• 제목/요약/키워드: Non-surgical treatment

검색결과 688건 처리시간 0.027초

관절내 종골 골절의 전산화 단층 촬영에 따른 분류 및 치료 (CT Classification and Treatment of Intraarticular Calcaneal Fractures - Conservative vs. Surgical Treatment by Prospective Study -)

  • 강재도;김형천;김진형
    • 대한족부족관절학회지
    • /
    • 제5권1호
    • /
    • pp.35-42
    • /
    • 2001
  • Purpose: To analyze the results of conservative or surgical treatment after computed tomograhy(CT) classification in intraarticular calcaneal fractures. Materials and methods: From January 1996 to May 1999, we prospectively analyze 23 cases of intraarticular calcaneal fractures who were treated conservatively or operated by open reduction and internal fixation by extensive L-shaped lateral approach after CT classification. Results: A functional scoring system of 0-100 points which was based upon the responses to AOFAS Ankle-Hindfoot Scale for the operative group was at 82.8, compared with 73.2 for the non-operative group, and these were meaningful statistically(P<0.05). Of type I fracture, in the operative group there were 2 excellent results and in the non-operative group there were 2 excellent results, 1 good result. or type II fractures, in the operative group there were 2 excellent results, 3 good results, 1 fair result and in the non-operative group there were 1 good result, 1 fair result, 2 poor results. Of type III fractures, in the operative group there were 2 fair results, 2 poor results and in the non-operative group there were 1 fair result, 3 poor results. Bohler angles of subtalar joint were changed from initial average $13.3^{\circ}$ to postoperative average $20.9^{\circ}$ for the operative group compared with from initial average $15.5^{\circ}$ to follow-up average $14.8^{\circ}$ of the non-operative group(P<0.01). Conclusions: Computed tomography in the evaluation of intraarticular calcaneal fractures is effective tool. We believed that open reduction and internal fixation in all Crosby & Fitzgibbons type II and according to degrees of comminution reducible type III for the intraarticular calcaneal fractures is more effective method than conservative treatment.

  • PDF

Clinical Profile, Treatment and Survival Outcome of Testicular Tumors: A Pakistani Perspective

  • Bhatti, Abu Bakar Hafeez;Ahmed, Irfan;Ghauri, Rashid Khan;Saeed, Qamar;Mir, Khurram
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권1호
    • /
    • pp.277-280
    • /
    • 2014
  • Background: Testicular cancer management is considered a marvel of modern science with excellent treatment results. Pakistan has a distinct ethnic variation and geographic distribution but data regarding clinical presentation of testicular tumors and their management is under reported. The objective of this study was to determine clinical profile, treatment modalities and survival outcome of testicular tumors in the Pakistani population. Materials and Methods: A retrospective review of patients who received treatment for testicular cancer at Shaukat Khanum Cancer Hospital from January 2009 to December 2012 was performed. Patient demographics, clinical features at presentation and treatment modalities were assessed. For categorical variables chi square test was used. Survival was calculated using Kaplan Meier survival curves and Log rank test was employed to determine significance. Results: The most common tumor was mixed germ cell tumor in 49% patients. For all tumor variants except seminoma, stage III was the most common clinical stage at presentation. Majority of patients with non seminomatous germ cell tumors presented in the15-30 year age group as compared to seminoma which was most prevalent in the 30-40 year age group. Orchiectomy followed by chemotherapy was the most common treatment modality in 80% patients. Expected 5 year survival for seminomas and non-seminomatous germ cell tumors was 96% and 90% respectively which was not significantly different (p=0.2). Conclusions: Despite a distinct clinical profile of testicular tumors in Pakistani population, survival is comparable with published reports.

The treatment of lower extremity defects with severe proliferative tissue using an adjustable horizontal mattress suture in a Tosa dog

  • Heo, Suyoung;Kim, Namsoo
    • 대한수의학회지
    • /
    • 제54권2호
    • /
    • pp.121-122
    • /
    • 2014
  • A 2-year-old male Tosa was admitted for treatment of a non-healing wound on the right forelimb. Skin tests were unremarkable; however, the lesion contained severe proliferative tissue. Surgical treatment was conducted due to the extensive skin defect and granulation tissue present. Following removal of the proliferative tissue, the wound was closed using the adjustable horizontal mattress suture method with multiple punctate relaxing incisions. The proliferative tissue healed completely after the surgical treatment. This technique can be considered an alternative treatment for the proliferative tissue when conditions require a skin graft or flap after surgical treatment.

비외과적.외과적 치주치료와 병행 투여된 비타민 C 특수영양 보충용 식품이 치주질환의 치유과정에 미치는 효과 (The effect of vitamin-C containing neutraceutical on periodontal wound healing as an adjunct to non-surgical or surgical periodontal treatment)

  • 백영란;박진우;이재목;서조영
    • Journal of Periodontal and Implant Science
    • /
    • 제39권2호
    • /
    • pp.157-166
    • /
    • 2009
  • Purpose: There are numerous reports about the usefulness of antibiotics such as doxycycline or metronidazole in the conventional treatment for the patients with chronic periodontal diseases. However, seldom are the reports about effects of vitamins or nutraceuticals. The purpose of this study was to evaluate the effects of nutrient supplement including multiple vitamins and neutraceuticals with PRF-K2 from plants and seaweed in treatment of the patients with chronic periodontitis which is needed a nonsurgical or a surgical treatment by evaluating the clinical parameters and the gingival crevicular fluid volume. Methods: The systemically healthy and nonsmoking patients diagnosed with chronic periodontitis were divided into a nonsurgical group and a surgical group. They were also divided into the test group with nutrient supplements and the control group without nutrient supplements. In the nonsurgical group, the clinical parameters (probing depth, clinical attachment level, sulcus bleeding index, and plaque index) and the gingival crevicular fluid volume were checked on baseline, at 1 week, at 3 week and at 9 week after a supplement treatment. In the surgical group, the clinical parameters and the gingival crevicular fluid volume were also checked at 15 week after a surgical treatment. Results: In both nonsurgical and surgical groups, reduction of pocket depth and increment of clinical attachment level were revealed in the test group compared with the control group, but there was not statistically significant difference (p>0.05), and sulcus bleeding index was decreased with statistically significant difference (p<0.05). In addition, plaque index was decreased with statistically significant difference (p<0.05) in the nonsurgical group. Gingival crevicular fluid volume was decreased with statistically significant difference (p<0.05) at week 9 in both non-surgical and surgical groups. Conclusions: In conclusion, our results demonstrate that providing nutrient supplement in both nonsurgical or surgical periodontal treatments may improve gingival inflammation and gingival crevicular fluid.

Surgical Treatment of Olecranon Fractures

  • Koh, Kyoung-Hwan;Oh, Hyoung-Keun
    • Clinics in Shoulder and Elbow
    • /
    • 제20권1호
    • /
    • pp.49-56
    • /
    • 2017
  • Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.

Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes

  • Gerrard, Adam Daniel;Charalambous, Charalambos P.
    • Knee surgery & related research
    • /
    • 제30권4호
    • /
    • pp.356-363
    • /
    • 2018
  • Purpose: A meta-analysis was performed to assess the outcomes following surgical intervention for medial knee plica. Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient-reported postoperative scores of "good" and "excellent". Meta-analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta-analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8-91.4). In those cases that had non-surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1-87). Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first-line treatment or when symptoms have not responded to non-surgical interventions. Level of Evidence: IV.

성대 용종의 예후 인자와 음성 위생법 치료 효과 분석 (Analysis for Risk Factors and Effect of Vocal Hygiene Education in Patients of Vocal Polyp)

  • 최나연;김동규;이길준
    • 대한후두음성언어의학회지
    • /
    • 제32권1호
    • /
    • pp.24-28
    • /
    • 2021
  • Background and Objectives Vocal polyp is one of the most common benign diseases of vocal fold caused by overuse of voice. Laryngeal microsurgery is the first treatment of choice for vocal polyp. However, surgery has many risks such as side effects of general anesthesia, injury of tooth and psychological burden. And we often experience reduction of vocal polyps without surgical procedure. The purpose of study is to evaluate the effect of non-surgical treatment such as vocal hygiene education and proton pump inhibitor (PPI) in patients with vocal polyp. Materials and Method We performed retrospective study for seventy-three patients of vocal polyp who treated with non-surgical modalities such as vocal hygiene education and PPI over three months. Treatment outcomes and risk factors such as age, sex, polyp size, position, symptom duration, presence of laryngopharyngeal reflux (LPR) symptoms, smoking history, voice abuse history and vocal hygiene education were evaluated by comparison between polyp size improved group and non-improved group. Results 5.5% of enrolled patients showed complete response and 23.3% showed partial response without surgery. Polyp size improved group significantly carried out more practice of vocal hygiene education treatment than the non-improved group (p=0.040). And the presence of LPR symptoms [hazard ratio (HR) 3.368, confidence interval (CI) 1.055-10.754, p=0.040] and not performing of vocal hygiene education (HR 3.664, 95% CI 1.078-12.468, p=0.038). Conclusion Vocal hygiene education can be a useful treatment option when making a decision to treat with vocal polyp.

Clinical case report on treatment of generalized aggressive periodontitis

  • Jung, Mi-Hwa;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
    • /
    • 제40권5호
    • /
    • pp.249-253
    • /
    • 2010
  • Purpose: The purpose of this study was to evaluate the improvement of periodontal health of generalized aggressive periodontitis (GAgP) diagnosed patients treated with non-surgical periodontal therapy accompanying systemic antibiotics administration. Methods: Two patients with GAgP were chosen for this study. Clinical indices were taken and a radiographic examination was performed at the baseline of the study and they were treated by periodontal therapy accompanying systemic antibiotics administration. Post-surgical visits were scheduled at regular intervals to check clinical and radiographic changes. Results: Through non-surgical periodontal therapy accompanying systemic antibiotics administration, GAgP patients showed decreased probing pocket depth, sulcus bleeding index, and increased attachment level and clinical index when comparing the initial and six month follow up data. In the six month follow-up radiographic examination after non-surgical periodontal therapy, resolution of the bony defect was observed. Conclusions: Non-surgical therapy combined with systemic antibiotics administration in GAgP patients is suggested to be an effective approach to enhance the periodontal health.

요추 척추관 협착증 환자 118례에 대한 임상적 고찰 (The Clinical Study on Spinal Stenosis of Lumbar Spine)

  • 조재희;이효은;문자영;임명장;강인;이한;정호석;김지형
    • 척추신경추나의학회지
    • /
    • 제3권2호
    • /
    • pp.77-85
    • /
    • 2008
  • Object : These studies are designed to make a survey of the effectiveness of the non surgical oriental medicine treatment with Chuna on spinal stenosis of lumbar spine. Methods : The clinical study was done on 118 cases of patients with spinal stenosis of lumbar spine diagnosed by M.R.I, symptoms and physical test who was in the admission in Ja-Seng Oriental Medcine Hospital from October 2006 to October 2008. after treatment we checked VNRS score to estimate the efficacy of treatment. Results : 1. As a Objectivity treatment record, they test excellent 17%, good 69%, fair 8%, poor 6%. 2. The mean NRS score decreased about 3.26 after the treatment. Conclusions : Non surgical oriental medicine treatment with Chuna has on useful effect on spinal stenosis of lumbar spine.

  • PDF

The Effectiveness of Occlusal Splint for the Treatment of Temporomandibular Joint Dislocation

  • Lim, Hyun-Dae;Lee, You-Mee;Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
    • /
    • 제39권4호
    • /
    • pp.152-155
    • /
    • 2014
  • Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.