• Title/Summary/Keyword: Iliac

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Rare Imaging of Fat Embolism Seen on Computed Tomography in the Common Iliac Vein after Polytrauma

  • Lee, Hojun;Moon, Jonghwan;Kwon, Junsik;Lee, John Cook-Jong
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.103-106
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    • 2018
  • Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

Surgical Treatment for Rupture of the Right Common Iliac Artery Caused by Transcatheter Balloon Aortic Valvuloplasty in a Baby with Congenital Aortic Stenosis - A case report - (선천성 대동맥 판막 협착증에서 풍선 판막 성형술 중 발생한 총장골 동맥 파열의 외과적 치료 -1예 보고 -)

  • Han, Jong-Hee;Kim, Yong-Ho;Yu, Jeong-Hwan;Kim, Si-Wook;Kil, Hong-Ryang;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.116-119
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    • 2008
  • Transcatheter interventions are widely used for diagnosis and treatment of congenital heart disease. Complications associated with transcatheter interventions are uncommon. However, when they occur they are most often self-limited. Rarely, however, serious catheter related complications occur that may require emergent surgical intervention. In this case, the right common iliac artery was disrupted during transcatheter balloon valvuloplasty during the treatment of congenital aortic stenosis in a 2-week-old baby. After immediate surgical intervention with bleeding control using two balloon catheters the baby did well. Here we report this case and review the medical literature.

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

  • Omeje, Kelvin;Efunkoya, Akinwale;Amole, Ibiyinka;Akhiwu, Benjamin;Osunde, Daniel
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.272-277
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    • 2014
  • Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. Materials and Methods: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean $26.0{\pm}10.6years$). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.

A Case Report on Pelvic Fracture Accompanied with Osteoporosis Improved by Conservative Treatment (골다공증을 동반한 골반 골절환자의 보존적 치료에 대한 증례)

  • Moon, Su-Jeong;Lee, Eu-Gene;Ko, Youn-Seok;Song, Yong-Sun;Lee, Jeong-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.1
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    • pp.49-56
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    • 2010
  • Objectives: The objective of this study is to report the effectiveness of conservative treatment on pelvic fracture accompanied with osteoporosis. Methods: A female patient, 68 years old, who were diagnosed as right iliac wing fracture with osteoporosis by X-ray, bone scan and bone densitometry, were treated with conservative treatment. We evaluated the effectiveness by checking Visual Analog Scale(VAS), Oswestry Disability Index(ODI) and 3D computed tomography. Results: The symptoms of the patient got improved and the 3D computed tomography image showed the fracture were healing. Conclusions: Conservative oriental treatment can be effectively used for a patient with iliac wing fracture and osteoporosis.

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RECONSTRUCTION OF MANDIBULAR DEFECT WITH COMPOSIITE AUTOGENOUS ILIAC BONE AND COSTOCHONDRAL GRAFTS (자가장골 및 늑연골의 복합이식을 통한 하악골 재건술)

  • Chang, Se-Hong;Ann, Jye-Jynn;Soh, Jae-Jung;Park, Chi-Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.104-109
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    • 1991
  • Loss of mandibular continuity due to neoplasm, trauma, or infection results in major esthetic and biologic compromise. The use of costochondral grafts for reconstruction of temporomandibular joint, described first by Gillies in 1920, has been accepted as a suitable method for replacing the mandibular condyle, especially in growing children. Autogenous iliac bone graft has been a satisfactory source of mandibular reconstruction since Sykoffs report in 1900. Autogenous bone grafts from the posterior aspects of the ilium provide large amount of PMCB with acceptable donor site morbidity. In timing of reconstruction, initial disease, age, medical history, growth and development, esthetic and psychologic factors should be considered. We present a case of osteosarcoma in the mandible that was treated by a hemimandibulectomy and the defect was reconstructed 20 months later with composite method of costochondral and posterior iliac bone graft.

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RECONSTRUCTION WITH A VASCULARIZED FREE ILIAC OSTEOMUSCULAR FLAP AFTER HEMIMANDIBULECTOMY FOR OSTEOSARCOMA OF THE MANDIBULAR CONDYLE REGION : A CASE REPORT (하악과두에서 발생한 악성 골육종 환자에서 외과적 절제 후 유리장골이식을 이용한 재건)

  • Park, Hong-Ju;Yu, Min-Gi;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.386-394
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    • 2008
  • Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.

DISTRACTION OSTEOGENESIS FOLLOWED BY IMPLANT INSTALLATION ON THE RECONSTRUCTED MANDIBLE WITH A FREE ILIAC BONE GRAFT IN A ODONTOGENIC MANDIBULAR MYXOMA PATIENT : CASE REPORT (하악 치성점액종 환자에서 유리장골이식으로 재건된 하악골의 골신장술 후 임플란트식립 : 증례보고)

  • Lim, Hun-Jun;Kim, Moon-Seob;Lee, Dae-Jung;Lee, Jong-Bok;Min, Seung-Ki;Paeng, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.419-424
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    • 2009
  • Odontogenic myxoma, a rare tumour that occurs in the jaws, locally invasive, destructive tumors that do not metastasize to lymph nodes. Large odontogenic myxoma on mandible is treated by mandibulectomy, defected mandible is reconstructed by bone graft. Reconstructed mandible is difficult to reconstruct dentition using implant because of deficiency of bone amount. So it is necessary to additional bone graft. But a poor aspect of soft tissue lead to unsatisfactory result. Because of distraction osteogenesis is possible to reconstruction of an amount of bone and soft tissue, that is advantage to reconstruction of alveolar bone on reconstructed mandible. We report with review of literatures the 25 years old male patient who had odontogenic myxoma in left mandible, was undergone mandibulectomy and successfully implant installation and prosthetic restoration after distraction osteogenesis(Track $Plus^{(R)}$, KLS Martin, Germany) on the reconstructed mandible with a free iliac bone graft, and we have conservative and successful result.

A Prognosis Evaluation after Iliac Bone Graft in Cleft Alveolus Patients (치조열 환자의 장골이식술 후 예후 평가)

  • Hong Jin-Ho;Soh Byung-Soo;Baik Jin-Ah;Shin Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.4 no.2
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    • pp.69-78
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    • 2001
  • Alveolar cleft exists in 75% of cleft patients, In alveolar cleft patients, alar base is widening, palatal fistular formation, maxillary growth disturbance & tooth loss of adjacent area is raised, Alveolar bone grafting, especially iliac bone grafting, is a general treatment method. As operation timing, bone grafting is classified with primary, early secondary, secondary, & late secondary, Here we report cleft width, marginal bone height, bone resorption rate, grafted shape & bone densities after secondary iliac bone grafting was done in the Dept. of oral and maxillofacial surgery of chonbuk national university hospital. We compared cleft width to bone resorption rate and grafted shape. Also, alveolar bone densities of grafted and contralateral site was compared with Emago 3 package? (Oral Diagonostic System, The Netherlands), The data obtained were analyzed using Spearman's rho coefficients and sign test with SPSS for window, The results were obtained as follows. 1. As alveolar cleft width is increase, bone resorption rate is, too. This relation showed significant difference(P<.01). 2, In proximal & distal area, alvolar cleft width and bone graft contour after bone grafting had a reverse proportional difference. It was not significant difference(P>.05). 3. After 3 month, in bone density results by using Emago 3 package? with periapical standard view, occlusal view & panoramic view, differences between grafted bone and alveolar bone of contralateral site didn't show a significant difference(P>.05). Thus, differences of bone densities in the alveolar bones didn't exist.

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Clavicle Nonunion: Matchstick Bone-grafting and Osteosynthesis

  • Park, Yong Bok;Yoo, Jae Chul;Park, Geun Min;Kum, Dong Ho;Tauheed, Mohammed;Jeong, Jeung Yeol
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.33-38
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    • 2016
  • Background: This study was conducted to evaluate the surgical outcomes of plate fixation using autologous iliac bone graft shaped in the form of a matchstick in clavicle nonunion resulting from prior surgical or non-surgical management. Methods: From May 2005 to February 2013, 17 patients underwent surgery for clavicle nonunion. The mean age at the time of surgery was 48.8 years. The iliac bone was harvested and shaped into slivers approximately 3 cm long, which resembled matchsticks. After opening of the medullary canal, the plate and screws were applied and cancellous bone was placed at the nonunion site. Matchstick bone grafts which were longitudinally placed and encircled on the nonunion site were tied with periosteum using 3-4 stitches. Union was determined via postoperative plane X-ray. Clinical status was evaluated using the visual analogue scale score for pain, and Constant and American Shoulder Elbow Surgeon score. Results: All patients had a stable radiological union at the follow-up. The mean duration from index operation to nonunion operation was 13.2 months (7-32 months). The mean follow-up period was 20.1 months (8-56 months), and the mean duration until union was 11.2 weeks (8-16 weeks). All clinical scores were improved at the final follow-up (p<0.001). The mean segmental defect was $3.3{\pm}2.6mm$ (1-18 mm); and the difference in clavicular length between operative and non-operative site was $5.9{\pm}6.9mm$. Conclusions: Matchstick shaped autologous iliac bone grafting technique in clavicle nonunion is acceptable with a high union rate.

Strut Support with Tricortical Iliac Allografts in Unstable Proximal Humerus Fractures: Surgical Indication and New Definition of Poor Medial Column Support

  • Lee, Seung-Jin;Hyun, Yoon-Suk;Baek, Seung-Ha
    • Clinics in Shoulder and Elbow
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    • v.22 no.1
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    • pp.29-36
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    • 2019
  • Background: The execution of fibular allograft augmentation in unstable proximal humerus fractures (PHFs) was technically demanding. In this study, the authors evaluated the clinical and radiographic outcomes after tricortical iliac allograft (TIA) augmentation in PHFs. Methods: We retrospectively assessed 38 PHF patients treated with locking-plate fixation and TIA augmentation. Insertion of a TIA was indicated when an unstable PHF showed a large cavitary defect and poor medial column support after open reduction, regardless of the presence of medial cortical comminution in preoperative images. Radiographic imaging parameters (humeral head height, HHH; humeral neck-shaft angle, HNSA; head mediolateral offset, HMLO; and status of the union), Constant score, and range of motion were evaluated. Patients were grouped according to whether the medial column support after open reduction was poor or not (groups A and B, respectively); clinical outcomes were compared for all parameters. Results: All fractures healed radiologically (average duration to complete union, 5.8 months). At final evaluation, the average Constant score was 73 points and the mean active forward flexion was $148^{\circ}$. Based on the Paavolainen assessment method, 33 patients had good results and 5 patients showed fair results. The mean loss of reduction was 1.32 mm in HHH and 5.02% in HMLO. None of the parameters evaluated showed a statistically significant difference between the two groups (poor and not poor medial column support). Conclusions: In unstable PHFs, TIA augmentation can provide good clinical and radiological results when there are poor medial column support and a large cavitary defect after open reduction.