• Journal of Trauma and Injury
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• v.31 no.3
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• pp.177-180
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• 2018

Heterotopic bone formation in abdominal incisions is a recognized but uncommon sequela of abdominal surgery. On the other hand, the formation of ectopic bone is a well-recognized complication following arthroplasty of the hip. Heterotopic ossification of midline abdominal incision scars is a subtype of myositis ossificans traumatica. Ectopic bone formation of midline abdominal incisions may cause regional pain or discomfort in the patient after surgery. If symptomatic, treatment is complete excision with primary closure. Radiologically, it is important to distinguish this benign entity from postoperative complications. We report a 69-year-old male who underwent exploratory laparotomy for traumatic small bowel perforation. A segment of abnormal hard tissue was found in the abdominal wall. Heterotopic ossification may occur at various sites and is a recognized but infrequent sequela of exploratory laparotomy. This case highlights clinical and etiological features of this finding.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.224-228
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• 2002

Ossification of the Achilles tendon is a rare condition to be distinguished from the more frequently occuring tendon calcification. It is characterized by the presence of an ossific mass contained within the fibrocartilaginous substance of the tendon and is usually associated with prior surgery or trauma to the tendon. We treated a 13 year old girl with ossification of the Achilles tendon after sprain-like injury. We excised it one year later and the microscopic finding of the extirpated bony mass revealed fully maturated lamellar bone.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.245-248
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• 2009

Ossification of the yellow ligament (OYL) is a pathologic condition that causes spinal stenosis, which is a form of ectopic ossification. OYL causes compressive myelopathy and radiculopathy. Although the pathogenesis of OYL is still unclear, diffuse mechanical stresses and degenerative changes caused by extreme ranges of motion may be related to the development of OYL in young sportsmen. Here we report an interesting case of thoracic radiculopathy due to OYL in a 35-year-old male amateur judo player who was successfully treated with continuous thoracic patient controlled epidural analgesia and epidural adhesiolysis.

• Biomolecules & Therapeutics
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• v.27 no.4
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• pp.342-348
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• 2019

Ossification of the posterior longitudinal ligament (OPLL) can be defined as an ectopic ossification in the tissues of spinal ligament showing a hyperostotic condition. OPLL is developed mostly in the cervical spine and clinical presentations of OPLL are majorly myelopathy and/or radiculopathy, with serious neurological pathology resulting in paralysis of extremities and disturbances of motility lowering the quality of life. OPLL is known to be an idiopathic and multifactorial disease, which genetic factors and non-genetic factors including diet, obesity, physical strain on the posterior longitudinal ligament, age, and diabetes mellitus, are involved into the pathogenesis. Up to now, surgical management by decompressing the spinal cord is regarded as standard treatment for OPLL, although there might be the risk of development of reprogression of ossification. The molecular pathogenesis and efficient therapeutic strategy, especially pharmacotherapy and/or preventive intervention, of OPLL has not been clearly elucidated and suggested. Therefore, in this review, we tried to give an overview to the present research results on OPLL, in order to shed light on the potential pharmacotherapy based on molecular pathophysiologic aspect of OPLL, especially on the genetic/genomic factors involved into the etiology of OPLL.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1377-1382
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• 2000

Ossification of ligamentum flavum(OLF) is a type of ectopic bone formation developed within the spinal ligament. Thoracic myelopathy is common symptom of OLF but radiculopathy is uncommon. We present 3 operated cases of OLF. Two showed myelopathy and one radiculomyelopathy. Main symptoms were motor weakness, sensory disturbance, incoordination of both legs, and back pain. One patient complained of left girdle pain in T4 dermatome. Deep tendon reflex(DTR) was increased in all cases. The diagnosis was made from myelogram, CT and MRI. Sufficient posterior decompressive laminectomy and medial facetectomy were performed. Postoperative diagnosis was comfirmed by histopathological examination. One patient could return to work 3 months after operation and two patients showed satisfactory improvement 2-3 months after operation. Early diagnosis and appropriate surgical treatment were prerequisite of good outcome.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.247-250
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• 2002

Myositis ossificans progressiva, otherwise called fibrodysplasia ossificans progressiva is a rare hereditary disease of unknown etiology, which is characterized by progressive ectopic ossification in connective tissues of the muscles, tendons, fascia and aponeurosis. We report a case of myositis ossificans progressiva confined to hands and feet, which has an unusual clinical feature with slow progression.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.68-79
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• 1996

To investigate the efficiency of a fibrous collagen membrane(FCM) composed of bovine skin type I atelocollagen as a carrier for BMP, partially purified bovine BMP/FCM($0.3mg/10{\times}5{\times}1mm$) composites were implanted into the dorsal subcutaneous tissue of rats. FCM alone was also implanted as a control. The implants were harvested at 1, 2, 3, and 10 weeks after implantation, then prepared for routine light microscopic observation. The FCM alone did not induce osteogenesis and revealed no specific foreign body reaction nor was there any definite resorptive evidence for 10 weeks after implantation, while the BMP/FCM composites induced favorable bone formation in a process that resembled an endochondral and direct ossification mode. At 10 weeks, the well formed bone confined to embedded collagen fibers revealed hematopoietic marrow between bony trabeculae without evidence of resorptive or degenerative changes . These findings support the suggestion that BMP may induce undifferentiated mesenchymal cells into either chondroblasts or osteoblasts or both independantly according to the chemico- physical characteristics of the carrier, which develops the endochondral and/or direct bone formation process, and suggest that the FCM may be a favorable carrier for BMP.

• BMB Reports
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• v.49 no.2
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• pp.122-127
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• 2016

Engineered bone tissue is thought to be the ideal alternative for bone grafts in the treatment of related bone diseases. BMP9 has been demonstrated as one of the most osteogenic factors, and enhancement of BMP9-induced osteogenesis will greatly accelerate the development of bone tissue engineering. Here, we investigated the effect of insulin-like growth factor 1 (IGF1) on BMP9-induced osteogenic differentiation, and unveiled a possible molecular mechanism underling this process. We found that IGF1 and BMP9 are both detectable in mesenchymal stem cells (MSCs). Exogenous expression of IGF1 potentiates BMP9-induced alkaline phosphatase (ALP), matrix mineralization, and ectopic bone formation. Similarly, IGF1 enhances BMP9-induced endochondral ossification. Mechanistically, we found that IGF1 increases BMP9-induced activation of BMP/Smad signaling in MSCs. Our findings demonstrate that IGF1 can enhance BMP9-induced osteogenic differentiation in MSCs, and that this effect may be mediated by the enhancement of the BMP/Smad signaling transduction triggered by BMP9.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.198-204
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• 1998

Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.242-249
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• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.