• Title/Summary/Keyword: Bone Reconstruction

검색결과 727건 처리시간 0.026초

How Can We Improve Crown-Implant Ratio in Reconstructed Mandible with Fibular Free Flap?: A New Surgical Technique Using 3D RP Model and Reconstruction Titanium Plates

  • Kim, Dong-Young;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • 제4권1호
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    • pp.13-16
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    • 2017
  • Fibular free flap reconstruction is the flap of the choice in long-span mandibular bone reconstruction. The most common disadvantage of the fibular flap is short bone height to install dental implant. Double barrel fibular flap has been tried, however, bulky flap in the oral cavity hinder its use. Titanium reconstruction plate has been used simultaneously with the free fibular flap to stabilize occlusion and to fix the fibular flap. In this study, titanium reconstruction plate was fixed in the lower border of the mandible and the fibular free flap was fixed in the superior border of the titanium plate to improve implant-crown ratio. This new technique improved the longevity of the dental prosthodontics with dental implants.

Modified Anterior Craniofacial Osteotomy Using Partial Nasal Bone Division and Reconstruction in Frontoethmoidal Sinus Meningioma

  • Park, Eon Ju;Kim, Hong Il;Park, Jin Hyung;Yi, Hyung Suk
    • Archives of Craniofacial Surgery
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    • 제18권2호
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    • pp.117-121
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    • 2017
  • Typical transcranial approaches are insufficient for adequate visualization and resection of skull base tumors. Different approaches with multiple modifications have been attempted. Here, we describe a new approach for a lesion that is central and hard to treat by conventional craniotomy and successful reconstruction with calvarial bone graft and titanium mesh plate. A 69-year-old female patient presented with recurrent meningioma. The tumor had invaded the frontal lobe, right supraorbital rim, and ethmoidal bone. We performed a modified anterior craniofacial approach that fully exposed the tumor and invaded bone. In consideration of the patient's age and cosmetic result, the tumor and invaded bone was resected and the defect area was reconstructed with titanium mesh and calvarial bone graft. At 6 months postoperative the patient had no complications and was satisfied with the esthetic result. We report this case to demonstrate the successful approach and reconstruction using this technique.

Comparative Study of Arthroscopic ACL Reconstruction Using Bone-Patellar Tendon-Bone Versus Four-Stranded Semitendinosus-Gracilis Tendon (관절경적 전방십자인대 재건술시에 골-슬개건-골과 네가닥 반건양건-박건을 이용한 방법의 비교연구)

  • Kim, Jin Goo;Lim, Young;Kim, Byung Jik;Ko, Han Suk;Moon, Hyung Tae
    • Journal of the Korean Arthroscopy Society
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    • 제2권2호
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    • pp.107-113
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    • 1998
  • This study is retrospective analysis of 31 patients treated by arthroscopically assisted ACL reconstruction, from September 1995 to September 1996. ACL reconstructions using autogenous bone patellar tendon bone (B-PT-B) were done in 18 patients, and using hamstring tendon were done in 13 patients. We used four-stranded hamstring tendon grafts and fixed the grafts using Endobutton and screw. The mean postoperative Lysholm knee score was 87.2 points in B-PT-B. group, and 89.0 points in hamstring tendon group. There were no clinically significant results between two groups in Telos test, quadriceps atrophy, Lachman test, anterior drawer test and pivot shift test, but the incidences of anterior knee pain were lower in hamstring group. Four-stranded hamstring tendon graft showed enough stability and good functional outcome similar to that of patellar tendon graft, and had an advantage of quicker return of quadriceps function and less donor site morbidity.

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A Study on the Voxel Mesh Technique for Finite Element Modeling of Human Bone (인체 골(bone)의 유한요소 모델링을 위한 VOXEL MESH 기법에 관한 연구)

  • 변창환;오택열;백승민;채경덕
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 한국정밀공학회 2002년도 추계학술대회 논문집
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    • pp.1081-1084
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    • 2002
  • In this study, we perform 3-D reconstruction of human proximal femur from DICOM files by using voxel mesh algorithm. After 3-D reconstruction, the model converted to Finite Element model which developed for automatically making not only 3-D geometrical model but also FE model from medical image dataset. During this job, trabecular pattern, one of characteristic of human bone can be added to the model by means of giving it's own elastic property calculated from intensity in CT scanned image to the each voxel. And then another model is made from same image dataset which have two material properties - one corresponds to cortical bone, another to trabecular bone. Finally, validity of voxel mesh technique is verified through comparing results of FE analysis, free vibration and stress analysis.

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MANDIBULAR RECONSTRUCTION BY TISSUE EXPANSION AND ILIAC BONE GRAFT (조직확장술및 장골이식을 이용한 하악골 결손부의 재건)

  • Lee, Kye-Young;Min, Kong-In;Cheung, Soo-Il;Park, Jae-Byum;Ahn, Jae-Jin;Kim, Do-Geun;Kim, Chal-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권4호
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    • pp.449-453
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    • 2000
  • Soft tissue expansion is widely used technique in oral & maxillofacial reconstruction and provide new method of reconstruction in posttraumatic alopecia, post burn, wide scar, congenital deformity, benign tumor, tattoo, etc. Expanded tissue flaps have the advantage of increased vascularity, proximity to the defect, and similarity of color and texture. They also preclude the need to advance flaps from distant sites. Tissue expansion can be used to form a well vascularized cavity to accomodate and nourish bone grafts. The following report describes the uses of tissue expanders by allowing bone grafting to correct both soft and bony defects of mandibular region

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LATE RECONSTRUCTION OF PARTIALLY-RESECTED MANDIBLE AFTER REMOVAL OF AMELOBLASTOMA OF THE MANDIBLE (하악골 부분절제술후 이물성형재료에 의한 즉시재건술이 실패된 예에서 양측 장골뼈와 Miniplate Osteosynthesis 를 이용하여 재건시킨 법랑아세포종 치험 1예)

  • Park, Hyung-Sik;Kim, Sun-Yong;Kwon, Joon-Ho;Lee, Sang-Hye
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.171-179
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    • 1990
  • This is a report on a case of delayed reconstruction after partial mandibularectomy for Ameloblastoma involving symphysis and bodies of the mandible by using of two large pieces of corticocancellous bone blocks obtained from both iliac crests. The authors failed immediate reconstruction with two kinds of Alloplasts(metal, methylmethacrylate) at two times of trial due to known infection and suggestive poor histocompatibility of materials aginst the host who has been suffered from long-term and active pulmonary tuberculosis. However we could get success late reconstruction of this problem-occured and curved area with two pieces of large corticocancellous blocks by using of miniplate osteosynthesis and biphasic external pin fixation. From our experience we are obtained some results as follows : 1. Alloplastic graft materials seemed to be dangerous to maintain successfuly in patient who has a long-term debilitating disease as a active pulmonary tuberculosis. 2. Biphasic external skeletal pin fixation appliance gave many advantages such as maintain functional position of the remained bodies and condyles of the mandible after removal of failed alloplasts and during control of inflammation of this area, assist supportive roles to fix and maintain bone grafts during healing, allow mandibular movement during healing and so offer to conduct normal functional stimuli to bone grafts during osteogenesis etc. 3. Bony union was successful between not only normal bones and grafted bones but also grafted bone pieces even though we used two pieces of large blocks of corticocancellous bone for graft. 4. Miniplate osteosynthesis was not affect any adverse effects to bone grafts but offered good role of fixation and maintenance for bone grafts.

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Reconstruction of the Glenoid Using Iliac Bone Graft for Recurrent Anterior Shoulder Instability with Severe Glenoid Bone Defect - A Report of Two Cases - (관절와의 심한 골결손을 동반한 견관절 전방 불안정성에서 장골 이식술을 이용한 관절와 재건술 - 2예 보고 -)

  • Lee, Seong-Man;Jung, Won-Ju;Lee, Hyun-Joo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • 제13권1호
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    • pp.117-122
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    • 2010
  • Purpose: The purpose of this report was to assess a surgical technique-using an autogenous tricortical iliac crest bone graft in patients with epilepsy-for anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency. Materials and Methods: We studied two cases of recurrent anterior dislocation of the shoulder due to epilepsy. These cases were treated with anatomical glenoid reconstruction using an autogenous tricortical iliac crest bone graft. Results: Both cases achieved bone union in 5 months. There was no recurrence of instability and pain. Both cases had normal range of motion. Conclusion: Anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with severe glenoid deficiency using an autogenous tricortical iliac crest bone graft is a successful surgical technique for achieving shoulder stability.

Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

  • Kwon, Seung Gee;Kim, Yong Oock;Rah, Dong Kyun
    • Archives of Plastic Surgery
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    • 제39권4호
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    • pp.345-351
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    • 2012
  • Background Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. Methods Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. Results The mean follow-up period was 11.8 months and the mean operation time for reconstruction was $8.4{\pm}3.36$ hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. Conclusions The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

Arthroscopic Posterior Cruciate Ligament Reconstruction without Tourniquet (지혈대 없이 시행한 관절경하 후방십자인대 재건술)

  • Kim, Sang-Bum;Lee, Young-Goo;Son, Jung-Hwan
    • Journal of the Korean Arthroscopy Society
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    • 제8권2호
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    • pp.94-97
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    • 2004
  • Purpose: To report the results of arthroscope assisted posterior cruciate ligament reconstruction without tourniquet, which has not yet been reported in documents within the country. Materials and Methods: Out of the 75 cases of arthroscope assisted posterior cruciate ligament reconstruction on patients with posterior cruciate ligament damage from January, 1998 to May,2003 in this hospital, study was done on 49 cases of patients with isolated posterior cruciate ligament damage, excluding 16 cases of patients who were applied tourniquet in extraarticular operation due to combined damage such as in lateral collateral ligament and posterolateral collateral ligament, and 10 cases where the postoperative observation period was less than 12 months. There were 13 cases where reconstruction was done using autogenous bone-patella tendon-bone, 19 cases using allogenous bone-patella tendon-bone, and 17 cases using allogenous achilles tendon. For assessment, the 49 cases were compared using Lysholm knee scoring scale. Results: The average duration of operation was 105 minutes. There were no severe complications such as swelling, bleeding, infection etc . Assessment results attained by Lysholm knee scoring scale was 74(fair) for cases where autogenous bone-patella ten-don-bone was used,75(fair) for cases where allogenous achilles tendon was used, and 76(fair) for cases where allogenous bone-patella tendon-bone was used. Conclusion: There are no difficulties to perform the arthroscopic assisted posterior cruciate ligament reconstruction. Reconstruction without tourniquet can be thought to prevent complications that could follow when using it.

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