• Title/Summary/Keyword: Metaphyseal cortical defects

Search Result 2, Processing Time 0.019 seconds

Radiographic Classification and its Clinical Features for Metaphyseal Cortical Defect of the Distal Femur (대퇴골 원위부 골간단의 피질골 결손에 대한 방사선학적 분류 및 그에 따른 임상적 경과관찰)

  • Park, Il-Hyung;Oh, Chang-Wug;Min, Woo-Kie
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.5 no.1
    • /
    • pp.17-22
    • /
    • 1999
  • Over 60 cases were enlisted, but only 31 cases among 24 patients were eligible with a minimum follow-up of 1 year and complete medical documents with imaging data. There were 18 boys and 6 girls, and 7 patients had bilateral lesions. The age of the patients ranged from 2 to 20 years(mean:10.5 years). At their first visit, most lesions had a highly characteristic location and radiographic appearance of radiolucent lesion(s) ranging from 1 to 3cm, except for one case of 5.5 cm in the posteromedial comer of distal femoral metaphysis. The margins were generally well-defined, although some were ill-defined. After reviewing our cases from the viewpoint of clinical course and radiographic patterns, we divided these lesions into two types. Type I is the osteolytic lesion excavated into the posteromedial aspect of the distal femur without cortical defect; and type II is the buldged out lesion of the femur with cortical irregularity into the surrounding soft tissues. Both types have distinctive clinical courses. Type I lesions were easy to make a definite diagnosis with plain radiographs alone, but in type II, it was sometimes very difficult to differentiate it from malignant tumors or chronic localized osteomyelitis. For this lesion, Gd-enhanced MRI was the most effective method for differential diagnosis. In this study, biopsy was not necessary to confirm the diagnosis. Clinical symptoms of type I were very minor or even absent. Many of them were accidentally found after minor trauma around the knee joint. Clinical symptoms disappeared far earlier than radiographical lesions. No treatment such as restriction of activity or drugs was necessary. For type II, the clinical symptoms were more accentuated and lasted longer, and it was necessary to restrict the activity for a certain period in many cases. However, all were self-limited.

  • PDF

Allogeneic Inlay Cortical Strut Grafts for Large Cysts or Post-curettage Cavitary Bony Defects (거대 낭종성 골병소 또는 소파 후 잔유 골 결손부에 시행한 내재형 동종 피질 지주골 이식술)

  • Chung, Yang-Guk;Kang, Yong-Koo;Kim, Chol-Jin;Lee, An-Hi;Park, Jeong-Mi;Bahk, Won-Jong;Yoo, Hyun-Ho
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.17 no.2
    • /
    • pp.73-78
    • /
    • 2011
  • Purpose: This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones. Materials and Methods: Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months. Results: Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up. Conclusion: Inlay cortical strut graft provided additional mechanical stability and bone stock for screw purchase in large cyst or cavitary defects of long bones, which allow early mobilization and excellent functional outcome.