ABC) can occur in many parts of the human body, but a primary ABC of the talus is extremely rare. ABCs are benign, but aggressively growing tumors that usually occur in the first two decades of life. Patients mainly complain of pain, limited movement of the involved joint or a palpable mass. Pain may worsen suddenly because of pathological fractures. If not treated properly, ABC has a risk of local recurrence, followed by the destruction of the joint and a significant functional deficit. While the complete removal of the bone tumor is essential, it is also important to treat the resultant bone defect after removal. The talus has an important part to play in weight-bearing. Therefore, an appropriate bone graft is required for large bone defects that occur after an ABC removal from the talus. We report a primary ABC of the talus in a 28-year-old male that was treated by curettage and a bone pillar pattern graft of autologous tricortical iliac crest bone. The patient had an excellent functional outcome with early weight-bearing, and there was no recurrence at 16 months of follow-up.

다발성 연골육종 1례 보고 (Multicentric Chondrosarcoma - case report -)

  • 전대근;이종석;김석준;이수용
    • 대한골관절종양학회지
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    • 제3권2호
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    • pp.112-118
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    • 1997
  • Multicentric chondrosarcoma other than the mesenchymal subtype is rare separate entity. We experienced a case with nonmonomelic synchronous multicentric chondrosarcoma without any preexisting lesions of Oilier's disease or Maffucci's syndrome. To our knowledge, there was no report of synchronous nonmonomelic multicentric chondrosarcoma. A thirty-three year old man had right distal thigh pain of one and half year. Bone scan showed hot lesions on medial condyle of right femur and shaft of left femur. Plain X-ray showed osteolytic lesion on right femur and slight cortical thickening and calcific lesion was observed on left femoral shaft. Curettage and bone cement filling was done on both lesions. The pathology reports were grade I chondrosarcoma on both side of femur. At one month from operation, pathologic fracture of left femur occurred on bone cement-host bone junction. Conservative treatment and radiotherapy of 60Gy was done. At 8 months from operation, nonunion was evident. Segmental resection of left femur with contralateral fibula graft and second look operation on right condyle lesion were done. At 6 months from revision, fracture occurred at host-graft bone junction. We removed previous hardware and applied long DCP and massive autogenous bone graft. Afterwards, the patient looks good and union was progressing. But at 4 years from last operation, hypertrophic nonunion occurred. Another revision was done with condylar plate and bone graft and now he is well without any sign of local recurrence or metastasis.

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근위 경골의 결합조직형성 섬유종 치료 후 발생한 골육종 - 1예 보고 - (Osteosarcoma Arising from Desmoplastic Fibroma of Proximal Tibia - A Case Report -)

  • 김태승;박용욱;박문향;장시형
    • 대한골관절종양학회지
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    • 제13권2호
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    • pp.162-166
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    • 2007
  • 결합조직형성 섬유종은 조직 소견상 연부 조직의 유건종(desmoid tumor)과 유사한, 비교적 드문 종양으로 대부분 장관골에 발생한다. 그러나 양성 종양이지만 골소파 및 골이식 치료후에는 국소 재발이 빈번한 것으로 알려져 있다. 더욱이 재발을 하게 되면, 아주 드물지만 골 육종으로 악성 변화되는 경우가 보고되고 있다. 본 교실에서는 17세 남자 환자에서 근위 경골에 발생한 결합 조직 섬유종에 대해 소파술 및 골 이식술을 시행 후, 11년 후에 골육종으로 악성 변화된 결합조직형성 섬유종 1례를 경험하였기에 보고하는 바이다.

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