• 제목/요약/키워드: Humerus Bone

검색결과 138건 처리시간 0.027초

Unrecognized bony Bankart lesion accompanying a dislocated four-part proximal humerus fracture before surgery: a case report

  • Lee, Seungjin;Shin, Daehun;Hyun, Yoonsuk
    • Clinics in Shoulder and Elbow
    • /
    • 제25권1호
    • /
    • pp.68-72
    • /
    • 2022
  • Proximal humerus fractures are the third most common fractures, totaling 4% to 5% of all fractures. Here, we present the case of a 39-year-old man with a dislocated four-part fracture of the proximal humerus with a huge bony Bankart lesion. Preoperatively, the bony Bankart lesion of the glenoid was not visualized on computed tomography scans or magnetic resonance imaging because the fracture of the proximal humerus was comminuted, displaced, and complex. It was planned for only the humerus fracture to be treated by open reduction and internal fixation using a locking plate. However, a fractured fragment remained under the scapula after reduction of the dislocated humeral head. This was mistaken for a dislocated bone fragment of the greater tuberosity and repositioning was attempted. After failure, visual confirmation showed that the bone fragment was a piece of the glenoid. After reduction and fixation of this glenoid part with suture anchors, we acquired a well-reduced fluoroscopic image. Given this case of complex proximal humerus fracture, a glenoid fracture such as a bony Bankart lesion should be considered preoperatively and intraoperatively in such cases.

Sensitivity analysis for finite element modeling of humeral bone and cartilage

  • Bola, Ana M.;Ramos, A.;Simoes, J.A
    • Biomaterials and Biomechanics in Bioengineering
    • /
    • 제3권2호
    • /
    • pp.71-84
    • /
    • 2016
  • The finite element method is wide used in simulation in the biomechanical structures, but a lack of studies concerning finite element mesh quality in biomechanics is a reality. The present study intends to analyze the importance of the mesh quality in the finite element model results from humeral structure. A sensitivity analysis of finite element models (FEM) is presented for the humeral bone and cartilage structures. The geometry of bone and cartilage was acquired from CT scan and geometry reconstructed. The study includes 54 models from same bone geometry, with different mesh densities, constructed with tetrahedral linear elements. A finite element simulation representing the glenohumeral-joint reaction force applied on the humerus during $90^{\circ}$ abduction, with external load as the critical condition. Results from the finite element models suggest a mesh with 1.5 mm, 0.8 mm and 0.6 mm as suitable mesh sizes for cortical bone, trabecular bone and humeral cartilage, respectively. Relatively to the higher minimum principal strains are located at the proximal humerus diaphysis, and its highest value is found at the trabecular bone neck. The present study indicates the minimum mesh size in the finite element analyses in humeral structure. The cortical and trabecular bone, as well as cartilage, may not be correctly represented by meshes of the same size. The strain results presented the critical regions during the $90^{\circ}$ abduction.

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

  • Lee, Chul-Hyung;Choi, Hyun;Kim, Tae-In;Kim, Jun Beom;Shin, Sang Yeop;Rhee, Seung-Koo
    • Clinics in Shoulder and Elbow
    • /
    • 제19권4호
    • /
    • pp.223-228
    • /
    • 2016
  • Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

Incidence and Mortality after Proximal Humerus Fractures Over 50 Years of Age in South Korea: National Claim Data from 2008 to 2012

  • Park, Chanmi;Jang, Sunmee;Lee, Areum;Kim, Ha Young;Lee, Yong Beom;Kim, Tae Young;Ha, Yong Chan
    • 대한골대사학회지
    • /
    • 제22권1호
    • /
    • pp.17-21
    • /
    • 2015
  • Background: There has been lack of epidemiology of proximal humerus fracture using nationwide database in Asia. The purpose of this study was to investigate the incidence of proximal humerus fracture and its mortality following proximal humerus fracture in Korean over 50 years of age. Methods: The Korean National Health Insurance data were evaluated to determine the incidence and mortality of proximal humerus fracture aged 50 years or older from 2008 through 2012. Results: Proximal humerus fracture increased by 40.5% over 5 year of study. The incidence of fracture increased from 104.7/100,000 in 2008 to 124.7/100,000 in 2012 in women and from 45.3/100,000 in 2008 to 52.0/100,000 in 2012 in men, respectively. One year mortality rate after proximal humerus fracture was 8.0% in 2008 and 7.0% in 2012. One year mortality rate were 10.8% for men and 7.0% for women in 2008 and 8.5% for men and 6.4% for women in 2012. Conclusions: Our study showed that the proximal humerus fracture in elderly was recently increasing and associated with high mortality in Korea. Considering proximal humerus fracture was associated with an increased risk of associated fractures and an increased mortality risk, public health strategy to prevent the proximal humerus fracture in elderly will be mandatory.

소의 장골에서 치밀골의 생체역학적인 특성 (Biomechanical Properties of Cortical Bone in Bovine Long Bones)

  • 김남수;황의희;최성진;정인성;최은경;최인혁
    • 한국임상수의학회지
    • /
    • 제20권3호
    • /
    • pp.345-350
    • /
    • 2003
  • We were preferred bovine cortical bone to the others in xenobonegrafts for human and small animals, because those were not limited to supply and have sufficient size for bone transplantation. The strength (ST) and stiffness (SF) of cortical bone in bone grafts were very important. The strength and stiffness of cortical bone were much difference according to position of long bone in bovine limbs because which were biomechanical different to bear body weight. Therefore, we determinated by three bending point test methods the strength and stiffness of cortical bone which were collected in diaphysis of humerus, radius, femur and tibia of bovine. In the results, the strengths and stiffness among these were highest in radius by ST: 253.84$\pm$40.80 MPa, SF: 7.89$\pm$1.91 Gpa and lowest in humerus by ST: 185.69$\pm$28.54 MPa, SF: 6.21$\pm$1.22 Gpa.

생비골 성장판 이식술을 통하여 화농성 관절염에 의한 상완골두 변형의 재건 (Reconstruction with Vascularized Fibular Epiphyseal Transplantation of Humeral Head Deformity by Septic Arthritis)

  • 정덕환;박광희;서재완
    • Archives of Reconstructive Microsurgery
    • /
    • 제21권2호
    • /
    • pp.137-142
    • /
    • 2012
  • Purpose: To report the clinical and radiological result of the vascularized fibular epiphyseal transplantation in the treatment of humeral head deformity by septic arthritis Material & Methods: A 3 years old male who has humeral head deformity and bone defect by septic arthritis on neonatal period. We replaced bone defect as vascularized fibular epiphyseal transplantation and lengthened humerus shaft for humerus discrepancy. We followed it up for 14 years. Result: We saw the callus formation 2 months after surgery and obtained bone union, one year after surgery. The transplanted fibular bone got hypertrophy. We could check full range of motion on lt. shoulder and The bone deformity was not worsened and The graft did not displaced on last follow up. Conclusion: Humeral head reconstruction by vascularized fibular epiphyseal transplantation showed good clinical outcome.

  • PDF

Vascularized bone grafts for post-traumatic defects in the upper extremity

  • Petrella, Giovanna;Tosi, Daniele;Pantaleoni, Filippo;Adani, Roberto
    • Archives of Plastic Surgery
    • /
    • 제48권1호
    • /
    • pp.84-90
    • /
    • 2021
  • Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5-6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

골모세포종으로 인한 상완골 간부의 병적 골절: 증례 보고 (Pathologic Fracture Due to an Osteoblastoma of the Humerus Shaft: A Case Report)

  • 염재광;박재구;김민규
    • 대한골관절종양학회지
    • /
    • 제17권2호
    • /
    • pp.87-90
    • /
    • 2011
  • 골모세포종은 뼈를 생성하는 드문 양성 종양으로 척추에 주로 발생하지만 장골에서 병적 골절을 발생시키는 골모세포종에 대한 보고는 거의 없다. 저자들은 상완골 간부에 골모세포종으로 인한 병적 골절에 대하여 종양은 소파술을 시행하였고 병적 골절에 대해서는 골수강내 금속정을 이용한 고정술을 시행하여 안정적인 골유합을 얻을 수 있었다. 저자들은 이처럼 보기 드문 상완골 간부애 골모세포종으로 인한 병적 골절을 진단하고 치료하는 경험을 하였기에 이에 관한 증례를 보고하고자 한다.

위팔뼈 의료용 디지털 영상 및 통신 표준 영상을 이용한 5축 가공기술의 융합적 연구 (A Convergence Study on the 5-axis Machining Technology using the DICOM Image of the Humerus Bone)

  • 윤재호;지태정;윤준;김형균
    • 한국융합학회논문지
    • /
    • 제8권11호
    • /
    • pp.115-121
    • /
    • 2017
  • 의료용 디지털 영상 및 통신 표준과 5축 가공기술의 융합적 연구를 통하여 맞춤형 인공관절의 기초적 지식을 얻고자 하였다. 연구방법으로 의료영상의 위팔뼈에 대해 3차원 모델링을 생성하고 케미컬우드 소재로 형상을 가공하여 해부학적 특징과 모델링 가공 연산시간을 비교하였다. 그 결과 스테레오리소그래피 모델링이 아이제스 모델링에 비해 중삭 2배, 정삭 10배 정도로 시간이 많이 소요되었다. 5축 가공된 위팔뼈는 해부목, 큰돌기, 작은돌기, 결절사이 고랑의 해부학적 구조가 3차원 의료영상과 동일한 특징으로 나타났다. 이와 같이 위팔뼈의 외과목 언더컷 등 다양한 형태의 구조가 5축으로 가공되는 융합적 가공 기술들은 인체의 정밀한 모형을 추구하는 맞춤형 관절 제작 시 향후 적용 가능성이 높음을 알 수 있었다.