• Korean Journal of Veterinary Research
• /
• v.54 no.3
• /
• pp.179-184
• /
• 2014

This study investigated the anatomy of the nutrient foramen (NF) in German Shepherds by recording the number, site, position, and direction of penetration of the nutrient canal (NC) in the humerus, radius, and ulna of 50 individuals. The site index of the nutrient foramen (SI) was calculated as the ratio of the length to the NF site from the proximal end to the greatest length of the bone. The NF diameter was measured using different sized needles. Most humeri had only one NF on the caudal surface, particularly on the lateral supracondylar crest, or distal cranial surface. All radii had one NF, usually on the caudal surface, while most ulnae had one NF located on either the cranial or lateral surfaces. The SI and NF diameters were 58.0~59.5% and 0.73~0.78 mm in the humerus, 30.4~30.9% and 0.74~0.76 mm in the radius, and 29.3~29.8% and 0.67~0.68 mm in the ulna, respectively. With the exception of the relatively proximal NF of the radius, the direction of penetration followed Berard's rule. This study provides novel information on the location and diameter of the NF and direction of the NC in the long bones of the pectoral limb of German Shepherds.

• Clinics in Shoulder and Elbow
• /
• v.3 no.1
• /
• pp.20-25
• /
• 2000

Purpose : To evaluate functional results and study factors influencing results after humeral hemiarthroplasty for comminuted fractures of the proximal humerus. Materials and Methods: We reviewed 12 patients with average follow-up period of 23 months(12 to 42). The proximal humeral fractures consisted of one anatomical neck fracture, five three-part and six four-part fractures or fracture-dislocations. Constant score and Compito et al' evaluation system were used for clinical assessment. Statistical analysis was done with the Wilcoxon test. Results: Six cases of anatomical neck, three-part fractures or fracture-dislocations showed 61 points on the average Constant score and three unsatisfactory results on the Compito et al' evaluation; Six of four-part fractures or fracture-dislocations showed 51 points and three unsatisfactory results. There were 59(two unsatisfactory) for five non-associated dislocation and 53(four unsatistactory) for seven associated dislocation; 66(one unsatisfactory) for three under 60 years and 41(five unsatisfactory) for nine over 60 years; 67(two unsatisfactory) for seven tuberosity union and 41(four unsatisfactory) for five tuberosity non-union or resorption; 58(four unsatisfactory) for ten early operation within two weeks and 43(all unsatisfactory) for two delayed operation; and 18(unsatisfactory) for one case of a accompanied rotator cuff tear. Conclusion: We concluded that tuberosity union was important factor influencing the results. Also, we thought that age, timing of operation and accompanied rotator cuff tear could be influenced to results.

• The Journal of the Korean bone and joint tumor society
• /
• v.12 no.2
• /
• pp.131-135
• /
• 2006

Chondrosarcoma can be divided into grade I, II and III by histological finding and a relationship between the prognosis and the histological grading has been identified. Although the surgical treatment of grade II and III chondrosarcoma necessitates wide resection margin, there has been controversy about curettage versus wide resection in case of grade I chondrosarcoma. The authors report a case of grade I chondrosarcoma of proximal humerus and grade II chondrosarcoma of distal humerus with good oncological and functional result through curettage and wide resection respectively.

• Biomaterials and Biomechanics in Bioengineering
• /
• v.3 no.2
• /
• pp.71-84
• /
• 2016

The finite element method is wide used in simulation in the biomechanical structures, but a lack of studies concerning finite element mesh quality in biomechanics is a reality. The present study intends to analyze the importance of the mesh quality in the finite element model results from humeral structure. A sensitivity analysis of finite element models (FEM) is presented for the humeral bone and cartilage structures. The geometry of bone and cartilage was acquired from CT scan and geometry reconstructed. The study includes 54 models from same bone geometry, with different mesh densities, constructed with tetrahedral linear elements. A finite element simulation representing the glenohumeral-joint reaction force applied on the humerus during $90^{\circ}$ abduction, with external load as the critical condition. Results from the finite element models suggest a mesh with 1.5 mm, 0.8 mm and 0.6 mm as suitable mesh sizes for cortical bone, trabecular bone and humeral cartilage, respectively. Relatively to the higher minimum principal strains are located at the proximal humerus diaphysis, and its highest value is found at the trabecular bone neck. The present study indicates the minimum mesh size in the finite element analyses in humeral structure. The cortical and trabecular bone, as well as cartilage, may not be correctly represented by meshes of the same size. The strain results presented the critical regions during the $90^{\circ}$ abduction.

• Clinics in Shoulder and Elbow
• /
• v.9 no.2
• /
• pp.169-175
• /
• 2006

Purpose: The purpose of this study was to evaluate the usefullness of polarus nailing in the treatment of proximal humerus fractures including 2 part, 3 part and proximal comminuted fractures. Materials and methods: Fifteen cases of proximal humerus fracture treated with Polarus nailing from March, 2002 to March, 2004 were selected. Man was 3 cases, and woman was 11 cases. There were one case of follow up loss due to decease. Average age was 60 years old (range, 23 to 84), and there were 6 cases of 2 part fracture, 3 cases of proximal segmental fracture, 5 cases of 3 part fracture. We analyzed the outcom results between 2 part fracture and 3 part fracture. The average follow up period after the operation was 1.5(range, 1 to 2) years. Range of motion (ROM), pain and functional outcome were evaluated by visual analogue scale(VAS) and american shoulder and elbow surgery (ASES) activity of daily living (ADL) functional scoring system. Results: All cases showed union on radiologic evaluation, with 2.3 months follow up. In 5 cases of 3 part fracture, average union time was 1.9 months regardless of proximal screw loosening in 4 cases. In 2 part fracture union time was 2.2 months (P>0.05). VAS pain score was 1.3, ROM was $160^{\circ}$ in forward flexion, $40^{\circ}$ in external rotation, L3 level in internal rotation, and ASES, ADL functional score was 21 in 2 part fracture. VAS pain score was 1.25, ROM was $160^{\circ}$, $43^{\circ}$ and L1 level, and ASES, ADL functional score was 21 in 3 part fracture. There were no statistically significant difference between two groups (P>0.05) VAS pain score was 1.6, ROM was $170^{\circ}$, $47^{\circ}$ and L3 level, and ASES, ADL functional score was 23 in proximal comminuted fracture. Conclusion: Polarus nailing could be used as an effective modality in certain cases of proximal humeral fracture including 2 part, proximal segmental and in cases of 3 part fractures with large greater tuberosity fragment.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.1-6
• /
• 2010

Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.5 no.1
• /
• pp.15-21
• /
• 2012

Primary radial nerve palsy occurs in association with approximately 10% of humerus shaft fractures. Secondary radial nerve palsy, which is iatrogenic, occurs in association with approximately 10% to 20% of humerus shaft fractures. Whether the radial nerve palsy is caused primarily by the fracture or secondarily by the surgery, it is necessary to determine whether the radial nerve is being disrupted or compressed by the surrounding structures. This evaluation will dictate whether to await natural recovery or to perform surgical exploration. The current authors report one case of primary radial nerve palsy, due to the humerus fracture, and one case of secondary radial nerve palsy, associated with the osteosynthesis procedure. In both patients, the radial nerve was assessed for anatomical integrity with ultrasonography. Nerve disruption was found in one patient, and a sural nerve graft was performed. Nerve adhesion was found in the other patient, and neurolysis was performed. In both cases, the clinical results were satisfactory. This report focuses on the usefulness of ultrasonography in radial nerve assessment in patients with radial nerve palsy.

• Journal of the Korea Convergence Society
• /
• v.8 no.11
• /
• pp.115-121
• /
• 2017

The present study aimed to obtain basic knowledge of a customized artificial joint based on the convergence research of Digital Imaging and Communications in Medicine(DICOM) and 5-axis machining technology. In the case of the research method, three-dimensional modeling was generated based on the medical image of the humerus bone, and the shape was machined using a chemical wood material. Then, the anatomical characteristics and the modeling machining computation times were compared. The results showed that the Stereolithography (STL) modeling required twice more time for semi-finishing and 10 times more time for finishing compared to the Initial Graphics Exchange Specification(IGES) modeling. For the 5-axis machining humerus bone, the anatomical structures of the anatomic neck, greater tubercle, lesser tubercle, and intertubercular groove were similar to those in the three-dimensional medical image. In the future, the convergence machining technology, where 5-axis machining of various structures(e.g., the surgical neck undercut of the humerus bone) is performed as described above, can be efficiently applied to the manufacture of a customized joint that pursues the precise model of a human body.

• Clinics in Shoulder and Elbow
• /
• v.15 no.1
• /
• pp.37-42
• /
• 2012

Purpose: To consider the proper management of proximal humerus fracture on gunshot wounds. Materials and Methods: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done. Result: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus. Conclusion: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.27-34
• /
• 2011

Purpose: We examined the clinical and radiological outcomes for displaced proximal humerus fractures that were treated with a PHILOS angular stable plate. Materials and Method: Forty four patients who underwent surgery between March 2007 and February 2010 were included in this study. All the cases were followed up for an average of 12 months. All the patients were examined and interviewed using the Visual Analog Scale (VAS) score, the Constant score and standardized X-rays to check the neck-shaft angle (NSA) and the presence of medial support. Results: The average Visual Analog Scale score was 2.8 points and the average Constant score was 70.5 points. The average neck shaft angle was $122.5^{\circ}$ and this was statistically significant between the good result group and the poor result group. There were 36 cases of the presence of medial support and 8 cases of the absence of medial support and the difference was statistically significant. Complications such as fixation failure happened in 12 cases. Conclusion: PHILOS angular stable plate fixation as an operative treatment for displaced proximal humerus fractures is a good and reliable treatment option.