• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.37-41
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• 2010

A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.7-13
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• 2014

Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

• The Journal of the Korea Contents Association
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• v.12 no.6
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• pp.353-360
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• 2012

The purpose of this study was to determine whether there are relationships between radiologic parameters for osteoporosis by the proximal femur radiograhps and bone mineral density, as assessed by Dual Energy X-ray Absorptiometry(DEXA). Proximal femur anterior-posterior projection were taken from 112 individuals who undergoing DEXA. Radiographic parameters including canal-to-calcar ratio(CCR) and cortical thickness indices(CTI) were measured and compared with bone mineral density($g/cm^2$), T-score. The intramedullary femoral canal width(FW) and calcar width(CW) at osteoporosis group was significantly larger than that of control group. The CCR were correlated negatively with bone mineral density($g/cm^2$)(r=-0.340, p<0.01), and the CTI were correlated positively(r=0.624). The diagnostic accuracy of CCR for osteoporosis was 63.4%, and kappa value was 0.271. And the accuracy of CTI was 67.0%, and kappa value was the level of fair agreement(${\kappa}$=0.258). The proximal femur with large CCR and small CTI had lower T-scores. When evaluating proximal femur anterior-posterior radiographs, those patients with the thinnest femur diaphyseal cortices should be referred for further osteoporosis investigation.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.157-162
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• 2008

Nowadays, most of the malignant bone tumor patient underwent limb salvage operation, however, reconstructive options for skeletally immature group are still controversial. There are three necessary conditions of most ideal reconstructive method in treating the skeletally immature children. As the epiphyseal plate sacrification is usually inevitable in malignant bone tumor around knee joint, ideal reconstructive technique would be as follows; 1)minimal or no damage to theadjacent epiphyseal plate, 2) maintaining mobile joint, 3) index procedure does not disturb subsequent operation such as lengthening. Segmental resection and reconstruction using autogenous pasteurized graft was done for 4 years old meta-diaphyseal osteosarcoma of femur. At 6 months from index operation, plain radiograph showed pasteurized bone resorption and loosening of fixation devise. To overcome the complication, we used allograft reconstruction by impacting the proximal host bone to the fluted portion of allobone. Three months later, proximal bone union was observed and patient showed good functional outcome.

• Proceedings of the Korean Society of Radiological Science
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• 2002.06b
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• pp.29-29
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• 2002

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.48-54
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• 2007

Purpose: To evaluate clinical results of the tumor prosthetic replacement for pathologic fracture of the proximal femur with extensive bony destruction due to metastatic bone tumors. Materials and Methods: From 2005 October to 2006 October, resection of proximal femur and tumor prosthesis replacement was performed for metastatic bone tumors extensively involving trochanteric area in 6 patients. The mean age of overall patients was 61(range, 48~77). Mean clinical follow up was 10.5 months (range, 6~16). Primary tumor consisted with multiple myeloma in 2 patients, lung cancer in 1, breast cancer in 1, transitional cell carcinoma of the renal pelvis in 1, unknown origin in 1 patient. $MUTARS^{(R)}$ proximal femur (Implantcast, Munster, Germany) were used in all cases. The functional evaluation in the lower extremities was performed with Musculoskeletal Tumor Society 1993 scores. The degree of pain relief after surgical treatment was assessed with Visual Analogue Scale (VAS). Results: At the final follow up, all of the patients survived. The mean lower extremities functional score of Musculoskeletal Tumor Society 1993 was 17.8(59.3%)(range, 12~25). VAS was improved to 2.5 from 8.5 after the surgical treatment. Ambulation was encouraged as soon as possible and mean duration after surgery for ambulation was 7.3(range, 3~16) days. Post-operatively, there was no surgical infection, periprosthetic fracture or loosening. Dislocation occurred in one out of six cases. Conclusion: Resection of proximal femur and tumor prosthesis replacement for metastatic bone tumors around proximal femur extensively involving trochanteric area seems to be safe procedure in view of post-operative complication, and effective for functional restoration as well as pain relief. Thus, it is accordant to the treatment principle of the metastatic bone tumors.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.120-123
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• 2004

Benign and malignant bone tumors occur most commonly around the knee. The proximal tibia is the most technically demanding site for limb salvage surgery. The most difficult problem using an endoprothesis for proximal tibial resection has been reconstruction of the extensor mechanism. After excision of proximal tibia, we resected distal femur and made a composite with resected distal femur, low heat treated autogenous proximal tibia and endoprothesis. Patella was fixed into the resected down-loaded distal femur. This article shows the new technique and the results of reconstruction of extensor mechanism after prosthetic replacement of the proximal tibia.

• Journal of Biomedical Engineering Research
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• v.24 no.3
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• pp.233-239
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• 2003

Falling related injuries are categorized as the most serious and common medical problems experienced by the elderly, hip joint fracture, one of the most serious consequences of falling in the elderly, occurs in only about 1% of falling. Nevertheless, hip fracture accounts for a considerable part of the disability, death, and medical costs associated with falling. In this study, we considered the impact angle and displacement rate in falling as another factor affecting femoral strength. Using a fresh-frozen human femur, we developed system to simulate the falling condition and then conducted the experiments changing the impact angle (0$^{\circ}$, 15$^{\circ}$, 30$^{\circ}$) of proximal femur. Also, in order to analyze the relative risk due to falling to normal situation in proximal femur, we did the static test simulating the two-legged stance condition. The results showed that the change in impact angle affected the strain distribution in proximal femur, and that a large deformation in femoral neck than in other sites. Furthermore despite low impact velocity, a large deformation in proximal femur occurred in the impact test and different strain distribution was observed compare to the static case.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.38-41
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• 2011

After closed reduction and internal fixation with proximal femoral nail for intertrochanteric fracture, some patients complained lateral hip pain. We report two cases of lateral hip pain due to tendinopathy confirmed by ultrasonography.

• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.535-539
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• 2021

Vascular complications following a femoral fracture are rare but can result in serious issues. Several case studies have reported pseudoaneurysms occurring after direct trauma or the insertion of a proximal femoral nail in the case of a proximal femoral fracture. The authors encountered an 85-year-old patient treated with retrograde intramedullary nail fixation for a distal femur fracture and suffered a decrease in the hemoglobin level, swelling, and pain on the 9^th day after surgery. The authors initially attributed the temporary hematoma and pain to ordinary postoperative processes. On the 16^th day after surgery, a pseudoaneurysm originating from the descending branch of the lateral femoral convolutional artery was diagnosed and treated by percutaneous vascular embolization. After the procedure, the hemoglobin level increased, and the swelling and pain decreased.