• Journal of Korean Foot and Ankle Society
• /
• v.19 no.2
• /
• pp.58-62
• /
• 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.

• Journal of Veterinary Clinics
• /
• v.33 no.6
• /
• pp.385-388
• /
• 2016

A 2-year-old, castrated male Chihuahua dog was referred for revision surgery for reluxation of the patella following surgery for medial patellar luxation (MPL) of the left stifle joint. On general inspection, the patient showed bilateral hindlimb weight-bearing lameness. On physical examination, bilateral non-reducible MPL was detected through palpation. Radiographs revealed bone deformities of both hindlimbs. Computed tomography (CT) was applied for a three-dimensional (3D) printing bone model to establish an accurate surgical plan. The bone plate was pre-contoured over the 3D-printing bone model after execution of corrective osteotomy and sterilized prior to use in surgery. Corrective osteotomy was performed through a staged, bilateral procedure. The patient showed improvement of limb function following surgery without reluxation of the patella. The use of 3D-printing bone model for accurate surgical planning of corrective osteotomy appears to be effective in increasing the accuracy of surgery. That may lead to successful surgical outcomes.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.1
• /
• pp.60-64
• /
• 2015

Objective : To present the incidence and management of dural tears and cerebrospinal fluid leakage during corrective osteotomy [Pedicle Subtraction Osteotomy (PSO) or Smith-Petersen Osteotomy (SPO)] for ankylosing spondylitis with kyphotic deformity. Methods : A retrospective study was performed for ankylosing spondylitis patients with fixed sagittal imbalance, who had undergone corrective osteotomy (PSO or SPO) at lumbar level. 87 patients were included in this study. 55 patients underwent PSO, 32 patients underwent SPO. The mean age of the patients at the time of surgery was 41.7 years (21-70 years). Of the 87 patients, 15 patients had intraoperative dural tears. Results : The overall incidence of dural tears was 17.2%. The incidence of dural tears during PSO was 20.0%, SPO was 12.5%. There was significant difference in the incidence of dural tears based on surgical procedures ( PSO vs. SPO) (p<0.05). The dural tears ranged in size from 12 to $221mm^2$. A nine of 15 patients had the relatively small dural tears, underwent direct repair via watertight closure. The remaining 6 patients had the large dural tears, consequently direct repair was impossible. The large dural tears were repaired with an on-lay graft of muscle, fascia or fat harvested from the adjacent operation site. All patients had a successful repair with no patient requiring reoperation for the cerebrospinal fluid leak. Conclusion : The overall incidence of dural tears during PSO or SPO for ankylosing spondylitis with kyphotic deformity was 17.2%. The risk factor of dural tears was complexity of surgery. All dural tears were repaired primarily using direct suture, muscle, fascia or fat graft.

• Journal of Korean Foot and Ankle Society
• /
• v.19 no.3
• /
• pp.122-127
• /
• 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.

• Clinics in Shoulder and Elbow
• /
• v.19 no.1
• /
• pp.43-47
• /
• 2016

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.2
• /
• pp.43-49
• /
• 2017

Hallux valgus is a deformity characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. When planning an operative treatment, it is important to realize that the deformity is tridimensional and diverse. Operative techniques include medial eminence resection, distal soft tissue procedure, first metatarsal osteotomy (distal, diaphyseal, proximal, or multiple), proximal phalanx osteotomy, arthrodesis (first metatarsophalangeal or metatarsocuneiform joint), and so on. Among these techniques, osteotomy is the main procedure for correcting the hallux valgus. The objective of this article is to describe the characteristics and recent advancements made for corrective osteotomies in the hallux valgus. The pathophysiology of the hallux valgus is also described.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.499-530
• /
• 2010

Purpose: Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. Methods: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously. Results: This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw. Conclusion: This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

• Archives of Plastic Surgery
• /
• v.34 no.2
• /
• pp.243-249
• /
• 2007

Purpose: Posttraumatic nasal deformities might not be corrected adequately by conventional osteotomy techniques when the configuration of the nasal bone has been changed due to malunion. To consistently obtain good aesthetic and functional results, the anatomic reduction of malunion sites of the nasal bone is important. The purpose of this study is to present an osteotomy technique, including refracture along malunion sites and anatomical reduction of a malformed nasal bone, for the correction of a posttraumatic deviated nose. Methods: From March of 2003 to May of 2004, 27 patients, who underwent corrective rhinoplasty for the correction of bony pyramid deviation, were included in this study. Postoperative results of the technique were evaluated objectively at 1 year after surgery regarding nasal midline location, nose symmetry, and nasal contour. Results were rated as excellent, good, fair, or poor. All patients were also evaluated subjectively for cosmetic improvement, changes in breathing, and overall satisfaction. Results: Objective analysis of the outcomes revealed an excellent result in 17 patients(63%), good in 9(33%), and fair in 1 patient(4%). No case evaluated had a poor result. Regarding subjective analysis, 19 patients(70%) evaluated the cosmetic outcome as perfect. Among the 21 patients with preoperative airway problems, 19 patients(90%) reported improved breathing post-operatively. Patients' overall satisfaction levels were also very positive. No postoperative complications occurred during the 14 month mean follow-up period. Conclusion: The osteotomy technique presented in this study is simple, effective, and safe for correcting posttraumatic nasal deviation, and also produces consistent results.

• Journal of Korean Foot and Ankle Society
• /
• v.18 no.2
• /
• pp.80-82
• /
• 2014

Occurrence of pseudoaneurysm in the foot and ankle is rare, and is usually caused by traumatic injury or by iatrogenic intervention. Iatrogenic pseudoaneurysms in the foot and ankle have been observed after rearfoot and ankle fusions, ankle arthroscopy, endoscopic and open plantar fasciotomy, tibial osteotomy with limb lengthening, midfoot amputation, and Lapidus procedure. We report on a patient who developed a pseudoaneurysm of the dorsal metatarsal artery following correction of hallux valgus. The patient underwent proximal chevron osteotomy and Akin phalangeal osteotomy. The feeding artery was ligated and the pseudoaneurysm was excised.

• Archives of Plastic Surgery
• /
• v.46 no.6
• /
• pp.610-611
• /
• 2019