• Title/Summary/Keyword: bone reconstruction

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Treatment of fibrous dysplasia of the zygomaticomaxillary complex with radical resection and three-dimensional reconstruction with autologous calvarial bone graft

  • Ahn, Sung Jae;Hong, Jong Won;Kim, Yong Oock;Lew, Dae Hyun;Lee, Won Jai
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.200-204
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    • 2018
  • Fibrous dysplasia (FD) is a rare, benign bone disease with abnormal bone maturation and fibroblastic proliferation. Optimal treatment of zone 1 craniofacial FD is radical resection and reconstruction. To achieve of structural, aesthetic, and functional goals, we use three-dimensionally designed calvarial bone graft for reconstruction of zygomatic defect after radical resection of FD. The authors used a rapid-prototyping model for simulation surgery for radical resection and immediate reconstruction. Donor site was selected from parietal bone reflect shape, contour, and size of defect. Then radical resection of lesion and immediate reconstruction was performed as planned. Outcomes were assessed using clinical photographs and computed tomography scans. Successful reconstruction after radical resection was achieved by three-dimensional calvarial bone graft without complications. After a 12-month follow-up, sufficient bone thickness and symmetric soft tissue contour was well-maintained. By considering three-dimensional configuration of zygomaticomaxillary complex, the authors achieved satisfactory structural, aesthetic and functional outcomes without complications.

ACL Reconstruction: Bone-Patellar Tendon-Bone Autograft (전방 십자 인대 재건술: 골-슬개건-골 자가이식물)

  • Koh, Hae-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.102-108
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    • 2005
  • The incidence of anterior cruciate ligament tears is increasing as a result of the increasing participation of individuals of all ages in high-risk sports. Endoscopic anterior cruciate ligament reconstruction using autogenous central third bone-patellar tendon-bone graft is the most commonly used method. With regard to BPTB graft as the go]d standard in ACL reconstruction, there are no data that refute this claim to date. Author reviewed the biomechanical properties, donor site morbidity and selection of the bone-patellar tendon-bone graft and described the surgical technique of endoscopic ACL reconstruction using BPTB autograft.

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Autogenous Low Heat Treated Bone Graft for Bone Reconstruction in Bone and Soft Tissue Tumors (골연부 종양에서 저온 열처리한 자가골을 이용한 재건술)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Cho, Wan-Hyeong;Kwag, Bong-Jun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.2
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    • pp.81-87
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    • 1998
  • Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

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All-Inside Technique of Anterior Cruciate Ligament Reconstruction using Central Quadriceps Tendon and Patella Bone Block (관절강 내에서 모든 수술 과정을 시행하는 관절경적 전방십자인대 재건술)

  • Jeong, Hwa-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.66-71
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    • 1997
  • The all inside anterior cruciate ligament reconstruction technique places an anterior ligament substitutes within two bony sockets rather than hone tunnel. This approach is accomplished through arthroscopic three portal which avoids the surgical exposure and morbidity associated with creating traditional bone tunnel. This technique has several distinct advantages when compared with the traditional ACL reconstruction through the bone tunnels. It offers the surgeon a less morbid method for ACL reconstruction that positions an ACL substitute at the anatomic attachment sites of the original ACL with two bone sockets, obviating the need for traditional bone tunnels. Graft fixation at or near the anatomic attachment points of the original ACL minimizes creep with early range of motion and reduces the abrasive 'wind-shield wipe' motion of the graft which occur with bone plugs positioned inside bone tunnels. The sagittal posterior angle to the tibial socket increases fixation strength to pullout with anterior translation force for the tibia on the femur. This technique is not graft specific and can accomodate any graft in which graft length can be customized to the intraarticular native ACL length.

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RECONSTRUCTION OF ALVEOLAR CLEFTS WITH ILIAC CANCELLOUS PARTICULATE OR BLOCK BONE GRAFTS : A COMPARATIVE STUDY (장골의 해면 입자골 또는 블럭골을 이용한 치조열의 재건에 관한 비교 연구)

  • Choi, Byung-Ho;Yi, Choong-Kook;Min, Yon-Sook;Hong, Soon-Xae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.189-191
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    • 2001
  • Objective : The objective of this study was to determine which forms of iliac cancellous bone grafts better restore alveolar clefts. Study design : Forty consecutive patients who required a unilateral alveolar cleft graft were studied. Group I (20 patients) had reconstruction with iliac cancellous particulate bone grafts and group II (20 patients) had reconstruction with iliac cancellous block bone grafts. The two groups were evaluated radiographically and clinically. Results : The group with the block bone grafts showed less postoperative problems and better incorporation of the bone graft than the group with the particulate grafts. Conclusion : Surgical reconstruction of alveolar process defects in patients with alveolar cleft using iliac cancellous block bone is a more reliable method than particulate bone grafts both for closing the oronasal fistula and for building interalveolar septal height.

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Reconstruction of Metaphyseal Defect of Large Long Tubular Bone with Double Barreled Fibular Graft (중첩한 비골 이식술을 이용한 대형 장골의 골 간단부 결손의 재건)

  • Chung, Duke-Whan;Park, Jun-Young
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.50-56
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    • 2005
  • There are limited treatment options in the reconstruction of the very large defect in the metaphyseal portion of distal femur and proximal tibia. Fibula is one of the most popular donor of the long bone reconstruction in reconstructive microsurgical field. It has many advantages such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter and long pedicle. There are limited donor site problems such as transient peroneal nerve dysfunction. In those situations with the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transferred. We performed 7 cases of "doule barrel" fibular transplantation on the metaphyseal portion of distal femur and proximal tibial large defects in which it is very difficult to fill the bony gap with conventional bone graft or callotasis methods. It takes averaged 8.3 months since that procedure to obtain bony union. After solid union of the transferred double barrelled fibular graft. There were no stress fracture in our series. So we can propose double barrel fibular graft is useful method in those cases with very large bone defect on the metaphysis of large long bone.

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Reconstruction of Mandibular Bone Defect Using a Titanium Mesh with Autogenous Particulate Cortical Bone Graft by an Intraoral Approach: A Case Report (구강내 접근으로 자가 분쇄 피질골과 Titanium Mesh를 이용한 광범위한 하악골 골결손부 재건: 증례보고)

  • Choi, Seok-Tai;Leem, Dae-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.466-472
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    • 2012
  • The loss of mandibular continuity due to trauma, neoplasm, or infection results in major esthetic and biologic compromise. The reconstruction of the mandibular bone defect still poses a challenge to oral and maxillofacial surgeons. There have been a number of variety graft materials. Among them, free block bone graft with rigid fixation has been widely used. However, cases using free block bone grafts may lead to a marked invasion of the donor site, mal-union, and absorption of the block bone. In this respect, particulate cortical bone using a titanium mesh tray can be an effective alternative option in order to achieve a proper bone contour and good oral rehabilitation. We have developed an intraoral approach for the mandibular reconstruction method using a titanium mesh tray with autogenous particulate cortical bone graft.

Reconstruction of Composite Defect of Hand with Two Segmented Osteocutaneous Fibular Free Flap (생비골 유리 피판술을 이용한 수부의 복합조직 결손의 재건)

  • Tark, Kwan-Chul;Kang, Sang-Yoon;Park, Yun-Gyu;Lee, Hoon-Bum;Park, Beyoung-yun
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.44-48
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    • 2000
  • The advent of free bone flaps has made successful replacement of extensive areas of bone loss in the upper and lower extremities. The microvascular free bone flaps have faster healing without bony absorption or atrophy and can heal in the hostile environment of scarred bed or infection. Since the fibula free flap introduced by Taylor and colleague in 1975, it has been used extensively for skeletal reconstruction of extremities. In 1988, the folded vascularized fibula free flap was first described as a technique to reconstruct significant long bone defect of upper and lower extremities. During the same time, the fibular free flap has evolved to become most preferred choice of mandibular reconstruction. Up to present day, few reports have been made on the fibular free flap used for reconstruction of injured hand containing metacarpal bone and soft tissue defect. We present here our new and unique experiences with vascularized fibular osteocutaneous free flap as useful and satisfactory one for reconstruction of hand with composite defects.

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Acellular dermal matrix and bone cement sandwich technique for chest wall reconstruction

  • Heo, Chan Yeong;Kang, Byungkwon;Jeong, Jae Hoon;Kim, Kwhanmien;Myung, Yujin
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.25-28
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    • 2022
  • The authors performed rigid reconstruction using the sandwich technique for full-thickness chest wall defects by using two layers of acellular dermal matrix and bone cement. We assessed six patients who underwent chest wall reconstruction. Reconstruction was performed by sandwiching bone cement between two layers of acellular dermal matrix. In all patients, there was no defect of the overlying soft tissue, and primary closure was performed for external wounds. The average follow-up period was 4 years (range, 2-8 years). No major complications were noted. The sandwich technique can serve as an efficient and safe option for chest wall reconstruction.

Vascularized Bone Graft Reconstruction for Upper Extremity Defects: A Review

  • Ava G. Chappell;Matthew D. Ramsey;Parinaz J. Dabestani;Jason H. Ko
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.82-95
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    • 2023
  • Upper extremity reconstruction may pose clinical challenges for surgeons due to the often-critical, complex functional demands of the damaged and/or missing structures. The advent of vascularized bone grafts (VBGs) has aided in reconstruction of upper extremity (UE) defects due to their superior regenerative properties compared with nonvascularized bone grafts, ability to reconstruct large bony defects, and multiple donor site options. VBGs may be pedicled or free transfers and have the potential for composite tissue transfers when bone and soft tissue are needed. This article provides a comprehensive up-to-date review of VBGs, the commonly reported donor sites, and their indications for the treatment of specific UE defects.