• 제목/요약/키워드: Repair technique

검색결과 672건 처리시간 0.027초

편측성 구순구개열 환자에 있어 구순성형술과 동반한 서골피판법 치험례 (Simultaneous Repair of Unilateral Cleft Lip and Hard Palate with Vomer Flap : a Case Report)

  • 박형욱;송인석;김유진;김수호;천강용;서병무
    • 대한구순구개열학회지
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    • 제15권2호
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    • pp.61-68
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    • 2012
  • Cleft lip and palate is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation advancement flap method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, Millard's rotation advancement flap method has its advantage in designing the flap using the patient's anatomic landmarks. For performing this rotation advancement technique, skillful operation is needed to obtain esthetically satisfactory results. Vomer flap sometimes is used to repair anterior hard palate in complete cleft lip and palate patients. Vomerine tissue is readily available in the vicinity of the palatal defect and elevation of the vomerine flap is relatively simple procedure. In this article, we will introduce the comprehensive vomer flap technique conjunction with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with Millard's rotation advancement method and vomer flap.

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Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study

  • George Samanidis;Konstantinos Kostopanagiotou;Meletios Kanakis;Georgios Kourelis;Kyriaki Kolovou;Georgios Vagenakis;Dimitrios Bobos;Nicholas Giannopoulos
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.187-192
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    • 2023
  • Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

전통 벽체 기법 변화에 관한 연구 (A Study on Changes of Traditional Wall Technique)

  • 조영민
    • 건축역사연구
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    • 제23권4호
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    • pp.47-56
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    • 2014
  • Traditional wall is ground coat, twice plater, last plaster by such a process has made a wide variety of used materials and techniques are accordingly diverse. These traditional techniques handed down the traditional walls of the techniques, rather than coming to the lowered cut off at any moment from now when the technique is used, not knowing whether to be used. Repair and restore cultural property maintenance work, it is not only the outward form hiding inside it is a technique to keep the preservation of cultural assets can be called true. When viewed from the side walls of these conventional techniques to reveal changes in the traditional process by looking at the changes in technology with traditional techniques for cause shall be made in stock. This paper is from the late Joseon Japanese occupation of techniques ranging from traditional wall to reveal the change process to its current significance of cultural property repair method to be helped.

Revision of a Pull-out Suture Anchor in the Lateral Row During the Suture-bridge Technique

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong;Yang, Jae-Hoon;Kim, Dong-Kyu;Kim, Bo-Kun
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2009년도 제17차 학술대회
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    • pp.159-159
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    • 2009
  • Repeated pulling-out of a suture anchor in the lateral row despite repeated attempts at insertion during a rotator cuff repair is not uncommon with the suture-bridge technique, especially in patients with osteoporosis. We describe a simple procedure for dealing with the pull-out of a PushLock anchor in the lateral row using a suture anchor with a suture eyelet during rotator cuff repair applying the suture-bridge technique.

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고리 봉합법을 이용한 심부 수지 굴건 종지부에서의 건봉합 (Loop Suture Technique for Flexor Digitorum Profundus Tendon Repair in the Insertion Site)

  • 이규철;이동철;김진수;기세휘;노시영;양재원
    • Archives of Plastic Surgery
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    • 제37권5호
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    • pp.650-658
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    • 2010
  • Purpose: In the case of repair for far distal parts of FDP (Flexor digitorum profundus) division, the method of either pull-out suture or fixation of tendon to the distal phalanx is preferred. In this paper, the results of a modified loop suture technique used for the complete division of FDP from both zone 1a and distal parts of zone 1b in Moiemen classification are presented. Methods: From July 2006 to July 2009, the modified loop suture technique was used for the 10 cases of FDP in complete division from zone 1a and distal parts of zone 1b, especially where insertion sites were less than 1 cm apart from a tendon of a stump. In a suture technique, a loop is applied to each distal and proximal parts of tendon respectively. Core suture of 2-strand and epitendinous suture are done with PDS 4-0. Out of 10 patients, the study was done on 6 patients who were available for the followup. The average age of the patients was 49.1 years (in the range from 26 to 67). 5 males and 1 female patients were involved in this study. There were 3 cases with zone 1a and distal parts of zone 1b. The average distance to the distal tendon end was 0.6 cm. There were 5 cases underwent microsurgical repair where both artery and nerve divided. One case of only tendon displacement was presented. The dorsal protective splint was kept for 5 weeks on average. The results of the following tests were measured: active & passive range of motion, grip strength test, key pinch and pulp pinch test. Results: The follow-up period on average was 11 months, in the range from 2 to 20 months. There was no case of re-rupture, but tenolysis was performed in 1 cases. In all 6 cases, the average active range of motion of distal interphalangeal joint was 50.8 degree. The grip strength (ipsilateral/contralateral) was measured as 88.7% and the pulp pinch test was 79.2% as those of contralateral side. Flexion contracture was presented in 2 cases (15 degree on average) and there was no quadrigia effect found. Conclusion: Despite short length of tendon from the insertion site in FDS rupture in zone 1a and distal parts of zone 1b, sufficient functional recovery could be expected with the tendon to tendon repair using the modified loop suture technique.

Soft tissue reconstruction in wide Tessier number 3 cleft using the straight-line advanced release technique

  • Kim, Gyeong Hoe;Baek, Rong Min;Kim, Baek Kyu
    • 대한두개안면성형외과학회지
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    • 제20권4호
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    • pp.255-259
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    • 2019
  • Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.

Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods

  • Al-Zajrawee, Mustafa Zahi;Aljodah, Mohammed Abd-Alhussein;Hassan, Qays Ahmed
    • Archives of Plastic Surgery
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    • 제46권2호
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    • pp.114-121
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    • 2019
  • Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle. Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a modification of the Millard and Manchester techniques. Patients with a very wide cleft lip and protruded or rotated premaxilla were excluded from this study. We analyzed 30 normal children for a comparison with our patients in terms of anthropometric measurements. Results By the end of the follow-up period (between 9 and 19 months), all our patients had obtained a full central segment with adequate white roll in the central segment and a deep gingivolabial sulcus, and we obtained nearly normal anthropometric measurements in comparison with age-matched normal children. Conclusions We recommend this modified technique for the treatment of bilateral cleft lip deformity.

Rehabilitation of notched circular hollow sectional steel beam using CFRP patch

  • Setvati, Mahdi Razavi;Mustaffa, Zahiraniza
    • Steel and Composite Structures
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    • 제26권2호
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    • pp.151-161
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    • 2018
  • The application of carbon fiber reinforced polymer (CFRP) composites for rehabilitation of steel structures has become vital in recent years. This paper presents an experimental program and a finite element (FE) modelling approach to study the effectiveness of CFRP patch for repair of notch damaged circular hollow sectional (CHS) steel beams. The proposed modeling approach is unique because it takes into account the orthotropic behavior and stacking sequence of composite materials. Parametric study was conducted to investigate the effect of initial damage (i.e., notch depth) on flexural performance of the notched beams and effectiveness of the repair system using the validated FE models. Results demonstrated the ability of CFRP patch to repair notched CHS steel beams, restoring them to their original flexural stiffness and strength. The effect of composite patch repair technique on post-elastic stiffness was more pronounced compared to the elastic stiffness. Composite patch repair becomes more effective when the level of initial damage of beam increases.

콘크리트 구조물의 중성화 및 LCC예측을 통한 최적보수공법 선정 (Optimal Repair Method Selection through Neutralization Prediction and LCC Evaluation of a Concrete Structure)

  • 강인석;이한승;정해문;안태송
    • 한국콘크리트학회:학술대회논문집
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    • 한국콘크리트학회 2005년도 추계 학술발표회 제17권2호
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    • pp.511-514
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    • 2005
  • In this study, LCC(Life Cycle Cost) evaluation technique is used for the purpose of accumulation of basic data required for such integrative system construction. We predicted the degradation time of concrete and repair material by neutralization through FEM analysis, and utilized the result for LCC evaluation It turned out that the repair method of construction in the most economical initial measure against degradation and a durable period can be chosen through the LCC evaluation in consideration of the degradation prediction using FEM analysis and the initial construction expense in a durable period and repair expense, and the number of repair times.

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Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique

  • Han, Kihwan;Park, Jeongseob;Lee, Seongwon;Jeong, Woonhyeok
    • 대한두개안면성형외과학회지
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    • 제19권1호
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    • pp.3-12
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    • 2018
  • Background: Millard's rotation-advancement repair, which is used by many surgeons, can make a natural philtral column, but most surgeons use a modification of the rotation-advancement flap. The purpose of this article is to introduce a modification utilized by the authors and to provide detailed surgical procedure. Methods: We retrospectively reviewed 82 patients' medical records and presented surgical technique and outcomes. The main features of the authors' strategy are emphasizing horizontal length of the lip, orbicularis oris muscle duplication for improving the definition of the philtral column, overcorrection of domal portion than the non-cleft side in order to compensate for the recurrence during growth. Two judges rated two times the appearance of the patients' nose and lip using Asher-McDade aesthetic index. Intra- and interobserver reliabilities were determined using Cohen's kappa statistics. Results: All patients recovered eventually after surgery; however, two patients have a minor complications (wound infection in one patient, wound disruption due to trauma in the other patient). The improvement of the aesthetic results can be achieved with this modified Millard technique. Total mean scores of the Asher-McDade index was 2.08, fair to good appearance. The intraobserver reliabilities were substantial to almost perfect agreement and the interobserver reliabilities were moderate to almost perfect agreement. Conclusion: We modified Millard method for repair of complete unilateral cleft lip. The surgical outcomes were favorable in long-term follow-up. We hope our technique will serve as a guide for those new to the procedure.