• Title/Summary/Keyword: graft union

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A Clinical Study of Free Vascularized Osteocutaneous Fibular Transplantation in Infected Nonunion of Tibia (감염성 경골 불유합에 시행한 혈관 부착 유리 피부편 및 생비골 이식 수술의 임상적 고찰)

  • Song, Joon-Min;Kim, Jin-Ill;Kwon, Hee;Yoo, Jae-Eung;Park, Jong-Suk;Rah, Soo-Kyoon;Choi, Chang-Uk
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.27-36
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    • 2000
  • February 1995 to September 1999, authors have experienced seven cases of infected nonunion of tibial fractures with associated soft tissue injury and skin defect, and have accomplished union in all cases by free vascularized fibular graft. All grafts healed with no radiographic evidence of bone necrosis or resorption and have been able to treat large bony defect and skin defect simultaneously. In this study, five cases of vascularized free fibular osteocutaneous flap transfer and two cases of free fibular graft are reported. All of seven cases were infected nonunion of tibia. The results were obtained as follows 1) The mean duration of the radiologic bone union was average 5.3months. 2) Grafted fibular has been hypertrophied, average 10.6 months. 3) In five cases of preservation of posterior cortex of tibia, bony union and hypertrophy of grafted bone were earlier than that two cases of complete segmental resection of tibia. 4) In two cases which only free vascularized fibular graft were performed because achievement of cutaneous flap was failed, authors found that soft tissue defect was filled with granulation tissue and split-thickness skin graft was possible over the granulation tissue after 3 weeks postoperatively.

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Comparison of osteogenic efficacy depending on implant preparation in autograft (자가골 이식에서 이식골편의 처리방법에 따른 골형성능력 비교)

  • Lee, Jong-Il;Song, Ha-Na;Kim, Nam-soo;Choi, In-hyuk
    • Korean Journal of Veterinary Research
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    • v.47 no.1
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    • pp.117-125
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    • 2007
  • Bone graft had been investigated previously to restore bone defects in orthopedics. The purpose of this study was to investigate the efficacy on new bone formation in bone autografts by treatment of implants. Cortical bone autografts were transplanted to midshaft of diaphyseal fibulae of 9 rabbits which were divided in 3 groups according to the treatment method of implants. Cortical bone implants for graft were treated with 3 different methods; freezing, freeze-drying, defat-freezing. Autografts were achieved by cross-transplantation method to bilateral fibulae of the presented rabbits after implant treatment procedures. The grafted regions of fibulae of all groups had been radiographed biweekly for 16 weeks to observe new bone formation and union between donor and recipient bone in the grafted region. Bone alkaline phosphatase (BALP) in all groups was evaluated biweekly till the end of the experiment to determine osteoblast activities. Unions of the experimental grafted regions were observed at 83% (5 of 6 cases) of freezing, 17% (1 of 6 cases) of freeze-drying and 67% (4 of 6 cases) of defat-freezing autografts, respectively. BALP was increased over 100% after 2 weeks of graft procedures in all union cases (all cases in freezing group and in defat-freezing group, and 1 of 3 in freeze-drying group, respectively), then gradually decreased from 4 th week of graft to 16 th week. In non-union cases, there is no significant variation in BALP value until the end of experiment. It is speculated that defat-freezing method of treatments of implants is more safe to preserve the osteogenic ability in autograft than freeze-drying method.

Comparison of osteoinductive efficacy of freezing, freeze-drying and defat-freezing implant preparation for allograft in rabbit (토끼 동종골이식에서 이식골편의 동결법, 동결건조법, 탈지 후 동결법 처리에 따른 신생골 형성능력 비교)

  • Lee, Jong-Il;Song, Ha-Na;Kim, Nam-soo;Choi, In-hyuk
    • Korean Journal of Veterinary Research
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    • v.47 no.2
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    • pp.219-228
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    • 2007
  • Bone allograft had been increased the need because autogenous bone graft is associated with donor site morbidity and is restricted in quantity. The bone allograft implants have to prepare properly for increasing osteoinductive ability and decreasing immune responses before providing to graft. The purpose of this study was to investigate the efficacy on new bone formation in bone allografts by treatment of implants. Cortical bone allografts were transplanted to experimental defects on midshaft of diaphyseal fibulae in 15 rabbits, which were divided to 3 experimental groups according to the preparation methods-freezing, freeze-drying, defat-freezing. The grafted regions of fibulae of all groups had been radiographed biweekly for 16 weeks to observe new bone formation and union between implant and recipient bone. Bone Alkaline Phosphatase (BALP) in all groups was evaluated biweekly till the end of the experiment to determine osteoblast activities. Unions between implant and recipient bone were observed at 30% (3 of 10 cases) of freezing, 50% (5 of 10 cases) of freeze-drying and 80% (8 of 10 cases) of defat-freezing. BALP was increased over 100% from before graft at 2 weeks of graft procedures in all union cases of freezing and defat-freezing group, then gradually decreased till 16th week. In non-union cases, there is no significant variation in BALP value. Defat-freezing method for allograft implants might be more effective for osteoinductive efficacy of implants than freezing and freeze-drying method.

Vascularized Fibular Graft in the Treatment of Bone Tumor (혈관부착 생비골 이식술을 이용한 골종양의 치료)

  • Han, Chung-Soo;Yoo, Myung-Chul;Chung, Duke-Whan;Lee, Geon-Hee;Lee, Chong-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.171-180
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    • 1995
  • Recently vascularized fibular transfer has been used in the treatment of bone tumor that are more than six centimeter in length. With refinements in microsurgical techniques and understanding of the biological and biomechanical characteristics of vascularized bone graft, the success rate of this procedure was increased. Fifteen bone tumor patients, sixteen cases seen from Apr. 1979 to Jun. 1995 were managed by means of vascularized bone graft at Kyung Hee University Hospital. Ten cases were done intercalary graft and the others were done osteoarticular graft. the ratio of male and female was 6 : 9, and mean age was 20.4 years old at operation. Mean follow up period was 5 years 4 months(range 17 months to 16 years 2 months) and mean graft length was 13.8cm. Duration for union was 5.3 months(range 3 months to 1 year) and over-all rate of union at the last follow up examination was 93.8%. Sufficient hypertrophy of grafted bone was obtained in all cases at the time of last follow up as compared to initial size of grafted bone. Several complications were found such as stress fractures, recurrence. Vascularized fibular transfer for the treatment of bone tumor is a valuable procedure in appropriately selected patients.

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Autogenous Low Heat Treated Bone Graft for Bone Reconstruction in Bone and Soft Tissue Tumors (골연부 종양에서 저온 열처리한 자가골을 이용한 재건술)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Cho, Wan-Hyeong;Kwag, Bong-Jun;Lee, Soo-Yong
    • 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.

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A Study on the Propagation of Lindera erythroearpa Makino (비목나무 번식에 관한 연구)

  • 이동철;심경구;서병기
    • Asian Journal of Turfgrass Science
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    • v.9 no.1
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    • pp.1-10
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    • 1995
  • This study was carried out to investigate the method of propagation of Lindera erythrocarpa Makino. The results were as follows: 1. After the treatment of warm stratification for 1 month followed by cold stratification for 3 months, the germination ratio of seeds of Lindera erythrocarpa was from 84.6 to 93.6 percent. But, dry stored seeds lose their viability Quickly and should be placed in pretreatment im-mediately. Also, the seeds of control district germinated from 68.6 to 74.6 percent. So it was confirmed that the seed of Lindera erythocaeicarpa was not doubly dormant. 2. Softwood cuttings of Lindera erythrocarpa with 5,000 ppm IBA on August 4. 1992 resulted in the best rooting of 95.0 percentage. 3.Twenty percent of the graft union were obtained in the green wood grafting in Lindera erythrocarpa on June 7, 1993. And five percent of the graft union were obtained in the hard wood grafting in Lindera erythrcoar pa on April 6. 1993.

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Some Chip Budding Techniques for Improving the Nursery Performances in Apple Trees (사과나무의 묘목생산성 향상을 위한 몇 가지 깎기눈접 기술)

  • Lee, Jong-Seob;Yoon, Tae-Myung
    • Horticultural Science & Technology
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    • v.19 no.3
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    • pp.352-357
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    • 2001
  • This experiment was carried out in order to develop some chip budding techniques related to the production of high quality maiden apple trees. Optimum chip budding time for apple trees appeared to be from mid-August to early September. Untying wrapping tapes after 6 8 weeks from budding led to higher graft success and better shoot growth than removing the tapes earlier or later than the 6-8 weeks. Dipping pre-cut bud chips into ordinary water of $25^{\circ}C$ for 5 hours did not hamper the graft-success nor the early season growth of the graft compared with non-treated control. Dipping the pre-cut bud-chips into the $35^{\circ}C$ water for 3 hours or for 5 hours hampered the union formation and shoot growth of the 'Fuji' apple trees.

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Stress fracture in Vascularized fibular Grafts (혈관 부착 이식 비골에 발생한 피로골절)

  • Kim, Hyoung-Min;Kim, Youn-Soo;Lee, Kee-Haeng;Jeong, Chang-Hoon;Kim, Jun-Seok
    • Archives of Reconstructive Microsurgery
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    • v.10 no.1
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    • pp.18-22
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    • 2001
  • Purpose : The purpose of this study was to evaluate stress fracture of vascularized fibular grafts(VFG) by analyzing factors associated with stress fracture and the treatment results. Materials and Methods : From June 1985 to May 1998, 7 patients with stress fractures in the 38 patients with long bone defect who had vascularized fibular graft were evaluated with clinical and radiologic methods including grafted fibular length and hypertrophic index of de Boer. The average age of the patients was 35 years(range, $14{\sim}60$ years). The mean follow-up period was 20 months(range, $16{\sim}32$ months). Results: 7(18.4%) stress fractures occurred in 38 patients. Characteristics of the fractures were (1) all occurred at lower extremity of male patients treated with VFG for long bone defected caused by infected nonunion; (2) all occurred 10 months at the average(range, $4{\sim}17$ months) after VFG; and (3) the length and hypertrophic index of grafted fibula had no influence on the incidence of stress fracture. Union was obtained in 3 patients by conservative treatment. 4 patients obtained union by internal fixation; one at immediately onset of fracture; and three after failure of conservative treatment who had fracture around the knee joint. Conclusion : Stress fracture may occur during the first one year after vascularized fibular graft and more attention must be paid for prevention of it, especially in the cases of infected nonunion. Stress fracture around the knee joint was expected to lead to a good result of early union by operative treatment.

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Case Report of Squamous-cell Carcinoma of the Mandibular Gingiva with Invasion of The Bone, Treated by Resection and Tibial Bone Graft (악골결손부에 경골이식술로 성형한 치험예)

  • Kim, Kwang-Hyun;Kim, Hong-Ki;Choi, Mock-Kyun
    • The Journal of the Korean dental association
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    • v.11 no.3
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    • pp.195-198
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    • 1973
  • The authors have treated a squamous-cell carcinoma occurred in molar region of the right mandible in 52-year old woman by means of bony resection and banked tibial bone graft, and made the normal appearance of her face. The result as follow: 1) The healing of a graft is similar to the healing of an uninfected fracture except that it will take considerably longer. It is of the utmost importance that it should be well immobilized, otherwsie there is danger of absorption of bone and fibrous union. 2) Until the graft acquires a blood supply it is easily infected, for it has no defence against organisms, so it is most important to prevent wound infection set in.

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Clavicle Nonunion: Matchstick Bone-grafting and Osteosynthesis

  • Park, Yong Bok;Yoo, Jae Chul;Park, Geun Min;Kum, Dong Ho;Tauheed, Mohammed;Jeong, Jeung Yeol
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.33-38
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    • 2016
  • Background: This study was conducted to evaluate the surgical outcomes of plate fixation using autologous iliac bone graft shaped in the form of a matchstick in clavicle nonunion resulting from prior surgical or non-surgical management. Methods: From May 2005 to February 2013, 17 patients underwent surgery for clavicle nonunion. The mean age at the time of surgery was 48.8 years. The iliac bone was harvested and shaped into slivers approximately 3 cm long, which resembled matchsticks. After opening of the medullary canal, the plate and screws were applied and cancellous bone was placed at the nonunion site. Matchstick bone grafts which were longitudinally placed and encircled on the nonunion site were tied with periosteum using 3-4 stitches. Union was determined via postoperative plane X-ray. Clinical status was evaluated using the visual analogue scale score for pain, and Constant and American Shoulder Elbow Surgeon score. Results: All patients had a stable radiological union at the follow-up. The mean duration from index operation to nonunion operation was 13.2 months (7-32 months). The mean follow-up period was 20.1 months (8-56 months), and the mean duration until union was 11.2 weeks (8-16 weeks). All clinical scores were improved at the final follow-up (p<0.001). The mean segmental defect was $3.3{\pm}2.6mm$ (1-18 mm); and the difference in clavicular length between operative and non-operative site was $5.9{\pm}6.9mm$. Conclusions: Matchstick shaped autologous iliac bone grafting technique in clavicle nonunion is acceptable with a high union rate.