• 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.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1043-1049
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• 2000

Objective : This study was undertaken to evaluate the availability of allogenic fibular bone graft filled with autogenous bone dust in anterior cervical fusion after cervical discectomy. Methods : During a 4-year period(1995-1998), twenty four cases of anterior cervical fusion after discectomy were performed with fibular allograft filled with autogenous bone dust in degenerative cervical disease. We used freeze-dried fibular allograft and autogenous bone dust. Autogenous bone dust obtained from spondylotic spurs, osteophytes, and during foraminotomy. Cervical plating system was done at 8 patients. 5 patients were 1 level and 3 patients were 2 levels. All patients were routinely evaluated after surgery at 2 weeks, 1 month, 3 months, 5 months and 12 months. Mean follow-up period was 21months. Results : Eighty eight percent of the patients were found to have excellent or good clinical results. Radiographic follow-up revealed that 92% of the patients obtained complete or partial union by 5 months after surgery. One patient had graft extrusion immediately after surgery and had the graft reinserted. Two patients had longitudinal graft fractures. There were no graft related complications. Conclusion : Fibular allograft filled with autogenous bone dust for cervical interbody fusion after discectomy is an ideal graft material by showing obvious benefits of good fusion rate and elimination of donor site complications. And also we were able to obtain satisfactory clinical outcome.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.209-213
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• 2013

Background A cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia. Methods From February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework. Results The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases. Conclusions Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.65-71
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• 1996

Twenty-nine cases of unicameral bone cyst developed in long bone of children have been treated and followed up for 4.5 years in average form Department of Orthopaedic Surgery, Guro Hospital, Korea University, College of Medicine since September, 1983, Treatment for those lesions differed to form largely two groups, one of which consised of insillation of Methyl-prednisolone for non-weight bearing bones(12 humeri) and the other of curettage and autogenous bone graft for weight-bearing bones(7 femur). Methl-prednisolone group required repetition of instillation for 3.5 time in average spanning over 4 years until cloudy obliteration occurs. Curettage and bone graft had healed in 3 year 6 months' time in average. There were neither recurrence nor pathologic fractures of the lesions with the latter group. Immobilization period was virtually non with Methyl-prednisolone group and 4-6 weeks by hip spica with curettage and bone graft group. As conclusions, It seems confirmed that treatment strategy of unicameral bone cyst consisted of Methyl-prednisolone instillation for humerus lesions and early curettage and bone graft for femur lesions is applicable as guideline having solid ground in clinical experiences.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.50-56
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• 2005

There are limited treatment options in the reconstruction of the very large defect in the metaphyseal portion of distal femur and proximal tibia. Fibula is one of the most popular donor of the long bone reconstruction in reconstructive microsurgical field. It has many advantages such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter and long pedicle. There are limited donor site problems such as transient peroneal nerve dysfunction. In those situations with the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transferred. We performed 7 cases of "doule barrel" fibular transplantation on the metaphyseal portion of distal femur and proximal tibial large defects in which it is very difficult to fill the bony gap with conventional bone graft or callotasis methods. It takes averaged 8.3 months since that procedure to obtain bony union. After solid union of the transferred double barrelled fibular graft. There were no stress fracture in our series. So we can propose double barrel fibular graft is useful method in those cases with very large bone defect on the metaphysis of large long bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.101-116
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• 1989

Proplast and Porous Polyethylene which have porous structures as low-modulus polymers have been recently used in maxillofacial plastic and reconstructive surgery. The purpose of this study was to compare the response of adajacent tissue, new bone formation and stability after augmentation by differen methods of subperiosteal graft using proplast and purous polythylene in rabbit mandible. The augmentation procedure was carried out by dividing into two groups, A and B. A group consisted of subperiosteal graft on the cortex, and the other B group was made up only graft following artificial decortication in the mandibular body of rabbit. The experimental animals were sacrificed on the 1st, 2nd, 4th and 8th week after grafting for macroscopic and light microscopic examination. The samples extracted at the 6th postgrafting week were also used for biometric testing and scanning electron microscopic examination. The results obtained from this study were as follows : 1. Macroscopically, infection of graft site, deformation and migration of graft material were not observed in all experimental groups. 2. B group showed more rapid and increased bone formation and the greater stability than A group, and tissue response was similar to each other. 3. In the tissue response, macrophages and cellular infiltrations were observed in Proplast group, but few in PHDPE group. 4. In bone formation of A group, Proplast group showed no bone formation until the 8th week, but PHDPE group showed small quantity of osteoid tissue from the 2nd week and appositional bone growth with new bone formation at the 8th week. 5. In bone formation of B group, both Proplast and PHDPE group showed bone formation, but PHDPE group showed more rapid and larger bone formation. 6. In pattern of bone formation, Proplast group mainly showed appositional bone growth pattern connected with graft site. On the other hand, PHDPE group showed mixed pattern of new bone formation in the pore connective tissue with appositional bone growth from graff site. 7. The maximum mean values of shear stress were serially $111.3gf/mm^{2}$ in PHDPE of B group, $84.8gf/mm^{2}$ in PHDPE of A group, $32.9gf/mm^{2}$ in Proplast B group, and $15.7gf/mm^{2}$ in Proplast of A group. From above results, It was suggested that the capacity of bone formation and stability between bone and graft material were dependent on the pore size and structure of graft material itself, the state of graft site and tissue response.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.216-221
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• 2014

Purpose: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. Methods: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. Results: The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. Conclusions: Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.5
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• pp.224-229
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• 2014

The maxillary posterior area is the most challenging site for the dental implant. Although the sinus graft is a predictable and successful technique for rehabilitation of atrophic and pneumatized posterior maxilla, when there is severe destruction of alveolar bone, a very long crown length remains challenging after successful dental implants installation with sinus graft. We performed vertical augmentation of the maxillary posterior alveolar ridge using the allogenic block bone graft with a simultaneous sinus graft using allogenic and heterogenic bone chips. After about six months, we installed the dental implant. After this procedure, we achieved a more favorable crown-implant fixture ratio and better results clinically and biomechanically. This is a preliminary report of vertical augmentation of maxillary posterior alveolar ridge using allogenic block bone graft and simultaneous maxillary sinus graft. Further research requires longer observation and more patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.570-578
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• 2006

A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.