• Title/Summary/Keyword: Orthopedic treatment

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Surgical Excision for Refractory Ischiogluteal Bursitis: A Consecutive Case Series of 21 Patients

  • Sun-Ho Lee;Won-Young Jang;Min-Su Lee;Taek-Rim Yoon;Kyung-Soon Park
    • Hip & pelvis
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    • 제35권1호
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    • pp.24-31
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    • 2023
  • Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

Danis-Weber B형 족근 관절 골절에 있어 유경 나사를 이용한 비골 외 과 골절의 치료 (Treatment of Lateral Malleolar Fractures with Cannulated Screws in Danis-Weber type B Ankle Fractures)

  • 박용욱;정영기;유정한;박홍준;유선오;강기만
    • 대한족부족관절학회지
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    • 제5권2호
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    • pp.129-135
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    • 2001
  • Purpose: To evaluate the radiographic results of the treatment for Danis-Weber type B lateral malleolar fracture with 2 cannulated screws. Materials and Methods: Thirty-four cases of Danis-Weber type B lateral malleolar fracture were available. Follow-up averaged 8 months (6-25 months). The medial clear space for lateral displacement of talus, talo-crural angle for lateral malleolar shortening, and malunion evidence of lateral malleolar fracture were observed. Results: Medial clear space was from 2mm to 4mm in 34 cases. Talo-crural angle was from $73^{\circ}$ to $82.5^{\circ}$ in 33 cases. One case was complicated with malunion of lateral malleolus. But, we found the same condition in the immediate post- operative radiographic film. Conclusion: We believe that the 2 cannulated screws fixation for Danis-Weber type B lateral malleolar simple fractures is an excellent treatment method.

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The Treatment of the Floating Shoulder

  • Oh Chang Wug;Jeon In Ho;Kyung Hee Soo;Kim Poong Taek;Ihn Joo Chul;Kim Hoon Woo
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2002년도 학술대회
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    • pp.74-75
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    • 2002
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부모의 관심이 많은 소아 정형외과 질환 (The common orthopedic problems in parent's concern)

  • 신동은;윤병호;정주환
    • Clinical and Experimental Pediatrics
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    • 제51권2호
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    • pp.122-128
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    • 2008
  • Roughly one third of medical problems in children are related to the musculoskeletal system. Most of these problems are common and can be precisely diagnosed. For these problems, nonoperative treatment or reassurance can be given by the pediatrician. Occasionally, a problem needs surgical treatment, but a precise diagnosis must be made. There is little agreement about what types of orthopedic problems a primary care pediatrician should understand in order to effectively care for children. Many pediatric residencies lack an organized teaching curriculum that effectively covers these topics or that includes a required pediatric orthopedic rotation. In this article the authors delineate pediatric orthopedic problems that require recognition and urgent surgical treatment and are relatively common, but have different treatment options (observation, conservative treatment, and surgery) depending on their natural history. Whenever possible, the diagnosis should be made before a decision to refer is made. An accurate diagnosis allows the pediatrician to discuss the natural history of the condition properly. Referral to the wrong specialty can needlessly generate expensive tests and further delay in treatment or generate inappropriate treatment. The parents can be reassured rather than waiting to hear the same information from another physician. In particular, orthopedic problems are known to generate pressure from the parents to seek specialty consultation for reassurance. It is important to communicate to the specialist that the reason for the referral is for parental reassurance rather than for further work-up or treatment. After a proper diagnosis, communication directly between the pediatrician and the appropriate specialist can often avoid an unnecessary referral, and avoid unnecessary tests. The authors reviewed our experience at our outpatient clinic over last 1 year and found that it is useful to classify conditions as common or uncommon, and whether they require surgical or nonsurgical treatment. Many conditions fall in between. The following is a discussion of some of these more important or common conditions.

거골의 골연골 손상의 보존적 치료의 결과 (Results in Conservative Treatment of Osteochondral Lesion of Talus)

  • 이경태;양기원;이영구;박신이;장문석
    • 대한족부족관절학회지
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    • 제12권2호
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    • pp.145-149
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    • 2008
  • Purpose: The purpose of this study is to determine the results of conservative treatment of osteochondral lesion of talus (OLT). This study would be helpful to determine the treatment methods for OLT patients. Materials and Methods: We have established 69 cases of osteochondral lesion of talus, from December 2004 to June 2006 in a period of 18 months. Symptoms were confirmed through survey and a medical examination by interviewing patients. Diagnosis was made through physical examination, simple radiography and MRI. AOFAS score of all the patients were measured. When the patients did not get improved with conservative treatment, surgical operation was done. Results: 27 out of the 69 patients were treated using conservative treatment. Initial AOFAS scored was $66.37{\pm}8.89$ points. After treatment, AOFAS scores had increased to $83.78{\pm}8.48$ points. In cases of surgery, AOFAS scores had increased from $64.17{\pm}13.43$ points preoperatively to $80.45{\pm}8.67$ points. Conclusion: 60% of conservative treatment was useless in treating OLT patients. Surgical operation is still needed to be performed. Therefore, treatment should be done with sufficient understanding of the results.

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구순구개열 환아의 조기 악정형치료에 관한 증례 (EARLY ORTHOPEDIC TREATMENT IN CLEFT LIP AND PALATE PATIENT: A CASE REPORT)

  • 윤태원;임광호;이창섭;이상호
    • 대한소아치과학회지
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    • 제23권3호
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    • pp.729-735
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    • 1996
  • Cleft lip and palate is the most common malformation in the craniofacial region. The patients with cleft lip and palate have functional problem such as, speech, feeding and respiratory as well as esthetic problem. So, treatment should be done by multidiciplinary team approach. The role of pediatric dentist in the team is advicement for feeding method, guidance of normal growth, caries control and preventive orthodontics. In cleft lip and palate patients, maxillary arch after cheiloplasty is usually collapsed by excessive tension of the scar. This collapse increase the difficulty of later orthodontic treatment. Therefore, the maxillary arch segments should be moved and retaind to normal position as soon as cheiloplasty is done to reduce the need and difficulty of orthodontic treatment. This concept is called by the early orthopedic treatment in cleft lip and palate. Also, this orthopedic appliance works as feeding applince to normal feeding and weight gain We reported two cases of early orthopedic treatment with favorable result in complete bilateral cleft lip and palate patients after cheiloplasty. Patients showed normal weight and their maxillary arch widths were increased.

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당뇨발 절단에 있어 원인 감염균과 치료 결과와의 관계 (Corelation between the Treatment Result and Causative Bacteria in Amputation of Diabetic Foot)

  • 이명진;이규열;김성수;김철홍;왕립;김현준;김기웅
    • 대한족부족관절학회지
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    • 제17권3호
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    • pp.209-214
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    • 2013
  • Purpose: To evaluate correlation between the clinical results and causative bacteria in diabetic foot patients with lower extremity amputation. Materials and Methods: One hundred twenty nine patients(131 feet) of diabetic foot amputations were followed for more than one year. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Retrospective analysis was performed using chart review and interview with the patients. Depending on the culture result, level of amputation, reinfection, duration of treatment, death rate, patient satisfaction and admission dates were evaluated. Results: Microorganisms were confirmed in 114 cases. In the other 17 cases, there were no cultured microorganisms. In bacterial growth group, Methicillin-sensitive Staphylococcus aureus was the most common pathogen and accounted for 34 cases. As other common pathogens, there were Methicillin-resistant Staphylococcus aureus(24 cases) and mixed infection(14 cases). Mortality is no difference in each infected group. Mixed bacterial infected patients have higher reinfection, longer hospital day and duration of treatment, but there is no difference in patients satisfaction and pain at last follow up. Conclusion: The most common pathogen in diabetic foot patients with lower extremity amputation was Methicillin-sensitive Staphylococcus aureus, and mixed bacterial infected patients have higher reinfection rate, longer admission date and duration of treatment than other bacterial infected patients.

거골 골연골병변의 자연 경과 (Natural History of Osteochondral Lesion of the Talus)

  • 경민규;이동오;이동연
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.37-41
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    • 2020
  • Many articles on operative treatment strategies for osteochondral lesions of the talus (OLT) have been published. On the other hand, there are only a few reports on the conservative treatment of OLT. Understanding the natural history of OLT is essential to establishing the correct treatment. Conservative treatment might lead to comparable clinical outcomes compared to the current options of the operative treatment in isolated OLT lesions. OLT lesions can be divided into two (or possibly three) types. Hence, the prognosis and outcome of certain operative treatments should be evaluated further. The prognosis of OLT combined with instability or malalignment appears poorer than that of isolated OLT lesions. Therefore, concomitant pathologies should be evaluated together when treating patients with OLT.

Current Concepts and Recent Trends in Arthroscopic Treatment of Large to Massive Rotator Cuff Tears: A Review

  • Rho, Joseph Y.;Kwon, Yong suk;Choi, Sungwook
    • Clinics in Shoulder and Elbow
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    • 제22권1호
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    • pp.50-57
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    • 2019
  • Rotator cuff tear is a common cause of shoulder pain and disability in adults. Due to the various nature of progression of rotator cuff tears and the complex biomechanics of the shoulder joint, repair and treatment of large-to-massive tears are challenging for many surgeons. Despite the recent popularity of reverse total shoulder arthroplasty as a treatment option for large-to-massive irreparable rotator cuff tears, biological and mechanical repair augmentation has also shown promise as a viable treatment option. The purpose of this study was to briefly summarize and review current studies on the assessment and arthroscopic treatment of large-to-massive rotator cuff tears, whether repairable or irreparable, to aid in developing a consensus on future treatment directions.