• Title/Summary/Keyword: distal femur

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Stress analysis of the effect of debonding of cement-femoral stem interface to the bone-cement interface -A three-dimensional Finite Element Analysis- (시멘트-대퇴Stem 경계면 해리가 골-시멘트 경계면에 미치는 응력 분석 -3차원 비선형 Finite Element Analysis-)

  • Kim, S.K.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.337-346
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    • 1996
  • Debonding of cement-femoral stem interface has been suggested as a initial focus of loosening mechanism in many previous studies of cemented total hip replacement. The purpose of this study was to investigate the effect of debonding of cement-femoral stem interface to the bone-cement interface by using three-dimensional non-liner finite element analysis. Three cases of partial debonded, full debonded, full bonded cement-bone interface were modelled with partial bonding of distal 70mm from the tip of femoral stem. Each situation was studied under loading stimulating one-leg stanced gait of 68kg patient. The results showed that under partial and full debonded cement-stem interface condition the peak von Mises stress(3.1 MPa) were observed at the cement of bone-cement interface just under the calcar of proximal medial of femur, and sudden high peak stresses(3.5MPa) were developed at the distal tip of femoral stem at the lateral bone-cement interface in all 3 cases of bonding. The stresses were transfered very little to the cement of upper lateral bone-cement interface in partial and full debonded cases. Thus, once partial or full debonded cement-femoral stem interface occured, 3 times higher stress concentration were developed on the cement of proximal medial bone-cement interface than full bonded interface, and these could cause loosening of cemented total hip replacement. Clinically, preservation of more rigid cement-femoral stem interface may be important factor to prevent loosening of femoral stem.

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The Role of Angled Blade Plate in Treatment of Bone Tumor Occurred in Femur (대퇴골 골종양의 치료에 있어서의 Angled Blade Plate의 역할)

  • Kim, Tai-Seung;Kang, Chang-Nam;Chung, Ung-Seo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.175-182
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    • 2005
  • Purpose: Bone tumor occurred in femur frequently involve proximal intertrochanteric region or distal metaphyseal region. Sometimes, the pathologic fracture can happen according to the size of tumor due to the substantial biomechanical stresses. Therefore, the prognosis can be improved biomechanically by the angled blade plate considering the anatomic configuration after the excision of tumor. Materials and Methods: Between October 1991 and April 2005, there were a total of 16 patients(17 cases) who were treated by the excision of tumor and internal fixation with the angled blade plate for bone tumor occurred in femur. After the excision of tumor, we filled the cavity by bone graft in 11 cases and bone cement in 6 cases. The internal fixation was used by angled blade plate in all cases. Result: The average follow-up time was 55.5 months(6-144 months) in 16 patients(17 cases). No metal failure occurred after the operation. Reoperation was performed in 4 cases due to tumor recurrence, and the internal fixation was firm until that. Conclusion: The angled blade plate can prevent the fracture until grafted bone incorporated to host bone, and protect fragile connection between cement and host bone.

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Femur Fractures Associated with Benign Bone Tumors in Children (양성 골종양을 동반한 소아 대퇴골의 병적 골절)

  • Jung, Sung-Taek;Kim, Byung-Soo;Moon, Eun-Sun;Lee, Keun-Bae;Seo, Hyoung-Yeon
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.111-117
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    • 2005
  • Purpose: We evaluate the results of treatment of pathologic femur fractures secondary to bone tumors in children. Materials and Methods: Between January 1995 and June 2004, 18 patients(20 cases) were evaluated. Their mean age of the first episode of fracture was 10.2 years and mean follow-up period is 42.5 months. Primary bone tumors, the location of fracture, time to union and complications were evauated. Results: Fractures occurred at proximal portion in 14 cases, shaft 3 cases and distal portion 3 cases. The bone tumors causing pathologic fracture were fibrous dysplasia(9 c ases), simple bone cyst(4 cases), aneurysmal bone cyst(4 cases), nonossifying fibroma(2 cases) and eosinophilic granuloma(1 case). In the treatment for fractures, cast was in 11 cases, internal fixation 8 cases and external fixation in 1 case. In the treatment for tumors, observation was in 11 cases, curettage & bone graft in 8 cases and resection in 1 case. In polyostotic fibrous dysplasia, all cases were treated by cast initially but deformity developed in all cases. Fracture prevention and deformity correction were obtained with intramedullary nailing. Conclusion: Adequate choice of treatment of bone tumor and fracture will result in good prognosis.

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Complications of Femoral Lengthening Using Monolateral External Fixator in Rabbits (토끼에서 단측성 외고정기구를 이용한 대퇴골 신연술의 합병증)

  • Song, Hae-Ryong;Hwang, Jae-Min;Koo, Ja-Min;Kim, Hyeon-Hui;Lee, Won-Ik;Kim, Gon-Sup;Lee, Hyo-Jong;Chang, Ki-Churl;Yeon, Seong-Chan
    • Korean Journal of Veterinary Research
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    • v.42 no.3
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    • pp.411-418
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    • 2002
  • Thirty rabbits underwent femoral lengthening using monolateral external fixator to evaluate results and complications of limb lengthening. Twenty rabbits survived until consolidation of callus formed at the lengthening site after finishing lengthening. Ten rabbits were sacrificed during femoral lengthening because of complications. Survived 20 rabbits were classified to two groups according the amount of lengthening: group I (10% lengthening of the femoral length); group II (20% lengthening). There was no significant difference of consolidation time between two groups (p=0.25). Varus angulation at the lengthening site occurred in 60% of two groups and the amount of varus angulation in group II was larger than that of group I. Degenerative change of articular cartilage at the medial condyle of the distal femur was found in 30% of group II. Of sacrificed ten rabbits, 5 had pin loosenings with pull an of pins from the femur, 2 had fermoral fractures around the pin-tract site, and 3 had severe osteomyelitis of the femur around the pin-tract site.

A CASE REPORT OF OSTEOCHONDROMA ON MANDIBULAR CONDYLE (하악골 과두에 발생한 골연골종의 치험례)

  • Kim, Mi-Suk;Lee, Mi-Hyang;Jang, Chang-Soo;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.2
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    • pp.298-307
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    • 1996
  • Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and the proximal metaphysis of the tibia, however, is occurred rarely on the facial skeleton. Development of the tumor is most frequently seen in the second or third decades of life. Typically, it arises directly from the cortex of the underlying bone, without any intervening zone of abnormal osseous tissue, and is covered by a cap composed of cartilage undergoing calcification. In case of osteochondroma of the mandibular condyle, its clinical features are occulusal change, facial asymmetry, headache, pain and click on temporomandibular joint, mouth opening limitation, and jaw deviation to involved site. This is a case report of a 13-year old woman who had mouth opening limitation and severe temporomandibular joint pain. We obtained successful results with surgical removal of the osteochondroma on the mandibular condyle.

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Painful Snapping Shoulder Complicating Soft Tissue Pseudotumor Secondary to Rib Osteochondroma: A Case Report (늑골의 골연골종에 속발된 가성 연부조직 종괴에 합병한 통증성발음성 견갑증상증후군)

  • Moon, Myung-Sang;Jeon, Dal-Jae;Kim, Sung-Soo;Yoon, Min Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.27-31
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    • 2014
  • Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the $6^{th}$ rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.

Correlation between anterior thigh pain and morphometric mismatch of femoral stem

  • Chung, Haksun;Chung, So Hak
    • Journal of Yeungnam Medical Science
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    • v.37 no.1
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    • pp.40-46
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    • 2020
  • Background: Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint. Methods: The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain. Results: Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain. Conclusion: Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

Radiographic Evaluation of Femoral Tunnel Placement During ACL Reconstruction (전방 십자 인대 재건술시 대퇴 터널의 위치에 대한 방사선학적 평가)

  • Chung, Hyun Kee;Choi, Choong Hyeok;Lee, Joong Hak
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.80-84
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    • 1998
  • The isometric position for the graft is important in the anterior cruciate ligament reconstruction surgery. It is well known that the femoral position is more critical than tibial side. But, there is few deciding method of proper graft position after the anterior cruciate ligament reconstruction surgery. So we planned to evaluate the ideal femoral isometric position with 6 adult cadavaric femurs and exact radiographs. After the insertion of femoral interference screw on ideal isometric position, we obtained roentgenograms of true lateral view and 10, 20, 30, 45 degree internal and external rotation views. Then we measured the shortest distance from the posterior cortical margin of lateral femoral condyle to posterior border of interference screw on the radiographs. We also measured true distance between posterior cortical margin of lateral femoral condyle to the posterior margin of femoral tunnel after cutting of distal femur. Based on this study, we could not determine the permissible rotation degree of radiographs. But we concluded that if the distance between posterior cortical margin of lateral femoral condyle and posterior border of interference screw ranges 4.5-6.5mm on the lateral view, the femoral position is considered as a relatively ideal isometric good position.

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Giant osteochondroma of the parapharyngeal space: a case report

  • Kim, Chul-Hwan;Lee, Yoon-Sun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.35-40
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    • 2013
  • Osteochondroma is a common benign tumor of the axial skeleton, especially in the distal metaphysis of the femur and the proximal metaphysis of the tibia, that can occur on the facial skeleton (albeit rarely). Osteochondroma is differentiated from chondroma, osteochondromatosis and osteoma. Osteochondroma shows an irregular radiopaque lesion and chondromatic area surrounded by the osteoma. When it develops in the long bone, it has a marked tendency to occur at 10 to 20 years of age and ceases with the end of pubertal growth. However, when it develops in the mandibular condyle, it is prevalent in the third decade and continuous to develop. Tumors that develop in the long bone have a predilection for men, but tumors in the mandible have a predilection for women. In osteochondroma of the mandibular condyle, clinical features presented include occlusal changes, facial asymmetry, headaches, pain and joint noise on the temporomandibular joint, mouth opening limitations, and jaw deviation at the involved site. The first choice of treatment for the massive osteochondroma is surgical removal. A 70-year-old female patient with an osteochondroma on her right mandibular condyle visited our clinic. We surgically removed the mass with favorable results. It is presented here along with a review of literature on osteochondroma.

IMMEDIATE RECONSTRUCTION USING VERTICAL RAMUS OSTEOTOMY AND BONE SLIDNG AFTER CONDYLECTOMY DUE TO OSTEOCHONDROMA: A CASE REPORT (골연골종으로 인한 과두절제 후 하악지 수직 골절단술 및 bone sliding을 통한 즉시 재건: 증례보고)

  • Jang, Ji-Young;Oh, Jae-Kyung;Cha, Du-Won;Baek, Sang-Heum
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.233-240
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    • 2007
  • Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and proximal metaphysis of the tibia. However, it occurred rarely on the facial skeleton. The coronoid and condylar processes have been considered to be the most common sites of occurrence for osteochondroma of the facial skeleton. The first treatment of osteochondroma is condylectomy, whereas extirpation was done by excision with condyle salvage. Condylectomy presents decrease of vertical dimension, jaw deviation, malocclusion. So, reconstruction is need. Methods of reconstruction are as follows: no reconstruction, condyloplasty, discectomy, costochondral graft, discplication or coronoidectomy, eminoplasty, alloplastic spacer placement, Le Fort I level maxillary osteotomy, extraoral and intraoral vertical ramus osteotomy. This is a case report of a 28-year old woman who had facial asymmetry, malocclusion and temporomandibular joint pain. We obtained moderate functional and cosmetic results with surgical removal of the osteochondroma by condylectomy and concomitant reconstruction of condyle by vertical ramus osteotomy with sliding technique.