• Title/Summary/Keyword: Growth plate deformity

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Seymour's Fracture of the Base of the Distal Phalanx in a Child (소아 원위지골 기저부에서 발생한 Seymour씨 골절의 치험례)

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.776-779
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    • 2006
  • Purpose: Prior to closure of the epiphysis of the distal phalanx, fracture usually occurs through the growth plate, Salter-Harris type I or II, or through the juxtaepiphyseal region 1 to 2 mm distal to the growth plate. The terminal tendon of extensor inserts into the epiphysis only, while insertion site of the flexor digitorum profundus spans both the epiphysis and metaphysis. Because of the difference between these tendon insertions, this injury mimics a mallet deformity. But, this type of injury does not involve a tear or avulsion of the extensor, unlike mallet finger of adults. Seymour was the first to describe this type of injury in children and called after his name, Seymour's fracture. This fracture is prone to infection or remain the residual deformity unless adequate treatment. Methods: We report a case of Seymour's fracture. A 9-year-old boy presented a laceration of the nail matrix, with the nail lies degloved from the nail fold on the right middle finger gotten from an impact against a door. An X-ray examination showed the fracture line lying 1 mm distal to the growth plate. The injury was treated with debridement and the fracture was reduced by applying hyperextension force. Under the C-arm, a single 0.7 mm K-wire was used to immobilize the distal interphalangeal joint. Intravenous antibiotics were applied for 5 days after surgery. Results: The K-wire was removed in the 3rd week. No infection or significant deformity was found until follow-up of 12 months. Conclusions: Seymour's fracture may be at first classically mallet deformity by its appearance. But it is anatomically different and more problematic injury. If it isn't corrected at the time of injury, derangement of the extensor mechanism, and growth deformity of the distal phalanx may occur. The fracture site should be debrided, removed of any interposed soft tissue, and the patient should be given appropriate antibiotics. Reduction should be maintained by K-wire fixation. We experienced no infection or premature epiphyseal closure.

Matrixplasty for the Treatment of Pincer Nail with Nail Growth Plate Deformity (성장판 변형을 동반한 집게 발톱 변형의 매트릭스플라스티를 이용한 치료)

  • Cho, Young-A;Choi, Kyung-Jin;Song, Young-Joon;Suh, Dong-Won
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.139-143
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    • 2011
  • Purpose: The purpose of this study was to introduce the 'Matrixplasty' for the treatment of a severely incurved toenail with growth plate deformity and to report our results treating this disease entity. Materials and Methods: Between January 2010 and May 2010, 48 consecutive patients (62 cases) underwent treatment of symptomatic incurved toenails with the 'matrixplasty'. The mean period of time at last follow-up was $14.0{\pm}1.3$ months. The recurrence rate and complication rate were evaluated. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned and patients were evaluated at pretreatment and the last follow-up meeting. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured at pretreatment and last follow-up. Results: All ingrown toenails healed and the nail deformity was corrected within 3 weeks after the procedure. Among the 62 cases, four cases had recurred by the last follow-up. The mean pretreatment AOFAS forefoot hallux score was $73.1{\pm}12.8$, and it improved to $98.7{\pm}1.1$ by the last follow-up (p<0.01). The mean center to edge angle of the toenail improved from $53.3{\pm}12.9$ degrees to $18.2{\pm}7.4$ degrees by the last follow-up (p<0.01). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in eight cases. Conclusion: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail (pincer nail) and this procedure also showed great improvement of the deformed toenail and its growth plate.

Diagnostic Radiography of Premature Closure of Distal Growth Plate of Ulna in a Dog (개에서 척골의 원위 성장판 조기 폐쇄증에 대한 방사선학적 평가)

  • 송경진;이희천;이기창;권정국;최민철
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.403-405
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    • 2003
  • A 11 month-old Shihtzu was referred to the Veterinary Medical Teaching Hospital, Seoul National University. Clinical signs of this patient were lameness, shortening limb, angular deformity, rotation of foot, subluxaion of elbow joint and restricted range of movement of left forelimb. For the evaluation of the abnormalities of left forelimb, radiographic examination was carried out. Radiographic findings were characteristics of premature closure of distal ulna such as closure of distal ulna growth plate and cranial bowing of radius. With radiographic signs and physical examination, it was diagnosed as premature closure of growth plate of the left forelimb. After osteotomy of the radius and ostectomy of the ulna, radiographic evaluation of limb about angulation of elbow joint was performed every 2-3 weeks for 3 months. In case of premature closure of distal growth plate of ulna, radiography was very useful for diagnositic method of premature closure of distal ulna and monitoring of healing process.

Low Grade Chondrosarcoma Presenting as Progressive Valgus Limb Deformity in a Growing Period (성장기 저등급 연골육종에 의한 사지의 진행성 외반)

  • Kang, Hyun Guy;Park, Weon Seo;Park, Seog Yun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.41-45
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    • 2014
  • A femoral bone tumor causing a valgus deformity by affecting the growth plate was found. Long intramedullary diaphyseal tumor was separated by septum at the metapysis. Low grade chondrosarcoma was confirmed diagnosed by pathologists. Progressive limb deformity can be a sign of bone tumor in growing period.

Most Reliable Time in Predicting Residual Kyphosis and Stability: Pediatric Spinal Tuberculosis

  • Moon, Myung-Sang;Kim, Sang-Jae;Kim, Min-Su;Kim, Dong-Suk
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1069-1077
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    • 2018
  • Study Design: A case study. Purpose: To assess the chronological changes of the disease-related kyphosis after chemotherapy alone, secondly to clarify the role of growth cartilage in the healed lesion on kyphosis change, and to define the accurate prediction time in assessing residual kyphosis. Overview of Literature: None of the previous papers up to now dealt with the residual kyphosis, stability and remodeling processes of the affected segments. Methods: One hundred and one spinal tuberculosis children with various stages of disease processes, age 2 to 15 years, were the subject materials, between 1971 to 2010. They were treated with two different chemotherapy formula: before 1975, 18 months of triple chemotherapy (isoniazid [INH], para-aminosalicylic acid, streptomycin); and since 1976, 12 months triple chemotherapy (INH, rifampicin, ethambutol, or pyrazinamide). The first assessment at post-chemotherapy one year and at the final discharge time from the follow-up (36 months at minimum and 20 years at maximum) were analyzed by utilizing the images effect of the remaining growth plate cartilage on chronological changes of kyphosis after initiation of chemotherapy. Results: Complete disc destruction at the initial examination were observed in two (5.0%) out of 40 cervical spine, eight (26.7%) out of 30 dorsal spine, and six (19.4%) out of 31 lumbosacral spine. In all those cases residual kyphosis developed inevitably. In the remainders the discs were partially preserved or remained intact. Among 101 children kyphosis was maintained without change in 20 (19.8%), while kyphosis decreased in 14 children (13.7%), and increased in 67 children (66.3%) with non-recoverably damaged growth plate, respectively. Conclusions: It could tentatively be possible to predict the deformity progress or non-progress and spontaneous correction at the time of initial treatment, but it predictive accuracy was low. Therefore, assessment of the trend of kyphotic change is recommended at the end of chemotherapy. In children with progressive curve change, the deformity assessment should be continued till the maturity.

Cleft Palate Speech - Language Management based on the Multidisciplinary Approach (다학문적 접근법의 구개열 말-언어 관리)

  • Yang, Ji-Hyung
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.2
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    • pp.95-105
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    • 2005
  • Cleft lip and palate is a congenital deformity which needs a professional and consistent management from the birth and along with the physical growth of patients. The patients with cleft lip and palate can have general speech problems with resonance disorders, voice disorders and articulation disorders after the successful primary surgical management and the physical growth. Speech problems of Cleft lip and palate are characterized hypernasality, nasal air emission, increased nasal air flow, and aberrant speech marks which decrease intelligibility. These speech problems of cleft lip and palate can be treated with the secondary surgical procedure, the application of temporary prosthesis and the effective and well-timed speech therapy. The speech and language problems of cleft lip and palate, the general procedures and schedules of the speech assessment and therapy based on the multidisciplinary approach are introduced for the patients with cleft lip and palate, their family and the other members of the cleft palate treatment team.

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Scar Revision in Patient with Secondary Cleft Lip Deformity Using Straight Line Repair-Report of Case (직선 봉합법을 이용한 편측 구순열의 반흔성형술 증례)

  • Lee, In-Woo;Lee, Ju-Hwan;Seo, Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.2
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    • pp.95-100
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    • 2009
  • In spite of all fine methods developed for treating cleft lip, a certain percentage of cases might still need secondary correction. Generally, secondary revision of cleft lip is much difficult to produce esthetic outcome, because the cleft lip scar gives a variable symmetrical and anatomic defect that may not be possible to make inconspicuous of this scar and rebuild good esthetics. In this case report, a five year-old girl was underwent secondary cleft lip repair using straight line technique to correct unfavorable postoperative scar, peaking of Cupid's bow, notching of vermillion and shortened lip on cleft side with simultaneous repairing cleft palatal fistula. After operation, the secondary deformity was much improved, but, long term follow up is needed to evaluate the additional postoperative deformity might be happen during growth.

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Tip Plasty using Biodegradable Plate as a Columella Strut (비주 버팀목으로 흡수성 고정판을 이용한 비첨 성형술)

  • Kim, Soo-Young;Lee, Soo-Hyang;Hwang, Eun-A;Choi, Hyun-Gon;Kim, Soon-Heum;Shin, Dong-Hyeok;Uhm, Ki-Il
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.259-264
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    • 2010
  • Purpose: Most surgeons have used autogenous cartilage for columella strut graft. But the supply of autogenous cartilage is often limited. So, this study is to investigate the usefulness of biodegradable plate as columella strut material. Methods: We studied 19 patients who have secondary cleft nasal deformity. Patients were divided into two groups. Group A patients who were not closed their growth plate underwent columella strut graft only with biodegradable plate through endonasal approach. The biodegradable plate was inserted between nasal tip and anterior nasal spine. Group B patients were closed their growth plate. They had an operation for columella strut graft with biodegradable plate fixed with autogenous conchal cartilage. If nasal tip projection was insufficient, we performed additionally onlay graft on nasal tip with autogenous soft tissue or remnant cartilage. Results: As a result of mean 14 months follow-up, we achieved a good nasal tip projection, narrowing of interalar distance and symmetrical nostril shape. No specific complications were reported except 2 cases, which were the extrusion of biodegradable plate into the nasal cavity and Staphylococcus aureus infection. Conclusion: The columella strut graft using biodegradable plate is simple and effective method. Biodegradable plate can be a good substitute for columella strut in patients who can not use autogenous cartilages.

Spinal Tuberculosis in Children: Predictable Kyphotic Deformity after Cure of the Tuberculosis (소아 척추 결핵: 투약 후의 병의 정지와 치유점, 그리고 후만 변형)

  • Moon, Myung-Sang;Kim, Dong-Hyeon;Kim, Sang-Jae;Moon, Hanlim;Kim, Sung-Soo;Kim, Sung-Sim
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.73-82
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    • 2017
  • Purpose: To assess the chronological changes of disease-related kyphosis after chemotherapy alone. Materials and Methods: A total of 101 children aged 2 to 15 years with spinal tuberculosis, accompanied by various stages of disease processes were enrolled for analysis. By utilizing the images in them, the growth plate condition and chronological changes of kyphosis after chemotherapy were analyzed at two points in time; the first assessment was at post-chemotherapy one-year and second at the final discharge. Results: Complete disc destruction in the cervical, dorsal and lumbosacral spines was observed in 2 out of 40 children (5.0%), 8 out of 30 children (26.7%), and 6 out of 31 children (19.4%), respectively. In those cases, the residual kyphosis inevitably developed. In the remaining children, the discs were intact or partially damaged. Among the 101 children kyphotic deformity was maintained without change in 20 children (19.8%). Kyphosis decreased in 14 children (13.9%), while it increased in 67 children (66.3%) with non-recoverably damaged growth plate. Conclusion: Although it is tentatively possible to predict the deformity progress or non-progress and spontaneous correction at the time of the initial treatment, its predictive accuracy is low. Therefore, assessment of the chronological changes should be performed at the end of chemotherapy. In children with progressive curve change, assessment of deformity should be continued until maturity.

A Case of Osteotomy of the Distal Radius and Ulna with Panarthrodesis of Carpus for Reform of (성장판 조기페쇄에 따른 요척골 외전과 완관절 아탈구 교정들 위한 요척골 절단술 및 광범위 완관절 고술의 일례)

  • 이종일;김남수;최인혁
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.485-489
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    • 2000
  • A 23.5 kg179, 8 months olds non-spaycd female Rottweiler dog was submitted to the veterinary teaching animal hospitals Chonbuk: national university, for chronic bitten trauma on right foreleg with pain, lameness, and pronation. The patient fought with a neighboring dog about five months ago and had mild anorexia, depression, bolt normal walking at that time. CBC and blood chemical examination were in normal range. Physical examination resulted in the right foreleg with edema and interval rotation of carpal joint. Radiograph of the right carpus showed varus and subluxation. We finally diagnosed the patient as the growth deformity of distal radius and ulna caused by medial premature closure of distal radial physis. Osteotomy was performed fur reforming of the varus of the distal radius and ulna with 6-hole straight plate and six 3.5 mm screws. Panarthrodcsis of carpus was preformed for correcting subluxation using 6-hole T-shaped plate and four 3.5 mm screws with cortical onlay autograft and strengthened by two 3.5 mm screws and tension wire band in lateral aspect of the carpus. Follow-up radiographs after 16 weeds of the surgery showed complete coaptation of osteotomy sire of the radius and uIna. After 6 months of the procedurc, talc plate, screws and the wire were removed except 7-shaped plate and four screws fur arthrodesis. The patient was seen in normal forelimb and could walk and run without lameness after 7 months of the procedure.

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