• Title/Summary/Keyword: bone deformity

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Establishment of Early Diagnosis and Surgical Operative Method in Puppies with Congenital Patellar Luxation (선천성 슬개골탈구를 지닌 자견의 조기 진단법 및 외과적 수술법 확립)

  • 정순욱;박수현
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.309-320
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    • 1999
  • Medial patellar luxation in dogs is one of the most common patellar problems presented to the veterinary practitioner. It is observed in toy and miniature breed and the majority of cases is a congenital form. Because of extensor mechanism's instability, it causes deformity and disorder in the growth of the affected limb when the luxation is left without treatment As lameness is not easily detectable in puppies, early diagnosis and correction are essential for therapy. Up to now, there has not been any reports refering to the diagnostic methods and the optimal age for correction in young dogs. Thirteen 45-90 days old puppies, have grade I and/or II medial patellar luxation. Only by palpation, all 13 dogs were diagnosed of patelar luxation. Skyline radiographic view was useful to interpret patellar morphology and depth of trochlear groove only above 60 days old. However, it was difficult to make definite diagnosis patellar luxation. The caudocranial and lateral radiographic view as well as ultrasonographic skyline view were not showed of patellar luxation. 2 puppies had unilateral patellar luxation and 11 puppies had bilateral patellar luxation which more serious on the left than on the right. Only 3 puppies among 11 puppies with bilateral patellar luxation were observed of lameness degree 1. Regardless of grade of patellar luxation and lameness, we performed trochlear chondroplasty using a U-shape sculpture blade to minimize cartilage injury, transposition of tibia tuberosity with No. 1 Supramid to align extensor mechanism and lateral imbrication. After surgery, we examined the operated animal daily for 10 days and on 15, 30 and 60 days after surgery respectively. After operation, pain and fever became normal on 7 days, swelling on 10 days, respectively. On 10 days after surgery, dogs showed normal standing position, and normal walking was observed in 15 days after surgery. In force plate analysis, the operated legs were normal weight bearing at 30 days after operation. After surgery, not only patellar luxation and clinical signs have been gradually reduced but also bone growth have become normal without showing growth physeal plate injury. The survival rate of puppies over 62 days old was 100%, while 42-45 days old 37.5%. The above results suggest that optimal age for surgical correction of congenital medial patellar luxation is recommended over 60 days old. In conclusion, combination of trochlear chondroplasty, transposition of tibia tuberosity, and lateral retinacular imbrication is appropriate for over 60 days old puppies to efficiently correct patellar luxation.

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A Cephalometric Analysis of Lateral Morphologic Feature in Adult Cleft Lip and Palate Patients (구순 구개열 환자의 성장 후 안모에 관한 두부방사선학적 계측)

  • Choi Sang-Hee;Chun Sang-Deuk;Yoon Hong-Sik;Lee Hee-Kyung;Chin Byung-Rho
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.1-15
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    • 2003
  • Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of development of maxillofacial region in adult cleft lip and palate patients and to compare post-treat-ment craniofacial morphology between cleft lip and palate patients with secondary alveolar bone graft group and normal group. The material for this study consisted of 20 adult male patients with cleft lip and palate(mean 22.5, range 18-31) visited in Yeungnam University medical center. Cephalometric tracing and measurements were done by one investigator. Results were followed: The values of Na. perpendicular to point A, SNA angle and Pogonion to Na. perpendicualrwere -4.93±5.70, 76.45±4.69, and -6.38±6.73. The values of effective maxillary length, effective mandibular length, mandibular plane angle and facial axis angle were 85.6±4. 42, 123.88±7.10, 29.9±5.09 and 5.53±2.03. The value of upper incisors to point A was 3.95±2.74.

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A CASE OF DELAYED ERUPTION IN A CHILD WITH MONOSTOTIC FIBROUS DYSPLASIA (단골성 섬유성이형성증 환아에서 나타난 맹출지연)

  • Min, Soo-Young;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Byung-Jae;Choi, Hyung-Jun;Kim, Seung-Hye;Song, Je-Seon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.270-275
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    • 2011
  • Fibrous dysplasia is a developmental tumor-like condition that is characterized by replacement of normal bone by an excessive proliferation of cellular fibrous connective tissue intermixed with irregular bony trabeculae. Craniofacial lesions may cause facial pain, headache, cranial asymmetry, facial deformity, tooth displacement and visual or auditory impairment. In this case, a 2-year-9-month old boy who was diagnosed as the fibrous dysplasia showed delayed eruption on affected area. Teeth of left lateral dentition group have erupted completely but teeth of right lateral dentition group are erupting slowly. Eruption and maturation of affected teeth are in progress, so continuous observation is required presently. If the eruption state stops, surgical opening or forced eruption of the impacted teeth will be considered.

Correlation between Karyotype and Phenotype in Turner Syndrome (터너증후군의 핵형과 표현형간의 연관성)

  • Shim, Ye-Jee;Hwang, Young-Ju;Lee, Kun-Soo
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.67-73
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    • 2009
  • Purpose : In spite of the karyotype and phenotype diversity in Turner syndrome patients, there are few reports about such differences in Korea. We reviewed the data of chromosome abnormalities, clinical manifestations, and comorbidities of Turner syndrome patients in Kyungpook National University Hospital to compare them to the recent hypotheses about sex chromosome gene loci related to Turner symptoms. Materials and Methods : We identified the cytologic findings of 92 patients with Turner syndrome and the clinical findings of 62 patients among them. Results : 54.3 percent of patients had 45,X while 45.7 percent showed other karyotype combinations (45,X/46,XX, 45,X/46,XX/47,XXX, 46,X,del(Xp), 46,X,del(Xq), 45,X/46,X,del(Xq), 46,X,i(Xq), 45,X/46,X,i (Xq)). The Turner symptoms found included short neck, high arched palate, broad chest, Madelung deformity, short metacarpals, scoliosis, cubitus valgus, low hair line, webbed neck, edematous extremities, pigmented nevus, and sexual infantilism. The specific diseases associated Turner syndrome included renal abnormalities, congenital heart disease, hearing defects, diabetes mellitus, hyperlipidemia, and decreased bone density. The phenotype of the mosaicism group was milder than that of the monosomy group. In the case of 46,X,del(Xp) and 45,X/46,X,del(Xq) groups, all had skeletal abnormalities, but the 46,X,del(Xq) group had none. In the case of 46,X,del(Xp) group, all showed short statures and skeletal abnormalities, but no sexual infantilism was observed. In the case of 46,X,i(Xq) and 45,X/46,X,i(Xq) groups, they all showed delayed puberty and had primary amenorrhea. Conclusion : It is important to study karyotype-phenotype correlations in patients with Turner syndrome to obtain interesting information about the genotype-phenotype correlations related to the X chromosome.

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In vivo 3-dimensional Kinematics of Cubitus Valgus after Non-united Lateral Humeral Condyle Fracture

  • Kim, Eugene;Park, Se-Jin;Lee, Ho-Seok;Park, Jai-Hyung;Park, Jong Kuen;Ha, Sang Hoon;Murase, Tsuyoshi;Sugamoto, Kazuomi
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.151-157
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    • 2018
  • Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

3-D FEA on the intrusion of mandibular anterior segment using orthodontic miniscrews (교정용 미니스크류를 이용한 하악 전치 함입 시 변위양상의 3차원 유한요소분석)

  • Park, Hyun-Kyung;Sung, Eui-Hyang;Cho, Young-Soo;Mo, Sung-Seo;Chun, Youn-Sic;Lee, Kee-Joon
    • The korean journal of orthodontics
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    • v.41 no.6
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    • pp.384-398
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    • 2011
  • Objective: The purpose of this study was to analyze the stress distribution and the displacement pattern of mandibular anterior teeth under various intrusive force vectors according to the position of orthodontic miniscrews and hooks, using three-dimensional finite element analysis. Methods: A three-dimensional finite element model was constructed to simulate mandibular teeth, periodontal ligament, and alveolar bone. The displacement of individual tooth on three-dimensional planes and the von Mises stress distribution were compared when various intrusion force vectors were applied. Results: Intrusive forces applied to 4 mandibular anterior teeth largely resulted in remarkable labial tipping of the segment according to the miniscrew position. All 6 mandibular anterior teeth were labially tipped and the stress concentrated on the labiogingival area by intrusive force from miniscrews placed mesial to the canine. The distointrusive force vector led to pure intrusion and the stress was evenly distributed in the whole periodontal ligament when the hook was placed between the central and lateral incisors and the miniscrew was placed distal to the canine. Conclusions: Within the limits of this study, it can be concluded that predictable pure intrusion of the 6 anterior teeth segment may be accomplished using miniscrews placed distal to the canine and hooks located between the central and lateral incisors.

In vivo 3D Kinematics of Axis of Rotation in Malunited Monteggia Fracture Dislocation

  • Kim, Eugene;Park, Se-Jin;Jeong, Haw-Jae;Ahn, Jin Whan;Shin, Hun-Kyu;Park, Jai Hyung;Lee, Mi Yeon;Tsuyoshi, Murase;Sumika, Ikemototo;Kazuomi, Sugamoto;Choi, Young-Min
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.25-30
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    • 2014
  • Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

MANAGEMENT OF DENTIGEROUS CYST AND ERUPTION GUIDANCE OF INVOLVED TEETH USING OBTURATOR (Obturator를 이용한 함치성 낭종의 처치 및 이환된 치아의 맹출 유도)

  • Im, Chul-Seung;Lim, Kwang-Ho;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.4
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    • pp.669-676
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    • 1999
  • The dentigerous cysts originate through alteration of the reduced enamel epithelium after amelogenesis is completed, with accumulation of fluid between the layers of the enamel epithelium, or between this epithelium and the tooth crown. Next to the radicular cyst, they are the second most common type of odontogenic cyst. They occur over a wide age range with a peak frequency in the 2nd to 3rd decade. A substantial majority involve the mandibular third molars, followed in order of frequency by the maxillary permanent canines, mandibular second premolars, and maxillary third molars. With regard to the treatment of these cysts, the marsupialization procedure with obturator is recommended during the age when the eruptive force of the teeth is still strong. It can be effective when preservation of the displaced teeth is desirable. We treated the dentigerous cyst by marsupialization with obturator and guided the eruption of involved teeth to normal position. And we got the results as follows : 1. Severely dislocated teeth associated with dentigerous cyst erupted into proper position. 2. The enamel hypoplasia and the root deformity were observed some cases. 3. The bone expansion and defect were healed without infection and recurrence.

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Shortening Scarf Osteotomy for Treatment of Hallux Rigidus Deformity (단축 Scarf 절골술을 이용한 무지 강직증의 치료)

  • Lee, Yeong Hyeon;Ahn, Gil Yeong;Nam, Il Hyun;Lee, Tae Hun;Lee, Yong Sik;Kim, Dae Geun;Lee, Young Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.152-157
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    • 2016
  • Purpose: To evaluate the effect of shortening scarf osteotomy on pain relief and range of motion (ROM) of the first metatarsophalangeal joint in hallux rigidus patients. Materials and Methods: Twenty-three cases of 19 patients who had been treated with shortening scarf osteotomy for the hallux rigidus between January 2007 and December 2013 were reviewed. The mean follow-up period was 21.4 months, and the mean age was 59.2 years. The first metatarsal bone was shortened until the ROM of the first metatarsophalangeal joint was greater than $80^{\circ}$ or $40^{\circ}$ of dorsiflexion. The length shortened by scarf osteotomy was measured. The authors also measured and compared the joint interval difference of the standing foot using an anteroposterior radiography. Moreover, the difference of ROM of the first metatarsophalangeal joint between the preoperative and final follow-up periods was also compared. The clinical results were evaluated and compared using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and visual analogue scale (VAS) score. Results: The mean shortening length was about 6.5 mm (range, 4~9 mm). The joint space has been increased to 1.8 mm, and the ROM of the first metatarsophalangeal joint has also been increased to $18.4^{\circ}$ after the operation. In three cases, the postoperative ROM has been decreased to less $10^{\circ}$. The AOFAS score has been improved from 41.7 (range, 32~55) to 86.2 (range, 65~95), and the VAS score was also decreased from 3.7 (range, 3~5) to 1.3 (range, 0~3). Two cases have shown no decrease in pain even after the operation. Conclusion: Shortening scarf osteotomy was found to decrease joint pain by decompressing the pressure of the first metatarsophalangeal joint. This osteotomy also helped improve the ROM of the first metatarsophalangeal joint. Shortening scarf osteotomy can be considered one of the effective methods for joint preservation.

LOCATION OF THE DESCENDING PALATINE ARTERY IN RELATION TO THE LE FORT I OSTEOTOMY IN KOREANS (한국인에 있어서 하행구개동맥의 위치 연구 (Le Fort I형 골 절단술과 관련하여))

  • Lee, Il-Gu;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Lee, Jong-Ho;Choung, Pil-Hoon;Kim, Myung-Jin;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.6
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    • pp.509-512
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    • 2007
  • Purpose: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy. Methods and patients: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery (DPA distance) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height. Results: The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right (range: $30{\sim}40mm$) and 33.7mm (range: $30{\sim}41mm$) on the left in males. Those in females were 33.4 mm on the right (range: $28{\sim}40mm)$ and 32.8mm (range: $27{\sim}38mm$) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. Conclusion: Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in mal, and 27 mm in female.