• Title/Summary/Keyword: avascular necrosis

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Ankle Arthrodesis Using Auto Fibula Bone Graft: Two Cases Report (자가 비골이식술을 이용한 족관절 유합술: 2예 보고)

  • Yi, Chang-Ho;Yoon, Won-Sik;Oh, Jin-Rok
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.102-106
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    • 2011
  • Recently, development and improvement in joint replacement therapy, the need for arthrodesis has been decreasing. However, result of joint replacement is not always satisfactory, and most cases are rather indicative to ankle arthrodesis than ankle replacement. Often, ankle arthrodesis can be more beneficial salvage method to treat cases with failure in joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation. In cases with large bone defect that need to be treated with ankle arthrodesis using internal fixation, it is difficult to fill the defect with conventional auto-iliac bone or all-bone graft. Thus, we make a report on our experience in treating 2 cases with ankle arthrodesis using auto-fibular bone graft and plate fixation.

$4^{th}$ Metatarsal Head AVN Treated by Callotasis in $4^{th}$ Brachymetatarsia (A Case Report) (가골 신연술을 이용한 제4 단중족증 치료 중 발생한 제4 중족골 골두의 무혈성 괴사(1예 보고))

  • Lee, Jun-Young;Cho, Sung-Won;Pak, Chi-Hyoung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.3
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    • pp.197-201
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    • 2012
  • Callotasis has been widely used to treat brachymetatarsia. But various complications have been reported. Avascular necrosis of the $4^{th}$ brachymetatarsia treated by callotasis has not been frequently addressed in the literature. We report 1 cases of avascular necrosis of the $4^{th}$ brachymetatarsia treated by callotasis with a review of the literature.

An Irreducible Hip Dislocation with Femoral Head Fracture

  • Kim, Tae-Seong;Oh, Chang-Wug;Kim, Joon-Woo;Park, Kyeong-Hyeon
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.181-188
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    • 2018
  • Urgent reduction is required in cases of traumatic hip dislocation to reduce the risk of avascular necrosis of the femoral head. However, in cases of femoral head fractures, the dislocated hip cannot be reduced easily, and in some cases, it can even be irreducible. This irreducibility may provoke further incidental iatrogenic fractures of the femoral neck. In an irreducible hip dislocation, without further attempting for closed reduction, an immediate open reduction is recommended. This can prevent iatrogenic femoral neck fracture or avascular necrosis of the femoral head, and save the natural hip joint.

Analysis of Results Using Percutaneous Vertebroplasty for the Treatment of Avascular Necrosis of the Vertebral Body

  • Kim, Han-Woong;Kwon, Austin;Lee, Min-Cheol;Song, Jae-Wook;Kim, Sang-Kyu;Kim, In-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.209-212
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    • 2009
  • Objective : Avascular necrosis (AVN) of the vertebral body is known as a relatively uncommon phenomenon in a vertebral compression fracture (VCF). The outstanding radiologic findings of AVN are intravertebral vacuum phenomenon with or without fluid collection. Several reports revealed that PVP or balloon kyphoplasty might be the effective treatment modalities for AVN. We also experienced excellent results when using PVP for the treatment of AVN of the vertebral body, and intend to describe the treatment's efficacy in this report. Methods : Thirty-two patients diagnosed with AVN of the vertebral body were treated with PVP. We measured the pre- and post-operative anterior body height and kyphotic angulation. The visual analogue scale (VAS) was used to determine the relief of back pain. Results : The anterior body height (pre-operative : 1.49 cm, post-operative : 2.22 cm) and kyphotic angulation (pre-operative : 14.47 degrees, post-operative : 6.57 degrees) were significantly restored (p<0.001). VAS was improved from 8.9 to 3.7. Pseudoarthrosis was corrected in all cases, which was confirmed by dynamic radiographs. Fluid collection was found in sixteen cases and was aspirated with serous nature. No organism and tumor cell were noted. Conclusion : PVP proved to be an effective procedure for the treatment of AVN of the vertebral body, which corrected dynamic instability and significantly restored the anterior body height and kyphotic angulation.

Two Cases of Avascular Necrosis of the Femur Head after Whole Pelvic Radiation Therapy for the Treatment of Cervical Cancer (자궁경부암의 전골반방사선치료 후 발생한 대퇴골두 무혈성괴사 2예)

  • Yu, Jeong-Il;Huh, Seung-Jae;Park, Won;Oh, Dong-Ryul;Lee, Jung-Ae
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.126-130
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    • 2008
  • Avascular necrosis(AVN) is a disease characterized by the temporary or permanent loss of the blood supply to the bones, resulting from many possible causes, including radiation therapy. The femoral head is known to be the most common site of AVN. The authors encountered two cases of AVN of the femoral head among 557 patients with cervical cancer treated with whole pelvic radiation therapy at the Samsung Medical Center. AVN of the femoral head was presented with a sclerotic density change in a plain roentgenography and a decreased signal intensity lesion on the T1 and T2 weighted phases of a magnetic resonance image(MRI). Although it is a very rare complication after whole pelvic radiation therapy, AVN of the femoral head should be considered when characteristic imaging findings appear on follow-up examinations.

Effects of Gait Training Using a Robot for Balance in Total Hip Arthroplasty Patients after Bilateral Avascular Necrosis: A Case Study

  • Kim, So-Yeong;Kim, Byeong-Geun;Cho, Woon-Su;Park, Chi-Bok
    • The Journal of Korean Physical Therapy
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    • v.33 no.5
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    • pp.231-237
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    • 2021
  • Purpose: This study sought to investigate the effects of robot-assisted gait training on balance in total hip arthroplasty (THA) patients after bilateral avascular necrosis (AVN). Methods: This case study in two patients utilized an 'A-B-A' single-subject experimental design that included five days of pre-intervention, followed by five days of intervention, and five days of post-intervention. The intervention involved the use of a standing inclined robot (R-bot) for 15 minutes. The outcome measures were evaluated using the Functional Reaching Test (FRT), Time Up to Go (TUG), and the Modified One Leg Standing Test (OLST). Results: Patient 1 showed improvement based on data gathered from baseline A to intervention period B, with results as follows: FRT improved from 27.7 cm to 41.28 cm, OLST LT from 14.03 seconds to 67.37 seconds, OLST RT from 2.94 seconds to 35.97 seconds, and TUG from 12.96 seconds to 7.82 seconds. Patient 2 also showed improvement from baseline A to intervention period B, with results as follows: FRT improved from 17.18 cm to 24.3 cm, OLST LT from 11.53 seconds to 52.01 seconds, OLST RT from 12.99 seconds to 62.19 seconds, and TUG from 27.31 seconds to 12.99 seconds. Conclusion: Based on the results of this study, robotic rehabilitation during the early stages after surgery is effective for promoting balance in patients who have undergone THA due to bilateral AVN.

Two Case Reports of Patients Diagnosed with Avascular Necrosis of the Femoral Head Treated with Korean Medicine Treatment Including Chuna Manual Therapy, Pharmacopuncture and Acupuncture (추나 요법 및 약침, 침치료를 비롯한 한방치료로 증상이 호전된 대퇴골두 무혈성 괴사 환자 2예 보고)

  • Kim, Da-hye;Kim, Eun-jung;Jo, Myeong-jae
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.1
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    • pp.195-204
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    • 2021
  • Objectives The purpose of this study is to report the effects of Korean medicine treatments including Chuna manual therapy, pharmacopuncture and acupuncture for two patients who have pain in hip joint diagnosed with avascular necrosis of the femoral head. Methods The treatment effect was evaluated with a numeric rating scale (NRS), range of motion (ROM), physical examination (Patrick test), and score of Harris hip score (HHS). Results After treatment, symptoms of the two patients such as hip joint pain and gait dysfunction were improved. The NRS decreased from 8 (right [Rt.]), 7 (left [Lt.]) to 4 (Rt.), 3 (Lt.) in case 1 and from 9 to 2 in case 2. Also the patients showed improvement in ROM and score of HHS increased from 55.5 to 88.5 in case 1 and from 63.5 to 85.5 in case 2. In addition, positive Patrick test improved to negative. Conclusions Korean medicine treatments including Chuna manual therapy, pharmacopuncture and acupuncture can be effective in relieving pain and recovering the fucnction of hip joint associated with avascular necrosis of the femoral head, even when surgery is recommended. Although further study such as controlled studies is needed.

Avascular Necrosis of the Fifth Metatarsal Head - A Case report - (제 5 중족골 두 무혈성 괴사 - 1례 보고 -)

  • Park, In-Heon;Song, Kyung-Won;Muhn, Young-Wan;Joe, Myoung-Il
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.1
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    • pp.44-47
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    • 2000
  • Freiberg's infarction involving the fifth metatarsal head is very rare condition. The authors experienced a case of avascular necrosis of the fifth metatarsal head and base of the proximal phalanx in a 27-year-old female patient. Involved bones were excised and internally fixed with 2 K-wires after autogenous cancellous bone grafting. Pain was relieved, and an excellent clinical result was obtained at the follow-up examination six months after the surgery.

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Avascular Necrosis of Bone after Renal Transplantation - Prevalence and Usefulness of Bone SPECT - (신장 이식후에 발생한 무혈관성 골괴사 -발생 빈도 및 골 SPECT의 유용성에 관하여 -)

  • Choi, Yun-Young;Yang, Seoung-Oh;Ryu, Jin-Sook;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.504-510
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    • 1995
  • Avascular necrosis(AVN) of bone can be resulted from various causes that distrub vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was deter-mined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivacal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip Joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be perfomed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

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