• Title/Summary/Keyword: Metaphysis

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A CLINICAL COMPARATIVE STUDY BETWEEN ANTERIOR ILIAC AND PROXIMAL TIBIAL METAPHYSIS PARTICULATED CANCELLOUS BONE GRAFTS (장골과 경골의 자가입자망상골 이식에 관한 임상적 비교연구)

  • Oh, Sung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.228-231
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    • 1998
  • This is a clinical and retrospective study of 36 patients received the autogenous particulated cancellous bone grafts from anterior iliac and proximal tibial metaphysis and we compared the clinical postoperative complications in operation sites and donor site morbidity. The results of this study indicate that, in all our patients, the proximal tibia provided an adquate volume of cancellous bone and there were no special contraindications, in choosing and using the proximal tibia as a donor site in most oral and maxillofacial cancellous bone graft surgeries. Furthermore, the proximal tibial metaphysis would appear a more easily obtainable cancellous bone source and offer a superior clinical results than anterior iliac crest in donor site morbidity.

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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 CASE REPORT OF OSTEOCHONDROMA ON MANDIBULAR CONDYLE (하악골 과두에 발생한 골연골종의 치험례)

  • Kim, Mi-Suk;Lee, Mi-Hyang;Jang, Chang-Soo;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.2
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    • pp.298-307
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    • 1996
  • Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and the proximal metaphysis of the tibia, however, is occurred rarely on the facial skeleton. Development of the tumor is most frequently seen in the second or third decades of life. Typically, it arises directly from the cortex of the underlying bone, without any intervening zone of abnormal osseous tissue, and is covered by a cap composed of cartilage undergoing calcification. In case of osteochondroma of the mandibular condyle, its clinical features are occulusal change, facial asymmetry, headache, pain and click on temporomandibular joint, mouth opening limitation, and jaw deviation to involved site. This is a case report of a 13-year old woman who had mouth opening limitation and severe temporomandibular joint pain. We obtained successful results with surgical removal of the osteochondroma on the mandibular condyle.

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Giant osteochondroma of the parapharyngeal space: a case report

  • Kim, Chul-Hwan;Lee, Yoon-Sun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.35-40
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    • 2013
  • Osteochondroma is a common benign tumor of the axial skeleton, especially in the distal metaphysis of the femur and the proximal metaphysis of the tibia, that can occur on the facial skeleton (albeit rarely). Osteochondroma is differentiated from chondroma, osteochondromatosis and osteoma. Osteochondroma shows an irregular radiopaque lesion and chondromatic area surrounded by the osteoma. When it develops in the long bone, it has a marked tendency to occur at 10 to 20 years of age and ceases with the end of pubertal growth. However, when it develops in the mandibular condyle, it is prevalent in the third decade and continuous to develop. Tumors that develop in the long bone have a predilection for men, but tumors in the mandible have a predilection for women. In osteochondroma of the mandibular condyle, clinical features presented include occlusal changes, facial asymmetry, headaches, pain and joint noise on the temporomandibular joint, mouth opening limitations, and jaw deviation at the involved site. The first choice of treatment for the massive osteochondroma is surgical removal. A 70-year-old female patient with an osteochondroma on her right mandibular condyle visited our clinic. We surgically removed the mass with favorable results. It is presented here along with a review of literature on osteochondroma.

IMMEDIATE RECONSTRUCTION USING VERTICAL RAMUS OSTEOTOMY AND BONE SLIDNG AFTER CONDYLECTOMY DUE TO OSTEOCHONDROMA: A CASE REPORT (골연골종으로 인한 과두절제 후 하악지 수직 골절단술 및 bone sliding을 통한 즉시 재건: 증례보고)

  • Jang, Ji-Young;Oh, Jae-Kyung;Cha, Du-Won;Baek, Sang-Heum
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.233-240
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    • 2007
  • Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and proximal metaphysis of the tibia. However, it occurred rarely on the facial skeleton. The coronoid and condylar processes have been considered to be the most common sites of occurrence for osteochondroma of the facial skeleton. The first treatment of osteochondroma is condylectomy, whereas extirpation was done by excision with condyle salvage. Condylectomy presents decrease of vertical dimension, jaw deviation, malocclusion. So, reconstruction is need. Methods of reconstruction are as follows: no reconstruction, condyloplasty, discectomy, costochondral graft, discplication or coronoidectomy, eminoplasty, alloplastic spacer placement, Le Fort I level maxillary osteotomy, extraoral and intraoral vertical ramus osteotomy. This is a case report of a 28-year old woman who had facial asymmetry, malocclusion and temporomandibular joint pain. We obtained moderate functional and cosmetic results with surgical removal of the osteochondroma by condylectomy and concomitant reconstruction of condyle by vertical ramus osteotomy with sliding technique.

Brodie's Abscess on the Distal Tibia caused by Salmonella Infection - A Case Report - (경골 원위부에 발생한 살모넬라 감염에 의한 Brodie 농양 - 1례 보고 -)

  • Kang, Jae-Do;Kim, Kwang-Yul;Kim, Hyung-Chun;Jung, Kyung-Chil;Han, Sang-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.2
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    • pp.97-101
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    • 1998
  • Primary subacute pyogenic osteomyelitis, or Brodie's abscess has received much attention since its initial documentation in the literature in 1832 by Sir Benjamin Brodie. Brodie's abscess is a localized form of chronic osteomyelitis that occurs most often in the metaphyseal area of the long bones of the lower extremities of young adults, Intermittent pain of long duration is the presenting complaint, along with local tenderness over the affected area. Laboratory evaluation is unrevealing, with a normal white blood cell count and differential count. The erythrocyte sedimentation rate may also be normal. Roentgenogram shows a markedly varied appearance and an abscess may be easily mistaken for various neoplasm. The most common organism cultured from abscess is Staphylococcus species. Treatment includes curettage of the lesion and administration of antibiotics. We present a case report (with a 1-year follow-up period), demonstrating the successful surgical treatment of Brodie's abscess of the distal metaphysis of the left tibia caused by Salmonella cholerasuis in a 33-year-0ld male who had no hemoglobinopathy.

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

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.106-111
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    • 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.

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Rickets caused by vitamin D deficiency in calves (송아지에서 비타민 D 결핍에 의한 구루병 증례 보고)

  • Kim, Ji-Hyeon;Lee, Kyunghyun;Jung, Ji-Youl;Yang, Siyeon;Lee, Hyunkyoung;So, ByungJae;Choi, Eunjin
    • Korean Journal of Veterinary Service
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    • v.40 no.4
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    • pp.281-285
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    • 2017
  • Six to seven-month-old 10 beef calves in 140-head beef cattle farm in Gimpo-si, Gyeonggi-do were suffered from ataxia and astasia. Two of them were submitted to Animal and Plant Quarantine Agency for diagnosis in July 9, 2015. At necropsy, the radius and tibia of both calves showed irregular thickening and hemorrhage of the physis in addition to hemorrhage and disruption of trabeculae in metaphysis. Histopathologically the physis showed irregular tongues of cartilage remaining the metaphysis. Disorganization, hemorrhage and fibrosis were observed in metaphyseal and epiphyseal bones. The serum 25-hydroxyvitamin $D_3$ ($D_3$) and calcium levels were lower than normal range. In addition, the serum $D_3$ levels in the other 9 calves of the same farm were lower than normal levels. Based on the pathological examination and serum chemistry measurements, we diagnosed this case as rickets caused by vitamin D deficiency in calves.

Endoscopic-Assisted Curettage of Brodie Abscess in Proximal Tibia - A Case Report - (경골 근위부에 발생한 Brodie 농양에서 내시경을 이용한 소파술 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Choi, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.134-138
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    • 2007
  • Brodie abscess is a localized form of subacute or chronic osteomyelitis which is common in children but may also occur in adulthood. When Brodie abscess is located in the posterior metaphysis of the proximal tibia, open biopsy and curettage have a difficulty in approach to the lesion and can cause neurovascular injury or soft tissue contamination. We report a case wherein a novel surgical technique was used to treat a Brodie abscess in the posterior proximal tibial metaphysis in 48 year-old-male with endoscopic-assisted curettage by commercial anterior cruciate ligament targeting device(Rigid Fix; Mitek, Johnson & Johnson, Norwood, MA). Two portals were created toward the abscess site and, through each portal interchangeably, the granulation tissue and sclerotic bone could be excised. We believe that endoscopic-assisted curettage presents safe technique, decreased morbidity, accurate assessment of the extent of the abscess and possible improvement in long-term outcomes.

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Desmoplastic Fibroma of the Skull

  • Hwang, Sung-Ho;Won, Yu-Sam;Yang, Jae-Young;Choi, Chun-Sik
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.53-56
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    • 2007
  • Desmoplastic fibroma is one of the uncommon osseous tumors that present in the skull. Although classified as benign tumor, desmoplastic fibroma exhibits local aggressiveness and has a high potential for recurrence. The most common sites include metaphysis of long bones and mandible. Only 15cases have been described in the skull. We report the 16th case of desmoplastic fibroma of the skull.