• Title/Summary/Keyword: 교정절골술

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Treatment of Calcaneal Fracture Malunion Using Lateral Exostectomy and Corrective Osteotomy: A Report of Three Cases (외측벽 절제술과 교정 절골술을 이용한 종골 부정유합의 치료: 3예 보고)

  • Noh, Young Min;Kim, Yu Mi;Kim, Sang Yul
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.122-127
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    • 2015
  • Inappropriate treatment for calcaneus fracture may result in malunion causing long-lasting pain and functional deficits. When such complications occur, the ideal principle of management is preserving congruence and motion of adjacent joints. For three patients with calcaneus fracture malunion, subtalar joint-preserving surgery using exostectomy and corrective osteotomy was performed, and satisfactory outcomes were achieved postoperatively.

Computer Simulation based Pre-operative Planning of Fracture Fixation and Deformity Correction (컴퓨터 시뮬레이션 기반 골절고정 및 기형교정수술 예비계획)

  • Kim, Yoon-Hyuk;Kwon, Young-Ha;Heo, Yu
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.06a
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    • pp.698-700
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    • 2003
  • This paper presents a model and analysis techniques for a unilateral external fixator to achieve fracture reduction and deformity correction in long bones precisely. through fixator joint adjustment. Combining the kinematic analysis with a graphic model of the tibia and the fixator allowed 3D simulation and visualization of the adjustments required to reduce fracture or correct bone deformity after osteotomy. The model and analysis technique can be used for fixator evaluation and clinical application planning.

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Modified Mau Osteotomy for the Treatment of Severe Hallux Valgus (중증 무지외반증에서 변형 Mau 절골술을 이용한 치료)

  • Bae, Su-Young;Kim, Young-Eun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.117-120
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    • 2004
  • Purpose: The purpose of this study was to evaluate the effect and short-term results of the modified Mau osteotomy designed by the author. Materials and Methods: Seventeen feet treated with newly designed osteotomy from 2003 to 2004 were included. We performed metatarsal osteotomy and distal soft tissue procedure on 17 feet (12 patients) and additional Akin osteotomy on 6 feet (4 patients). An oblique osteotomy was made from the neck in the dorsum, aiming proximal to the base of the first metatarsal with vertical short arm on the base. We performed long arm of osteotomy parellel to the acrylic plate which was supposed as ground plane. Preoperative radiographs and follow up radiographs at three month were used for radiologic evaluation. Results: Mean hallux valgus angle was $43.6^{\circ}$ and mean intermetatarsal angle was $20.4^{\circ}$ on preoperative weight bearing radiograph. Mean amount of correction of the hallux valgus angle was $37.5^{\circ}$ and intermetatarsal angle was $14.2^{\circ}$ at three months after operation. There was no fixation loss or malunion, and the clinical result was subjectively exellent. Conclusion: More proximal rotational axis can achieve sufficient intermetatarsal angle correction, and vertical arm can provide more stable contact. So this newly modified Mau osteotomy was considered as a good alternative procedure in the treatment of severe hallux valgus.

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A Comparison of the Contact Area between Three Different Correcting Angles after Proximal Crescentic Osteotomy and Ludloff Osteotomy of the First Metatarsal (Preliminary Report) (제1 중족골 근위 반월형 절골술과 Ludloff 절골술 후 교정 각도에 따른 절골편간 접촉 면적 비교(예비보고))

  • Park, Yong-Wook;Jang, Keun-Jong;Park, Sang-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.5-10
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    • 2010
  • Purpose: This study was performed to compare the contact area between three different correcting angles after the proximal crescentic and Ludloff osteotomies of the first metatarsal. Materials and Methods: We used the two sawbone models. Proximal crescentic (PCO) and Ludloff osteotomies (LO) were performed and secured using K-wires under the correcting intermetatarsal angle (IMA) $5^{\circ}$, $10^{\circ}$, and $15^{\circ}$. Then each 6 osteotomized model was scanned five times and measured the contact area using the calculating program. We excluded the highest and lowest values. Results: The mean area of cutting surface was 189 $mm^2$ in PCO, 863 $mm^2$ in LO. The mean contact area (contact ratio; contact area $\times$100/area of cutting surface) of PCO was 149 $mm^2$ (79%) in $5^{\circ}$, 139.5 $mm^2$ (74%) in $10^{\circ}$, 107 $mm^2$ (57%) in $15^{\circ}$ IMA. The mean contact area (contact ratio) of LO was 711 $mm^2$ (82%) in $5^{\circ}$, 535.5 $mm^2$ (62%) in $10^{\circ}$, 330 $mm^2$ (38%) in $15^{\circ}$ IMA. Conclusion: A significant decrease in the contact area and contact ratio according to increase in correcting IMA was noticed in LO. We recommend the PCO rather than LO, when the IMA is needed to correct over $15^{\circ}$.

The Effect of Dwyer's Osteotomy and the 1st Metatarsal Osteotomy for Cavovarus Correction on Radiographic Parameters (요내반족 교정에 있어 드와이어씨 절골술 및 제 1중족골 절골술이 방사선학적 지표에 미치는 영향)

  • Choi, Jun Young;Cha, Seong Mu;Yeom, Ji Woong;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.27-31
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    • 2016
  • Purpose: Several techniques have been introduced for correction of pes cavo-varus deformity. We retrospectively reviewed and compared the data of patients who underwent 1st metatarsal osteotomy alone, Dwyer's osteotomy alone, and 1st metatarsal osteotomy combined with Dwyer's osteotomy to determine the effect on radiographic parameters. Materials and Methods: Data on 28 cases in 27 consecutive patients recruited from 2006 to 2014 who underwent 1st metatarsal osteotomy alone (group F), Dwyer's osteotomy alone (group H), or 1st metatarsal osteotomy followed by Dwyer's osteotomy (group HF) with a minimum 1-year follow-up were reviewed retrospectively. Results: Calcaneal pitch angle on the standing foot lateral radiographs was significantly decreased after the operation in groups H and HF whereas Meary angle was decreased in groups F and HF. Hindfoot alignment angle and ratio on the hindfoot alignment view were improved in groups H and HF. Maximal medial cuneiform height reduction was observed in group HF. 1st ray was significantly shortened in groups F and HF. Conclusion: Combined forefoot and hindfoot operation took the largest correction power of all radiologic parameters.

Tibia Vara Caused by Focal Fibrocartilaginous Dysplasia(FFCD) - Case Report - (국소적 섬유연골성 이형성증(FFCD)에 의한 경골 내반 - 증례 보고 -)

  • Lee, Sang-Soo;Hwang, Ho-Yeun;Lee, Dong-Hee;Nam, Il-Hyun;Paik, Ae-Lan;Sohn, Kyung-Rak;Lee, Sang-Un
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.106-111
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    • 2000
  • Focal fibrocartilaginous dysplasia(FFCD) is an uncommon, benign condition associated with unilateral tibia vara among young children. FFCD has a typical plain radiographic finding, which has a concave radiolucent defect in the metadiaphyseal junction of medial aspect of the proximal tibia. The varus deformity occurs at the site of the lesion. Spontaneous remodeling and resolution of bony defect may be expected, but the corrective osteotomy may also be needed in some cases. The authors described a case of unilateral tibia vara caused by FFCD, diagnosed by excisional biopsy and treated with dome-shaped proximal tibial osteotomy and bone graft.

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Correction of Sesamoid after Proximal Metatarsal Osteotomy and Distal Soft Tissue Procedure in Hallux Valgus (무지외반증 치료에서 근위 중족골 절골술과 원위 연부조직 교정술 후 종자골의 교정정도)

  • Jung, Hwa-Jae;Shin, Hun-Kyu;Chang, Il-Sung;Lee, Jong-Keun
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.74-80
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    • 2005
  • Purpose: A retrospective review of the radiographs of the proximal metatarsal osteotomy and distal soft tissue procedure for hallux valgus, evaluating the correction of the tibial sesamoid, was undertaken. We evaluated the correlation between the reduction of the tibial sesamoid and the clinical outcomes. Materials and Methods: 17 patients (23 cases) with moderate to severe hallux valgus deformity underwent the proximal metatarsal osteotomy and distal soft tissue procedure. The preoperative and last follow-up radiographs were reviewed according to the tibial sesamoid grade classification recommended by the Research Committee of the American Orthopedic Foot and Ankle Society (AOFAS). We divided them into two groups according to the reduction of the tibial sesamoid. We anaylyzed the clinical outcomes in each group according to Mayo Clinic Forefoot Scoring System (FFSS). Results: In all of the patients, the preoperative tibial sesamoid position were grade 2 or greater. At the last follow-up, 52% (n=12) were grade 1 or less (Group I) and 48% (n=11) were grade 2 or greater (Group II). In group I, the forefoot score was improved from preoperative mean value of 32.0 points to final follow-up value of 66.3 points. In group II, the forefoot score was improved from preoperative mean value of 31.7 points to final follow-up value of 65.9 points. There was no statistical significance between postoperative, average scores in group I and II (p>0.05). Conclusion: The position of the tibial sesamoid was corrected insufficiently in almost half of all cases. In view of clinical outcomes, there was no significant difference between the corrected group and the other group.

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Three-Dimensional Corrective Osteotomy for Treatment of Cubitus Varus after Supracondylar Fracture of the Humerus (상완골 과상부 골절후 발생한 내반주 변형에 대한 삼차원 교정 절골술)

  • Kim Poong Taek;Ihn Joo Chul;Kyung Hee Soo;Oh Seung Hoon
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.58-65
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    • 1998
  • Cubitus varus deformity after supracondylar fracture of the humerus in children generally includes deformities of varus, hyperextension and internal rotation. Recently almost all corrective osteotomies for treatment of the varus deformity have been limited to correction of only the varus or of the varus and hyperextension deformity. Electromyographic study has revealed unphysiological joint motion and muscle activity around the joint in elbows with cubitus varus, hyperextension and internal rotation deformity. On this basis we have successfully attempted simultaneous correction of all three deformities. The end results in ] 3 elbows have been satisfactory without any complications such as delayed union, limitation of elbow motion or nerve palsy. In conclusion, we recommend simultaneous correction of the three elements of cubitus varus deformity to restore anatomic alignment of the elbow joint.

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Corrective Osteotomy of Metatarsal Bone for Surgical Treatment of Morton's Neuroma (모턴씨 신경종의 수술적 치료를 위한 중족골 교정 절골술)

  • Chu, Intak;Jang, Hoseong;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.2
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    • pp.58-62
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    • 2015
  • Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

The Results of the First Ray Forefoot Osteotomy Using Low Profile Wedge Plate without a Bone Grafting for Pes Planus Correction (제 1열 전족부 절골술을 통한 평발 교정에 있어 골이식 없이 사용한 소형 쐐기형 금속판의 치료 결과)

  • Choi, Jun Young;Shin, Myung Jin;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.7-11
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    • 2017
  • Purpose: We retrospectively analyzed the radiographic and clinical results after the first ray of forefoot osteotomy using low profile wedge plate without additional cancellous bone grafting for pes planus correction. Materials and Methods: Twenty-four patients were enrolled in this study. Medial cuneiform opening wedge osteotomy was performed in 12 patients (Cotton osteotomy, group C) and first metatarsal base osteotomy was performed in 12 patients (group MT). Results: On average, the wedge size was 5.61 mm (5~6 mm). The mean time to radiographic union was 3.18 and 3.27 months in groups C and MT, respectively. Postoperative talonavicular coverage angle, talo-first metatarsal angle (anteroposterior), talo-first metatarsal angle (lateral), talo-calcaneal angle (lateral), medial cuneiform height, and American orthopaedic foot, as well as ankle society midfoot scale were significantly improved in both groups. Nonunion, delayed union or fixation failure was not presented in our series. Conclusion: We have shown that low profile wedge plate was effective in the case of first ray forefoot osteotomy for pes planus correction without any additional cancellous bone grafting.