• Title/Summary/Keyword: Humerus Bone

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Limb Salvage in the Treatment of the Upper Extremity Bone Tumors (상지에 발생한 악성 및 침윤성 양성골종양에 대한 사지 구제술)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bum-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.154-163
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    • 1995
  • With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.

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The Effects of Erect Bipedal Stance Exercise on Bone Formation and Resorption in Rats (체중 부하 운동이 흰쥐의 골대사에 미치는 영향)

  • Hong Hee-Ok;Maeng Won-Jai
    • Journal of Nutrition and Health
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    • v.39 no.2
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    • pp.109-114
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    • 2006
  • The effects of the erect bipedal stance exercise on bone mass and the biomarkers of bone formation and resorption were investigated in rats. Five-week old rats were assigned into control and exercise groups. The rats of exercise group were weight-bearing-trained for 13 weeks in the cage designed to adjust progressively the height from 26.5 cm to 31.5 cm to force the rats rising an erect bipedal stance for feeding and drinking. There was no significant difference in food intakes between two groups. But body weight gain was significantly increased in control group. The lengths of femur, tibia, humerus and radius were significantly longer in control group than exercise group, but the femur and tibia weights per body weight were significantly higher in exercise group than control group. Also the breaking force of femur and tibia in exercise group were higher than control group significantly. The calcium contents of femur and tibia were significantly increased in exercise group than control group. The activity of bone specific alkaline phosphatase (B-ALP) and the osteocalcin contents of serum (the biomarkers of bone formation) in exercise group were higher than control group, but the carboxyterminal propeptide of type I procollagen (P1CP) contents of serum did not show any difference between two groups. However the urinary deoxypridinolin (DPD) excretion, biomarker of bone resorption, was significantly lower in exercise group than control group. From these results, it has been indicated that the erect bipedal stance exercise enhanced the density and the strength of femur and tibia by increasing biomarkers of bone formation and suppressing a biomarker of bone resorption in rats.

Treatment of Open Proximal Humerus Fracture by Gunshot (총격에 의한 개방성 근위 상완골 골절의 치료 - 증례 보고 -)

  • Kim, Sung-Jae;Lee, Jae-Hoo;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.37-42
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    • 2012
  • Purpose: To consider the proper management of proximal humerus fracture on gunshot wounds. Materials and Methods: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done. Result: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus. Conclusion: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.

Proximal Humerus Brown Tumor with Primary Hyperparathyroidism in Pregnancy (임신중 발생한 원발성 부갑상선 기능 항진증을 동반한 상완골 근위부의 Brown tumor)

  • Jung, Sung-Taek;Kim, Hyun-Jeong;Lee, Dam-Seon;Park, Gi-Heon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.173-179
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    • 2007
  • Brown tumor is tumor like lesion resulted from hyperparathyroidism, and it has been rarely reported recently. We evaluated a 29-year-old woman who had brown tumor on proximal humerus caused by primary hyperparathyroidism. She first had presented pain and swelling over the upper arm, and was suspected as giant cell tumor in biopsy combined with hyperparathyroidism. Wide marginal excision and tumor prosthesis were performed. However, it was confirmed as brown tumor resulted from parathyroid adenoma according to laboratory findings and radioactive isotopes image, and surgical excision of adenoma relieved clinical symptoms. We report this case with a review of literatures.

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A Study of Tube Angle and Patient's Rotation Angle in Scapular Y View (어깨뼈 후전사방향촬영에서 Tube 각도와 환자의 회전각도 관한 연구)

  • Ahn, ByeoungJu;Lee, JunHaeng
    • Journal of the Korean Society of Radiology
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    • v.7 no.4
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    • pp.271-275
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    • 2013
  • Shoulder bone scan everyday life, sports activities at the side of the shoulder joint, or applying strong force in the lateral occurs. Mainly on upper arm abduction, temple, other rotational dislocation of the shoulder joint gahaejyeo as useful for observing the presence or absence of lesions is used. Shoulder PA oblique projection prevent distortion of the image due to the angle and the most useful diagnostic radiological investigate shooting angle. Shoulder blade body and the acromion and coracoid process Y-view is formed characters. $10^{\circ}$ angle between the shoulder blades and the acromion is the obstruction. $20^{\circ}{\sim}25^{\circ}$ to the Y-view of the humerus head looks superimposed, the position of the shoulder joint and seemed appropriate. $35^{\circ}$ of the humerus head superimposed on the Y-view, but above the humerus head and shoulder joints were distorted. When $45^{\circ}$ elevation observed on the side of the best has come Y-view also acromion and coracoid process is finished.

Arthroscopic Excision of Intra-articular Osteochondroma of the Elbow: A Case Report

  • Jang, Suk-Hwan;Song, Han-Eui
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.172-175
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    • 2016
  • Osteochondromas are one of the most common benign bone tumors usually involving extraarticular metaphysis of long bone. Solitary intra-articular osteochondroma arising from the elbow joint has rarely been reported. We present a case of 23-year-old female who had pain and limited motion of the left elbow as a result of intraarticular osteochondroma of the distal humerus. Arthroscopic excision of the osteochondroma yielded complete relief of symptoms. Absence of recurrence was confirmed radiographically at two years after surgery. To the best of our knowledge, this is the first report of osteochondroma of the elbow successfully treated arthroscopically.

Chondroblastoma of the Rib -A Case of Report- (늑골에 발생한 연골아세포종 -1례 보고-)

  • 안상구
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.494-496
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    • 1994
  • Chondroblastoma is a rare benign bone tumor most frequently found in the epiphyseal region of long bones. The most common locations are the knee and proximal humerus,but the rib is an unusual site. Second decade is the most common age group. The ossification centers for the rib appear in the second fetal month and ossify in a caudal-to-cranial direction. There are also epiphyseal centers at the head and tubercle of the rib that appear at puberty and ossify in the third decade. The epiphyseal plates of the head and tubercle may be the site of origin of the posterior chondroblastomas; the anterior lesions may arise from the costochondral junction. The histologic features consist of polygonal chodroblast, small foci of chondroid production, osteoclast-like giant cell, and are diagnostic of chondroblastoma.We experienced a case of the chondroblastoma arising from the rib, and its clinical and histologic features are discussed.

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Treatment of Chondroblastoma (연골아세포종의 치료)

  • Han, Chung-Soo;Cho, Chang-Hyun;Yang, Hyoung-Seop;Kim, Sung-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.29-34
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    • 1999
  • Chondroblastoma is an uncommon neoplasm in bone, occurring at the epiphysis or apophysis of growing long bones and is known to have a recurrence rate of around 10% after surgical treatment. We reviewed 14 patients of pathologically proven chondroblastoma, who were surgically treated, from December 1987 to August 1997. The location of tumors was proximal femur in 4 cases, distal femur in 4 cases, proximal tibia in 2 cases, patella in 1 case, proximal humerus in 1 case and calcaneus in 1 case. The most common complaint was pain. In all nine cases in which MRI was performed, the MR imaging showed a lobulated low signal intensity(SI) rim. Low SI foci within the tumor were present in 4 of 9 cases and corresponded to calcification seen on radiographs or CT. Bone marrow edema was also present in 4 of 9 cases on MR imaging. The average duration of follow-up was 2 years, 5 months, ranging from 1 year to 7 years, 2 months. Twelve patients were treated by curettage and autogenous bone graft, one by curettage only, and one by curettage and bone cementing. Two cases which showed local recurrence were treated with curettage and bone graft. Two recurred cases had the presence of bone marrow edema on MR imaging. The presence or absence of bone marrow edema may be a useful indication of tumor activity, although further study will be required.

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Clinicopathology Profile and Bone Involvement of Multiple Myeloma Patients in Dharmais National Cancer Hospital, Indonesia

  • Sutandyo, Noorwati;Firna, Evi;Agustina, Julyanti;Prayogo, Nugroho;Widjaja, Leovinna
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6261-6265
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    • 2015
  • Background: Even though rarely found in Indonesia, the incidence of multiple myeloma (MM) is increasing every year. Bone involvement of MM is the most often a clinical disorder which leads to worsening clinical conditions and low quality of life of patients. Purpose: To determine the clinicopathology profile of bone involvement of MM patients in Indonesia. Materials and Methods: The cross-sectional study of MM conducted at Dharmais National Cancer Hospital (DNCH) by collecting data from medical records of MM patients who came to DNCH in period 2008-2012. Results: There were 39 MM patients all with age above 60 years. There were 56.4% male and 43.6% female patients. Most were diagnosed at stage III (32.4%), and 41% had obesity. The comorbid conditions were anemia (82.9%), hypoalbuminemia (60%), increased creatinine level (38.5%), increased ${\beta}2$ microglobulin level (94.1%), increased LDH level (23.1%) and plasmocytes above 30% (65%), but only 4.2% patients presented with hypercalcemia. Meanwhile, bone involvement occurred in 76.9% of MM patients with 4 lesions on average and a maximum of 16 lesions. The locations of bone lesions were spine (70%), skull (70%), pelvis (33.3%), humerus (30%), and femur (30%). Conclusions: The incidence of MM in Indonesia is increasing annually with bone involvement in more than three-fourths, but interestingly without hypercalcemia.

Study on the Treatment of Fractures in Korean Native Calves: 52 Cases (2017-2020)

  • Kim, Hoon;Kang, Jinsu;Heo, Suyoung;Kim, Namsoo
    • Journal of Veterinary Clinics
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    • v.39 no.4
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    • pp.156-161
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    • 2022
  • The objective of the present study was to assess the prevalence, occurrence pattern, and clinical outcomes of transfixation pinning and casting (TPC) for fractures in Korean native calves, and to identify the advantages of the procedure. The study investigated 52 cases of bone fractures documented from January 2017 to December 2020. Hindlimb fractures (72%) were the most common in bone fractures (n = 50). The distribution of fractures was highest in the tibia (n = 15), followed by the metatarsal (n = 12), femur (n = 9), radius/ulna (n = 8), metacarpal (n = 3), humerus (n = 3), mandible (n = 1), and caudal vertebrae (n = 1). All cases were diagnosed via radiographic evaluation. Closed fractures (86%) were the most common, followed by open fractures (14%). Surgery was performed on 34 calves using intramedullary pin (IM pin), TPC, cross pin, flexible wire (F-wire), and/or plate fixation. The rest of the calves were treated with external coaptation (n = 12) or were not treated (n = 6). Subsequently, 24 calves with follow-up records were evaluated in the bone fracture cases (n = 50). Bone union was observed in 15 (62%) calves; 3 (12%) calves showed non-union; 4 (16%) calves were dead after surgery; and 2 (8%) calves were euthanized at the owner's request. Among the 24 follow-up surgery cases, the most successful cases were tibia fractures (75%) surgically treated using TPC and/or IM pin. These findings suggest that TPC surgery is effective in the management of fractures in Korean native calves.