• Title/Summary/Keyword: Distal fibula

Search Result 43, Processing Time 0.017 seconds

Clinical Application of Recombinant Human Bone Morphogenetic Protein-2 for Delayed Fractures in Dogs (개에서 골절의 지연유합에 대한 rhBMP-2의 임상적 적용 2례)

  • Kim, Jae-Kyong;Kim, Se-Eun;Go, A-Ra;Kim, Seung-Hyun;Shim, Kyung-Mi;Bae, Chun-Sik;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Veterinary Clinics
    • /
    • v.29 no.5
    • /
    • pp.412-415
    • /
    • 2012
  • A 1-year-old, castrated male Yorkshire terrier (case 1) and a 7-year-old female Poodle (case 2) presented with delayed union fractures. In case 1, the dog had a fractured right distal radius and ulna. In case 2, the dog had a fractured left distal tibia and fibula. A physical examination and radiographs performed in both dogs revealed delayed union fractures with large gaps. The fracture sites were fixed by bone plate and screws. Autogenous cancellous bone graft was applied into the fracture gap. To encourage rapid bone union, we used matrigel containing $20{\mu}g$ of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the fracture site. Radiographs were taken postoperatively to monitor healing. Rapid bone union was noted in both dogs in long-term radiographs. In case 1, the radiographs revealed that the fracture gaps of the radius and ulna were bridged at 2 weeks. Fracture lines were not observed and normal appearance was restored at 20 weeks. In case 2, the radiographs showed that fracture repair had progressed at 11 weeks. The fractures healed faster than expected in these two cases. The results indicate that rhBMP-2 and matrigel may be effective and useful materials to enhance healing of delayed fractures.

Anatomical Study of Superficial Peroneal Nerve Accessory Artery and Perforators in the Anterior Intermuscular Septum of Lower Leg Using Cadaveric Dissection (시체 해부를 통한 다리의 얕은종아리신경 동반동맥과 앞근육사이막에 존재하는 관통가지에 관한 해부학적 연구)

  • Kim, Jun Sik;Shin, Sang Ho;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Nam Gyun
    • Archives of Plastic Surgery
    • /
    • v.33 no.6
    • /
    • pp.695-699
    • /
    • 2006
  • Purpose: In the 1990s, skin island flap supplied by the vascular axis of the sensitive superficial nerves had been introduced. For example, neurocutaneous flaps supplied by the vascular axis of the sural nerve and saphenous nerve have been used. But the flap supplied by the vascular axis of superficial peroneal nerve has not been used commonly. Because there have been few anatomical reports about the superficial peroneal nerve accessory artery(SPNAA), we could not apply the neurocutaneous flap supplied by SPNAA. The aim of this study is to investigate the anatomy of SPNAA, number and location of its perforators, and septocutaneous perforators from the anterior tibial artery in anterior intermuscular septum. Methods: So, we dissected a total of eight cadavers. Measurements were made of the positions of the dissected arteries and perforators from the head of the fibula. Results: In all cadavers the superior lateral peroneal artery was originated from the anterior tibial artery and contributed SPNAA. Arising from the anterior tibial artery an average of 5.63 cm inferior to the fibular head, it varied from 10 cm to 16 cm in length. SPNAA gave off an average of 4.38 perforators to supply lateral aspect. In one case the inferior lateral peroneal artery was present and arose from the anterior tibial artery 18 cm inferior to the fibular head. There were an average of 3.38 direct septocutaneous perforators from the anterior tibial artery. Conclusion: Septocutaneous perforators from SPNAA mainly exist from proximal 1/6 to 3/5 of lower leg. In the distal 1/3 of lower leg where the accessory artery was disappeared, exist mainly direct septocutaneous perforators from the anterior tibial artery. Our results can be helpful to applications of the neurocutaneous flap using SPNAA or fasciocutaneous flap based on direct septocutaneous perforators.

The Reconstruction with Extracorporeal Irradiated Autograft for Osteosarcoma of Extremities (사지 골육종에서 체외 방사선 조사를 이용한 재건술)

  • Kim, Jae-Do;Lee, Gun-Woo;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.16 no.1
    • /
    • pp.1-7
    • /
    • 2010
  • Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.