• Title/Summary/Keyword: 골결절

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Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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A Case of Metastatic Oral Carcinoma from Rectal Cancer (직장암 유래 전이성 구강 암종의 진단예)

  • Shin, Keum-back;Kang, Kee-hyun;Chae, Gyu-sam
    • Journal of Oral Medicine and Pain
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    • v.24 no.2
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    • pp.171-179
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    • 1999
  • The authors experienced a oral carcinoma involving the medial cortex of the right ramus of mandible and the left side of the maxilla which was metastasized from primary rectal adenocarcinoma based on the comprehensive evaluation of data obtained from (1) the past medical history of primary rectal adenocarcinoma, (2) the computerized tomographic views of the homogeneous mass on the anteromedial region of the right ramus of mandible destructing the medial cortex of the right ramus of mandible, and the irregular mass around the clivus spreading into the sphenoid sinus and destructing the left side of the maxilla ; the bone scanning of hot spots on the nasal region and the left side of maxilla ; the posteroanterior chest radiographic view of multiple nodular radiopacities on the lung, (3) the retrospective review of the sonographic view of a hypoechoic, well-demarcated, target-like mass with central hyperechoic focus on right lobe of liver in a Korean female of 49-year-old who complained the ptosis of left eyelid, the swelling on left zygomatic area, the left facial paralysis, the facial asymmetry and a round-shaped, elevated lesion with a hematoma on the mucosa covering the right ramus of mandible.

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Operative Treatment of Stenosing Tenosynovitis of the Peroneus Longus Tendon Associated with Hypertrophy of the Peroneal Tubercle: A Case Report - 1 Case (비대 비골 결절에 의한 장비골건의 협착성 비골건염의 수술적 치료: 증례 보고-1예)

  • Park, Se-Jin;Jeong, Hwa-Jae;Kim, Eugene;Lee, Jae-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.150-153
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    • 2013
  • An enlarged peroneal tubercle causes lateral ankle and foot pain, and which is a cause for stenosing peroneal tenosynovitis. In this report, we present a case of stenosing tenosynovitis of the peroneus longus tendon associated with hypertrophy of the peroneal tubercle without involvement of the peroneus brevis tendon. Surgical excision of the enlarged peroneal tubercle along with exploration of the peroneal tendons was successful.

Sural Nerve Entrapment and Tenosynovitis of Peroneus Longus by Hypertrophied Peroneal Tubercle: A Case Report (비후된 비골 결절에 의해 발생한 비복신경 포착 및 장비골건의 건막염: 증례 보고)

  • Lee, Dong Joo;Choi, Jun Young;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.131-134
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    • 2018
  • A hypertrophied peroneal tubercle can present as a bony prominence at the lateral aspect of the foot and a peroneal tenosynovitis or tear. We report a case of a 52-year-old man complaining of lateral foot tingling pain and numbness. The sural nerve entrapment and peroneus longus tenosynovitis by hypertrophied peroneal tubercle were confirmed. Good results were obtained after excision of the hypertrophied peroneal tubercle and sural nerve release.

Tumors of the Foot (족부의 종양)

  • Shin, Duk-Seop;Park, Sung-Hyuk;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.69-76
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    • 2003
  • Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

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Anchor Hole Augmentation with Bone Cement in Arthroscopic Rotator Cuff Repair (관절경적 회전근 개 봉합술에서 골 시멘트를 이용한 봉합 나사 구멍 보강술)

  • Lee, Ho-Min;Tae, Suk-Kee;Park, Jeong-Min
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.237-243
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    • 2010
  • Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.

Outcomes of Diffuse-Type Pigmented Villonodular Synovitis (PVNS) after Open Total Synovectomy (미만형 색소 융모 결절성 활액막염의 관혈적 활막 전 절제술 후 경과)

  • Lee, Mo-Ses;Lee, Soo-Hyun;Suh, Jin-Suck;Yang, Woo-Ik;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.27-36
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    • 2010
  • Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.

Hemiarthroplasty in Comminuted Fracture and Dislocation of the Proximal Humerus (상완골 근위부 분쇄성 골절 및 탈구에서 시행한 견관절 반치환술)

  • Hwang Sung-Kwan;Kim Yong-Seok
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.205-211
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    • 1998
  • The comminuted fracture and dislocation of the proximal humerus occur more frequently in older patient group and operative treatment is difficult due to poor bone quality. Based on Neer's work, hemiarthroplasty has now become widly accepted for the management of the three-part fracture and four-part fracture-dislocation of the proximal humerus in old age group. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after hemiarthroplasty for proximal humerus fractures and dislocations. Authors reviewed and analyzed 14 prosthetic replacement in comminuted proximal humeral fracture and dislocation at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine from March, 1988 to May, 1997. The results were as follows the average age was 58.9years and the ratio of males and females was 5:9. The most common cause of injury was traffic accident(43%). According to the classification of Neer, three part fracture were three(21%), four-part fracture and four-part fracture-dislocation were eleven(79%). The prosthetic replacement was performed within two weeks in eight patient and six were performed after two weeks. The results were analysed according to Neer's criteria and five cases showed satisfactory results. We concluded that hemiarthroplasty for fracture and dislocation of the proximal humerus facilitated the restoration of humerus length and pain relief, thereby allowing earlier motion to prevent the development of painful shoulder: stiffness.

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MAXILLARY SINUS AUGMENTATION WITH BOVINE BONE MINERAL(Bio-$Oss^{(R)}$) AND THE MAXILLARY TUBEROSITY (상악결절과 다공성 골 미네랄의 복합이식을 통한 상악동 골이식술)

  • Han, Ki-Deok;Chung, Il-Hyuk;Lee, Eun-Kyung;Suh, Je-Duck;Song, Seung-Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.4
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    • pp.391-396
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    • 2007
  • The aim of this study was to evaluate implant stability placed in the maxillary sinus which was augmented with bovine bone mineral(Bio-$Oss^{(R)}$) mixed with autogenous bone from the maxillary tuberosity. Maxillary sinus floor augmentation with the mixture of bovine bone mineral and autogenous maxillary tuberosity bone was performed in 30 maxillary sinuses, and 68 implants were placed at the time of sinus graft. After 6 months of implant placement abutments were connected and implant stability quotient(ISQ) was measured by radio frequency analysis(RFA). In addition, bone level changes was evaluated by taking periapical radiograph. During surgical procedures, no complication was observed, and all patients healed uneventfully. At 6 months the implant showed stable ISQ values. The marginal bone level changes around the fixtures was stably maintained through out the follow up period. This study confirmed that maxillary sinus floor augmentation with mixture of bovine bone mineral and maxillary tuberosity bone could be reliable for bone regeneration in subantral space.

Giant Synovial Chondromatosis of the Knee Mimicking a Parosteal Osteosarcoma: A Case Report (방골성 골육종과 유사한 슬관절의 거대 활막 연골증식증)

  • Kang, Chang-Ho;Park, Jong-Hoon;Lee, Dae-Hee;Kim, Chul-Hwan;Park, Jeong-Mi;Lee, Won-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.95-98
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    • 2010
  • Synovial chondromatosis is a benign nodular cartilaginous proliferation arising in the synovium of joints. The radiolographic features of this condition are variable. Rarely, it would be confused with malignancy such as chondrosarcoma, osteosarcoma or synovial sarcoma. We report a case of primary synovial chondromatosis of the posterior aspect of the proximal tibia mimicking a parosteal osteoarcoma on the radiography, which showed a homogeneously radiopaque juxtacortical mass. However, subsequent computed tomography (CT) showed multiple intra-articular masses containing chondroid mineralization, suggesting synovial chondromatosis.