• Clinics in Shoulder and Elbow
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• v.23 no.3
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• pp.152-155
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• 2020

Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.110-113
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• 2021

We present an unusual case of bone metastases from renal cell carcinoma around orthopedic implants in a 78-year-old female with osteolytic, expansile, highly vascularized, malignant infiltration around suture anchors in the proximal humerus. The patient had undergone arthroscopic rotator cuff repair using suture anchor implants 6 years previously. After diagnosis of bone metastasis, she was successfully treated with metastasectomy and internal fixation using a plate and screws, with cement augmentation. This report is the first to document metastases around a suture anchor in a bone and suggests the vulnerability of suture anchor implants to tumor metastasis.

• Imaging Science in Dentistry
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• v.30 no.2
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• pp.117-122
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• 2000

Fibrous dysplasia is a benign disorder of bone consisting of intramedullary proliferation of fibrous tissue and irregularly distributed, poorly developed bone. The disease manifests itself in the monostotic form in which only one bone is involved and the polyostotic form in which multiple bones at different sites are affected. We reported a extensive case of polyostotic fibrous dysplasia with involvement of craniofacial bones, mandible, ribs and extremities. A 18-year-old man showed remarkable right facial swelling who had been treated on right femur 3 years ago with a bone graft for pathologic fracture and he recognized facial swelling 5 years ago. Extraoral radiograms and computed tomogram showed diffuse sclerosis with a ground glass appearance of the most cranial bones, facial bones. The right mandibular lesion showed very expansile lesion with mottled appearance. Bone scans showed mutifocal increased uptakes in craniofacial bones, right mandible, bilaterally in ribs, humerus, femur, tibia and characteristic varus deformity of right femur (shepherd's crook defomity). This case showed exceptionally bilateral, extensive nature of bone lesion and didn't show any features of skin pigmentation and endocrine disturbances.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.202-208
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• 2010

Purpose: In this study we introduced minimal invasive plate osteosynthesis (MIPO) and analyzed clinical outcomes to determine the effectiveness of this intervention in proximal humerus fractures. Materials and Methods: We studied 27 patients including 16 cases with a 2-part fracture, 10 cases with a 3-part fracture, and 1 case with a 4-part fracture. Clinical outcomes were evaluated using UCLA score, KSS score and recovery of range of motion. Time to union and humerus neck-shaft angle change were estimated by radiologic assessment. The average follow up period was 19 months. Results: UCLA scores were "excellent" for 15 patients, "good" for 12 patients. The mean KSS score was 91.4 at final follow-up. The average shoulder range of motion was $167.2^{\circ}$ in forward elevation. Bone union occurred by 14.1 weeks postoperatively. Humerus neck-shaft angle recovery was "excellent" in 24 patients and "moderate" in 3 patients. There were no complications such as axillary nerve paralysis, deep infection, or subacromial impingement of the plate. Conclusion: MIPO for proximal humerus fractures is an effective procedure if performed with sufficient understanding of the anatomical structures. MIPO leads to minimized dissection of soft tissue, low complication rates and early recovery of range of motion.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.97-104
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• 2005

Purpose: To report the results of surgical treatment of comminuted fractures of distal humerus and to identify factors that affect the results. Materials and Methods: Thirty-two patients who were treated with open reduction and internal fixation for comminuted fracture of distal humerus were enrolled. According to the AO classification, A2.3 was 1 case, A3.2, 2 cases, A3.3, 8 cases, B1.3, 1 case, B2.3, 1 case, C2.2, 5 cases, C2.3, 4 cases, C3.2, 3 cases and C3.3, 7 cases. As fixation technique, 17 cases were fixed by double plates, 4 cases by only K-wires, 4 cases by only screws, 3 cases by K-wires and screws and 4 cases by one plate and screws. The mean age at the time of the operation was 49 years(range, $19{\sim}77$ years). The mean follow-up period was 16 months(range, $8{\sim}51$ months). Results: At the last follow-up, the mean maximum flexion was $116.4^{\circ}\;(range,\;85{\sim}140^{\circ})$ and the mean loss of terminal extension was $11.8^{\circ}\;(range,\;0{\sim}40^{\circ})$. The average Mayo elbow performance score was $91.4^{\circ}\;(range,\;55{\sim}100^{\circ})$. Overall 29 cases(91%) showed good to excellent results. The mean range of motion of extraarticular and intraarticular fracture group was $105.5^{\circ}\;(range,\;65{\sim}140^{\circ})$ and $104^{\circ}\;(range,\;55{\sim}140^{\circ})$, respectively. The average elbow score of both groups was$93^{\circ}\;(range,\;70{\sim}100^{\circ})$ and $90.7^{\circ}\;(range,\;55{\sim}100^{\circ})$. Over 90% showed more than good results. 30 cases(94%) showed complete bony union but two cases, nonunion. One case of the nonunion cases underwent replating with bone graft as revision surgery and total elbow arthroplasty was performed in the other case. At the last follow-up, 27 patients(84.4%) showed subjective satisfaction. Conclusion: Open reduction and internal fixation with appropriate surgical technique for comminuted fractures of distal humerus showed good results, which were not affected by age at the time of operation, fixation methods and anterior transposition of the ulnar nerve. Transolecranon approach may be considered as good choice for intraarticular comminuted fractures of distal humerus.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.2
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• pp.81-87
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• 1998

Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.41-49
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• 2015

Free or pedicled vascularized fibular grafts (VFG) are useful for the reconstruction of large skeletal defects, particularly in cases of scarred or avascular beds, or in patients with combined bone and soft tissue defects. Compared to non-VFG, VEG, which contains living osteocytes and osteoblasts, maintains its own viability and serves as good osteoconductive and osteoinductive graft. Due to its many structural and biological advantages, the free fibular osteo- or osteocutaneous graft is considered the most suitable autograft for the reconstruction of long bone defects in the injured extremity. The traditional indication of VFG is the long bone and soft tissue defect, which cannot be reconstructed using a conventional operative method. Recently, the indications have been widely expanded not only for defects of midtibia, humerus, forearm, distal femur, and proximal tibia, but also for the arthrodesis of shoulder and knee joints. Because of its potential to allow further bone growth, free fibular epiphyseal transfer can be used for the hip or for distal radius defects caused by the radical resection of a tumor. The basic anatomy and surgical techniques for harvesting the VFG are well known; however, the condition of the recipient site is different in each case. Therefore, careful preoperative surgical planning should be customized in every patient. In this review, recently expanded surgical indications of VFG and surgical tips based on the author's experiences in the issues of fixation method, one or two staged reconstruction, size mismatching, overcoming the stress fracture, and arthrodesis of shoulder and knee joint using VFG are discussed with the review of literature.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.101-105
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• 1992

The leukemias represent diffuse lesions of the bone marrow and significant bony abnormalities are associated with the more aggressive varieties of leukemias and with the younger age groups. On plain film, several roentgenographic findings are observed such as diffuse osteopenia, radiolucent metaphyseal bands, osteolytic lesions and periostitis. We evaluated bone scintigraphic findings using $^{99m}Tc-methylene$ diphosphonate $(^{99m}Tc-MDP)$ in ten patients with proven leukemia. The scan is abnormal in 90%. We classified abnormal scintigraphic findings to 3 types and these are increased diffuse juxta-articular uptake, focal increase of uptake and combined type. The common sites of focal uptake were femur, humerus, tibia, spine, ribs, calvarium, scapula and mandible. We concluded that $(^{99m}Tc-MDP)$ bone scintigraphy is sensitive imaging modality in leukemic patients with bone pain.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.1
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• pp.26-31
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• 1997

One of the most common benign tumors of bone is the osteochondroma which is a cartilage-capped bony projection on the surface of a bone. It may occur in any bone that has been performed from cartilage, but the most common locations are the long bone at the metaphyseal region of the most active growth cartilage, that is, the lower end of femur, the upper end of the tibia, and the upper end of the humerus. Other bones often involved are the ilium, scapula, fibula, and phalanges of hands and feet. But, the vertebral column is very rare location for osteochondroma. Only one case of osteochondroma involving the lumbar spine has been previously reported in Korea. We report an unusual case of osteochondroma arising from the left lamina and inferior articular process of the 3rd lumbar spine causing spinal cord compression.

• Food Science of Animal Resources
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• v.38 no.6
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• pp.1273-1285
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• 2018

The aim of this study is to determine the some physicochemical (proximate composition, pH and $a_w$ values) and reconstitution (wettability, dispersibility and solubility index (SI)) properties of spray-dried bone broth powder (BBP) along with the effects of the addition of different carrier agents. Subsequently, the powdered products were stored to determine the storage stability (pH, lipid oxidation, color, browning index) for 3 mon at $-18^{\circ}C$. For this purpose, firstly marrow-containing bones (Os femur and Os humerus) have been boiled to get the bone broth. Three different emulsions were respectively prepared (1) 20% maltodextrin (MD) added BBP, (2) 20% whey powder isolate (WPI) added BBP and (3) 10% MD and 10% WPI added BBP and the emulsions were dried using a spray-dryer with $185^{\circ}C$ inlet and $95^{\circ}C$ outlet temperature. The proximate composition and reconstitution properties of BBP were found statistically different (p<0.05) depending on the use of different carrier agents. MD added BBP showed uniform and smooth morphology. The color, browning index, thiobarbituric acid reactive substances (TBARS) and pH values of BBP significantly changed (p<0.05) during storage. In conclusion, both the results of physicochemical and storage period analyses showed that the most suitable encapsulation material in the production of the bone broth powder is MD.