• Title/Summary/Keyword: Distal femur

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Treatment and Rehabilitation in a Common Kestrel (Falco tinnunculus) with Both Legs Broken (양쪽 다리 골절 황조롱이의 치료와 재활 1례)

  • Kim, Hee-jong;Kim, Young-jun;Kim, Moon-jung;Park, Young-seok;Kim, Byeong-su;Park, Seong-jun
    • Journal of Veterinary Clinics
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    • v.36 no.1
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    • pp.82-84
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    • 2019
  • A common kestrel (Falco tinnunculus) was presented with inability to stand and fly at Chungnam Wild Animal Rescue Center. The kestrel showed non-weight bearing ambulation on both legs and crepitation with no external wound. Radiographs revealed a fracture on mid-diaphysis of right tibiotarsus and a distal end fracture of left femur. Intramedullary pinning was chosen for reduction of both fractures. The right tibiotarsal fracture was corrected first, and left femur was repaired 5 days later. The kestrel was managed with a specially designed sling to prevent further iatrogenic damage for 2 weeks. Three weeks after the surgery, the kestrel was able to stand and found to perch in 4 weeks. On 5 weeks, The kestrel could fly free at outdoor aviary and was released through rehabilitation for 3 months finally.

Two Cases of Giant Cell Tumor of the Bone Diagnosed by Fine Needle Aspiration Cytology (골 거대세포종의 2예 세침 천자 세포학적 소견)

  • Myong, Na-Hye;Ha, Chang-Won;Cho, Kyung-Ja;Jang, Ja-June;Baek, Goo-Hyun;Lee, Soo-Yong
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.93-97
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    • 1990
  • Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses In both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.

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Treatment of Benign Bone Tumor with Xenograft (이종골 이식을 이용한 양성 골 종양 치료)

  • Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.189-193
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    • 1995
  • The authors reviewed 49 cases(48 patients) of benign bone tumor who had surgical treatment with xenograft at department of orthopedic surgery, Seoul National University Hospital from May, 1980 to May, 1994. Materials consist of 21 males and 27 females. The mean age at operation was 20.1 years(range : 4 -55 years) and the mean follow up period was 25.4 months(range : 7 - 85 months). We did xenograft only in 34 cases and xenograft mixed with autograft in 15 cases(14 cases, from ilium, 1 case from femur). The used materials for xenograft were $Lubboc^{(R)}$ in 29 cases, $Surgibone^{(R)}$ in 17 cases and $Pyrost^{(R)}$ in 3 cases. The average durations when bony union was achieved in radiograph were 13.8 weeks in whole cases, 12.5 weeks(range : 8 - 24 weeks) in $Lubboc^{(R)}$ graft cases and 15.7 weeks(range : 6 - 24 weeks) in $Surgibone^{(R)}$ graft cases. The tumor recurred in 4 cases, 1 case was recurred giant cell tumor at distal femur treated with mixed auto and $Lubboc^{(R)}$ graft and 2 cases were large cystic lesions at the proximal humerus diagnosed as simple bone cyst and at distal tibia diagnosed as fibrous dysplasia treated with $Surgibone^{(R)}$ graft and 1 case was aneurysmal bone cyst of the proximal tibia treated with $Lubboc^{(R)}$ graft. Wound infection occurred in 1 case. More transfusion was done in the cases that the lesion was larger than 5cm, the lesions were in the ilium or femur and the cases that were treated with mixed with autograft. This study implies that benign bone tumor is successfully treqated with curettage and xenograft or xenograft mixed with autograft. And also this method will reduce morbidity of donor site, intraoperative bleeding and post-transfusion complications.

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Factors Affecting the Period of Bone Union When Treating Femoral Fractures with a Retrograde Intramedullary Nail (역행성 골수강 내 금속정을 이용한 대퇴골절의 치료 시 골유합 기간에 영향 미치는 인자)

  • Kim, Bum-Soo;Kim, Seong-Tae;Shin, Seungyup;Jeon, Seong Man
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.326-333
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    • 2021
  • Purpose: A retrograde intramedullary nail is commonly used to treat femoral shaft and distal femur fractures. The authors analyzed the treatment results and the factors affecting the period of bone union for thirty-five patients treated with a retrograde intramedullary nail. Materials and Methods: Thirty-five patients who could be followed up for more than twelve months after the treatment with retrograde intramedullary nailing were analyzed retrospectively. The treatment results and the relationship between the period of bone union and the patient's age, sex, comminution of fracture, presence of open fracture, location of the fracture, and accompanying fractures were evaluated. Results: The average bone union time was 4.50 months. The period of bone union was unaffected by the age, sex, location, and presence of open fractures but was affected by the presence of comminution and accompanying fractures. Conclusion: Retrograde intramedullary nailing is effective for distal and shaft of fractures of the femur. The period of bone union is affected by the presence of comminution and accompanying fractures.

Updated Surgical Techniques and Expanded Indications of Free Vascularized Fibular Graft

  • Park, Jong Woong
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.41-49
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    • 2015
  • Free or pedicled vascularized fibular grafts (VFG) are useful for the reconstruction of large skeletal defects, particularly in cases of scarred or avascular beds, or in patients with combined bone and soft tissue defects. Compared to non-VFG, VEG, which contains living osteocytes and osteoblasts, maintains its own viability and serves as good osteoconductive and osteoinductive graft. Due to its many structural and biological advantages, the free fibular osteo- or osteocutaneous graft is considered the most suitable autograft for the reconstruction of long bone defects in the injured extremity. The traditional indication of VFG is the long bone and soft tissue defect, which cannot be reconstructed using a conventional operative method. Recently, the indications have been widely expanded not only for defects of midtibia, humerus, forearm, distal femur, and proximal tibia, but also for the arthrodesis of shoulder and knee joints. Because of its potential to allow further bone growth, free fibular epiphyseal transfer can be used for the hip or for distal radius defects caused by the radical resection of a tumor. The basic anatomy and surgical techniques for harvesting the VFG are well known; however, the condition of the recipient site is different in each case. Therefore, careful preoperative surgical planning should be customized in every patient. In this review, recently expanded surgical indications of VFG and surgical tips based on the author's experiences in the issues of fixation method, one or two staged reconstruction, size mismatching, overcoming the stress fracture, and arthrodesis of shoulder and knee joint using VFG are discussed with the review of literature.

Periosteal Ganglion of the Distal Fibula - A Case Report - (원위 비골에서 발생한 골막하 결절종 - 증례 보고 -)

  • Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.178-181
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    • 2008
  • In contrast to ganglion of the soft tissue, periosteal ganglion occurring within or beneath the periosteum is a rare disorder. The differential diagnosis includes periosteal chondroma, lipoma, giant cell tumor of tendon sheath and periosteal osteosarcoma. Most common location for periosteal ganglion is the tibia, followed by radius, femur and ulna. To our knowledge, only 1 case of periosteal ganglion of the fibula has been reported in the literature. We report a case of periosteal ganglion of the distal fibula in a thirty-year-old woman treated with excision of the cyst and the adjacent periosteum.

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Comparative Biomechanical Study of Stiffness on Ligamentous Attached Sites of Distal Femur - Experimental Laboratory Study on Cadaver Femora - (원위 대퇴골 인대 부착부의 강도 비교 - 사체의 대퇴골에 행한 실험적 연구 -)

  • Kwak, Ji-Hoon;Sim, Jae-Ang;Yang, Sang-Hoon;Kim, Dong-Hee;Lee, Beom-Koo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.26-32
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    • 2009
  • Purpose: This study was performed to compare the strength of ligamentous attached sites of cadaveric distal femur and to obtain reliable biomechanical data to use in ligamentous reconstruction or augmentation. Materials and Methods: Fifteen cadaveric distal femurs were used for this study. After measuring the bone density, 5.0 mm cannulated screw (Experiment 1) or reconstructed porcine ligament (Experiment 2) was inserted into the each ligamentous attached sites of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). In experiment 2, reconstructed porcine graft was fixed with bioabsorbable screw in ligamentous insertion sites. And we measured the maximal pullout force of each ligamentous attached sites of cadaveric distal femur. Results: Average bone mineral density was $1.205{\pm}0.137\;g/cm^2$ in experiment 1, $1.236{\pm}0.089\;g/cm^2$ in experiment 2, which showed no statistically significant differences. In experiment 1, average pull-out strength of ACL, PCL, MCL and LCL group were $519.1{\pm}111.7$ N, $638.9{\pm}144.4$ N, $169.7{\pm}56.0$ N, $225.6{\pm}61.5$ N respectively. In experiment 2, the average pull-out strength were $310.6{\pm}31.0$ N, $379.9{\pm}47.4$ N, $104.0{\pm}14.4$ N, $131.5{\pm}21.9$ N respectively. In experiment 1, there was no significant difference between ACL and PCL group and between MCL and LCL group. However, the maximal pullout strength of MCL and LCL group were significantly lower than that of ACL and PCL group (p<0.01). Experiment 2 showed the same results of experiment 1. Conclusion: Because stiffness of MCL and LCL attached sites are much lower than that of ACL and PCL attached sites, we may consider augmented fixation in ligamentous reconstructions of MCL and LCL.

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The Mechanical Properties of Trabecular Bone in Knee Joint (무릎관절 해면뼈의 기계적 물성)

  • Kwak, Dai-Soon;Oh, Taek-Yul;Han, Seung-Ho
    • Journal of the Korean Society for Precision Engineering
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    • v.26 no.6
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    • pp.131-135
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    • 2009
  • In this study, we performed the compressive strength test of trabecular bone in knee joint for measuring the elastic modulus and ultimate strength. The main knee joint is femorotibial articulation between the lateral and medial femorotibial condyle. In the case of osteoarthritis, some patients have only medial condylar osteoarthritis. We performed the mechanical test for comparison the difference of the each condylar strength. We used diamond core-drill and linear precision saw for making the specimens. Specimens were cored from both condyle in distal femur and proximal tibia in fresh cadaver (male 10, female 12), and tested by universal test machine with temperature control saline circulation system. Results of the test in distal femoral parts, averaged elastic modulus was $360.61{\pm}159.40MPa$ for male, $150.89{\pm}70.65MPa$ for female. Averaged ultimate strength was $6.79{\pm}2.91MPa$ for male, $2.89{\pm}1.31MPa$ for female. Male was 2.4 times stronger than female. In the proximal tibial parts, averaged elastic modulus was $108.80{\pm}52.88MPa$ for male, $73.45{\pm}55.06MPa$ for female. Averaged ultimate strength was $2.59{\pm}1.39MPa$ for male, $1.75{\pm}1.16MPa$ for female. Male was 1.5 times stronger than female. In the distal femoral condyle, medial condyle had more strength than lateral condyle at middle region. But lateral condyle had more strength than medial condyle at anterior & posterior regions (p<0.02). In the proximal tibial condyle, medial condyle had more strength than lateral condyle. (p<0.01).

Determination of Femoral and Tibial Joint Reference Angles in Small-breed Dogs

  • Kim, Jooho;Heo, Suyoung;Na, Jiyoung;Kim, Namsoo;Kim, Minsu;Jeong, Seongmok;Lee, HaeBeom
    • Journal of Veterinary Clinics
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    • v.33 no.6
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    • pp.340-345
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    • 2016
  • The present study determined the normal reference ranges for the femoral and tibial joint orientation angles of small-breed dogs. For this purpose, 60 each of cadaveric canine femurs and tibias from normal small-breed dogs (Maltese, Poodle, Shih Tzu, Yorkshire Terrier) were examined with radiographs and photographs. Axial and frontal radiographs and photographs of each bone were obtained, from which anteversion and inclination angles, anatomic lateral proximal and distal femoral angles (aLPFA and aLDFA), mechanical lateral proximal and distal femoral angles (mLPFA and mLDFA), and mechanical medial proximal and distal tibial angles (mMPTA and mMDTA) were measured. The 95% CI for radiographic values of all femurs and tibiae were anteversion angle, $23.4-27.4^{\circ}$; inclination angle, $128.4-130.4^{\circ}$; aLPFA, $117.8-122.1^{\circ}$; aLDFA, $93.7-95.2^{\circ}$; mLPFA $113.8-117.3^{\circ}$; mLDFA $99.2-100.5^{\circ}$; mMPTA $96.8-98.5^{\circ}$; mMDTA $89.4-90.7^{\circ}$. The Maltese had a larger anteversion angle than the Poodle and the Yorkshire Terrier and a larger mLPFA than the Poodle. In the comparison between the radiographs and the photographs, significant differences were found in the anteversion angle, mLPFA, mMPTA, and mMDTA. The established normal reference values might be useful for determining whether a valgus or varus deformity of the femur or the tibia is present and if so, the degree of angular correction needed.

Changes in Impact Characteristics of the Body by Different Heel Strike Patterns during Running (달리기 시 착지 유형에 따른 인체에 미치는 충격의 변화)

  • Young-Seong Lee;Sang-Kyoon Park
    • Korean Journal of Applied Biomechanics
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    • v.33 no.4
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    • pp.164-174
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    • 2023
  • Objective: The aim of this study was to quantitatively analyze the impact characteristics of the lower extremity on strike pattern during running. Method: 19 young subjects (age: 26.53 ± 5.24 yrs., height: 174.89 ± 4.75 cm, weight: 70.97 ± 5.97 kg) participated in this study. All subjects performed treadmill running with fore-foot strike (FFS), mid-foot strike (MFS), and rear-foot strike (RFS) to analyze the impact characteristics in the lower extremity. Impact variables were analyzed including vertical ground reaction force, lower extremity joint moments, impact acceleration, and impact shock. Accelerometers for measuring impact acceleration and impact shock were attached to the heel, distal tibia, proximal tibia, and 50% point of the femur. Results: The peak vertical force and loading rate in passive portion were significantly higher in MFS and FFS compared to FFS. The peak plantarflexion moment at the ankle joint was significantly higher in the FFS compared to the MFS and RFS, while the peak extension moment at the knee joint was significantly higher in the RFS compared to the MFS and FFS. The resultant impact acceleration was significantly higher in FFS and MFS than in RFS at the foot and distal tibia, and MFS was significantly higher than FFS at the proximal tibia. In impact shock, FFS and MFS were significantly higher than RFS at the foot, distal tibia, and proximal tibia. Conclusion: Running with 3 strike patterns (FFS, MFS, and RFS) show different impact characteristics which may lead to an increased risk of running-related injuries (RRI). However, through the results of this study, it is possible to understand the characteristics of impact on strike patterns, and to explore preventive measures for injuries. To reduce the incidence of RRI, it is crucial to first identify one's strike pattern and then seek appropriate alternatives (such as reducing impact force and strengthening relevant muscles) on that strike pattern.