• Title/Summary/Keyword: 골변형

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Bizarre Parosteal Osteochondromatous Proliferation of the Femur (Nora's Lesion) - A Case Report - (대퇴골에 발생한 Bizarre Parosteal Osteochondromatous Proliferation of the Femur (Nora 병변) - 증례 보고 -)

  • Shin, Bong-Kyung;Cho, Hyun-Deuk;Yum, Bum-Woo;Choi, Jong-Sang;Kim, Chul-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.3
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    • pp.178-182
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    • 1999
  • We report a case of bizarre parosteal osteochondromatous proliferation of the right femur in an 18-year-old man. Roentgenograms showed a calcific mass attached to the underlying cortex with a broad base. Histologically, the lesion showed hypercellular cartilaginous tissue with maturation into trabecular bone, which contained spindle cells and lymphocytes in the intertrabecular spaces. Bizarre parosteal osteochondromatous proliferations are a form of heterotopic ossification and should not be mistaken for osteosarcoma or chondrosarcoma.

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Data Augmentation Method for Deep Learning based Medical Image Segmentation Model (딥러닝 기반의 대퇴골 영역 분할을 위한 훈련 데이터 증강 연구)

  • Choi, Gyujin;Shin, Jooyeon;Kyung, Joohyun;Kyung, Minho;Lee, Yunjin
    • Journal of the Korea Computer Graphics Society
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    • v.25 no.3
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    • pp.123-131
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    • 2019
  • In this study, we modified CT images of femoral head in consideration of anatomically meaningful structure, proposing the method to augment the training data of convolution Neural network for segmentation of femur mesh model. First, the femur mesh model is obtained from the CT image. Then divide the mesh model into meaningful parts by using cluster analysis on geometric characteristic of mesh surface. Finally, transform the segments by using an appropriate mesh deformation algorithm, then create new CT images by warping CT images accordingly. Deep learning models using the data enhancement methods of this study show better image division performance compared to data augmentation methods which have been commonly used, such as geometric conversion or color conversion.

ANALYSIS OF STRESS AND DISTORTION DISTRIBUTION USING THE FINITE ELEMENT METHOD - EFFECTS OF THE CHIN CAP ON THE MANDIBLE - (유한요소법을 이용한 응력 및 변형 분포의 분석 - 하악골의 이모장치효과 -)

  • Lee, Young-Hoon;Baik, Byeong-Ju;Kim, Jae-Gon;Yang, Yeon-Mi;Lee, Min-Jeong;Ko, Young-Han
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.2
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    • pp.109-118
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    • 2011
  • The aims of this study were analyze the amount of stress condition when the traction force was applied to the condyle head from the chin area of mandible and amount of distortion condition when intended 0.5 mm distraction distance from surface or one point of dissected midline of mandible. For this study, 3D finite element analysis were performed. The following results were obtained : 1. When traction force of 500 g was applied to the condyle head from the chin area, condylar neck area showed the greatest amount of stress and coronoid process was the least amount of stress area. For the amount of distortion condition, infra dental area showed the greatest. 2. When 0.5 mm of intended surface distortion was applied after dissection of mid-mandible area, base anterior area showed the greatest amount of stress but the least stress area was coronoid process. For the amount of distortion, infra dental, menton area showed the greatest amount. 3. One point distortion was applied after dissection of mid-mandible area, ramus posterior area showed the greatest amount of stress and menton area were the least stress condition. For the amount of distortion, menton area showed the greatest amount of distortion condition.

Conservative Management in Simple Bone Cyst (단순 골 낭종의 보존적 치료)

  • Kim, Ji-Youn;Cho, Yong-Jin;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.51-57
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    • 2011
  • Purpose: This study evaluated the results of conservative treatment for simple bone cyst. Materials and Methods: We studied 126 cases of simple bone cyst, which were treated by observation or steroid injection from February 1990 to May 2010. Their mean age at diagnosis was 14 years (${\pm}9$ years, 2-60 years) and the mean follow-up duration for this study were 41 months (${\pm}37$ months, 12-159 months). Observation and steroid injection was applied for conservative management of simple bone cyst and results was scored by modified Neer classification. Results: 31 cases (24.6%) were treated by observation and 95 cases (75.4%) were treated by steroid injection. The 95 patients were treated by a mean of 1.1 (${\pm}0.9$, 0-4) steroid injections and a single steroid injection was given in 65 cases (51.6%). The 102 cases (80.9%) were resulted in modified Neer classification I and II which could be considered as healing of simple bone cyst. Conclusion: Conservative management can be considered as an initial treatment for simple bone cyst with good result.

Dental Management in a Patient with Infantile Osteopetrosis : A Case Report with a 7-Year follow-up (유아기형 골화석증 환자의 치과적 관리 : 7년간의 경과 관찰)

  • Cheon, Minkyoung;Yang, Sunmi;Kim, Jaehwan;Choi, Namki;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.2
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    • pp.257-264
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    • 2018
  • Osteopetrosis is characterized by impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form of the disease and has characteristics such as diffusely sclerotic skeleton, pancytopenia, cranial nerve entrapment, infection susceptibility, and abnormal craniofacial appearance. Patients with infantile osteopetrosis often experience developmental delay, and may have a short life span. A 14-month-old girl with osteopetrosis presented to the department of pediatric dentistry. Incipient caries on deciduous incisors were observed. The patient revisited 4 years of age. Besides medical problems, oral complications such as growth retardation, narrow upper arch, crowding, dental caries, and abnormal tooth development were observed. After consultation with her pediatrician, dental treatments were performed on the deciduous molars under sedation after a prophylactic antibiotic injection. At a periodic follow-up, multiple deciduous teeth were treated and extracted, and oralrehabilitation with a removable partial denture was initiated. Patient with osteopetrosis are highly susceptible to infection because of their compromised immune system and problems associated with wound healing that lead to osteomyelitis or sepsis development. Active participation in dental care for sugar intake management and proper oral hygiene are obligatory.

External Tibial Torsion with Proximal Tibia Vara in Total Knee Arthroplasty of Advanced Osteoarthritis with Severe Varus Deformed Knees (심한 내반 변형의 진행성 관절염 환자의 인공 슬관절 전치환술 시 경골 근위부의 내반을 동반한 외회전 변형)

  • Sun, Doo-Hoon;Song, In-Soo;Kim, Jun-Beom;Kim, Cheol-U;Jung, Deukhee;Jeong, Uitak
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.62-70
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    • 2020
  • Purpose: External tibia torsion and proximal tibial vara have been reported in severe varus deformed osteoarthritis, which is a tibio-femoral angle of more than 20°. The radiology measurements were compared with those of control group and the preoperative and follow-up radiology and clinical results were examined. Materials and Methods: From January 2007 to March 2016, 43 knees from 37 persons, who underwent total knee arthroplasty for a severe varus deformity of more than 20° on the tibio-femoral angle on the standing radiographs and had a follow-up period more than two years, were examined. The mean follow-up period was 45.7 months. The control group, who underwent conservative treatments, had Kellgren-Lawrence grade three osteoarthritis and a tibio-femoral angle of less than 3° varus. The external tibial torsion of enrolled patients and control group were estimated using the proximal tibio-fibular overlap length and the tibial torsion values on computed tomography. The proximal tibia vara was measured using the proximal tibial tilt angle. The preoperative and postoperative proximal tibio-fibular overlap length, tibial torsion value, proximal tibial tilt angle, and hospital for special surgery (HSS) score were evaluated. Results: The mean proximal tibio-fibular overlap length was 18.6 mm preoperatively and 11.2 mm (p=0.031) at the follow-up. The control group had a mean proximal tibio-fibular overlap length of 8.7 mm (p=0.024). The mean tibial torsion value was 13.8° preoperatively and 14.0° (p=0.489) at the follow-up. The control group had a mean tibial torsion value of 21.9° (p=0.012). The mean proximal tibial tilt angle was 12.2° preoperatively and 0° (p<0.01) at the follow-up. The control group had a mean proximal tilt angle of 1.2° (p<0.01). The preoperative tibiofemoral angle and mechanical axis deviation were corrected from preoperative 28.3° and medial 68.4 mm to postoperative 0.7° and medial 3.5 mm (p<0.01, p<0.01), respectively. The HSS scores increased from 34 points of preoperatively to 87 points at the last follow-up (p=0.028). Conclusion: Patients with advanced osteoarthritis with a severe varus deformity of more than 20° had significant increases in the external tibial torsion and varus of the proximal tibia. The tibial torsion value before and after surgery in the enrolled patients was not changed statistically, but good clinical results without complications were obtained.

How to Overcome Complications of Allograft Transplantation? (골종양 절제 후 동종골을 이용한 재건술의 합병증 및 해결방법)

  • Cho, Yool;Choi, Young;Kwon, Young-Ho;Chung, So-Hak;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.65-72
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    • 2011
  • Purpose: We evaluated the complications of allograft reconstruction after a bone tumor resection, and reviewed literatures to overcome such complications. Materials and Methods: We retrospectively reviewed clinical records and radiographs of fifteen patients in whom reconstruction with allograft after bone tumor resection. Results: Eight patients were men and seven were women with a mean age of 27.1 years (1-56 years) and a mean follow-up period of 89.5 months (33-165 months). All postoperative complications related to the allograft were recorded. Twenty patients (80.0%) obtained a radiologic bony union at a mean of 8.35 months (4-12 months). The mean Musculoskeletal Tumor Society score was 73.5% (46.6-93.0%). Nine patients (60.0%) experienced one event and 3 (20.0%) patients experienced multiple events during the follow-up period. Recorded events were infection (3), fracture (2), nonunion (2), limb length discrepancy (2) and varus deformity (2). The mean event free survival period was 60.8 months (6-144 months). The mean allograft survival period was 80.2 months and the 5 year survival rate of the allografts was 83.0%. Conclusion: In order to overcome complications, the combination of an allograft and vascularized fibular graft is highly recommended. In the near future, the tissue engineering technique, the application of the stem cell and PRP, could reduce the complication of allograft such as resorption and nonunion.

MAXILLARY ADVANCEMENT USING RIGID EXTERNAL DISTRACTION(RED) IN CLEFT LIP AND PALATE PATIENT : CASE REPORT (견고 구외 골신장술을 이용한 구순구개열 환아의 치험례)

  • Yu, Nan-Young;Kim, Sung-Min;Lee, Ju-Hyun;Seo, Hyun-Woo;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.709-716
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    • 2005
  • Patients with cleft tip and palate present severe maxillary hypoplasia due to scar of lip and palate, often accompanied by compromised mastication, speech abnormalities. Sometimes maxillary hypoplasia persist even though active orthodontic treatment was done. In theses cases, patients born with cleft lip and palate will be potential candidates for maxillary advancement with bone grafting after growth to correct the functional deformities and improve aesthetic facial proportions. But, maxillary advancement using standard surgical approaches has several limitations : increased relapse tendency after maxillary advancement, necessity of additional bone graft and mandibular setback surgery. Distraction osteogenesis is current treatment modality to overcome these limitations, thus has become popular for treatment of maxillary hypoplasia associated cleft lip and palate, craniosyntosis. Especially, rigid external distraction, contrary to internal device, has advantages : better vector control of osteotomized segment, effective traction of the bony segments, the ease of the application and removal the distraction device. This study showed that relatively successful result could be generated by using rigid external distraction osteogenesis(RED) in the case of cleft lip and palate with severe maxillary hypoplasia, 6 years 7 months old.

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Shoulder Replacement Arthroplasty after Failed Proximal Humerus Fracture (상완골 근위부 골절의 치료 실패 후 견관절 치환술)

  • Park, Jin-Young;Seo, Beom-Ho;Lee, Seung-Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.110-119
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    • 2019
  • Proximal humerus fracture can be defined as a fracture that occurs in the surgical neck or proximal part of the humerus. Despite the appropriate treatment, however, various complications and sequelae can occur, and the treatment is quite difficult often requiring surgical treatment, such as a shoulder replacement. The classification of sequelae after a proximal humerus fracture is most commonly used by Boileau and can be divided into two categories and four types. Category I is an intracapsular impacted fracture that is not accompanied by important distortions between the tuberosities and humeral head. An anatomic prosthesis can be used without greater tuberosity osteotomy. In category I, there are type 1 with cephalic collapse or necrosis with minimal tuberosity malunion and type 2 related to locked dislocation or fracture-dislocation. Category II is an extracapsular dis-impacted fracture with gross distortion between the tuberosities and the humeral head. To perform an anatomic prosthesis, a tuberosity osteotomy should be performed. In category II, there are type 3 with nonunion of the surgical neck and type 4 with severe tuberosity malunion. In type 1, non-constrained arthroplasty (NCA) without a tuberosity osteotomy should be considered as a treatment. On the other hand, reverse shoulder arthroplasty (RSA) should be considered if types 1C or 1D accompanied by valgus or varus deformity or severe fatty degeneration of the rotator cuff. In general, the results are satisfactory when NCA is performed in type 2 sequelae. On the other hand, RSA can be considered as an option when there is no bony defect of the glenoid and a defect of the rotator cuff is accompanied. In type 3, it would be effective to perform internal fixation with a bone wedge graft rather than shoulder replacement arthroplasty. Recent reports on the results of RSA are also increasing. On the other hand, recent reports suggest that good results are obtained with RSA in type 3. In type 4, RSA should be considered as a first option.