• Title/Summary/Keyword: Epiphysis

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Partial Knee Joint Defect Reconstruction with Vascularized Proximal Fibular Articular Surface (슬관절 부분결손에 대한 혈관부착 비골근위 관절면을 이용한 재건술)

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.157-164
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    • 1998
  • It has been very difficult to managing partial joint defect in any etiologies, especially in children. Unicondylar defect of the tibial condyle in children reconstructed with proximal fibular head with articular cartilage from 1995. Two kinds of transfering methods were used, peroneal artery pedicled ipsilateral fibula head transposition to defective lateral tibial condyle defect that revealed poor prognosis with gradual absorption of transposed fibular epiphysis. Free vascularized fibular head transplantation with microvascular anastomosis underwent in the case with medial condyle defect of tibia which revealed very satisfactory results. Author can conclude with these clinical experiences: 1. Tranposition without epiphyseal vesssels intact is not sufficient in fibular head osteochondral transplantation in reconstruction of tibial condyle defect. That means peroneal arterial vascular pedicle is not enough for transplanted proximal epiphysis maintains its function on articular surface and growth activity in children. 2. The anterior recurrent tibial artery is one of the most important and easy to utilizing vessel in proximal fibular epiphyseal transplantation. 3. Free vascularized fibular head transplantation is hopeful method in reconstruction of the knee joint in the patient with partial joint defect which has no effective solution in conventional methods.

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Slipped Capital Femoral Epiphysis Associated with Hypopituitarism in Patients over 20 Years (20세 이상의 뇌하수체 기능 저하증에 의한 대퇴골두 골단분리증)

  • Na, Seung Min;Kim, Yong Uk;Cho, Yong Jin;Jung, Sung Taek
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.567-573
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    • 2019
  • Slipped capital femoral epiphysis (SCFE) is a rare disorder of the proximal femur in adolescents. The pathogenesis of SCFE is unclear, but it is believed to be the result of a mechanical insufficiency of the proximal femur physis. SCFE appears to caused by mechanical, endocrinal, and immunological abnormalities. Few cases have reported the SCFE associated with endocrine disorder in the domestic literature, particularly in patients over 20 years old. This paper reports two cases of SCFE associated with hypopituitarism in adults over 20 years old.

Physeal Remodeling after Internal Fixation of Slipped Capital Femoral Epiphysis (대퇴골두골단분리증 환자 중 금속내고정술을 시행받은 환자에서의 골단판의 재형성)

  • Kim, Se-Dong;Park, Byung-Won
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.28-35
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    • 2003
  • Purpose: To evaluate physeal remodeling after internal fixation of slipped capital femoral epiphysis, We performed a retrospective review of the medical records and radiographs of 14 children (17 cases) who had had slipped capital femoral epiphysis. Materials and Methods: We reviewed 14 patients who had slipped capital femoral epiphysis. They were divided two groups. Group I were in situ pinning with single screw and group II were corrective osteotomy with multiple pinning. We identified physeal remodeling camparing with their preoperative, postoperative and last follow-up radiographs with measuring physeal-shaft angle. Results: Early closure of the physis was observed in 6 cases among 14 patients (17 hips). Compared with their postoperative radiographs, the last follow up radiographic study revealed that physeal remodeling was observed in 4 patients (4 hips) at group I (mean, $7.8^{\circ}$), in 2 patients (3 hips) at group II (mean, $10.7^{\circ}$). Conclusion: In this study, physeal remodeling was observed in 4 patients (4 hips) in group I and 2 patients (3 hips) in group II. The incidence of physeal remodeling was related with degree of epiphyseal slippage, and age was not related with physeal remodeling potential.

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Longitudinal Tracking of Alteration Pattern on Trabecular Bone Microarchitecture at Tibial Epiphysis Induced by Post Traumatic Osteoarthritis Over Time (외상성 관절염 진행에 따른 경골 골단 해면골에서의 골 미세구조 변화 패턴 추적 관찰)

  • Lee, Joo-Hyung;Chun, Keyoung-Jin;Lee, Kwon-Young;Kim, Dae-Jun;Kim, Han-Sung;Lim, Do-Hyung
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.36 no.11
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    • pp.1081-1090
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    • 2012
  • This study aims to track the longitudinal alteration pattern on the trabecular bone microarchitecture at tibial epiphysis induced by T-OA over time using in vivo micro computed tomography (${\mu}CT$). Ten SD rats were divided into control (n = 5) and T-OA (n = 5) groups. Anterior cruciate ligament transaction was performed for the T-OA group. The results showed that the alteration pattern on the trabecular bone microarchitecture at tibial epiphysis in the T.OA group was definitely different compared with that in the CON group from 0 to 8 weeks (approximately 4-16%, P > 0.05). In particular, a difference was observed in the bone formation and density distributions over time (from 0 or 4 to 8 weeks; approximately 5.15%, P < 0.05). An improved understanding of the alteration pattern on the trabecular bone microarchitecture at tibial epiphysis may assist in developing more targeted treatment interventions for T-OA.

Osteochondritis Dissecans in Medial Trochlea of the Humerus in a Pitcher - A Case Report

  • Lee, Jin-Ho;Kim, Myung-Sun
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.40-43
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    • 2014
  • Osteochondritis dissecans (OCD) is an idiopathic condition affecting the articular epiphysis. Initially described in the knee, this entity affects several other parts of the body such as the talar dome, tarsal navicular, and femoral capital epiphysis. Osteochondritis dissecans (OCD) of the elbow is typically located in the capitellum of the humerus in young teenagers. OCD of humeral trochlea is very rare, but can be occurred among young athletes. OCD developed medial trochlea was extremely rare, especially, without any other trauma. We present a patient, pitcher with OCD in the medial trochlea of the humerus who underwent arthroscopic debridement and microfracture.

Seymour's Fracture of the Base of the Distal Phalanx in a Child (소아 원위지골 기저부에서 발생한 Seymour씨 골절의 치험례)

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.776-779
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    • 2006
  • Purpose: Prior to closure of the epiphysis of the distal phalanx, fracture usually occurs through the growth plate, Salter-Harris type I or II, or through the juxtaepiphyseal region 1 to 2 mm distal to the growth plate. The terminal tendon of extensor inserts into the epiphysis only, while insertion site of the flexor digitorum profundus spans both the epiphysis and metaphysis. Because of the difference between these tendon insertions, this injury mimics a mallet deformity. But, this type of injury does not involve a tear or avulsion of the extensor, unlike mallet finger of adults. Seymour was the first to describe this type of injury in children and called after his name, Seymour's fracture. This fracture is prone to infection or remain the residual deformity unless adequate treatment. Methods: We report a case of Seymour's fracture. A 9-year-old boy presented a laceration of the nail matrix, with the nail lies degloved from the nail fold on the right middle finger gotten from an impact against a door. An X-ray examination showed the fracture line lying 1 mm distal to the growth plate. The injury was treated with debridement and the fracture was reduced by applying hyperextension force. Under the C-arm, a single 0.7 mm K-wire was used to immobilize the distal interphalangeal joint. Intravenous antibiotics were applied for 5 days after surgery. Results: The K-wire was removed in the 3rd week. No infection or significant deformity was found until follow-up of 12 months. Conclusions: Seymour's fracture may be at first classically mallet deformity by its appearance. But it is anatomically different and more problematic injury. If it isn't corrected at the time of injury, derangement of the extensor mechanism, and growth deformity of the distal phalanx may occur. The fracture site should be debrided, removed of any interposed soft tissue, and the patient should be given appropriate antibiotics. Reduction should be maintained by K-wire fixation. We experienced no infection or premature epiphyseal closure.

Hypopituitarism and Legg-Calve-Perthes disease related to difficult delivery

  • Bas, Veysel Nijat;Uytun, Salih;Vurdem, Umit Erkan;Torun, Yasemin Altuner
    • Clinical and Experimental Pediatrics
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    • v.58 no.7
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    • pp.270-273
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    • 2015
  • Legg-Calve-Perthes (LCP) disease is characterized by idiopathic avascular osteonecrosis of the epiphysis of the femur head. The main factor that plays a role in the etiology of the disease is decreased blood flow to the epiphysis. Many predisposing factors have been suggested in the etiology of LCP disease, and most have varying degrees of effects. Here we present the case of a boy aged 4 years and 10 months with complaints of short stature and a diagnosis of multiple hypophyseal hormone deficiency, in whom LCP disease and difficult birth-related pituitary stalk interruption syndrome were identified by anamnesis. The present case revealed that LCP disease and hypophyseal hormone deficiency could be secondary to difficult birth and that LCP disease could be secondary to insulin-like growth factor 1 deficiency. Additionally, to the best of our knowledge there is no published case on the relation between LCP disease and insulin-like growth factor 1 deficiency. Therefore, we believe that this case is worthy of presentation.

The histological study on ossification of the body of the piglet axis (자돈 축추골 몸통의 골화에 관한 조직학적 연구)

  • Ahn, Dong-choon;Kim, In-shik;Yang, Hong-hyun;Paik, Young-ki
    • Korean Journal of Veterinary Research
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    • v.35 no.1
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    • pp.19-28
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    • 1995
  • The histological and histochemical study of the axis body of piglet was performed in order to clarify the ossification process. These experimental animals collected from after birth to 52 days were used for this study. The results were summarized as follows; 1. The epiphysis, the intercentrum 2 and the centrum of proatlas were appeared in the axis body and dens of piglet after birth. 2. In 39 days of age piglet, the ossification of the intercentrum 2 was first observed but the epiphysis was already initiated. The centrum of proatlas was observed cranioventral part of the dens of the 52 days piglet axis. 3. The notochordal remnants revealed distinctively in the part between the centrum 1 and the centrum2, in the apical cartilaginous tissue of dens and in the caudal cartilaginous part of body of axis. 4. Intramembranous ossification occurred in the adjacent area of perichondrium of centrum 2. These ossified trabeculae show the woven bone configuration.

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Spontaneous Femoral Capital Physeal Fracture with Proximal Tibial Epiphyseal Dysplasia in a Cat

  • Yoo, Saejong;Kim, Dae-Hyun;Lee, Yunsub;Yeo, Seungyeob;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.112-115
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    • 2019
  • An 11-month-old, 5.6 kg, grade 4 on a 5-point scale body condition score, castrated male Korean short hair cat was presented with right hindlimb lameness for 3 days without trauma. On physical examination, severe pain with crepitation was elicited at the hip region but not at the stifle. Radiographic examination and computed tomography revealed a Salter-Harris type 1 fracture of the femoral capital physis and dysplasia of the proximal tibial epiphysis. Spontaneous femoral capital physeal fracture was suspected and femoral head and neck osteotomy was performed. Treatment for proximal tibial dysplasia was not performed. On histopathologic examination of femoral head, a cluster of chondrocytes in a proliferative zone at the epiphyseal plate was observed. Therefore, spontaneous femoral capital physeal fracture was diagnosed. The patient recovered his gait, and no related clinical signs were observed during 6 months of follow-up.