• 제목/요약/키워드: Bone graft procedure

검색결과 218건 처리시간 0.021초

악성 흑색종 치료를 위한 피판술의 임상적 결과 (The Clinical Outcome of Flap Coverage for the Treatment of Malignant Melanoma)

  • 전우주;강종우;김일환;손길수;박종웅
    • Archives of Reconstructive Microsurgery
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    • 제19권2호
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    • pp.81-87
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    • 2010
  • In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.

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Ligamentoplasty with interposition of the proximal interphalangeal joint in the treatment of unicondylar osteochondral defects: a cadaveric feasibility study

  • Hery, Jean-Charles;Picart, Baptiste;Malherbe, Melanie;Hulet, Christophe;Lombard, Aude
    • Archives of Plastic Surgery
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    • 제48권6호
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    • pp.635-640
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    • 2021
  • Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx that can restore joint amplitudes and provide PIP stability. Methods In this cadaveric feasibility study, unicondylar defects were generated using striking wedges and chisels. First, a transverse tunnel measuring 2 mm in diameter passing through the head of the proximal phalanx was made. A second tunnel at the base of the middle phalanx with the same diameter was then created. The hemitendon of the flexor carpi radialis graft was passed through each of these tunnels. The proximal end of the graft was interposed in the area with a loss of bone substance. The ligamentoplasty was then tensed and fixed by two anchors on the proximal phalanx. Joint amplitudes and frontal stability were measured preoperatively and postoperatively. Results There was no significant change in the joint's range of motion: preoperatively, the mean mobility arcs were -2° to 113.80°, and they were -2° to 110° after the procedure (P=0.999). There was no significant difference in joint stability (P>0.05). Conclusions Ligamentoplasty with PIP interposition appears to be a possible solution for the management of unicondylar defects of the proximal phalanx. An evaluation of clinical results is planned in order to definitively confirm the validity of this procedure.

Infective Costochondritis after Augmentation Mammoplasty: A Rare Case Report and Review of the Literature

  • Sally Min;Jinil Choi;Kwon Joong Na;Ki Yong Hong
    • Archives of Plastic Surgery
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    • 제50권5호
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    • pp.488-491
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    • 2023
  • Silicone breast implant insertion is a commonly performed surgical procedure for breast augmentation or reconstruction. Among various postoperative complications, infection is one of the main causes of patient readmission and may ultimately require explantation. We report a case of infective costochondritis after augmentation mammoplasty, which has rarely been reported and is therefore difficult to diagnose. A 36-year-old female visited the clinic for persistent redness, pain, and purulent discharge around the left anteromedial chest, even after breast implant explantation. Magnetic resonance imaging showed abscess formation encircling the left fourth rib and intracartilaginous and bone marrow signal alteration at the left body of the sternum and left fourth rib. En bloc resection of partial rib and adjacent sternum were done and biopsy results confirmed infective costochondritis. Ten months postoperatively, the patient underwent chest wall reconstruction with an artificial bone graft and acellular dermal matrix. As shown in this case, early and aggressive surgical debridement of the infected costal cartilage and sternum should be performed for infective costochondritis. Furthermore, delayed chest wall reconstruction could significantly contribute to the quality of life.

성견 1면 골결손부에서 Bioactive Glass가 치주조직 치유에 미치는 영향 (The effects of bioactive glass on the periodontal healing of 1-wall intrabony defects in dogs)

  • 박원영;조규성;채중규;김종관;최성호
    • Journal of Periodontal and Implant Science
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    • 제28권1호
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    • pp.145-160
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    • 1998
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease, and numerous kinds of materials and techniques have been developed to achieve this goal. Bone grafts include autografts, allografts, xenografts and synthetic grafts. Among the synthetic grafts, bioactive glass has been used in dentistry for more than ten years and Fetner reported improved new bone formation and more amount of new attachment after grafting PerioGlas, a kind of bioactive glass, in 2-wall defects of monkeys in 1994. It Is well known that 1-wall defects have less osteogenic potential and more epithelial migration, so we need to study the erect of bioactive glass in 1-wall dejects in dogs. The present study evaluates the effect of bioactive glass on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony detects of dogs. Four millimeter deep and four millimeter wide 1-wall defects were surgically cheated in the mesial aspects of premolars. The test group received bioactive glass with a flap procedure and the control underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results: 1. The height of gingival margin was 1.30{\pm}0.73mm$ above CEJ in the control and $1.40{\pm}0.78mm$ in the test group. There was no statistically significant difference between the two group. 2. The length of epithelial growth (the distance from CEJ to the apical end of JE) was $1.74{\pm}0.47mm$ in the control and $1.12{\pm}0.36mm$ in the test group. These was a statistically significant difference between the two groups (P<0.01). 3. The length of new cementum was $2.06{\pm}0.73mm$ in the control and $2.62{\pm}0.37mm$ in the test group. There was no statistically significant difference between the two groups. 4. The length of new bone was $1.83{\pm}0.74mm$ in the control and $2.39{\pm}0.59mm$ in the test group. There was no statistically significant difference between the two groups. These results suggest that the use of bioactive glass 1-wall intrabony defects has significant effect on the prevention of junctional epithelium migration, but doesn't have any significant effect on new bone and new cementum formation.

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조혈줄기세포이식후 발생한 이식편대숙주병의 구강병소에 대한 최소침습적 레이저조직생검 증례 (Minimally Invasive Laser-Assisted Biopsy of the Oral Lesions for Oral Graft-Versus-Host Disease after Hematopoietic Stem-Cell Transplantation)

  • 김윤미;윤희정;김현실;김기덕;정복영;방난심;박원서
    • Journal of Oral Medicine and Pain
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    • 제37권3호
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    • pp.147-154
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    • 2012
  • 조혈줄기세포이식은 면역 결핍 질환, 자가 면역 질환, 악성 조혈 종양의 주된 치료법이다. 이종 조혈줄기세포이식의 주요한 합병증은 이식편대 숙주질환이다. 구강 점막 생검은 이식편대 숙주 질환의 확진과 치료계획 수립을 위해 필요하나 영양 결핍과 화학 요법으로 인해 전신상태가 불량한 환자에게 출혈과 균혈증을 일으킨다. 본 논문에서는 레이저를 이용한 최소 침습적 조직생검의 효능을 평가하였다. 모두 3개의 증례가 소개되었고 모든 환자의 의료 기록, 임상 사진, 조직병리학적 결과가 레이저를 이용한 조직생검의 효능을 평가하기 위해 검토되었다. 모든 환자는 생검 후 불편감이 없었고 심각한 합병증이 발생하지 않았다. 생검 조직의 질이 이식편대 숙주 질환을 확진하는 데에 적당했다. 구강 점막의 레이저를 이용한 최소 침습적 생검은 통상의 조직병리학적 생검에 비해 출혈을 일으키지 않아 감염과 균혈증, 술 후 흉터 생성을 줄이므로 이식편대 숙주 질환의 확진에 이로울 것이다.

항생제 혼합 시멘트 충전물을 이용한 감염된 족무지 지관절의 2단계 치료(1예 보고) (Two Stage Procedure with a Temporary Antibiotic-impregnated Cement Spacer of Infected Hallux Interphalangeal Joint (A Case Report))

  • 채수욱;김영진;송하헌;김종윤
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.135-139
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    • 2012
  • The interphalangeal joint (IPJ) of the hallux has received little attention compared with the first metatarsophalangeal joint. But, the hallucal IPJ has several disorders such intra-articular fractures, dorsal dislocation, alignment disorder, and inflammatory or degenerative arthritis. Among these disorders septic arthritis of the IPJ of the hallux is rare. We report a case of sepsis of the hallucal IPJ and adjacent underlying osteomyelitis without neuropathic problem and was performed through infected soft tissue and osseous debridement, temporary antibiotic-impregnated cement spacer, and delayed intercalary allogenic fibular bone graft with K-wire fixation.

A review of complications of maxillary sinus augmentation and available treatment methods

  • Kim, Joongmin;Jang, Hyonseok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권4호
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    • pp.220-224
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    • 2019
  • Maxillary sinus grafting is a dependable procedure that has been in use for a long time. However, clinical complications often arise. To prevent complications of maxillary sinus grafting, it is necessary to know the contra-indications, both for general implantation and for maxillary bone grafting. In addition, presence of various complications requires careful consideration of treatment method; therefore, dentists should be familiar with the treatment protocols. Complications can be divided into postoperative, immediate postoperative, and delayed postoperative complications. Particularly for the outpatient, it is necessary to quickly distinguish between treatable cases and cases for which transfer is required. The purpose of this review is to discuss the contra-indications, complications, and treatment options for complications of maxillary sinus graft.

Cosmetic Lateral Canthoplasty: Lateral Canthoplasty to Lengthen the Lateral Canthal Angle and Correct the Outer Tail of the Eye

  • Chae, Soo Wook;Yun, Byung Min
    • Archives of Plastic Surgery
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    • 제43권4호
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    • pp.321-327
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    • 2016
  • There are many women who want larger and brighter eyes that will give a favorable impression. Surgical methods that make the eye larger and brighter include double eyelidplasty, epicanthoplasty, as well as lateral canthoplasty. Double eyelidplasty produces changes in the vertical dimension of the eyes, whereas epicanthoplasty and lateral canthoplasty create changes in the horizontal dimension of the eyes. Epicanthoplasty, a surgical procedure which enlarges the eye horizontally, is performed at the inner corner of the eye, whereas lateral canthoplasty enlarges the outer edge of the eye. In particular, if the slant of the palpebral fissure is raised and the horizontal dimension of the palpebral fissure is short, adjusting the slant of the palpebral fissure through lateral canthoplasty can achieve an enlargement of eye width and smoother features. Depending on the patient's condition, even better results can be achieved if this procedure is performed in conjunction with other procedures, such as double eyelid-plasty, epicanthoplasty, eye roll formation surgery, fat graft, and facial bone contouring surgery. In this paper, the authors will introduce in detail their surgical method for a cosmetic lateral canthoplasty that lengthens the lateral canthal angle and corrects the outer tail of the eyes, in order to ease the unfavorable impression.

MBCP를 이용하여 거상된 상악 구치부에 식립한 임플란트의 기능 후 2년 누적 생존율 - 후향적 임상 연구 (A cumulative survival rate of implants installed on posterior maxilla augmented using MBCP after 2 years of loading: A retrospective clinical study)

  • 김민수;이지현;정의원;김창성;최성호;조규성
    • Journal of Periodontal and Implant Science
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    • 제38권4호
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    • pp.669-678
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    • 2008
  • Purpose: The purpose of this study was to evaluate 2 years cumulative survival rate of implants on augmented sinus area using MBCP, mixture of MBCP and ICB, and mixture of MBCP and autogenous bone by means of clinical and radiologic methods. Materials and Methods: In a total of 37 patients, 41 maxillary sinuses were augmented and 89 implant fixtures were installed simultaneously or after a regular healing period. The patients were divided in 3 groups: MBCP only, MBCP combined with ICB, MBCP combined with autogenous bone. After delivery of prosthesis, along 2 years of observation period, all implants were evaluated clinically and radiologically. And the results were as follows. Results: The results of this study were as follows. 1. A 2 year cumulative survival rate of implants placed with sinus augmentation procedure using MBCP was 97.75%. 2. Survival rate of implants using MBCP only was 97.62%, MBCP and ICB was 100%, MBCP and autogenous bone was 95%. There was no statistically significant difference between 3 groups. 3. Only 2 of 89 implants were lost before delivery of prosthesis, so it can be regarded as an early failure. And both were successfully restored by wider implants. Conclusion: It can be suggested that MBCP may have predictable result when used as a grafting material of sinus floor augmentation whether combined with other graft(ICB, autogenous bone) or not. And the diameter, length, location of implants did not have a significant effect on 2 year cumulative survival rate.

Bio-Oss와 β-TCP를 이용한 토끼 상악동 거상술 후의 조직학적 비교 연구 (Histological Comparative Study of Rabbit Maxillary Sinus Augmentation with Bio-Oss and β-TCP)

  • 문용석
    • 생명과학회지
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    • 제28권10호
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    • pp.1220-1232
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    • 2018
  • 본 연구는 토끼의 상악동에 Bio-Oss와 ${\beta}-TCP$를 이식한 후 골 재생 과정을 조직학적으로 비교하기 위하여 수행되었다. 12마리의 수컷 토끼를 4마리씩 3군으로 구분하였다. 토끼의 양쪽 상악동 점막을 거상한 후 한쪽은 Bio-Oss를 이식하였고, 다른 쪽은 ${\beta}-TCP$를 이식한 후 본래의 골편으로 창을 봉합하였다. 2주, 4주 및 8주 후에 토끼를 희생시키고 조직절편을 만든 후 Bio-Oss군과 ${\beta}-TCP$군의 골 재생 양상을 비교하였다. 조직계측학적 분석을 위하여 각각의 조직절편에 hematoxylin-eosin, Masson trichrome 및 tartrate-resistant acid phosphatase 염색을 하였고, proliferating cell nuclear antigen (PCNA), type I collagen 및 osteocalcin의 발현 양상을 비교하기 위하여 면역조직화학 염색을 하였다. 광학현미경 시야에서 계측프로그램을 이용하여 계측하고 분석하여 다음과 같은 결과를 얻었다. Bio-Oss군과 ${\beta}-TCP$군 모두 2주군에서 초기 골 형성이 시작되었고, 4주군에서는 각 이식재 입자의 표면에 형성된 다량의 신생골이 관찰되었으며, 8주군에서는 신생골의 골량이 더 증가되어 있었고 층판골과 골수조직도 관찰되었다. 신생골의 양은 4주군까지 두 군이 비슷하였으나, 8주군에서는 ${\beta}-TCP$군에서 유의한 증가가 계측되었다. 이식재의 양은 4주군부터 8주군까지 ${\beta}-TCP$군에서 유의하게 감소되었으며, 파골세포의 수는 4주군에서 8주군까지 ${\beta}-TCP$군에서 유의하게 증가되어 있었다. PCNA에 대한 면역반응성은 8주군에서 감소되었지만 두 군간의 유의한 변화는 없었다. Type I collagen의 발현은, 2주군에서는 ${\beta}-TCP$군에서 유의하게 증가되었지만, 8주군에서는 Bio-Oss군에서 유의한 증가가 관찰되었다. Osteocalcin에 대한 면역반응성은 8주까지 증가되었으며 두 군간의 유의한 차이는 없었다. 이러한 조직학적 결과들은 임플란트를 위한 이식재의 선택에 도움을 줄 수 있다. 이상의 결과들을 종합하면 Bio-Oss와 ${\beta}-TCP$는 모두 검증된 이식재 이지만, 토끼의 상악동 거상술에서는 ${\beta}-TCP$가 좀 더 우수한 골 재생 결과를 보였다.