• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.106-111
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• 1996

Purpose : Propose a surgical technique in donor harvesting method in free vascularized proximal fibular epiphysis. Methodology : Concerned about growth potentials of the transplanted epiphysis in our long term results of the epiphyseal transplanted 13 cases more than 4 years follow-up, anterior tibial artery which contains anterior tibial recurrent artery is most reliable vessel to proximal fibular epiphysis which is the best donor of the free vascularized epiphyseal transplantation. In vascular anatomical aspect proximal fibular epiphysis norished by latearl inferior genicular artery from popliteal, posterior tibial recurrent artery and anterior tibial recurrent artery from anterior tibial artery and peroneal artery through metaphysis. The lateral inferior genicular artery is very small and difficult to isolate, peroneal artery from metaphysis through epiphyseal plate can not give enough blood supply to epiphysis itself. The anterior tibial artery which include anterior tibial recurrent and posterior tibial recurrent artery is the best choice in this procedure. But anterior tibial recurrent artery merge from within one inch from bifucating point of the anterior and posterior tibial arteries from popliteal artery. So it is very difficult to get enough vascular pedicle length to anastomose in recipient vessel without vein graft even harvested from bifucating point from popliteal artery. Authors took recipient artery from distal direction of anterior tibial artery after ligation of the proximal popliteal side vessel, which can get unlimited pedicle length and safer dissection of the harvesting proximal fibular epiphysis. Results : This harvesting procedure can performed supine position, direct anterolateral approach to proximal tibiofibular joint. Dissect and isolate the biceps muscle insertion from fibular head, micro-dissection is needed to identify the anterior tibial recurrent arteries to proximal epiphysis, soft tissue release down to distal and deeper plane to find main anterior tibial artery which overlying on interosseous membrane. Special care is needed to protect peroneal nerve damage which across the surgical field. Conclusions : Proximal fibular epiphyseal transplantation with distally directed anterior tibial artery harvesting technique is effective and easier dissect and versatile application with much longer arterial pedicle.

• 대한의용생체공학회:의공학회지
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• 제33권2호
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• pp.78-88
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• 2012

Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

• 대한족부족관절학회지
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• 제12권2호
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• pp.180-184
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• 2008

Purpose: To evaluate the result of percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fracture of the distal tibial epiphysis in children. Materials and Methods: Between May 2004 and December 2007, 14 cases with triplane fractures were treated by percutaneous fixation with cannulated screws and Ilizarov external fixator after underwent CT imaging to assess the fracture pattern, articular disruption and to plan further management. Mean age and follow-up period were 14.1 years old and 15 months respectively. Results: There were satisfactory results in all 14 cases that had excellent reduction and stable fixation. All cases regained full range of movement within 6 weeks. Conclusion: We obtained satisfactory result after percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fractures of the distal tibial epiphysis in children.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.157-164
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• 1998

It has been very difficult to managing partial joint defect in any etiologies, especially in children. Unicondylar defect of the tibial condyle in children reconstructed with proximal fibular head with articular cartilage from 1995. Two kinds of transfering methods were used, peroneal artery pedicled ipsilateral fibula head transposition to defective lateral tibial condyle defect that revealed poor prognosis with gradual absorption of transposed fibular epiphysis. Free vascularized fibular head transplantation with microvascular anastomosis underwent in the case with medial condyle defect of tibia which revealed very satisfactory results. Author can conclude with these clinical experiences: 1. Tranposition without epiphyseal vesssels intact is not sufficient in fibular head osteochondral transplantation in reconstruction of tibial condyle defect. That means peroneal arterial vascular pedicle is not enough for transplanted proximal epiphysis maintains its function on articular surface and growth activity in children. 2. The anterior recurrent tibial artery is one of the most important and easy to utilizing vessel in proximal fibular epiphyseal transplantation. 3. Free vascularized fibular head transplantation is hopeful method in reconstruction of the knee joint in the patient with partial joint defect which has no effective solution in conventional methods.

• 대한기계학회논문집B
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• 제36권11호
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• pp.1081-1090
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• 2012

외상성 관절염 발생시 슬관절에서의 해면골 미세구조 변화 특성에 대한 연구는 부족한 실정이다. 따라서 본 연구에서는 생체 내 미세 단층 촬영을 통해, 소동물(SD rat; 10 마리)의 경골 골단 해면골 미세구조 변화패턴을 연속적으로 추적 관찰하여 정량적으로 분석하였다. 외상성 관절염 군(5 마리)에는 전방십자인대절제술을 실시하였고, 정상군(5 마리)에는 아무런 외과적 처치를 가하지 않았다. 외상성 관절염군은 정상군과 비교시 수술후 8 주까지 약 4-16%의 유의한 골 미세구조 차이를 나타내었다(P<0.05). 동일 기간 동안 골 밀집 정도 및 골 형성 정도는 5-15% 정도로 유의한 차이를 나타내었다(P<0.05). 본 연구는 외상성 관절염 발생에 의한 경골 골단 해면골의 골 미세구조 변화 특성 기준 정립 및 외상성 관절염의 이해와 치료에 도움이 될 것으로 기대된다.

• 대한골관절종양학회지
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• 제16권1호
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• pp.37-41
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• 2010

골성 골단에서 발생하는 혈관종은 극히 드물어서 그 보고를 찾아보기가 쉽지 않다. 우측 슬관절부 동통과 굴곡 구축을 주소로 내원한 5세 환아로 단순 방사선 및 자기공명영상 소견상, 대퇴골 원위부 골단 및 근위부 경골에서 병변을 보였으며, 생검한 결과 혈관종으로 진단되었다. 8년간 추시 관찰하였으며, 대퇴골 원위부 골단에 발생한 혈관종은 치유되었으며, 경골 근위부 골단에 발생한 병변도 치료없이 자연적으로 소실되었다. 또한, 하지 길이의 단축이나 슬관절 기능 장애는 발생하지 않았다.

• 대한수의학회지
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• 제46권3호
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• pp.285-289
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• 2006

This study was performed to assess the growth plate closure time with aging in the Korean native goat. Radiographs of proximal and distal epiphysis of humerus, radius, ulna, femur and tibia were obtained at 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 17, 18, 20, 21, 30, 43 and 52 weeks after birth in 30 Korean native goats. The secondary ossification centers were scrutinized and assessed the maturity process on the basis of the criteria(stage 0 to 10). The secondary ossification centers of proximal and distal epiphysis of humerus, radius, femur and tibia and proximal ulna epiphysis appeared immediately after birth. While, that of distal ulna epiphysis appeared during the 1st to 2nd week of life. The fusion of distal humeral epiphysis occurred during the period from 8 to 12 months. The fusion of proximal radial epiphysis and distal tibial epiphysis were found at 1 year. The fusion of proximal and distal epiphysis of ulna and femur, proximal epiphysis of humerus and tibia and distal epiphysis of radius were found at 1 year or more than 1 year. As a result, growth plate closure was highly related to age in the Korean native goat and it is suggested that the estimation of animal's age might be useful by illustration of maturity process of the secondary ossification centers in the Korean native goat.

• 한국임상수의학회지
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• 제36권2호
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• pp.112-115
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• 2019

An 11-month-old, 5.6 kg, grade 4 on a 5-point scale body condition score, castrated male Korean short hair cat was presented with right hindlimb lameness for 3 days without trauma. On physical examination, severe pain with crepitation was elicited at the hip region but not at the stifle. Radiographic examination and computed tomography revealed a Salter-Harris type 1 fracture of the femoral capital physis and dysplasia of the proximal tibial epiphysis. Spontaneous femoral capital physeal fracture was suspected and femoral head and neck osteotomy was performed. Treatment for proximal tibial dysplasia was not performed. On histopathologic examination of femoral head, a cluster of chondrocytes in a proliferative zone at the epiphyseal plate was observed. Therefore, spontaneous femoral capital physeal fracture was diagnosed. The patient recovered his gait, and no related clinical signs were observed during 6 months of follow-up.

• Biomolecules & Therapeutics
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• 제3권3호
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• pp.233-237
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• 1995

The growth effects of newly developed recombinant human growth hormone (rHGH), were compared with those of Biotropine. For the effective evaluation, we examined the increasing rate of body weight and the thickness of tibial epiphysis as criteria of growth effects on hypophysectomised female rats treated with varing concentration of rHGH for 4 days. rHGH treated groups showed significant body weight gain which was less evident in Biotropine and vehicle treatment group. In tibial epiphyseal test, rHGH also showed clear effects compared to Biotropine and vehicle treatment group. Above findings indicate that newly developed rHGH has better effects of growth stimulation on female rats than Biotropine does.

• 대한족부족관절학회지
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• 제13권2호
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• pp.179-183
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• 2009

The triplane fracture has been described as a fracture of the distal tibial epiphysis occurring across three planes-sagittal, transverse and coronal. The characteristic pattern of fusion of distal tibial epiphysis explains the special configuration of the fragments in the triplane fracture. According to Dias-Tachdjian classification, triplane fracture is classified two part fracture, three part fracture, four part fracture and two part fracture with extension to the medial malleolus. Among four types, two part triplane fracture with extension to the medial malleolus is a relatively rare injury and generally is not treated by closed reduction. Such fractures should have an anatomic reduction and adequate fixation to restore the joint congruity and obtain an anatomic reduction of the growth plate to prevent a future growth deformity. This is usually best accomplished with an open reduction and screw fixation or k-wire fixation. We experienced two part triplane fracture with extension to medial malleolus and check the CT to define the extent of the injury completely. And then we underwent open reduction and screw fixation for the fracture. As a result, we present four cases of two part triplane fracture with extension with review of related literatures.