• 대한족부족관절학회지
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• 제16권1호
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• pp.70-72
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• 2012

Stress fractures of the proximal phalanx of the great toe are rare. This fractures have been associated with halux valgus deformity in most reports. We performed open reduction and internal fixation with distal chevron osteotomy for the stress fracture of the proximal phalanx of the great toe in a basketball player with hallux valgus, and obtained successful bony union and rapid return to sports.

• 대한골관절종양학회지
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• 제9권2호
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• pp.139-147
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• 2003

목적: 양성 골종양을 치료하기 위해 골이식 대체물을 이식하였을 때 골 유합을 얻을 수 있는지 여부와 골 이식 대체물 중 황산칼슘(calcium sulfate)과 수산화인회석 (hydroxyapatite)을 이용하여, 골 이식술 후 유합 정도를 비교하여 골 치유 과정에 대한 두가지 골 이식 대체물의 차이점을 보고하고자 한다. 대상 및 방법: 양성 골종양 환자 중 병소의 소파술 시행 후 골 이식 대체물을 이식한 20례를 대상으로 술전후 단순 방사선 소견상 병소 크기, 신생골의 형성, 병소의 재발 여부와 이식 후 조직학적 소견을 관찰하였다. 결과: 총 20례 중 남자가 13례, 여자가 7례였으며 평균 연령은 15.8세(2~5), 술 후 평균 추시 기간은 3년이었다. 방사선 사진상 병소의 면적은 평균 30.7 $cm^3$였으며, 최종 추시상 전체 20례 중 19례에서 성공적인 결과를 보였으며, 1례에서 병소의 재발을 보였다. 나이, 병소 크기와 병변 종류에 따른 차이는 관찰되지 않았다. 결론: 황산칼슘은 생체 적합성이 뛰어나고, 골 전도 작용이 있으며 새로운 골형성에 비례하여 생체내로 흡수되는 특성을 보였고, 이에 반해 수산화인회석은 골 전도 작용이 있지만, 병변의 크기나 주위 환경에 따라 자가골, 자가 골수 이식, 이종골과 병행 사용시 양호한 골치환 결과를 얻을 수 있을 것으로 사료되며, 황산칼슘에 비해 더 느리게 생체내로 흡수되는 결과를 보였다.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.33-37
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• 2009

목적: 상완골 간부 골절의 불유합에 대해 그 원인을 분석하고, 금속판 고정 및 자가골 이식술을 통한 수술적 치료의 결과를 평가하고자 하였다. 대상 및 방법: 총 18예를 대상으로 하였으며, 평균 추시 기간은 28개월이었다. 불유합에 대해 금속판 고정 및 자가골 이식술을 시행하였고, 골결손이 심한 경우 골단축술을 병행하였다. 술후 추시 단순 방사선 검사로 골유합을 확인하였고, ASES 점수 평가법을 이용하여 임상적 평가를 시행하였다. 결과: 불유합의 원인은 처음 수술시 금속판을 시행한 12예의 경우에서는 불충분한 금속판 길이가 6예, 금속판의 파손 2예, 나사못의 이완이나 파손이 2예, 감염이 1예, 정신과적 문제로 인한 환자의 불응성이 1예였고, 금속정 고정술을 시행한 3예에서는 전 예에서 골절 부위의 신연이 원인이었으며, 외고정을 시행한 3예에서는 불충분한 고정이 원인이었다. 전 예에서 골유합을 얻을 수 있었으며, 골유합까지의 기간은 평균 24주였다. 임상적 결과는 우수가 11예, 양호가 6예, 보통이 1예였다. 결론: 불유합에 대한 수술 시 불유합 부위에 존재하는 섬유조직이나 괴사된 골조직을 철저하게 제거한 후, 충분한 길이의 금속판 내고정술 및 자가골 이식술을 이용하면 만족스러운 결과를 얻을 수 있을 것으로 사료된다.

• 대한정형외과학회지
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• 제55권3호
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• pp.237-243
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• 2020

목적: 고령 여성에서 대퇴부에 발생한 골다공증과 동반된 전자간 골절에서 수술 후에 부갑상선 호르몬 제제 투여 후 골절 치유에 대한 영향을 알아보고자 하였다. 대상 및 방법: 2013년 7월부터 2017년 12월까지 대퇴부 전자간 골절 및 골다공증을 진단 받은 후 수술을 시행한 65세 이상의 여자 환자에서 부갑상선 호르몬 제제를 투여한 군과 투여하지 않은 군을 대상으로 최초 가골의 형성 시기, 가골교로의 진행 시기 및 골유합 진행 시기를 조사하였다. 결과: 부갑상선 호르몬 투여군에서 최초 가골의 형성은 평균 32일, 가골교로의 진행은 평균 58일, 골유합이 된 시기는 평균 83일로 투약을 하지 않은 군에 비하여 통계적으로 의미 있게 기간이 단축된 소견을 보였다. 결론: 골다공증 치료제인 부갑상선 호르몬 제제는 고령의 여성에서 골다공증이 동반된 전자간 골절에서 가골의 형성 및 치유 과정을 촉진시킨다. 따라서 수술 후 이의 투여가 도움이 될 거라 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권1호
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• pp.1-13
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• 1990

The main objectives of this study was to observe the effects of hyperbaric oxygen therapy on the healing processes of mandibular fracture of streptozotocin-induced diabetic rats. Author used 60 rats (Sprague-Dawley Strain) deviding into control(30) and experimental groups(30). Complete fracture was produced on the left mandibular body of 60rats, rendered hyperbaric oxygen therapy (2 hrs. daily at 2.5 atm.) on experimental group and observed effects of hyperbaric oxygen therapy by microscopically. The obtained results were as follows; 1. Infiltration of inflammatory cells was no significant differences between the control and experimental group until 3rd week, but experimental group showed decreasing tendency after 4th week. 2. Severe proliferation of fibroblasts showed rather rapider in experimental group, at 2nd week, while at 3rd week in control group. 3. Osteoclasts appeared at 1st week in experimental group while at 3rd week in control group, and experimental group showed early bone resorption pattern. 4. Osteoblasts appeared at 1st week in experimental group while at 3rd week in control group, and experimental group showed prominent osteoblastic activity. 5. Moderate proliferation of capillary blood vessels showed in initial stage of experimental group while mild proliferation at 1-2nd week in control group. 6. Formation of cartilaginous callus showed at 4th week in experimental group, while at 6th week in control group. 7. Formation of bony callus showed mildly at 5th week, and moderately at 6th week in experimental group, while no appearance in control group, but complete bony union was not observed even in experimental group throughout this experiment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권3호
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• pp.222-225
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• 2006

The treatment objective of mandibular fracture is a return to normal function. According to Champy, a rigid fixation of mandibular angle fracture is performed by using 4 or 6 holes titanium miniplates on the external oblique ridge of mandible. However, the limitations of metal plate such as hypersensitivity, interference with the cranio-facial growth of growing child, secondary bone resorption around the plate, foreign body reaction, declination of primary callus formation, and bone atrophy due to the lack of normal stress reaction of the bone have been reported. Recently, biodegradable miniplate has been introduced and used as an alternative to the metal plate despite its lower strength than that of the titanium plate and the side effect caused by the resorption in the body. In this study, 61 patients diagnosed as mandibular angle fracture and treated from Jan. 1998 to Dec. 2004 in our department have been reviewed. Metal plate fixation was used in 50 patients and biodegradable plate fixation in 11 patients on the external oblique ridge around the fractured mandibular angle according to the principle of monocortical osteosynthesis by Champy. We compared the incidence of side effects and the degree of bony union at the mandibular inferior border in two different fixation methods. In conclusion, we have found that one miniplate regardless of matter could provide enough strength to grasp bony fragments of the tension site and compress the inferior border of mandible without any complications.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1469-1475
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• 2000

Objective : The goal of this study was to evaluate the clinical outcome of the posterior C1-2 transarticular screw fixation without C1-2 sublaminar wiring in atlantoaxial instability. Methods : Between Apr. 1995 and Feb. 2000, we used this technique in treat randomly selected 17 patients (11 men, 6 women) who had atlantoaxial instability. The causes of instability were : type II-A odontoid process fracture(10 cases) ; type II-P odontoid process fracture(1 case) ; Os odontoideum(2 cases) ; transverse ligament laxity due to rheumatoid disease(1 case) ; and, transverse ligament injury without bone fracture(3 cases). All cases were operated with posterior C1-2 transarticular screw fixation with 3.5mm cortical screw and interlaminar iliac graft without sublaminar wire fixation. The mean follow-up period was 28 months(5 to 58 months) and the mean age at the time of operation was 41 years(15 to 68 years). All Patients were allowed to ambulate with Philadelphia neck collar on the first post-operation day. Results : Bony fusion was successfully achieved in all cases demonstrated at 3-month follow-up studies. There was no operative mortality or morbidity. Conclusion : The authors conclude that the posterior transarticular screw fixation without C1-2 sublaminar wiring provide adequate stability with high bony union rate in atlantoaxial instability of various causes.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.212-216
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• 2011

Purpose: Ameloblastomas are rare benign tumors of odontogenic origin, and compose about 1% of all oral and maxillomandibular cysts and tumors. Because this neoplasm has a high rate of local recurrence, segmental mandibulectomy with a 1~2 cm safety margin and immediate microsurgical reconstruction is an accepted treatment modality. The authors experienced four mandibular reconstruction cases that underwent secondary dental implantation. Here, the authors describe these cases and their long-term results. Methods: Four patients with ameloblastoma of the mandible underwent segmental mandibulectomy and reconstruction with a free fibula osseous flap from January 1999 to May 2005, followed by secondary dental implantation. Recurrence, bony union, implant osseointegration, and functional and aesthetic results were evaluated by radiologic imaging, by physical examination, and by using photographs. Results: All free flaps survived with no evidence of flap loss. To date, no recurrence has been noted clinically or radiologically. Imaging after mandibular reconstruction with a free fibular flap revealed satisfactory bony unions and mandibular contours. The patients achieved good aesthetic and functional results after the secondary implantation. Conclusion: Mandibular reconstruction using a fibular osseous flap and secondary dental implantation can produce good functional and aesthetic results after segmental mandibulectomy for ameloblastoma.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.125-132
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• 2007

Introduction: Ulna is nearly equal to radius in function and bony architecture and strength in forearm. But in lower extremity, fibula is 1/5 of tibia in anatomic and functional point so we can find fibula transposition is commonly used in defect of tibia. We cannot find other article about segmental forearm bone transposition in man. The purpose of this study was to report our clinical and functional result of undergoing segmented transposition of ipsilateral ulna with its own vascular supply in defect of radius in 6 cases. Material and method: From June 1994 to October 2007, 7 segmented bone transpositional grafts in forearm were performed in Kyung Hee Medical Center. The distribution of age was from 20 years old to 73 years old. There was male in 6 cases and female in 1 case. The causes of operation were giant cell tumor in 1 case and traumatic origin in 6 cases; it was nonunion in 2 cases and fracture with severe comminution in 4 cases. Ipsilaterally segmented ulna keeping its own vascular supply was transported to defect of radius in severe traumatic patients and one patient whose tumor in radius had been excised. Transported ulna was fixed to proximal and distal radius remnants by plate and screw. In one case with giant cell tumor, transported ulna was connected to radius across wrist joint as wrist joint fusion. Joint preserving procedures were performed in 6 cases with crushing injury of radius. Results: We could obtain solid bony union in all cases and good functional results. The disadvantage was relative shortening of forearm, but we could overcome this problem. Conclusion: We think that ipsilateral segmented ulna transposition keeping its own vascular supply to radius can be perfomed with one of procedures in cases with wide defect in radius.

• 대한족부족관절학회지
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• 제4권2호
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• pp.72-78
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• 2000

Purpose: To validate the major bony causes and postoperative results of the first metatarsal head plantar pain. Materials and Methods: We experienced one case of the fracture and non-union of the medial sesamoid treated by autogenous calcaneal bone graft, one case of the fracture and non-union and two cases of the hypoplasia of the medial sesamoid treated by excision of medial sesamoid, one case of the arthrosis between the first metatarsal head and the medial sesamoid treated by plantar 1/2 partial excision of the medial sesamoid, and two cases of the metatarsus primus nexus treated by basal metatarsal closing wedge osteotomy between October 1995 and September 1999. The mean follow-up period was 28 months. We evaluated the results by using of the clinical rating systems for the hallux and the radiographic findings. Results: An excellent results were achieved in all cases except one which was preoperatively diagnosed as metatarsus primus nexus. But, clinically this one case also satisfied with the postoperative result. Radiologically, We did not find the malunion or nonunion of the medial sesamoid treated by bone graft and of the metatarsus primus flex us treated by basal metatarsal closing wedge osteotomy. And also we did not find the postoperative fracture of the medial sesamoid treated by plantar 1/2 partial excision. There were no postoperative complications in all cases. Conclusion: We think that the good results may be achieved from the patients with the plantar pain of the first metatarsal head by the exact diagnosis and aggressive treatments.