• Title/Summary/Keyword: 근위부 대퇴골

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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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Treatment and Prognosis of Chondroblastoma (연골모세포종의 치료 결과)

  • Lee, Young-Kyun;Han, Il-kyu;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.81-87
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    • 2007
  • Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.

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A Finite Element Analysis of Stress on the Femoral Stem with Resorption of Proximal Medial Femur after Total Hip Replacement (대퇴골 근위부 골흡수가 인공 고관절 대퇴 stem에 미치는 응력에 관한 연구-FEM을 이용한 분석)

  • 김성곤
    • Journal of Biomedical Engineering Research
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    • v.15 no.2
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    • pp.183-188
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    • 1994
  • In clinical orthopaedics, bone resoption in the cortex is often seen post operatively on X-rays or bone densitometry after total hip replacement (THR) in the form of cortical osteoporosis or atropy. Stress shielding of bone occurs, when a load, normally carried by the bone alone, is shared with an implant as a result, the bone stresses are abnormal and with remodelling analysis this may cause extensive proximal bone resoption, possibly weakening the bone bed to the point of failure. The author made finite element models of the cemented and non-cemented type implanted femoral stem with bone resorption of the proximal medial femur and studied the feed back effect of the various degree of bone resoption to THR system by parametric analysis on the stress of the femoral stem and interface. The results of the present finite element analysis implied that the extent of proximal bone resorption has the effect of more increasing stress on the distal stem tip, cement mantle and interface in both type of femoral stem and this high distal stress possibly can cause the mechanical failure of loosening or failure after THR.

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Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate (잠김 금속판을 이용한 하지의 전이성 병적 골절에 대한 치료)

  • Seo, Chang-Young;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.80-86
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    • 2010
  • Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

Osteoid Osteoma of the Elbow in 2 years Old Child - A Case Report - (2세 소아에서 주관절에 발생한 유골골종 - 증례 보고 -)

  • Kim, Ki-Hyeong;Seo, Hyung-Yeon;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.198-202
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    • 2008
  • Although Osteoid osteoma has occurred in every bone of the body, it is rarely found at the elbow and in younger children than 5 years old. In 2 years old child, diagnosis can be delayed because of nonspecific clinical, radiological features and making it difficult for the child to communicate with physician. We report a case of osteoid osteoma of the distal humeral metaphysis with intracapsular nidus and synovitis of elbow in 2 years old girl who was treated by a surgical excision.

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Double Primary Presentation of Liposarcoma and Ewing's Sarcoma: A Case Report (대퇴부 지방육종 수술 후 발생한 반대측 근위 경골의 유잉육종/원시 신경 외배엽 세포종)

  • Park, Hyeong-Won;Jung, Sung-Taek;Nah, Seon-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.95-99
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    • 2011
  • The development of different entities of soft tissue sarcoma in one patient is rare. It usually affects head and neck or abdominal region, whereas those affecting the extremities are much rarer. We describe a patient with double primary presentation of liposarcoma and Ewing's sarcoma in extremity. This case implies that sarcoma patients are at increased risk of a second malignancy, and this implies a need to search for occult tumors during follow up.

A Study of Osteoporosis Prediction using Morphological Measuring of Proximal Femoral Part and Trabecular Characteristics Based on Femoral Radiographic Image (대퇴부 방사선영상에서 대퇴골 근위부의 형태학적 측정과 골소주의 특성을 이용한 골다공증 예측에 관한 연구)

  • Kim, Sung-Min;Roh, Seung-Gyu;Ro, Yong-Man
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.59 no.4
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    • pp.823-830
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    • 2010
  • This study was designed to examine the morphological measurement and characteristics of trabecullae based on femoral radiographic image for prediction of osteoporosis. Study subjects were 34 females (average age of 62.1 years) and 6 males (average age of 60.1 years), they were categorized into normal group and osteoporosis group in accordance with the T-score value. Measurement of the bone density of femoral bone was measured with DEXA(Dual Energy X-ray absorptiometry). ROI(Region of interests) was selected on femoral neck and trochanter. Characteristics of trabecullae was analyzed by using the skeletonization analysis of trabecular image. Morphological measurement was analyzed through femoral radiographic image in order to examine the correlation with osteoporosis. The result demonstrated statistically significant correlation between neck cortical thickness, shaft width, shaft cortical thickness, periphery, mean gray level and trabeculae area with BMD average (T-score) of femoral part. The results show that morphological measurement and characteristics of trabecullae based on femoral radiographic images for osteoporosis prediction could be effective.

Predict of Fracture Risk Rate According to Morphological Measuring of Proximal Femoral Part Using Dual Energy X-ray Absoptiometry (이중에너지 X선 흡수계측법을 이용한 대퇴골 근위부의 형태학적 측정에 따른 골절 위험도의 예측)

  • Yoon, Han-Sik
    • Journal of radiological science and technology
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    • v.25 no.1
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    • pp.49-53
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    • 2002
  • The femoral fracture is the most serious problem of old ages haying osteoporotic fractures. First of all, prevention to reduce the incidence of hip fracture and to identify the risk factor is essential subject. The purpose of this study is to investigate which geometric parameters of proximal femur are related to the hip fracture risk in old ages. Author analyzed the bone density and bone content of over 60 years old women who had suffered hip fracture (n=60) and non fracture groups (n=60). Author concluded that geometric measurements of proximal femoral part made on dual energy x-ray absorptiometry can predict hip fracture independently of bone mineral density.

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The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry (이중에너지 X-ray 흡수법을 적용한 근위 대퇴골 및 요추부 골밀도 검사의 상관관계 분석)

  • Han, Man-Seok;Cho, Dong-Heon
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.9
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    • pp.165-169
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    • 2012
  • To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine at age. It is based on 62 cases who visited the out-patient department. They were classified into three groups by age, group I (30~40 yr) and II (40~60 yr) and III (60~80 yr). Then we evaluated the average and the degree of correlation between the three groups and analyzed the correlation of the three sites according to the BMD result and T & Z-score through the t-test analysis. The results are listed below, first, if rise in age T-score is lower and over 60age occurred osteopenia, second, compared three groups, the correlation of BMD results was some of the highest between Lumbar spine and Proximal femur of T-score & Z-score. the correlation of BMD results is very high. It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.

Changes in Bone Mineral Density and Biochemical Markers of Bone Turnover in Young Women: A 1-Year Follow-up Study (청년기 여성의 골밀도와 골대사지표의 변화: 1년 추적조사)

  • Kim, Myung-Hee;Hwang, Sun-Kyung;Kim, Ju-Sung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3943-3952
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    • 2009
  • This study investigated the changes in bone mineral density(BMD) and biochemical bone turnover markers over 1 year in healthy young college women. In comparison of changes in BMD at the lumbar spine, proximal femur (trochanter, femoral neck, Ward's triangle), and whole body over 1 year, there was only a significant difference in that at forearm. However, serum osteocalcin, a marker of bone formation, and urinary deoxypyridinoline, a marker of bone reabsorption, were significantly changed over 1 year. These findings indicate that although BMD does not significantly change in early young adult, the changes of bone metabolism markers seem to mean active bone turnover in early young adult women.