• 제목/요약/키워드: femoral osteotomy

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Oblique Single-Cut Rotation Osteotomy for Correction of Femoral Varus-Torsional Deformities in 3D-Reconstructed Canine Bone Models

  • Kim, Hyeon-Ho;Roh, Yoon-Ho;Lee, Je-Hun;Jeong, Jae-Min;Jeong, Seong Mok;Lee, Hae Beom
    • 한국임상수의학회지
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    • 제37권4호
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    • pp.180-184
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    • 2020
  • The purpose of this study was to report the reliability and validity of oblique single-cut rotation osteotomy (OSCRO) in 3D-reconstructed canine bone models with femoral varus and torsional deformities. A healthy adult male beagle was recruited to create a 3D bone model, and this bone model was modified by using a 3D program. Fifteen bone models were constructed for this study. OSCRO simulation was performed in accordance with the plan after printing using a 3D printing machine. The anatomical lateral distal femoral angle (aLDFA), anteversion angle (AA), anatomical caudo-distal femoral angle (aCdDFA), mechanical caudo-distal femoral angle (mCdDFA) and pre- and postoperative bone length were calculated. There were no significant differences between the target values and postoperative values. In addition, the difference between pre- and postoperative bone length was small (p = 0.001). Our findings suggest that OSCRO could be an effective surgical option for MPL with bone deformities in small-breed dogs that often undergo conventional distal femoral osteotomy.

Clinical Results of Distal Femoral Osteotomy for Treatment of Grade 4 Medial Patella Luxation with Concurrent Distal Femoral Varus in Small Breeds Dogs: 13 Cases

  • Roh, Yoon-Ho;Jung, Jin-Ho;Lee, Je-Hun;Jeong, Jae-Min;Jeong, Seong Mok;Lee, HaeBeom
    • 한국임상수의학회지
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    • 제37권3호
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    • pp.135-140
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    • 2020
  • The purpose of this study was to determine the outcome of distal femoral osteotomy for distal femoral varus and medial patellar luxation (MPL) grade 4 in small-breed dogs. Radiographs and medical records were reviewed to collect data and plan the surgery in small-breed dogs with MPL grade 4. Computed tomography (CT) imaging was also performed in cases of severe bone deformities. Signalment, weight, medial patellar luxation and lameness grade, radiographic bone union, complications, pre- and postoperative femoral varus angle, passive range of motion, static weight bearing distribution and visual analogue scale scores were recorded. Thirteen corrective distal femoral osteotomies were performed with ancillary and additional procedures in 9 dogs; 4 dogs had staged bilateral procedures; and four stifles were suspected to have partial or complete rupture of the cranial cruciate ligament. One stifle underwent patellar groove replacement. The mean ± SD pre- and postoperative femoral varus angles were 109.15°± 3.71° and 96.30°± 2.97°, respectively. Significant improvements in passive range of motion, thigh circumference and visual analogue scale (VAS) scores were observed. There was no reluxation of the patella. This study suggests that distal femoral osteotomy with traditional and additional procedures provided satisfactory outcomes in patient healing and functional recovery in small-breed dogs with excessive femoral varus angles.

개에서 Propionyl Promazine과 Ketamine HCI의 투여 및 대퇴골두절단술이 림프구 유약화능에 미치는 영향 (Effect of the Administration of Propionyl promazine and ketamine HCI and Osteotomy of Femoral Head on the Lymphocyte Blastogenesis in Dogs)

  • 연성찬;권오경;남치주
    • 한국임상수의학회지
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    • 제10권1호
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    • pp.47-54
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    • 1993
  • To investigate the effects of sedation, anesthesia and surgery on lymphocyte blastogenesis, the administration of propionyl promzine and ketamine HCI and osteotomy of femoral head either alone of in combination were performed in dogs. Lymphocyte blastogenesis to the PHA-M stimulation was measured by counting $^3H-thymidine$ incorporated. Significant decrease of blastogenesis was observed until 72 hours after treatment in the group treated with propionyl proazine, but only at 4 hours in the group treated with ketamine HCI. In the group in which anesthesia and osteotomy of femoral head were performed blastogenesis decreased significantly until 24 hours after treatment. The present study indicated that transient depression of the lymphocyte blastogenesis after surgery was occurred due to the sedation and anesthesia as well as surgery itself.

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퇴행성 골관절염 환자에서 시행한 근위 경골 절골술 후 대퇴골의 회전과 임상결과의 상관관계 (Correlation between femoral rotation and clinical results after high tibial osteotomy in primary osteoarthritis patient)

  • 박상은;문상원
    • 대한정형외과스포츠의학회지
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    • 제10권2호
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    • pp.100-104
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    • 2011
  • 이 연구의 목적은 근위 경골 절골술 후 대퇴골의 회전각도와 슬관절 운동범위 및 주관적 환자 만족도 사이의 상관 관계를 분석하는 것이다. 2004년 6월부터 2008년 8월까지 고위 경골 절골술을 시행한 15명의 원발성 골 관절염 환자들이 연구 대상으로 수술 전 후 슬관절 CT를 시행하였다. 9명은 여자였으며 6명은 남자였다. 수술 전 후 슬관절의 CT를 촬영하여 대퇴골 회전 각도(TEA (Fig. 1) 및 Akagi's line (Fig. 2)으로 측정)를 백분율로 환산하여 분석하였으며 수술 후 슬관절 운동 각도와 주관적 만족도(Lysholm)의 상관관계를 확인하였다. 통계적 기법은 Kendall's 및 Spearman's nonparameter correlation coefficient 로 검정하였다. 결과상 대퇴골회전 정도와 수술 후 슬관절의 운동 각도는 의미 있는 상관 관계가 없으며 대퇴골 회전 정도와 수술후 환자의 주관적 만족도와는 의미 있는 상관 관계가 있었다. 따라서 이런 점을 알고 수술적 계획을 세운다면 보다 좋은 임상결과를 얻을 수 있을 것이다.

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개에서 대퇴골두 제거술 후 전침 자극이 통증완화에 미치는 영향 (Analgesic Effect of Electroacupuncture after Femoral Head Osteotomy in Dogs)

  • 최인영;정종태;신태균;이주명
    • 한국임상수의학회지
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    • 제21권4호
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    • pp.374-397
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    • 2004
  • This experiment was designed to investigate the analgesic effect of non-invasive electroacupuncture treatment on femoral head osteotomy in dogs. Twelve dogs were divided into 3 groups in this experiment. Electroacupuncture group was non-invasively electrostimulated in Huan Tiao (GB-30) acupoint for 10 minutes by 4.5V, 5Hz for 10 days. Medication group was treated with carprofen (4mg/kg, P.O.) for 10 days. Control group was not treated. Each group was pre-operatively and post-operatively scored by using VAS (Visual Analogue Scale), SDS (Simple Descriptive Scale), NRS (Numerical Rating Scale), and measured serum cortisol levels. The results of VAS, SDS and NRS in electroacupuncture and medication groups were better than those of control group. And, the results of electroacupuncture group were better than those of medication group since 6th day after osteotomy in pain management(p<0.05). But, there were no significances in serum cortisol level among 3 groups. In conclusion, non-invasive electroacupuncture treatment showed sufficient analgesic effect on postoperative pain management after femoral head osteotomy, and VAS, SDS, and NRS scoring system would be adapted in evaluation of pain management.

대퇴골두 무혈성괴사의 치료에서 전방 회전 절골술의 조기 추시 결과 (The Early Result of Anterior Rotational Osteotomy in the Treatment of Osteonecrosis of the Femoral Head)

  • 김세동;신덕섭;장우석
    • Journal of Yeungnam Medical Science
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    • 제11권2호
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    • pp.284-292
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    • 1994
  • 1992년 12월부터 1994년 6월까지 영남대학교 의과대학 부속병원 정형외과에 내원한 대퇴골두무혈성 괴사 환자 28명, 31 고관절에 대해 시행한 경전자간 회전 절골술의 결과는 다음과 같다. 1. 대상 환자는 한명을 제외하고는 모두 남자였으며, 평균 연령은 44.3세로 삼, 사십대가 대부분이었다. 2. 무혈성 괴사의 원인은 과다한 음주에 의한 것이 18례로 가장 많았고, 괴사의 정도는 Ficat와 Arlet의 분류에 의하면 II a가 16례로 가장 많았다. 3. 절골술 후 고정 방법으로는 screw가 15례, DHS가 16례였고, 고정 방법에 따른 대퇴경간각의 변화로는, screw를 사용한 경우는 술전에 비해 내반고 되는 경향을 보였고, DHS를 사용한 경우는 외반고 되는 경향을 보였다. 4. 술전 대퇴골두 측면 방사선 사진에서 측정한 대퇴골두 전체 관절면에 대한 건전한 관절면의 비는 1/3이하가 8례, 1/3 이상이 23례(74%)이었다. 5. 술후 고관절의 전후면 방사선 사진에서 측정한 비구의 체중 부하면에 대한 전위된 건전한 대퇴골두의 관절면 비는 36% 이상이 24례(78%), 21-35%가 6례, 20% 이하가 1례였다.

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One-stage Hip Reconstruction for Developmental Hip Dysplasia in Children over 8 Years of Age

  • Qadir, Irfan;Ahmad, Saeed;Zaman, Atiq uz;Khan, Chirag Muhammad;Ahmad, Shahzad;Aziz, Amer
    • Hip & pelvis
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    • 제30권4호
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    • pp.260-268
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    • 2018
  • Purpose: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). Materials and Methods: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015. The average age at surgery was $11.02{\pm}3.43$ years. According to the Tonnis classification, there were 10, 14, 22, and 31 patients in grades 1, 2, 3, and 4, respectively. The pelvic procedure utilized in this study was triple osteotomy (47 hips) followed by double and Salter osteotomy (18 and 12 hips, respectively). Postoperative evaluations were conducted using the modified MacKay's scoring system (functional outcomes) and Severin's scoring method (radiological assessment). Results: Postoperatively, there were 38 (49.4%), 19 (24.7%), 14 (18.2%), and 6 (7.8%) hips in Severin grade I, II, III and IV, respectively. According to the modified McKay criteria, there were 22 hips (28.6%) in excellent condition, 44 (57.1%) in good condition, 9 (11.7%) in fair condition and 2 (2.6%) in poor condition. Both patients with poor outcomes had an unstable, painful hip with evidence of avascular necrosis of the femoral head. Conclusion: Based on the results presented here, we recommend the single stage procedure of open reduction, femoral shortening and pelvic osteotomy for treatment of DDH in older children with good to excellent functional and radiological outcomes.

대퇴골 주요축의 3차원 모델링에 의한 전염각의 측정 (The Measurement of Femoral Neck Anteversion by 3D Modeling of Femoral Major Axes)

  • 김준식;김선일
    • 대한의용생체공학회:의공학회지
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    • 제19권4호
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    • pp.341-350
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    • 1998
  • 대퇴 전염각의 정확한 측정은 뼈를 절개하여 각을 조절하는 시술(derotation osteotomy)에 있어서 매우 중요하다 대퇴 전염각을 정확히 측정하기 위해서는 대퇴골 장축과 목축, 관절구축의 정확한 선정이 필수적이다. 기존의 2차원 영상에 의한 대퇴 전염각의 측정 방법은 간단하지만 3차원 공간상에서 축들을 결정하기 모호한 단점을 가지고 있고, 3차원 영상을 이용하는 방법은 뼈를 밖에서 직접 측정하는 것과 같은 결과를 얻을 수 있어 2차원 방법보다는 정확한 측정이 가능하나 처리과정이 복잡하고 정량적이고 객관화된 결과를 얻는 것이 어려운 문제점을 가지고 있다. 본 연구에서는 대퇴골을 3차원으로 모델링하여 정량적이고 객관적인 대퇴 전염각의 측정법을 제시한다. 이것은 먼저 촬영된 슬라이스 영상들을 3차원상에서 재구성한 뒤, 대퇴골두와 목 모델로부터 대퇴골 목축을 정하고, 대퇴 관절구 모델로부터 대퇴 관절구축을 결정한다. 또한, 대퇴골 주축을 원통으로 모델링하여 장축을 결정한다. 대퇴 전염각은 대퇴관절구의 접평면에 대한 대퇴골축의 기울어진 정도로 정의되며, 이 정의를 이용하여 대퇴 전염각을 구한다. 결과에서 20명 CT영상으로부터 대퇴골 샘플을 측정하여 기존의 2차원 및 3차원 영상법의 결과와 비교하여 제시한 방법이 객관적이고 정확한 측정방법임을 검증한다.

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Spontaneous Femoral Capital Physeal Fracture with Proximal Tibial Epiphyseal Dysplasia in a Cat

  • Yoo, Saejong;Kim, Dae-Hyun;Lee, Yunsub;Yeo, Seungyeob;Kim, Hwi-Yool
    • 한국임상수의학회지
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    • 제36권2호
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    • pp.112-115
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    • 2019
  • An 11-month-old, 5.6 kg, grade 4 on a 5-point scale body condition score, castrated male Korean short hair cat was presented with right hindlimb lameness for 3 days without trauma. On physical examination, severe pain with crepitation was elicited at the hip region but not at the stifle. Radiographic examination and computed tomography revealed a Salter-Harris type 1 fracture of the femoral capital physis and dysplasia of the proximal tibial epiphysis. Spontaneous femoral capital physeal fracture was suspected and femoral head and neck osteotomy was performed. Treatment for proximal tibial dysplasia was not performed. On histopathologic examination of femoral head, a cluster of chondrocytes in a proliferative zone at the epiphyseal plate was observed. Therefore, spontaneous femoral capital physeal fracture was diagnosed. The patient recovered his gait, and no related clinical signs were observed during 6 months of follow-up.

세 마리의 소형견에서 대퇴 단축 절골술에 의한 4단계 내측 슬개골 탈구의 치료 증례 (Treatment of Grade IV Medial Patellar Luxation by Femoral Shortening Osteotomy in Three Small-Breed Dogs)

  • 강병재;류다은;김용선;이승훈;윤대영;김완희;권오경
    • 한국임상수의학회지
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    • 제31권5호
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    • pp.421-424
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    • 2014
  • 세 마리의 소형견이 4단계의 내측 슬개골 탈구로 내원하였다. 세 마리 모두에서 일반적인 기존 수술 방법으로는 슬개골 탈구가 환납되지 않았다. 따라서 슬개골 탈구를 교정하기 위해 대퇴 단축 절골술이 실시되었다. 수술 후에 세 마리 모두 임상 증상이 개선되었고 합병증이나 재발은 확인되지 않았다. 대퇴 단축 절골술은 심한 골격 기형과 관련된 내측 슬개골 탈구가 있는 소형견에서 효과적인 치료 방법으로 고려될 수 있다.