• Title/Summary/Keyword: Humerus Bone

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Pathologic Fracture of Unicameral Bone Cyst (단순 골낭종에서 발생한 병적 골절)

  • Choo, Suk-Kyu;Lee, Hee-Du;Oh, Hyoung-Keun
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.58-64
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    • 2011
  • Purpose: The purpose of this study is to observe unicameral bone cyst (UBC) outcome after the fracture has healed and if there is any identifiable prognostic factors. Materials and Methods: 13 UBC patients with pathologic fracture from 2001 to 2010 were reviewed. The mean follow up were 26 months (3-90 months). There were 11 male and 2 female patients and the mean age of the patients were 10.2 years old (6-16 years). 9 involved proximal humerusand 2 involved humerus shaft and 1 involved proximal femur and 1 involved proximal tibia. The treatment of UBC fracture was conservative cast application to heal the fracture initially, and 1 patient was treated with primary auto bone graft and open reduction with internal fixation. 5 patients were treated with steroid injection during follow up period and 2 patients with auto bone graft. We analyzed the change of UBC during pathologic fracture healing period and prognostic factor about age, the size of UBC, the involvement of physis. Results: The mean duration of the fracture healing was 8.2 months. Complete healing were occurred at 4 patients (31%). No statiscal difference was checked with age about UBC healing (p=0.42). But, more larger size about UBC and more closer to physis, the healing was difficult (p=0.05, p=0.03). Conclusion: While pathologic fracture of UBC was possibly healed, active treatment should be applied especially those cysts that involvescloser area of the physis or large size.

An Epidemiologic Study of Metastatic Bone Tumor (전이성 골종양의 역학적 연구)

  • Kim, Jae-Do;Lee, Duk-Hee;Park, Jeong-Ho;Son, Young-Chan;Hong, Yonng-Gi;Son, Jeong-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.38-44
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    • 1995
  • Metastatic bone tumor is the most common bone tumor and 32.5% of all primary malignant tumors are eventually metastasize to bone. Metastatic bone tumor has been more frequently encountered disease in the orthopedic fields due to the greater longevity of life of the patients with primary visceral cancers by major advances in early detection, diagnosis, and surgical/radiotherapeutic/chemotherapeutic treatment of primary and metastatic lesions. Therefore, the epidemiologic data about the incidences and the patterns of bone metastasis is important. We reviewed 417 patients who were diagnosed and treated for metastatic bone tumor at Kosin University Medical Center from 1985 to 1993 to analyse the primary lesion, age and sex distributions, location of bone metastasis, patterns of metastasis according to the primary. The results were as follows : 1. The common origin of bone metastasis were lung(29.5%), stomach(15.3%), breast(11.3%), unknown(7.7%), cervix(5.3%), liver(4.8%) in order of frequency. 2. There were 251 men and 166 women and their mean age was 54.8 years and the peak age incidence was in 6th decades. Most cases(85.3%) were occured beyond 5th decades. 3. The preferred sites of metastatic deposits were spine(64.0%), pelvis(40.5%), rib(38.8%), femur(36.7%), skull(21.1%), humerus(13.9%), scapula(13.0%) in order of frequency. In the spine, thoracic(42.1%), lumbar(39.1%), cervical(13.2%), sacral(5.6%) vertebrae were involved in order of frequency. 4. Multiple bone metastases were more common(73.1%) than single metastasis(26.9%). 5. In the lung cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, pelvis, femur. 6. In the stomach cancer, the peak age incidence was 6th decades, and the preferred sites of bone metastasis were spine, femur, pelvis. 7. In the breast cancer, the peak age incidence was 5th decades, and the preferred sites of bone metastasis were spine, rib, pelvis. 8. In the bone metastasis with unknown primary site, the peak age incidence was 7th decades, the preferred sites of bone metastasis were spine, femur, pelvis, and the common histologic types were adenocarcinoma and squamous cell carcinoma.

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Expression of receptors of Vitamin D and cytokines in osteoclasts differentiated by M-CSF and ODF (Macrophage Colony-Stimulating Factor와 Osteoclast Differentiation Factor로 분화 유도된 생쥐 파골세포에서 Vitamin D 및 수종의 싸이토카인 수용체의 발현)

  • Seong, Soo-Mi;Um, Heung-Sik;Ko, Sung-Hee;Woo, Kyung-Mi;Chang, Beom-Seok
    • Journal of Periodontal and Implant Science
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    • v.32 no.4
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    • pp.865-873
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    • 2002
  • The primary cause of tooth loss after 30 years of age is periodontal disease. Destruction of alveolar bone by periodontal disease is done by bone resorbing activity of osteoclasts. Understanding differentiation and activation mechanism of osteoclasts is essential for controling periodontal disease. The purpose of this study is to identify the possible effects of Vitamin D and cytokines affecting osteoclasts and its precursor cells. Four to six week-old mice were killed and humerus, radius, tibia and femur were removed aseptically and washed two times with Hank's solution containing penicillin-streptomycin and then soft tissue were removed. Bone marrow cells were collected by 22 gauge needle. Cells were cultured in Hank's solution containing 1 mg/ml type II collagenase, 0.05% trypsin, 41mM EDTA. Supernatant solution was removed 5 times after 15 minutes of digestion with above mentioned enzyme solution, and remained bone particles were maintained in alpha-MEM for 15 minutes and $4^{\circ}C$ temperature. Bone particles were agitated for 1 minute and supernatant solution containing osteoclast precursor cells were filtrated with cell stainer. These separated osteoclast precursor cells were dispensed with 100-mm culture dish by $1{\times}10^7$ cells unit and cultured in ${\alpha}$- MEM containing 20 ng/ml recombinant human M-CSF, 30 ng/ml recombinant human soluble osteoclast differentiation factor and 10% fetal calf serum for 2 and 7 days. Total RNA of osteoclast precursor cells were extracted using RNeasy kit. One ${\mu}g$ of total RNA was reverse transcribed in $42^{\circ}C$ for 30 minutes using SuperScriptII reverse transcriptase. Expression of transcribed receptors of each hormone and cytokine were traced with 1 ${\mu}l$ of cDNA solution by PCR amplification. Vitamin D receptor WAS found in cells cultured for 7 days. TNF-${\alpha}$ receptor was found in cells cultured for 2 days and amount of receptors were increased by 7 days. IL-1 type I receptor was not found in cells cultured 2 and 7 days. But, IL-1 receptor type II was found in cells cultured for 2 days. TGF-${\alpha},{\beta}$type I receptor was found in cells cultured 2 and 7 days, and amount of receptors were increased by 7 days of culture. These results implies Vitamin D and cytokines can affect osteoclasts directly, and affecting period in differentiation cycle of osteoclasts is different by Vitamin D and cytokines.

Comparison of Gap Pressure in Opening Wedge High Tibial Osteotomy versus Compressive Strength of Allogenous Wedge Bone Blocks (경골 근위부 개방 절골술 시 개방부 압력과 동종 쐐기 골편의 최대압축하중 비교)

  • Yoon, Kyoung Ho;Kim, Jung Suk;Kwon, Yoo Beom;Kim, Eung Ju;Lee, Myeong-Kyu;Kim, Sang-Gyun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.127-134
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    • 2020
  • Purpose: The aims of this study were (1) to investigate the relationship between the characteristics of allogenic bone block and the compressive strength of an allogenic bone block measured by biomechanical experiments, and (2) to compare the maximum pressure load of allogenic bone block with the gap pressure measured at the high tibial opening osteotomy. Materials and Methods: Ten patients who provided informed consent for gap pressure measurements during opening wedge high tibial osteotomy (OWHTO) were included. The gap pressures were measured at 1 mm intervals while opening the osteotomy site from 8 mm to 14 mm. Seventeen U-shaped allogenous wedge bone blocks were made from the femur, tibia, and humerus. The height, width, cross-sectional area, and cortex thickness of the bone blocks were measured, along with the maximum compressive load just before breakage. The relationship between these characteristics and the maximum pressure load of the bone blocks was evaluated. The gap pressures measured in OWHTO were compared with the maximum pressure loads of the allogenous wedge bone blocks to evaluate the possibility of inserting allogenous wedge bone blocks into the osteotomy site without a distractor in OWHTO. Results: The OWHTO gap pressure increased with increasing osteotomy site opening. The mean gap pressure, which occurred at a 14-mm opening, was 282±93 N; the maximum pressure was 427 N. The maximum pressure load of the allografts was 13,379±6,469 N (minimum, 5,868; maximum, 29,130 N) and was correlated significantly with the cortical bone thickness (correlation coefficient=0.693, p=0.002) and cross-sectional area (correlation coefficient=0.826, p<0.001). Depending on the sterilization method, the maximum pressure loads for the bone blocks were 13,406±5,928 N for freeze-dried and 13,348±7,449 N for fresh frozen. The maximum compressive load of the allogenous wedge bone blocks was 13.7-times greater than that in OWHTO opened to 14 mm (5,868 N vs. 427 N). Conclusion: The compressive strength of allogenous wedge bone blocks was sufficiently greater than the gap pressure in OWHTO. Therefore, allogenous wedge bone blocks can be inserted safely into the osteotomy site without a distractor.

Fat Embolism Syndrome Which Induced Significant Cerebral Manifestation Without Respiratory Distress (호흡기 증상 없이 발생한 뇌 지방색전증 1례)

  • Kim, Hyung Geun;Lee, Kyung Mi;Kim, Ji Hye;Kim, Jun Sig;Han, Seung Baik
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.175-178
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    • 2005
  • Fat embolism syndrome is a collection of respiratory, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of clinical syndrome is low while the embolization of marrow fat appears to be an almost inevitable consequence of long bone fractures. The pathogenesis is a subject of conjecture and controversy. There are two theories which have gained acceptance(mechanical theory, biochemical theory). Onset of symptom is usually within 12 to 72 hours, but may manifest as early as 6 hours to as late as 10 days. The classic triad of fat embolism syndrome involves pulmonary changes, cerebral dysfunction and petechial rash. The cornerstone of treatment is preventing the stress response, hypovolemia and hypoxia and operative stabilization of fractures. Corticosteroid are the only drugs which have repeatedly shown a positive effect on the prevention and treatment of fat embolism syndrome. We report a case of post-traumatic fat embolism syndrome with severe cerebral involvement without respiratory distress. A 55 years old female had a traffic accident. She sustained pelvic bone fracture and both humerus fracture. Approximately 4 hours after the accident, mental status change developed without a focal neurologic deficits. She had no respiratory symptom and sign. Her brain MRI showed multiple cerebral fat embolism lesion. The patients received supportive treatment with corticosteroid, albumin. Her neurologic status stabilized over several days. After orthopedic surgery, she was discharged 62 days after admission.

Synchronous Monomelic Juxta-articular Multicentric Chondrosarcoma -A Case Report- (동시성 단지성 관절 근접 다발성 연골 육종 -증례 보고-)

  • Oh, Joo-Han;Kim, Jae-Yoon;Gong, Hyun-Sik;Kim, Woo-Sung;Kim, Tae-Yune
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.71-77
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    • 2006
  • Chondrosarcoma is one of the most common types of primary bone sarcoma. With the exception of the mesenchymal subtype, chondrosarcomas are usually low-grade lesions and rarely show multicentricity or distant metastasis. Only rare cases of multicentric chondrosarcomas have been reported in association with Ollier's disease and Maffucci's syndrome. To our knowledge, no report has been issued of a synchronous multicentric chondrosarcoma occurrence across a joint. We experienced a 30-year-old man with a synchronous monomelic juxta-articular multicentric chondrosarcoma across a shoulder joint in the absence of pulmonary and visceral metastases. He was treated by curettage and cement filling with allograft in the acromion and wedge resection with cement filling in the proximal humerus. At the 18-month follow-up, there was no evidence of recurrence, and the patient had full range of motion without pain.

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Metronomic Chemotherapy with Toceranib Phosphate for a Disseminated Histiocytic Sarcoma in a Miniature Schnauzer Dog

  • Hong, Hwaran;Lim, Seula;Shin, Hye-Ri;Choi, Ho-jung;Lee, Haebum;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.441-444
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    • 2017
  • A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient's pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.

The Effects of Low-Intensity Ultrasound and Laser on Healing of Bone Fracture (저강도 레이저와 초음파의 동시 적용이 골절 치유 촉진에 미치는 효과)

  • Lee, Hyun-Kee
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.331-372
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    • 2003
  • The purpose of study was to evaluate effects of low-intensity ultrasound and laser on healing of bone fracture. Twenty fracture patient were selected for this study(fourteen males, six females. mean aged 44.8) fracture area was humerus, tibia, forearm bones. The obtain result are as follows. 1. The result of this study were following that pain score was significantly reduced pre intervention compared with post intervention in male(P<.001). 2. The result of this study were following that pain score was significantly reduced pre intervention compared with post intervention in female(P<.001). 1. The result of this study were following that pain score was not appeared reduced pre intervention compared with post intervention in male and female(P<.001). 4. The result of this study were following that pain score was not appeared pre intervention compared with post intervention in male between age(P<.001). 5. The result of this study were following that pain score was not appeared pre intervention compared with post intervention in female between age (P<.001). 6. The result of this study were following that radiologic score was significantly reduced pre intervention compared with post intervention in male(P<.001). 7. The result of this study were following that radiologic score was significantly reduced pre intervention compared with post intervention in female(P<.001). 8. The result of this study were following that radiologic score was not appeared reduced pre intervention compared with post intervention in male and female(P<.001). 9. The result of this study were following that radiologic score was not appeared pre intervention compared with post intervention in male between ages(P<.001). 10. The result of this study were following that radiologic score was not appeared pre intervention compared with post intervention in female between ages(P<.001). 11. The result of this study were following that healing on fracture area was observed that reduced pre intervention compared with post intervention

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Clear Cell Chondrosarcoma of the Tibia Diaphysis: A Case Report (경골 간부에 발생한 투명세포연골육종: 증례 보고)

  • Kang, Chang Min;Han, Chung Soo;Jung, Gwang Young;Jeong, Ho Yeon;Kim, Young Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.89-93
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    • 2014
  • Clear cell chondrosarcoma is a very rare malignant bone tumor that shows a strong predilection for the epiphysis or metaphysis of long bones. Many studies have reported that the proximal end of the femur is the most commonly affected site, followed by the proximal end of the humerus. Histopathologically, tumor cells of this type have centrally located round nucleoli with clear cytoplasm and a distinct cytoplasmic membrane. Generally, clear cell chondrosarcomas is not confused with conventional chondrosarcomas. However, when it involves the diaphysis in long bones, diagnosis can be hindered, as only three reports of this exist in the literature. We report herein an unusual case of clear cell chondrosarcoma of the tibial diaphysis in a 42-year-old male.

Painful Snapping Shoulder Complicating Soft Tissue Pseudotumor Secondary to Rib Osteochondroma: A Case Report (늑골의 골연골종에 속발된 가성 연부조직 종괴에 합병한 통증성발음성 견갑증상증후군)

  • Moon, Myung-Sang;Jeon, Dal-Jae;Kim, Sung-Soo;Yoon, Min Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.27-31
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    • 2014
  • Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the $6^{th}$ rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.