• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.137-142
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• 2008

목적: 잠김 압박 금속판(LCP)을 이용한 상완골 근위부 골절의 수술적 치료에 대한 임상적, 방사선적 치료 결과를 평가해보고자 하였다. 대상 및 방법: 2005년 1월부터 2007년 4월까지 상완골 근위부 골절에 대해 LCP를 이용해 치료받고 12개월 이상 추시가 가능했던 24예를 대상으로 하였으며, 남자는 8예, 여자는 16예이었다. 평균 연령은 68.9세(33~90)이었다. 임상적 결과는 Neer의 기능적 평가 방법을, 방사선적 결과는 골 유합 시기 및 경간각을 이용한 Paavolainen의 방법으로 평가하였다. 결과: 평균 골 유합 기간은 11.9주(8~15)이었다. Neer의 기능적 평가상, 만족 이상의 결과를 보인 경우는 21예(87%)이었고, Paavolainen의 방법에 의한 방사선적 결과가 양호 이상인 경우는 22예(91%)이었다. 3예(13%)에서 금속 실패, 무혈성 골 두 괴사, 관절 강직의 합병증이 각각 발생하였다. 결론: 상완골 근위부 골절에 대해 LCP를 이용한 내고정술은 비교적 양호한 임상적, 방사선적 결과 및 적은 합병증을 보여, 상완골 근위부 골절의 수술적 치료에 유용한 방법 중 하나로 판단된다.

• 대한족부족관절학회지
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• 제7권2호
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• pp.279-282
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• 2003

Most simple bone cysts are found in the metaphysis of the long bone, such as proximal humerus or proximal femur. Appropriate treatment is aspiration of the cyst followed by instillation of methylprednisolone or curettage with bone graft. We experienced 1 case of the simple bone cyst of the metatarsal bone. This case was treated by curettage and inserting allograft into the defect.

• Clinics in Shoulder and Elbow
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• 제20권1호
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• pp.42-45
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• 2017

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.95-99
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• 2017

Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

• Archives of Reconstructive Microsurgery
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• 제15권1호
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• pp.26-32
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• 2006

Purpose: The purpose of this study was to evaluate the effectiveness of limb reconstruction and functional recovery using vascularized fibular graft in the treatment of extensive bone defect of long bone caused by various diseases. Materials and Methods: From september 1995 to March 2005, 21 patients with segmental bone defects were managed with vascularized fibular graft: 13 males and 8 females, aged 39 years on average (range, $8{\sim}65\;years$). The reconstructed site was the humerus in 9 patients, the femur in 5, the tibia in 4 and the forearm bone in 3. The length of bone defect ranged from $8{\sim}17\;cm$. Results: Twenty grafts were successful. The mean period to obtain radiographic bone union was 5.7 months on average. Conclusion: Fibular grafts allow the use of a segment of diaphyseal bone and of sufficient length to reconstruct most skeletal defects of the long bone. The vascularized fibular graft is indicated in patients with intractable nonunions where conventional bone grafting has failed or large bone defects.

• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.216-222
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• 2016

Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.

• 대한수의학회지
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• 제35권4호
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• pp.643-649
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• 1995

An abnormal Korean native cow of six years old with extra legs was observed macroscopically and radiographically. The results were summarized as follows; 1. External features included two normal forelimbs and hindlimbs, and two extra forelimbs which were underdeveloped. The extra forelimbs of different length attached laterally to the cranial regions of neck on right scapula. 2. The large extra forelimb had scapular meromelia. It consisted of underdeveloped humerus, antebrachial skeleton, several carpal bones, metacapal bone(MC3+4) and two digitis with each pairs of hoof and a rudimentary hoof of dewclaw. 3. The small extra forelimb had scapular and antebrachial meromelia. It consisted of underdeveloped metacarpal and carpal bone, severely deformed humerus, fused carpal bones, and two digitis with two hooves, and a rudimentary hoof of dewclaw. 4. The dermoid cyst was observed between the large and small extra forelimbs.

• 대한수의학회지
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• 제54권3호
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• pp.179-184
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• 2014

This study investigated the anatomy of the nutrient foramen (NF) in German Shepherds by recording the number, site, position, and direction of penetration of the nutrient canal (NC) in the humerus, radius, and ulna of 50 individuals. The site index of the nutrient foramen (SI) was calculated as the ratio of the length to the NF site from the proximal end to the greatest length of the bone. The NF diameter was measured using different sized needles. Most humeri had only one NF on the caudal surface, particularly on the lateral supracondylar crest, or distal cranial surface. All radii had one NF, usually on the caudal surface, while most ulnae had one NF located on either the cranial or lateral surfaces. The SI and NF diameters were 58.0~59.5% and 0.73~0.78 mm in the humerus, 30.4~30.9% and 0.74~0.76 mm in the radius, and 29.3~29.8% and 0.67~0.68 mm in the ulna, respectively. With the exception of the relatively proximal NF of the radius, the direction of penetration followed Berard's rule. This study provides novel information on the location and diameter of the NF and direction of the NC in the long bones of the pectoral limb of German Shepherds.

• 대한골관절종양학회지
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• 제12권2호
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• pp.131-135
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• 2006

연골육종은 조직학적 소견에 따라 grade I, II, III로 나누어지며 예후와도 깊은 관련이 있다. Grade II 및 III의 연골육종의 수술 시 광범위 절제를 주로 시행하나 grade I 연골육종의 경우에는 소파술과 광범위 절제술 사이에 이견이 많다. 저자들은 상완골의 근위부에 grade I, 원위부에 grade II의 연골육종이 발생한 경우에 grade I은 소파술을, grade II는 광범위 절제술을 시행한 경험을 하였기에 보고하는 바이다.

• 대한골관절종양학회지
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• 제2권1호
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• pp.65-71
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• 1996

Twenty-nine cases of unicameral bone cyst developed in long bone of children have been treated and followed up for 4.5 years in average form Department of Orthopaedic Surgery, Guro Hospital, Korea University, College of Medicine since September, 1983, Treatment for those lesions differed to form largely two groups, one of which consised of insillation of Methyl-prednisolone for non-weight bearing bones(12 humeri) and the other of curettage and autogenous bone graft for weight-bearing bones(7 femur). Methl-prednisolone group required repetition of instillation for 3.5 time in average spanning over 4 years until cloudy obliteration occurs. Curettage and bone graft had healed in 3 year 6 months' time in average. There were neither recurrence nor pathologic fractures of the lesions with the latter group. Immobilization period was virtually non with Methyl-prednisolone group and 4-6 weeks by hip spica with curettage and bone graft group. As conclusions, It seems confirmed that treatment strategy of unicameral bone cyst consisted of Methyl-prednisolone instillation for humerus lesions and early curettage and bone graft for femur lesions is applicable as guideline having solid ground in clinical experiences.