• 제목/요약/키워드: epiphysis

검색결과 71건 처리시간 0.022초

소아의 대퇴골 원위부 골단에 발생한 혈관종 (Juvenile Hemangioma Occurred in Distal Femoral Epiphysis)

  • 김태승;이창훈;박찬금
    • 대한골관절종양학회지
    • /
    • 제16권1호
    • /
    • pp.37-41
    • /
    • 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.

A radiographic study of growth plate closure compared with age in the Korean native goat

  • Choi, Hojung;Shin, Heejae;Kang, Sangkyu;Lee, Heechun;Cho, Jongki;Chang, Dongwoo;Lee, Youngwon;Jeong, Seong Mok;Park, Seongjun;Shin, Sang Tae
    • 대한수의학회지
    • /
    • 제46권3호
    • /
    • pp.285-289
    • /
    • 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.

혈관부착 근위비골성장판 이식시 공여부 수술의 새로운 술식 (New Surgical Technique for Harvesting Proximal Fibular Epiphysis in Free Vascularized Epiphyseal Transplantation)

  • 정덕환
    • Archives of Reconstructive Microsurgery
    • /
    • 제5권1호
    • /
    • pp.106-111
    • /
    • 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.

  • PDF

전방십자인대 손상으로 인한 슬관절 불안정성에 따른 경골 골단 해면골 미세구조 변화 : 내방과 외방에서의 해면골 미세구조 패턴 변화 (Alteration of Trabecular Bone Microarchitecure at Tibial Epiphysis due to Knee Joint Instability by Anterior Cruciate Ligament Rupture: Difference between Medial and Lateral Part)

  • 이주형;전경진;김한성;임도형
    • 대한의용생체공학회:의공학회지
    • /
    • 제33권2호
    • /
    • pp.78-88
    • /
    • 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.

소아 경골 원위 골단부 삼면 골절의 경피적 나사못 고정술과 Ilizarov 외고정 장치를 이용한 치료 (Percutaneous Fixation with Cannulated Screws and Ilizarov External Fixator in Triplane Fracture of the Distal Tibial Epiphysis in Children)

  • 현윤석;김갑래;이광남;이은수
    • 대한족부족관절학회지
    • /
    • 제12권2호
    • /
    • pp.180-184
    • /
    • 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.

  • PDF

소아 상완골 원위부 골단의 골절 및 분리 (Fracture-Separation of the Distal Humeral Epiphysis in Children)

  • 구자웅;김세동;안종철
    • Journal of Yeungnam Medical Science
    • /
    • 제8권2호
    • /
    • pp.121-127
    • /
    • 1991
  • 상완골 원위부 골단의 골절 및 분리 7례를 장기 추시하여 분석한 결과를 요약하면 다음과 같다. 세밀한 이학적 검사와 방사선 검사로 상완골 외과 골절이나 주관절 탈구와 감별진단이 필요하며, 정확한 진단에서 치료를 시도하는 것이 바람직할 것으로 사료된다. 치료는 골절의 정복 상태를 객관적이고 정확하게 평가할 수 있는 방법이 없어 어려우나 저자들의 경우 보존적인 치료로서 비교적 좋은 결과를 얻었다.

  • PDF

연골 모세포종 - 골단과 견인골단의 비교 - (Chondroblastoma of Bone - Comparison of Epiphysis and Apophysis -)

  • 이승환;이모세;신규호;한수봉
    • 대한골관절종양학회지
    • /
    • 제14권1호
    • /
    • pp.17-24
    • /
    • 2008
  • 목적: 연골 모세포종은 드문 원발성 양성 골종양으로 대부분이 장관골의 골단에 호발하는 것으로 알려져 있다. 본 연구에서는 19례의 환자를 대상으로 골단과 견인골단에 발생한 연골모세포종을 비교 분석하고자 하였다. 대상 및 방법: 1987년 8월부터 2005년 8월까지 연골모세포종으로 치료 받은 19례의 환자를 대상으로 하였으며 평균 추시기간은 5년이었다. 발생 연령은 평균 17.6세였으며 남자가 15명, 여자가 4명이었다. 수술적 치료로는 소파술, 소파술 및 골이식술, 소파술 및 시멘트 충전술을 시행하였다. 후향적 연구 방법을 통해 골단과 견인골단에 발생한 연골 모세포종에서 발생 연령, 증상의 기간, 종양의 크기, 성장판의 개폐여부, 병적골절여부, 재발여부 및 동맥류성 골낭종의 동반여부 등의 차이를 분석하였다. 결과: 발생부위는 골단이 11례, 견인골단이 8례였다. 골단에 발생한 경우는 대퇴골 원위부가, 견인골단은 대퇴골 대전자가 가장 많았다. 평균 발생 연령은 골단이 14.2세, 견인골단이 22.3세로 통계적으로 유의한 차이를 보였다. 골단에 발생한 11례중 3례에서는 성장판 유합후에 발생하였으며, 견인골단에서는 전례(100%)에서 유합후에 발생하여 통계적으로 유의한 차이가 있었다. 종양의 크기는 견인골단에 발생한 경우 통계적으로 유의하게 큰 것으로 나타났다. 결론: 연골 모세포종은 주로 장관골의 골단에 호발하는 것으로 알려져 있으나 20세 이상에서는 견인골단에서 주로 발생하여 진단에 주의를 요한다. 두 그룹간 발생 연령, 성장판의 개폐여부 및 종양의 크기가 통계적으로 유의한 차이가 있었으며 증상의 기간, 병적골절, 재발, 동맥류성 골낭종의 동반여부에는 차이가 없는 것으로 나타났다.

  • PDF

전완원위부 변형에 대한 혈관부착 성장판 이식술 (Long-Term Result of the Epiphyseal Transplantation in Distal Forearm)

  • 정덕환;한정수;유명철;한수홍
    • Archives of Reconstructive Microsurgery
    • /
    • 제4권1호
    • /
    • pp.16-22
    • /
    • 1995
  • We analyzed 11 children who underwent epiphyseal transplantation to the forearm for manage growing deformity ranged from 2 years 6 months to years(average 5 years 10 months) follow-up period. Etiologies of the functional impairment of the eleven were five traumatic, three congenital and three tumorous conditions. Lesions of epiphysis were distal radius in eight patients and distal ulna in three patients. Operation was performed with removal of non-functioning or deformed epiphysis followed by transplantation of free vascularized proximal fibular epiphysis with microvascular anastomesis. Evaluation was performed radiologically and functionally. The 9(81.8%) patients showed growth of transplanted epiphysis by radiological examination during follow up. At the last follow up, average growth rate was 0.86cm per year excepts 2 cases of no growth. Active wrist motion near normal to contralateral joint was achieved in 7 patients. In other 2 patients, active joint motion was improved but weaker than contralateral joint. Complications on donor site were two transient peroneal nerve palsy which have been resolved after 2 and 5 months post operation and one valgus ankle deformity. The ankle deformity was corrected with $Langenski\"{o}ld$ operation of the dital tibiofibular fusion. At recipient site, there was one superficial infection and it was easily controlled by systemic antibiotics. Many subsequent reports have described successful nonvascularized epiphyseal transplante, but overall results have been inconsistent and unsatisfactory. Other experimental and clinical studies in the transfer of vascularized epiphyses has encourage its clinical application. We also could gel successful growth in several cases with free vascularized epiphyseal transplantation.

  • PDF

두개인두종 치료 후 발생한 범뇌하수체기능저하증과 동반된 양측 대퇴골두골단분리증 (Panhypopituitarism due to craniopharyngioma with bilateral slipped capital femoral epiphysis)

  • 김선우;송영진;최은정;한동희;정현연;유성훈;유형준;유재명
    • Journal of Yeungnam Medical Science
    • /
    • 제31권1호
    • /
    • pp.61-64
    • /
    • 2014
  • Craniopharyngiomas are rare primary intracranial tumors. Despite their benign histological appearance, they are often associated with an unfavorable prognosis. The typical manifestations upon diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, disturbance of pubertal development, and significant weight gain. The treatment options include radical surgery or radiotherapy, or a combination of these modalities. Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder. SCFE occurs when the capital femoral epiphysis displaces posteriorly on the femoral neck at the level of the physis. The etiology of SCFE is thought to be multifactorial and may include obesity, growth surges, and less common endocrine disorders. The related endocrine disorders include hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Reported herein is a case of panhypopituitarism caused by craniopharyngioma combined with SCFE.

생쥐 대퇴골단(大腿骨端) 골형성(骨形成)에 관(關)한 전자현미경적(電子顯微鏡的) 연구(硏究) (The Fine Structure of the Femoral Epiphysis of Growing Mouse: Endochondral Osteogenesis)

  • 윤재룡;김용주;오창석
    • Applied Microscopy
    • /
    • 제24권1호
    • /
    • pp.59-76
    • /
    • 1994
  • Fine structure of the distal femoral epiphysis of growing mouse was studied by electron microscopy. The first morphological evidence of developing secondary center of ossification in the distal femoral epiphysis was found at newborn mouse. Ossification center was in the form of multiple foci of calcification and its cells were represented by remnant of degenerated cells within large lacunae that were separated by mineralized cartilaginous septa. Endochondral ossification beneath the articular cartilage proceeded in a less orderly manner than metaphyseal endochondral ossification. Columns of hypertrophied chondrocytes were not distinctly parallel to intercellular mineralized septa in all direction. Hypertrophied chondrocytes in the inner zone of the epiphseal center of ossification showed disintegrated. Resorption of mineralized cartilaginous septa was undertaken by perivascular cells and multinucleated chondroclasts. Resorption of the calcified cartilage was restricted to the region of ruffled border of the chondroclast. Growth along the metaphyseal side of the epiphyseal center of ossification was different from that along the articular surface. As the secondary center expanded toward the metaphyseal side, many vascular buds penetrated unmineralized cartilaginous septa and invaded viable chondrocytes. Many hypertrophied chondrocytes bodering the metaphyseal side of bone center remained viable after they became embedded in mineralized cartilaginous septa. This result suggested that the hypertrophied.

  • PDF