• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.111-117
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• 2005

Purpose: We evaluate the results of treatment of pathologic femur fractures secondary to bone tumors in children. Materials and Methods: Between January 1995 and June 2004, 18 patients(20 cases) were evaluated. Their mean age of the first episode of fracture was 10.2 years and mean follow-up period is 42.5 months. Primary bone tumors, the location of fracture, time to union and complications were evauated. Results: Fractures occurred at proximal portion in 14 cases, shaft 3 cases and distal portion 3 cases. The bone tumors causing pathologic fracture were fibrous dysplasia(9 c ases), simple bone cyst(4 cases), aneurysmal bone cyst(4 cases), nonossifying fibroma(2 cases) and eosinophilic granuloma(1 case). In the treatment for fractures, cast was in 11 cases, internal fixation 8 cases and external fixation in 1 case. In the treatment for tumors, observation was in 11 cases, curettage & bone graft in 8 cases and resection in 1 case. In polyostotic fibrous dysplasia, all cases were treated by cast initially but deformity developed in all cases. Fracture prevention and deformity correction were obtained with intramedullary nailing. Conclusion: Adequate choice of treatment of bone tumor and fracture will result in good prognosis.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.141-147
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• 2006

In 1996, a nine-year-old girl was treated with recycling autograft after wide resection of the distal femoral osteosarcoma. The leg lengthening and revision with growing tumor prosthesis were performed due to limb leg discrepancy and epiphyseal problem. However, deep infection developed after operation, and a temporary spacer with cement and Ender nail was inserted. After infection was controlled completely, the final leg lengthening was performed with mono-external fixator for limb length discrepancy (10 cm). Lastly, Tumor prosthesis was reinserted to preserve the joint function.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.110-116
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• 1991

Fracture site osteomyelitis begins rarely with an acute event but rather has a subacute onset. It develops almost exclusively in the mandibular region. The treatment principles of mandibular fracture site osteomyelitis are complete removal of inflammatory tissue and drainage, rigid fixation with or without autogenous bone bone graft and specific antibiotic therapy. But hyperbaric oxygen used as a modality in the treatment of intractable osteomyelitis. In this paper, we reported that the three patients who have osteomyelitis accompying secondary in fection after mandibular fracture.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.71-81
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• 2005

Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.3
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• pp.83-89
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• 2002

Purpose: To analyze the postoperative functional and radiographic follow-up results in patients who underwent percutaneous radiofrequency ablation therapy after the diagnosis of osteoid osteoma. Materials and Methods: Seven patients, who were clinically and radiographically diagnosed with osteoid osteoma from July 1999 to January 2001, and received percutaneous radiofrequency ablation therapy. The average follow-up period was 15.5 months(range, 8~25 months). For the diagnosis and accurate localization of the lesion, simple radiography, computed tomography and magnetic resonance imaging(MRI) were performed preoperatively. Simple radiographs and MRI were taken periodically for the follow-up studies. Results: In all 7 patients, symptoms completely disappeared within 3 days after the operation. The average period of hospitalization was 2.4 days, excluding 1 patient who needed an additional burn treatment. The average postoperative night and day pain scores were 1.8 and 1.3, respectively. The average vocational and recreational activity scores were 1 and 0.6, respectively. Conclusions: Satisfactory functional results were obtained with percutaneous radiofrequency ablation therapy for the elimination of osteoid osteoma. Compared to conventional treatment, the advantages of this therapy were short hospitalization period, no internal fixation and bone graft for preventing fracture, and no limitation of joint motion by long fixation period.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.44-51
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• 2009

Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.99-103
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• 2012

Little literature exists about the risk of atypical femoral fracture in patients received zoledronic acid for prevention of skeletal metastasis. We report an atypical subtrochanteric femoral fracture in a patient with multiple myeloma received zoledronic acid. The patient was treated by closed reduction and internal fixation with cephalomedullary nailing.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.33-42
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• 1994

Obwegeser II method and Rigid fixation conserving the condylar position has been performed on 5 patients with severe mandibular prognathism, and we obtained the result after the follow up study follows. 1. Obwegeser II method is considered to move the distal segment passively when surgical correction of severe open bite correction and large amount of set back above 15mm is needed. 2. In one case that has more change of condylar position after operation, documented immediate post-operative relapse have been occurred 3. In the others that have adequate control of condylar position, passive set back and firm skeletal fixation, more functional and esthetic improvement and more post-operative stability has been achieved

• The Journal of the Korean bone and joint tumor society
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• v.8 no.2
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• pp.58-62
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• 2002

The incidence of giant cell tumors represents only 5% to 10% of all bone tumors. Occurrence on the small bones of the hand and foot are very rare. They typically present with pain and sometimes a pathologic fracture or even soft tissue extension. The radiographic appearance is highly characteristic. An eccentric osteolytic lesion is seen, producing cortical thinning and expansion, and possessing a delicate trabecular pattern. In tarsal bones, poorly or well-defined osteolytic lesions of variable size are encountered. Surgical treatment remains the preferred therapy. Marginal or wide en bloc resection has had far better results in term of local recurrence. Several authors have suggested extended curettage and cement as an alternative to en bloc resection. Follow-up is necessary to monitor for both local recurrence and the infrequent pulmonary metastases.