• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.42-47
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• 2008

Introduction: To evaluate the efficacy of superior gluteal artery-pedicled iliac crest for the treatment of avascular necrosis of femoral head. Material & Method: From January 2001 to October 2001, we used the superior deep branches of superior gluteal artery for the pedicled posterior iliac crest bone graft to revascularize the avascular femoral head in 4 patients. They were 1 man and 3 women, and the mean age of the patients was 34 years (range, 27 to 60). The average follow-up after surgery was over 57 months (range, 15 to 82). We analyzed the clinical results by the Harris hip score, and evaluated the vascularity of the femoral head by radiographic methods. Results: All cases showed no evidence of collapse on femoral heads and good revascularizations on the radiographic images. The average Harris hip score was 88.5 points. There was no complication. Conclusion: The revascularization procedure using the superior gluteal artery-pedicled posterior iliac crest was thought to be one of the effective and promising techniques for the treatment of the avascular necrosis of femoral head.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.76-79
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• 2009

Purpose: Capsulolabral reconstruction in a traumatic anterior instability of the glenohumeral joint is successful not only for the prevention of recurrent instability but also for the restoration of function. Materials and Methods: However, a capsulolabral procedure alone cannot guarantee a successful result when there is severe bone loss of the glenoid. Results: We report the surgical technique and results of capsulolabral repair and extraarticular bone block with an autogenous iliac crest graft performed on three cases (all male, average age 28 years, minimum follow-up 12 months) with traumatic anterior instability associated with more than 30% glenoid bone loss.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.338-345
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• 1993

Mandibular discontinuity defect due to benign tumor, malignant tumor, infection, or truma results in major esthetic and biologic compromise. The primary goal of reconstruction is full restitution of function, which secondarily lead to normalization of the cosmetic deformity. The authors make a clinical study of 61 consecutive bone graft cases for mandibular reconstruction of discontinuity defect which were studied retrospectively using clinical data and radiographic findings. The cases were reviewed to evaluate the clinical success in the period from 1981 to 1990 in the Dept. of Oral & maxillofacial Surgery, Seoul National University Hospital. The criteria of the success in bone graft, are no residual infection, graft in with maintain its integrity, and remain over a half of its original size of graft in the radiographic features. The purpose of this clinical survey is to study of the mandibular discontinuity defects and success rate of free bone graft in mandibular defects. To summarize the clinical study of free bone graft, the main type of autogenous bone graft is iliac bone and corticocancellous type. Overall success rate is 80.3% in 61 followup cases over 6 months. Wire fixation and Extraoral approach has realtively better prognosis than other methods. It showed relatively poor prognosis in symphysis defects than other recipient site.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.547-552
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• 2004

Recently, autologous bone marrow cell transplantation (CTx) for angiogenesis and myogenesis in ischemic myocardium has been extensively investigated to improve heart functions. This study was designed to evaluate the effects of CTx with off-pump coronary artery bypass grafting (OPCAB) in patients who were not feasible for complete revascularization. Material and Method: Four male patients underwent CTx and OPCAB simultaneously. Bone marrow was aspirated from iliac bone. Mean 1.5 ${\times}$ 10$^{9}$ mononuclear cells including mean 6.7 ${\times}$ 10$^{6}$ CD34 + cells and 3.7 ${\times}$ 10$^{6}$ AC133 + cells were obtained and concentrated with 10 cc. These cells were transplanted into non-graftable ischemic myocardium after OPCAB. The heart function of all patients were evaluated using the MIBI scan, echocardiogram and MRI preoperatively. The effects of CTx was evaluated using MIBI scan and echocardiogram at 1 month postoperatively. Result: An average of 2 grafts were bypassed to left anterior descending artery territory. Other territories were transplanted with isolated mononuclear cell. All patients had uncomplicated postoperative course. After 1 month follow up, there were improvement in symptom, ejection fraction (from 49% to 55%) on echocardiogram and myocardial perfusion on MIBI scan in all patients. Conclusion: These preliminary data showed improvement of heart function and myocardial perfusion and also showed the feasibility and safety of combined therapy with OPCAB and CTx in ischemic myocardium. However, the effectiveness of CTx alone cannot be readily assessed. Further randomized, controlled studies are required to evaluate the effectiveness of CTx alone.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.255-263
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• 2009

Purpose: An osseous defect in the glenoid and humeral head is closely associated with recurrence of anterior shoulder instability. The purpose of this article is to describe the open surgical techniques and introduce our experiences with anterior instability with a significant osseous defect. Materials and Methods: We reviewed the articles that have focused on and/or mentioned the affect of osseous defects on anterior shoulder instability. The open surgical techniques and its related pearls are summarized in this review. Results: Accurate evaluation for the size and location of the osseous defect is critical for preventing recurrence after restoration of the anterior capsulolabral structure. The glenoid bone restoration techniques include the coracoids transfer (the Bristow procedure and the Latarjet procedure) and a structural iliac bone graft. Rotational humeral osteotomy and an osteoarticular allograft could be used for repairing a significant posterosuperior humeral defect (Hill-Sachs lesion). Shoulder arthroplasty may be tried for treating a humeral bone defect, but more study on this is needed. Conclusion: Open surgical restoration decreases the risk of recurrence anterior shoulder instability that is combined with a significant osseous defect. Arthroscopic surgery currently has limitations for treating an osseous defect, but it will become useful in proportion to the development of arthroscopic instruments and techniques in the future.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.220-226
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• 2007

Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.380-385
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• 2010

Introduction: The iliac crest has been the accepted place to obtain bone for reconstruction in oral and maxillofacial surgery. The iliac crest has many advantages because of its accessibility, large amount of cancellous bone, relative ease of bone harvest, possibility of two team approach and ability to close the wound primarily. This study evaluated retrospectively the morbidity of bone harvesting from the anterior iliac crest to provide a logical guide for recognizing the complications and morbidities of an iliac crest bone graft. Materials and Methods: Fifty healthy patients (mean age of 35.5 years; range 7 to 59) underwent iliac crest bone harvesting for a maxillofacial reconstruction from January 2007 to September 2009 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University Hospital. Age, sex, size and kind of grafted bone, duration of pain on donor site, duration of gait disturbance, sensory deficit, scar, contour defect were measured in each patients by retrospective research. Results: The mean duration of pain is 6.7 days, and mean duration of gait disturbance is 7.2 days. Most patients were free from gait disturbances and pain within 2 weeks and there was no correlation between the size of the harvesting block bone and the duration of gait disturbance or pain. However, this study showed that the duration of pain is associated with gait disturbance. In addition, most patients had no complaints regarding their surgical scar and contour defect, and only one patient had permanent impairment of the sensory function. Moreover, an iliac bone graft did not extend the length of hospitalization. Conclusion: This study suggests that split thickness bone harvesting from the inner table of the anterior iliac crest is a well accepted procedure with relatively low morbidity.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.53-59
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• 1989

The ameloblastoma is the most common form of the odontogenic tumors exhibiting minimal inductive change in connective tissue, it comprising 1% of all tumor and cysts of the jaws. It is a true neoplasm, generally considered to be a benign but persistent or, locally malignant lesion. The tumor occurs most commonly in persons between the age of 20 and 50 years. 80% and 90% of all lesions are in the mandible. The presenting clinical signs and symptoms of the ameloblastoma very from patient to patient, but most common symptom was swelling, followed by pain, draining sinuses, and superficial ulcerations. It is slow-growing lesion, and the radiographic features of the ameloblastoma depend large one the nature and the local bone reaction to the particular tumor. Recurrence rate is about 33%, but this is probably due to incommplete initial removal of lesion. We had operated a patient ; 29-year-old female immediate reconstruction combined with autocompression plate and iliac bone graft and screw fixation after hemimandibulaectomy with recurred ameloblastoma involving from premolar to ascending ramus at right side mandible. We obtained favorable results of good function, short intermaxillary fixation periods and easy operation precedure than the other reconstruction methods.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.551-562
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• 2004

The purpose of this study was to evaluate the effects of negatively electric field on bone healing in rabbit segmental long bone defects using negatively charged PTFE membrane. Ten millimeter segmental defects in the rabbit radius were used as the experimental model. After membranes were then charge injected using a corona-charging apparatus, the left defects were covered with non charged PTFE membranes as control groups, whereas the right defect was covered with negatively charged PTFE membranes as test group. The animals were divided into 4 groups of 2 rabbits each, and sacrificed at 2, 4, 6, and 8 weeks. Histomorphometric analysis showed a more newly formed bone in negatively charged membrane at early healing period. At 2 weeks, the proportion of new bone formation to total defect area was 0.32% in control group, 1.10% in experimental group. At 4 weeks, the proportion of new bone formation to total defect area was 6.86% in control, and 13.75% in experimental. At 6 and 8 weeks, no obvious difference was found between the two groups but newly formed bone in test groups were slightly more than that in control groups. In conclusion, negatively charged membranes showed more newly bone tissue than noncharged membranes at an early healing period. Although the number of samples was small, this study showed that the combination of negatively electrical stimulation and P1FE membrane may be of value in long bone healing.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.70-75
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• 2000

The cemento-ossifying fibroma is a well-demarcated and occasionally encapsulated neoplasm composed of fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. The greatest number of cases are encountered during the third and fourth decades of life and there is a definite female predilection, with female-to-male ratios as high as 5 : 1 being reported. The mandible is involved far more than the maxilla, and 90 percent of all cases are located in the mandible. The mandibular premolar-molar area is the most common site. Radiographically, the lesion is most often well defined and unilocular. Depending on the amount of calcified produced in the tumor, it may appear as completely radiolucent ; more often it shows varying degrees of radiopacity. Some lesions may be largely radiopaque with a radiolucent halo. On microscopic study, the tumor is composed of fibrous tissue of varying degrees of cellularity containing calcified material. This may be in the form of trabeculae of osteoid and bone or basophilic ovoid calcifications that resemble cementum-like material. Admixture of the two types of calcifications are commonly seen. On this case, large cemento-ossifying fibroma has grown in the mandible and this lesion was treated by complete surgical excision and posterior iliac bone graft. A review of literature and a report of a case of cemento-ossifying fibroma are presented.