• Title/Summary/Keyword: 부정유합

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Calcaneal Malunion (종골의 부정 유합)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.79-86
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    • 2012
  • Calcaneal fractures account for 2% of all fractures and approximately 60 to 70% of tarsal fractures. These fractures typically are the result of high-energy injury, such as a motor vehicle accident or a fall from a height. The potential for disabling malunion following intrarticular displaced calcaneal fracture is high, regardless of treatment. Fracture displacement typically results in loss of hindfoot height, varus and widening of the hindfoot, with possible subfibular impingement and irritation of the peroneal tendon and/or sural nerve. Frequently, subtalar joint develops posttraumatic arthritis. In symptomatic patients with calcaneal malunion, systemic evaluation is required to determine the source of pain. Nonsurgical treatment, such as activity and shoe modification, bracing, orthoses, and injection, is effective in many patients. Surgical treatment may involve simple ostectomy, subtalar arthrodesis with or without distraction, or corrective calcaneal osteotomy. A high rate of successful arthrodesis and of patient satisfaction has been reported with surgical manamgent.

Late Sequelae of Secondary Haglund's Syndrome after Malunion of Tongue Type Calcaneus Fracture - Report of Three Cases - (설상형 종골 골절의 부정 유합 후에 발생한 Haglund씨 증후군 - 3례 보고 -)

  • Jung, Hong-Geun;Rho, Han-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.1
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    • pp.48-54
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    • 2000
  • Haglund's syndrome produces retrocalcaneal bursitis or achilles tendinitis due to impingement of posterior superior bursal projection of calcaneus on insertional fibers of achilles tendon. Haglund's syndrome has been mainly associated with wearing rigid counter shoes and with athletes. We experienced three case of late sequelae of secondary Haglund's syndrome after malunion of tongue type calcaneus fracture. It is to be the first description of secondary Haglund's syndrome after calcaneus malunion and also the first report as the late complication of calcaneus fractures. Three cases were all tongue type intraarticular fractures and were treated with $45^{\circ}$ superior angle resection of superior calcaneal tuberosity. Clinical results by modified Rowe score were excellent with complete pain relief for all three cases.

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Treatment of Talonavicular Subluxation Accompanied by Calcaneal Malunion (A Case Report) (종골 부정 유합에 동반된 거주상 관절 아탈구의 치료 (1예 보고))

  • Cha, Seong-Mu;Chang, Bo Hoon;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.270-275
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    • 2012
  • There may be complications after comminuted or intraarticular calcaneal fracture regardless of the initial treatment. Transcalcaneal talonavicular dislocation is rarely reported severe form of calcaneal fracture. We experienced a neglected transcalcaneal talonavicular subluxation case, who had been treated for intraarticular calcaneal fracture conservatively. Subtalar distraction bone block fusion was done for calcaneal malunion with talonavicular subluxation. Inspite of successful subtalar fusion, pain was persisted because of talonavicular re-subluxation with arthritis and calcaneocuboid arthritis. So, second operation, the talonavicular and calcaneocuboid fusion, was done. After union achieved, the patient's foot pain was improved. Calcaneal malunion combined with talonavicular subluxation and unstable transverse tarsal joint, such as this case, initial triple arthrodesis could be considered.

CRANIOFACIAL RECONSTRUCTION USING VASCULARIZED OUTER TABLE CALVARIAL BONE FLAP : REPORT OF TWO CASES (혈관화 두개골 외층골피판을 이용한 두개안면부 재건)

  • Kim, Ki-Young;Jeong, Seung-Lyong;Jeong, Joo-Sung;Kim, Chang-Lyong;Lee, Seung-Ho;Park, Mun-Seong;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.546-554
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    • 1996
  • Vscularized calvarial bone flaps have been useful tools in the reconstuction of different type of bone defects in craniofacial surgery Vascularized bone transfer are often preferred to nonvascularized bone grafts because nonvascularized bone grafts are less resistant to infection, not as mechanically strong, and do not survive well in a poorly vascularized bed. Potential advantages of vascularized outer table calvarial bone flap include proximity to the operative field, membranous origin similar to that of the facial skeleton, maleability which allows for a variety of shapes and sizes, inconspicous donor sit scar. The following are the case reports of two patients who underwent craniofacial reconstruction suing vascularized outer table calvarial bone flap.

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Recent Treatment Options for the Clavicle Fracture (쇄골 골절 치료의 최근 경향)

  • Oh, Joo-Han;Choi, Hye-Yeun
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.43-51
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    • 2012
  • Purpose: We sought to determine the appropriate management modality for clavicle fracture through the review of current literature. Materials and Method: This article provides an overview of the knowledge regarding clavicular fracture in adults, including epidemiology, classification, surgical indication, current technique, and results. We also addressed recent debates: the range of the surgical indication for mid-clavicular fracture and the introduction of anatomically precontoured plate as a new treatment modality. Result and Conclusion: Nonsurgical treatment has been regarded as the first choice in the management of clavicle fractures. Quite recently, mounting evidence has shown that adverse outcomes, after a nonsurgical treatment, such as nonunion and malunion, were more prevalent than previously assumed. Accordingly, the indications for surgical fixation appear to be broadening. However, given that the ideal treatment option remains to be determined, the appropriate treatment of clavicle fractures should be tailored based on careful assessment of individual patient's data and preference.

CORRECTION OF SECONDARY LIP DEFORMITIES IN CLEFT PATIENTS (구순열 환자의 이차 구순 성형술)

  • Kim, Jong-Ryoul;Byun, June-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.4
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    • pp.401-406
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    • 1999
  • Secondary deformities of the lip and nose in individuals with repaired unilateral and bilateral clefts may vary in severity, depending on the state of the original defect, the care taken in the initial surgical procedure, the pattern of the patient's facial growth, and the effectiveness of interceptive orthodontic technique. Because each patient has a unique combination of deformities, their surgical reconstruction usually requires the modification and combination of several surgical techniques. Residual lip deformities after primary repair may be esthetic or functional and include scars, skin shortage or excess(vertical and transverse), orbicularis oris muscle malposition or diastasis. The key to accurate repair of secondary cleft lip deformities is a precise diagnosis. This requires observation of the patient in animation and repose. The quality of the scar is not the only factor determining the overall appearance of the lip. Observing the patient in the animated position is critical to assess muscular function. Factors that require precise analysis include lip length, the appearance of the Cupid's bow and philtrum, and nasal symmetry. Only after this detailed analysis can a decision be made as to wether a major or minor deformity exists. We report successful cases using various techniques for the secondary lip deformities.

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RECONSTRUCTION COMBINED WITH HBO THERAPY AND ILIAC BONE GRAFT IN MANDIBULAR FRCTURE SITE OSTEOMYELITIS (하악골 골절후 이차감염으로 인한 골수염시 유리 장골 이식술과 고압산소 요법을 이용한 재건 치험례)

  • Kim, Su-Nam;Lee, Dong-kuen;Lim, Chang-Joon;Yun, Seong-Pill
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.110-116
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    • 1991
  • Fracture site osteomyelitis begins rarely with an acute event but rather has a subacute onset. It develops almost exclusively in the mandibular region. The treatment principles of mandibular fracture site osteomyelitis are complete removal of inflammatory tissue and drainage, rigid fixation with or without autogenous bone bone graft and specific antibiotic therapy. But hyperbaric oxygen used as a modality in the treatment of intractable osteomyelitis. In this paper, we reported that the three patients who have osteomyelitis accompying secondary in fection after mandibular fracture.

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A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture (쇄골 간부 골절의 최소 침습적 경피적 금속판 고정술과 관혈적 수술 비교)

  • Yoo, Seong-Ho;Kang, Suk-Woong;Kim, Bu-Hwan;Song, Moo-Ho;Kim, Yeong-Joon;Park, Gyu-Taek;Kwack, Chang-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.1-6
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    • 2017
  • Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.

Occlusal rehabilitation of post-traumatic malocclusion patient after reduction of panfacial fracture, using selective occlusal adjustment and implant prostheses on centric relation: a case report (다발성 안면 골절의 정복 후 발생한 부정교합 상태의 환자를 중심위에서 선택적 교합 조정 및 임플란트 보철수복으로 교합관계를 회복시킨 증례)

  • Dae-Kyun Kim;So-Young Park;Jung-Jin Lee;Yeon-Hee Park;Kyoung-A Kim;Jae-Min Seo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.204-213
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    • 2023
  • Invasive or non-invasive reduction of fractures could be conducted as treatments of traumatic maxillofacial bone fractures. But when suboptimal reduction or malunion of maxillofacial bone fracture occurs, malocclusion could occur as a result of the lost relationship of the mandible and midface. This malocclusion is called post-traumatic malocclusion and orthognathic surgery, orthodontic treatment, selective grinding and prosthetic reconstruction are suggested as treatments for post-traumatic malocclusion after securement of stable TMJ. Stable TMJ is essential for occlusal rehabilitation to prevent occlusal change and relapse of malocclusion. Centric relation and adapted centric posture are suggested as start points of occlusal rehabilitation because they are most stable TMJ position. This case report presents a case in which post-traumatic malocclusion occurred after reduction of panfacial fracture. To rehabilitate full mouth occlusion, selective grinding and prosthetic reconstruction of implant supported fixed prostheses were conducted in centric relation and showed satisfying results in functional and occlusal aspects.

Comparison of Results Between Immediate Fixation Group and Delayed Reconstruction Group in Displaced Mid-shaft Fractures of the Clavicle (쇄골 전위성 간부 골절에서 조기 고정술 군과 지연 재건술 군 간의 결과 비교)

  • Kim, Doo-Sub;Rah, Jung-Ho;Yoon, Yeo-Seung;Lee, Chang-Ho
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.61-66
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    • 2009
  • Purpose: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. Materials and Methods: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. Results: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. Conclusion: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options.