• Title/Summary/Keyword: arthrodesis

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Surgical Treatment of Malignant Tumors in Shoulder Girdle (견갑관절 주위 악성종양의 치료경험)

  • Song, Seok-Whan;Chang, Ju-Hai;Kang, Yong-Koo;Kim, Jung-Man;Kim, Hyoung-Min;Rhee, Seung-Koo;Woo, Young-Kyun;Bahk, Won-Jong;Moon, Myung-Sang;Kim, Yang-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.68-76
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    • 1995
  • To evaluate the clinical result of surgical treatment of malignant tumors in shoulder girdle, nine patients who were treated in Department of Orthopedics, Catholic University Medical College between January 1991 and December 1993, were evaluated. There were 5 men, 4 women. The mean age at operation was 47 years(range from 22 to 64 years). Of 9 patiens, 2 were soft tissue tumors(1 MFH, 1 dermatofibrosarcoma protuberance); one was treated with forequarter amputation, and the other with wide excision, Seven were bone tumor(2 chondrosarcoma, 1 osteosarcoma, 1 MFH, 1 plasmacytoma, 1 thyroid carcinoma metastasis, 1 malignant schwannoma); one patient was treated with segmental excision of proximal humerus, 4 with Malawer type I-A resection and arthroplasty or arthrodesis, 1 with Malawer type V-B resection and arthrodesis. Five patients received adjuvant chemotherapy, with or without local radiation therapy, and one patient received radiation therapy alone. All patients have survived now, but I had local recurrence. Functional results of arthrodesis and arthroplasty were similar.

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Efficacy of Ilizarov External Fixation and Autologous Bone Grafting for Performing Arthrodesis on the Ankle Arthropathy with Risk Factors (불유합의 위험 인자를 가진 족관절 병변에 시행한 족관절 유합술로서 Ilizarov 외고정 기구 장착술 및 자가골 이식술의 유용성)

  • Lee, Yong-Sik;Nam, Il-Hyun;Lee, Tae-Hun;Ahn, Gil-Yeong;Lee, Yeong-Hyeon;Lee, Hee-Hyung;Hwang, Sung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.189-195
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    • 2019
  • Purpose: The aim of this study is to evaluate if the Ilizarov external fixation procedure with axial compression can help to obtain fusion across the ankle joint in patients with a high risk of nonunion. Materials and Methods: From January 2006 to December 2015, the study reviewed 17 patients who underwent ankle arthropathy with a high risk of nonunion and who underwent ankle fusion using the Ilizarov external fixator with axial compression and auto bone grafting. After the lateral surface of the ankle joint was exposed through a lateral trans-fibular approach, massive removal of the articular cartilage and excision of any loose or avascular bone were done. With the cortical bone harvested from the pelvis as corticocancellous bone blocks, we inserted the two cortical blocks longitudinally into the anterior and posterior part of the free ankle space from lateral to medial to make the rectangular chamber to fill the cancellous bones. After the Ilizarov external fixator was equipped, we tightened the frame by 5 mm to compress the bone graft space. We accessed the American Orthopaedic Foot and Ankle Society (AOFAS) AnkleHindfoot score both preoperatively and postoperatively. Results: The average age at the time of operation was 63.4 years (range, 47~78 years). The mean frame time was 17.4 weeks (range, 15~23 weeks). The average follow-up period was 3.7 years (range, 2~6 years). Osseous fusion was obtained in 15 patients (88.2%). There were two stable pseudarthroses among the rheumatoid arthritis patients, and we continued their follow-up. The mean AOFAS AnkleHindfoot score improved from 48.5 to 73.7 points. Conclusion: Ankle arthrodesis using the Ilizarov external fixation with axial compression and auto bone grafting on the ankle arthropathy that had difficult conditions to achieve union is considered one of the useful methods with a correspondingly low incidence of complications.

Fractures and Dislocations of the Cervicothoracic Junction

  • Kim, Jin-Wook;Jeong, Ju-Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.211-215
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    • 2007
  • Cervicothoracic junction instability should be stabilized with the circumferential fusion. In addition, cervicothoracic junctional area should be examined carefully in acute traumatic injury not only to confirm hidden lesions but also to make the proper surgical plans. Here, three patients who underwent cervicothoracic arthrodesis at our institution are presented with a review of literature.

Radiological Diagnosis and Surgical Stabilization of the Atlantoaxial Subluxation in a dog (개의 환축추 아탁구의 방사선진단 및 외과적 고정)

  • 김남수
    • Journal of Veterinary Clinics
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    • v.14 no.1
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    • pp.126-130
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    • 1997
  • 10개월경의 그리폰 벤딘 수컷 강아지가 8개월경부터 점점 운동 실조 및 마비증상을 나타내어 머독대학 동물병원에 내원 하였다. 내원 했을 때 주변에 매우 민감한 반응과 경계를 늦추지 않았지만 호흡과 심박수 및 체온은 정상이었다. 일반 방사선 사진 및 척수조영사진(myelography)을 촬영하여 확인한 결과 환축추의 불안정에 따른 척수의 복측 압박을 확인할 수 있었다. 외과적 고정은 복측 접근을 통하여 2개의 키르크너 강선(Kirschner wire)과 자가골이식을 실시하였으며 8주동안 외부 고정을 하였다. 수술 후 5개월 동안 지켜본 결과 증상은 꾸준히 좋아졌으며 환축추 관절으 관절고정술(arthrodesis)은 완벽한 고정을 유지하고 있었다.

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Early Stress Fracture of the Pelvic Ring Following Proximal Extension of an Instrumented Lumbosacral Fusion to Treat Junctional Kyphosis

  • Kim, Won-Joong;Lee, Sang-Ho;Shin, Song-Woo
    • Journal of Korean Neurosurgical Society
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    • v.38 no.1
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    • pp.77-79
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    • 2005
  • We report a case of early stress fracture of the pelvic ring following an extension of a multilevel instrumented lumbosacral fusion in an osteopenic female. Surgeons should be aware of possibilities of pelvic complications in osteopenic patients with lumbosacral arthrodesis and should take care when harvesting iliac bone graft.

Surgical Treatments and Clinical Outcomes for Idiopathic Osteoarthritis of the Tarsometatarsal Joints (족근 중족 관절의 특발성 골관절염에 대한 수술적 치료 및 임상적 결과에 대한 분석)

  • Jung, Hong-Geun;Byun, Woo-Sup;Myerson, Mark S.;Schon, Lew C.
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.31-38
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    • 2004
  • Purpose: The purpose of the study was to identify the subtypes of idiopathic osteoarthritis of the tarsometatarsal joints based on accompanying hindfoot, midfoot, or foot deformities and their corresponding surgical options and also to evaluate the overall clinical results. Materials and Methods: The study included 59 patients (67 feet) with idiopathic tarsometatarsal joint osteoarthritis. Tarsometatarsal fusion was performed for tarsometatarsal joint and accompanied secondary change was divided into subtypes and various bony reconstruction was carried out. The patients were evaluated with the AOFAS midfoot score and FFI. The average patient age was 60.2 years with 40.6 months follow-up. Fifty-four feet (80.6%) had been treated with realignment fusion. Twenty-six feet had first and second tarsometatarsal joint fusion, and 20 feet had first tarsometatarsal fusion only. Six subtypes were identified based on associated foot deformities: 1) in-situ without deformities (18%), 2) pes planovalgus (45%), 3) rockerbottom (15%), 4) cavus foot (1%), 5) hallux valgus (12%), and 6) hallux valgus with pes planovalgus or rockerbottom (9%). Plantar-medial closing-wedge resection was used in 10 feet to correct rockerbottom. For pes planovalgus, a medial sliding calcaneal osteotomy was done. Lateral column lengthening with medial sliding calcaneal osteotomy was done for severe pes planovalgus, and triple arthrodesis was done for rigid pes planovalgus. Hallux valgus was corrected with the Lapidus procedure (85.7%). Results: AOFAS midfoot scores improved from preoperative 34.1 points to postoperative 83.9 points (p<0.05). The Foot Function Index postoperatively also showed significant improvement (p<0.05), with a high satisfaction rate (86.6%). There were 29 complications, most commonly sesamoid pain. Conclusion: Idiopathic tarsometatarsal OA feet can be classified into six categories. Pes planovalgus feet should be treated with medial sliding calcaneal osteotomy, lateral column lengthening, or triple arthrodesis in addition to tarsometatarsal joint realignment fusion. Rockerbottom and hallux valgus deformities should also be addressed.

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Efficacy of Calcium Sulfate Pellets as Bone Graft Substitute in Lumbar Posterolateral Fusion - Preliminary Report - (요추부 후측방 유합술에서 골편대체물로서 황산칼슘의 효과에 대한 연구)

  • Lee, Seung Ku;Kim, Choong Hyun;Cheong, Jin Hwan;Bak, Koang Hum;Kim, Jae Min;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.605-610
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    • 2001
  • Objective : The authors investigated the efficacy of the calcium sulfate(OsteoSet$^{(R)}$ pellets) as an autograft extender when used to perform posterolateral lumbar fusions. Patients and Methods : Twenty patients who underwent lumbar posterolateral arthrodesis for various spinal diseases between October 1999 and March 2000 were evaluated. Arthrodesis was performed by transpedicular screw fixation and bone grafting with a mixture of autograft + calcium sulfate in a 1 : 1 ratio. At time intervals of 1, 2, 3, and 6 months, postoperative radiographs were obtained to review the resorption of calcium sulfate and the evidence of fusion. A modified Lenke scale was used to assess the status of the fusion. Results : At 2 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 3.8. However at 6 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 1.8. Resorption of calcium sulfate pellets was revealed in all cases at 6 months after surgery. Conclusion : It is presumed that a combination of calcium sulfate and autograft can play a role as an effective autograft extender in the posterolateral spinal fusion.

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New Technical Tip for Anterior Cervical Plating : Make Hole First and Choose the Proper Plate Size Later

  • Park, Jeong-Yoon;Zhang, Ho-Yeol;Oh, Min-Chul
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.212-216
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    • 2011
  • Objective : It is well known that plate-to-disc distance (POD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our hypothesis was that the new technical tip may increase POD as compared with the standard anterior cervical plating procedure. Methods : We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). POD and ratios between POD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases. Results : The mean durations of follow-up were $16.42{\pm}5.99$ (Group A) and $19.83{\pm}6.71$ (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad POD (5.43 versus 3.46 mm, p=0.005) and cephalad POD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal POD (5.92 versus 5.06 mm), caudal POO/ABH (0.37 versus 0.32) and clinical results. Conclusion : The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

The Use of a Porcine Cancellous Bone Graft for Arthrodesis of Bilateral Antebrachiocarpal Luxation in a Dog (양측 전완앞발목관절 탈구의 관절고정술을 위한 돼지뼈 해면골이식의 적용)

  • Heo, Su-Young;Lee, Ki-Chang;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.259-262
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    • 2012
  • A seven-year-old Yorkshire terrier 2.1 kg was admitted with a 2 months history of sever bilateral forelimb lameness and joint instability. Examination and radiographs revealed caudal luxation of bilateral antebrachiocarpal joint. Luxation of bilateral antebrachiocarpal (ABC) joint in a toy breed dog was treated with pancarpal arthrodesis. Modified external skeletal fixator (ESF) (type IIb) with polymethylmethacrylate (PMMA) was utilized in this case. Porcine cancellous bone graft (PCBG) was inserted to fill the joint space in carpus. The clinical and radiographic assessments of joint after the surgical procedure proved that PCBG can be used a promising alternative to Autogenous cancellous bone graft (ACBG).

Two Staged Surgical Treatment of Post-Traumatic Severe Ankle Equinus Deformity - Preliminary Report - (외상 후 발생한 심한 족관절 첨족 변형의 2단계 수술적 치료방법 - 예비보고 -)

  • Kim, Jung-Ho;Lee, Jun-Young;Ha, Sang-Ho;You, Jae-Won;Lee, Sang-Hong;Na, Woong-Chae
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.86-91
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    • 2011
  • Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.