• Title/Summary/Keyword: Pediatric reconstruction

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Thirty-Three Years Old Modified Senning Operation

  • Michalis, Alkiviadis;Kanakis, Meletios A.;Thanopoulos, Vassilios;Laskari, Cleo;Mitropoulos, Fotios A.
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.394-397
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    • 2014
  • Numerous technical modifications and various complications of the Senning procedure have been described in the literature. We describe the excellent clinical status and anatomic result of a 33-year-old patient who underwent a modified Senning operation using the left atrial appendage for reconstruction more than 30 years prior to presentation.

Effect of nano-composite materials on repair of ligament injury in sports detoxification

  • Lu, Chunxia;Lu, Gang;Dong, Weixin;Liu, Xia
    • Advances in nano research
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    • v.13 no.3
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    • pp.247-257
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    • 2022
  • Extraordinary properties of nanocomposites make them a primary replacement for many conventional materials. Anterior cruciate ligament (ACL) reconstruction, which is a frequent surgery in sport activities, is one of the fields in which nanocomposites could be utilized. In the present study, the mechanical properties of different porous scaffolds made from graphene nano-composites are presented ad load bearing capacity of these materials is calculated using finite element method. The numerical results are further compared with experimental published data. In addition, several geometrical and material parameters are analyzed to find the best configuration of nanocomposite scaffolds in reconstruction of ACL. Moreover, coating of detoxification chemicals are extremely easier on the nano-structured materials than conventional one. Detoxification potential of nano-composites in the injured body are also discussed in detail. The results indicated that nano-composite could be successfully used in place of auto- and allografts and also instead of conventional metallic screws in reconstruction of ACL.

A DIAGNOSIS OF SUBMANDIBULAR SIALOLITHIASIS WITH COMPUTED TOMOGRAPHY (전산화 단층촬영술을 이용한 악하선 타석증의 진단)

  • Koo, Chi-Kyun;Choi, Hyung-Jun;Lee, Jong-Gap;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.545-548
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    • 1998
  • Sialolithiasis is the formation of calcareous concretions within ductal system of a major or minor salivary gland. They are formed by deposition of calcium salts around a central nidus which may consist of desquamated epithelial cells, bacteria, foreign bodies, or products of bacterial decomposition. An 11-year-old boy complained of pain during meals and intermittent mild swelling in the right submandibular region. Although it was not detected in true occlusal radiograph, panoramic radiograph showed a round radiopaque mass 3mm in diameter. Computed tomography(CT) was taken for locating the stone and 3-dimensional reconstruction was performed. Under general anesthesia, sialoadenectomy was done through extraoral approach. Diagnosis of submandibular sialolithiasis using high-resolution CT with reconstructions was helpful for surgical decisions, namely radical removal of the submandibular gland and its duct.

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Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report

  • Sarah Douglas-Seidl;Camille Wu
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.447-450
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    • 2023
  • Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

Chest Wall Reconstruction with a Transverse Rectus Abdominis Musculocutaneous Flap in an Extremely Oversized Heart Transplantation

  • Yim, Ji Hong;Eom, Jin Sup;Kim, Deok Yeol
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.89-92
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    • 2014
  • An 8-year-old girl diagnosed with dilated cardiomyopathy and Russell-Silver syndrome was admitted to our pediatric intensive care unit due to low cardiac output and multiple-organ dysfunction. The patient was placed on the heart transplant waiting list and extracorporeal membrane oxygenation was performed as a bridge to transplantation. After 17 days, heart transplantation was performed. The donor was a 46-year-old female (weight, 50 kg; height, 150 cm). The donor:recipient weight ratio was 3.37:1. Because the dimension and volume of the recipient's thoracic cage were insufficient, the sternum could not be closed. Nine days after transplantation, the patient underwent delayed sternal closure. To obtain adequate space, we left the sternum 4.5 cm apart from each margin using four transverse titanium plates. A transverse rectus abdominis musculocutaneous flap was chosen to cover the wound. Due to the shortage of donors, a size-mismatched pediatric heart transplantation is sometimes unavoidable. Closure of the opened sternum of a transplant recipient can be challenging. Sternal reconstruction after an extremely oversized heart transplantation with transverse titanium plate fixation and a musculocutaneous flap can effectively achieve sternal closure and stability.

The sequential management of recurrent temporomandibular joint ankylosis in a growing child: a case report

  • Cho, Jung-Won;Park, Jung-Hyun;Kim, Jin-Woo;Kim, Sun-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.39.1-39.6
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    • 2016
  • Background: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. Case report: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood. The multiple surgeries including a costochondral graft and gap arthroplasty using interpositional silicone block were performed, but re-ankylosis of the TMJ occurred after surgery. Alloplastic TMJ prosthesis was conducted to prevent another ankylosis, and signs or symptoms of re-ankylosis were not found. Additional reconstruction surgery was performed to compensate mandibular growth after confirming growth completion. During the first 3 years of long-term follow-up, satisfactory functional and esthetic results were observed. Conclusions: This is to review the sequential management for the recurrent TMJ ankylosis in a growing child. Even though proper healing was expected after reconstruction of the left TMJ with costal cartilage graft, additional surgical interventions, including interpositional arthroplasty, were performed due to re-ankylosis of the affected site. In this case, alloplastic prosthesis could be an option to prevent TMJ re-ankylosis for growing pediatric patients with TMJ ankylosis in the beginning.

Clinical Study of Inguinal Hernia in Children (소아 서혜부 탈장의 임상적 고찰)

  • Kim, Kyeung-Rae;Kim, Sung-Soo;Lee, Young-Taek;Park, Yong-Kee;Choi, Chang-Rok
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.48-54
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    • 1998
  • A total of 335 pediatric inguinal hernias were analyzed at the Department of General Surgery, St. Benedict Hospital, for last 10 years (1986 to 1995). Male patients were predominant(2.25 : 1), and 78.2 % were under 2 years of age. Right side was 1.63 times more frequent than the left. Among the 19 cases of incarcerated hernias, 84 % could be safely reduced preoperatively. Twelve cases(3.6 %) were repaired by the Bassini procedure and 21 cases(6.3 %) by internal ring repair. The majority (90.1 %) however did not require a posterior wall reconstruction. Bilaterality was found in 25 cases(7.5 %), and in 8 cases(2.4 %) subsequent contralateral hernia developed after primary ipsilateral repair. Postoperative complication occurred in 15 cases(4.5 %); scrotal seroma and/or hematoma(3%), wound infection(0.6 %), and pneumonia(0.9 %). In order to reduce the incidents of complications, children with inguinal hernias should be treated by a pediatric surgeon.

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DENTAL IMPLANTS IN EDENTULOUS PATIENTS WITH COGNITIVE DISABILITIES: CASE REPORTS (정신적 장애 환자의 임플란트를 이용한 보철 치료)

  • You, Eun-Kyu;Choi, Sung-Chul;Park, Jae-Hong;Kim, Kwang-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.1
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    • pp.11-14
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    • 2011
  • Individuals with cognitive disabilities face many barriers to oral care, often suffering from partial or complete edentulism. While the use of implant reconstruction is becoming more common in general population, such care is still being used infrequently in individuals with intellectual impairment. Because of the patients'oral hygiene practice is poor, special need is required for prosthetic design. These two cases were restored by prostheses using implants. Prosthetic modalities were different but the implants were fully osseointegrated, presenting satisfactory functional and esthetic conditions without clinical or radiographic signs of alterations or pathologies. We report that it is good for cognitive disabilities to give prosthetic treatment using implants.

Cranial Base Reconstruction and Secondary Frontal Advancement for Meningoencephalocele Following LeFort III Osteotomy in a Patient with Crouzon Syndrome: Case Report

  • Sungmi Jeon;Yumin Kim;Ji Hoon Phi;Jee Hyuk Chung
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.54-58
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    • 2023
  • Patients with Crouzon syndrome have increased risks of cerebrospinal fluid rhinorrhea and meningoencephalocele after LeFort III osteotomy. We report a rare case of meningoencephalocele following LeFort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed tomography and magnetic resonance imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencephalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during LeFort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.

Short Bowel Syndrome as the Leading Cause of Intestinal Failure in Early Life: Some Insights into the Management

  • Goulet, Olivier;Nader, Elie Abi;Pigneur, Benedicte;Lambe, Cecile
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.4
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    • pp.303-329
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    • 2019
  • Intestinal failure (IF) is the critical reduction of the gut mass or its function below the minimum needed to absorb nutrients and fluids required for adequate growth in children. Severe IF requires parenteral nutrition (PN). Pediatric IF is most commonly due to congenital or neonatal intestinal diseases or malformations divided into 3 groups: 1) reduced intestinal length and consequently reduced absorptive surface, such as in short bowel syndrome (SBS) or extensive aganglionosis; 2) abnormal development of the intestinal mucosa such as congenital diseases of enterocyte development; 3) extensive motility dysfunction such as chronic intestinal pseudo-obstruction syndromes. The leading cause of IF in childhood is the SBS. In clinical practice the degree of IF may be indirectly measured by the level of PN required for normal or catch up growth. Other indicators such as serum citrulline have not proven to be highly reliable prognostic factors in children. The last decades have allowed the development of highly sophisticated nutrient solutions consisting of optimal combinations of macronutrients and micronutrients as well as guidelines, promoting PN as a safe and efficient feeding technique. However, IF that requires long-term PN may be associated with various complications including infections, growth failure, metabolic disorders, and bone disease. IF Associated Liver Disease may be a limiting factor. However, changes in the global management of IF pediatric patients, especially since the setup of intestinal rehabilitation centres did change the prognosis thus limiting "nutritional failure" which is considered as a major indication for intestinal transplantation (ITx) or combined liver-ITx.