• 제목/요약/키워드: proximal femur

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Updated Surgical Techniques and Expanded Indications of Free Vascularized Fibular Graft

  • Park, Jong Woong
    • Archives of Reconstructive Microsurgery
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    • 제24권2호
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    • pp.41-49
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    • 2015
  • Free or pedicled vascularized fibular grafts (VFG) are useful for the reconstruction of large skeletal defects, particularly in cases of scarred or avascular beds, or in patients with combined bone and soft tissue defects. Compared to non-VFG, VEG, which contains living osteocytes and osteoblasts, maintains its own viability and serves as good osteoconductive and osteoinductive graft. Due to its many structural and biological advantages, the free fibular osteo- or osteocutaneous graft is considered the most suitable autograft for the reconstruction of long bone defects in the injured extremity. The traditional indication of VFG is the long bone and soft tissue defect, which cannot be reconstructed using a conventional operative method. Recently, the indications have been widely expanded not only for defects of midtibia, humerus, forearm, distal femur, and proximal tibia, but also for the arthrodesis of shoulder and knee joints. Because of its potential to allow further bone growth, free fibular epiphyseal transfer can be used for the hip or for distal radius defects caused by the radical resection of a tumor. The basic anatomy and surgical techniques for harvesting the VFG are well known; however, the condition of the recipient site is different in each case. Therefore, careful preoperative surgical planning should be customized in every patient. In this review, recently expanded surgical indications of VFG and surgical tips based on the author's experiences in the issues of fixation method, one or two staged reconstruction, size mismatching, overcoming the stress fracture, and arthrodesis of shoulder and knee joint using VFG are discussed with the review of literature.

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

  • 김미숙;이미향;장창수;김철환
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권2호
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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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치조 골소주 모폴로지 특성과 골다공증의 연관관계에 대한 연구 (Relationship between the morphologic features of alveolar trabecular bone and systemic osteoporosis)

  • 이창진;장훈상;이병도
    • Imaging Science in Dentistry
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    • 제35권3호
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    • pp.141-146
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    • 2005
  • Purpose : The purpose of this study was to investigate the preliminary use of morphologic operation (MO) in analyzing trabecular pattern of alveolar bone for the predicting systemic osteoporosis. Materials and Methods : Study subjects consisted of 35 females (average age 48.5 years) and 25 males (average age 25.8 years). Bone mineral density BMD $(grams/cm^2)$ of lumbar spine and proximal femur of these subjects were measured by a dual energy X-ray absorptiometry (DEXA). Regions of interest (ROIs) were selected from the digitized periapical radiographs of subjects' posterior jaw. A custom computer program processed morphology operations of ROIs. We compared mean values of 11 MO variables according to the osteoporotic group divided by the T-scores of DEXA. We also studied correlation between radiographic density and these MO variables. Results : The mean radiographic densities insignificantly correlated with MO variables. There were statistically significant differences among the values of 9 MO variables according to the osteoporotic group. Conclusion Morphologic operation can be effective in analyzing trabecular pattern of alveolar bone for the predicting osteoporosis.

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저 악성도 연골 육종에서 발생한 미분화 연골육종 - 1례 보고 - (Dedifferentiated Chondrosarcoma from Low Grade Chondrosarcoma)

  • 박종훈;고한상;이수용
    • 대한골관절종양학회지
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    • 제11권2호
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    • pp.213-218
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    • 2005
  • 미분화 연골육종은 연골육종 중 가장 악성도가 높은 종양으로서, 연골육종의 약 10%에서 발생되는 것으로 알려져 있다. 미분화 연골 육종에 의해 발생된 악성종양은 방사선 및 화학요법에 반응을 하지 않아 광범위 종양 절제술만이 근치적 치료법이다. 본 연구는 근위 대퇴골에 발생한 저악성도 연골육종을 보존적으로 수술하고 추시 관찰 중, 골육종으로 미분화한 연골육종 1례를 보고하고자 한다.

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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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    • 제39권1호
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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.

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

  • 장지영;오제경;차두원;백상흠
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권3호
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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.

골육종으로 악성 전환된 섬유성 골 이형성증 - 1예 보고 - (Malignant Transformation of Fibrous Dysplasiainto Osteosarcoma - A Case Report -)

  • 김태승;이진규
    • 대한골관절종양학회지
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    • 제15권1호
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    • pp.87-91
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    • 2009
  • 섬유성 골 이형성증(fibrous dysplasia)은 한 개 또는 수개의 골조직이 섬유성 조직으로 대치되는 양성 골 질환으로 발생학적 장애로 일어나는 양성 골 질환으로 분류된다. 악성 전환(malignant transformation)은 매우 드문 경우로 다발성 섬유성 골 이형성증에서 단발성 섬유성 골 이형성증보다 더 호발하는 것으로 알려져 있다. 저자들은 57세 남자 환자에서 대퇴골 근위부에 병적 골절 및 내반고 변형을 동반한 다발성 섬유성 골 이형증에 대하여 소파술, 절골술, 내고정술 및 골 이식술을 시행 후, 2년 5개월 만에 골육종(osteosarcoma)으로 악성 전환된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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Efficacy of Intra-articular Steroid Injection in Patients with Femoroacetabular Impingement

  • Park, Jung Sun;Jang, Young Eun;Nahm, Francis Sahngun;Lee, Pyung Bok;Choi, Eun Joo
    • The Korean Journal of Pain
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    • 제26권2호
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    • pp.154-159
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    • 2013
  • Femoroacetabular Impingement (FAI) arises from morphological abnormalities between the proximal femur and acetabulum. Impingement caused by these morphologic abnormalities induces early degenerative changes in the hip joint. Furthermore, FAI patients complain of severe pain and limited range of motion in the hip, but a guideline for treatment of FAI has not yet been established. Medication, supportive physical treatment and surgical procedures have been used in the treatment of the FAI patients; however, the efficacies of these treatments have been limited. Here, we report the diagnosis and treatment for 3 cases of FAI patients. Intra-articular (IA) steroid injection of the hip joint was performed in all three patients. After IA injection, pain was reduced and function had improved for up to three months.

동맥류성 골낭종으로 오인된 거골에 발생한 연골모세포종: 증례 보고 (Chondroblastoma of the Talus Mimicking an Aneurysmal Bone Cyst: A Case Report)

  • 박지수;서진수;최준영
    • 대한족부족관절학회지
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    • 제23권1호
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    • pp.31-34
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    • 2019
  • Chondroblastoma is a rare benign tumor that produces giant cells and cartilage matrix. The tumor occurs in people between 10 and 25 years with slightly higher incidence in males. The condition occurs in the proximal epiphysis of the tibia and humerus, distal epiphysis of the femur, but its occurrence in the talus is relatively rare, accounting for 4% of the total number of chondroblastoma cases. Chondroblastoma is often misdiagnosed as a primary aneurysmal bone cyst, giant cell tumor, chondromyxoid, and lesion of a secondary aneurysmal bone cyst by fibrous dysplasia. The most commonly used surgical method for chondroblastoma is broad curettage with bone grafting. In general, an aneurysmal bone cyst is associated with a second degree chondroblastoma, which is approximately 20%. Chondroblastoma of the talus and secondary aneurysmal bone cysts can be misdiagnosed as primary aneurysmal bone cysts. This paper reports a case of a young male patient with chondroblastoma of the talus, which was initially misdiagnosed as an aneurysmal bone cyst with involvement of the talo-navicular joint.

Palm Vitamin E Prevents Osteoporosis in Orchidectomized Growing Male Rats

  • Ima-Nirwana, S.;Kiftiah, A.;Zainal, A.G.;Norazlina, M.;Gapor, M.T.;Khalid, B.A.K.
    • Natural Product Sciences
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    • 제6권4호
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    • pp.155-160
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    • 2000
  • Testosterone deficiency increased bone resorption, giving rise to osteoporosis. Testosterone deficiency also increased lipid peroxidation and free radical formation. Free radicals have been shown to be toxic to osteoblasts as well as to activate osteoclasts. In this study, the effects of giving an antioxidant, i.e. vitamin E-rich extract from palm oil on bone mineral density and calcium content was studied. Palm vitamin E prevented the loss in bone mineral density due to orchidectomy, seen in the whole femur, proximal amd midshaft regions, as well as L4 vertebra. Similar observations were seen in bone calcium content of the L5 vertebra. Giving palm olein also prevented the loss in bone mineral density in the femoral midshaft and L4 vertebra; and bone calcium content in the L5 vertebra. In conclusion, vitamin E-rich extract from palm oil was effective in preventing the loss in bone mineral density and calcium content of orchidectomized male rats. This action is probably due to its role as an antioxidant.

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