• 제목/요약/키워드: Rotational surgery

검색결과 97건 처리시간 0.032초

대퇴골두 무혈성괴사의 치료에서 전방 회전 절골술의 조기 추시 결과 (The Early Result of Anterior Rotational Osteotomy in the Treatment of Osteonecrosis of the Femoral Head)

  • 김세동;신덕섭;장우석
    • Journal of Yeungnam Medical Science
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    • 제11권2호
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    • pp.284-292
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    • 1994
  • 1992년 12월부터 1994년 6월까지 영남대학교 의과대학 부속병원 정형외과에 내원한 대퇴골두무혈성 괴사 환자 28명, 31 고관절에 대해 시행한 경전자간 회전 절골술의 결과는 다음과 같다. 1. 대상 환자는 한명을 제외하고는 모두 남자였으며, 평균 연령은 44.3세로 삼, 사십대가 대부분이었다. 2. 무혈성 괴사의 원인은 과다한 음주에 의한 것이 18례로 가장 많았고, 괴사의 정도는 Ficat와 Arlet의 분류에 의하면 II a가 16례로 가장 많았다. 3. 절골술 후 고정 방법으로는 screw가 15례, DHS가 16례였고, 고정 방법에 따른 대퇴경간각의 변화로는, screw를 사용한 경우는 술전에 비해 내반고 되는 경향을 보였고, DHS를 사용한 경우는 외반고 되는 경향을 보였다. 4. 술전 대퇴골두 측면 방사선 사진에서 측정한 대퇴골두 전체 관절면에 대한 건전한 관절면의 비는 1/3이하가 8례, 1/3 이상이 23례(74%)이었다. 5. 술후 고관절의 전후면 방사선 사진에서 측정한 비구의 체중 부하면에 대한 전위된 건전한 대퇴골두의 관절면 비는 36% 이상이 24례(78%), 21-35%가 6례, 20% 이하가 1례였다.

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Evaluating Scapular Notching after Reverse Total Shoulder Arthroplasty

  • Kim, Young-Kyu;Won, Jun-Sung;Park, Chang-Kyu;Kim, Jong-Geun
    • Clinics in Shoulder and Elbow
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    • 제18권4호
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    • pp.248-253
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    • 2015
  • Background: Scapular notching can happen at diverse location depending on implant design or operative technique, therefore, it is easily misdiagnosed. Thus, this study purposed to suggest a method helpful to assess scapular notching. Methods: The subjects were 73 cases of reverse shoulder arthroplasty (RSA) for cuff tear arthropathy during the period from May 2009 to April 2014 and followed-up for over a year. There was medialized RSA in 22 cases, bone increased offset RSA (BIO-RSA) in 36 cases, and metal increased offset RSA (metal-RSA) in 15 cases. Scapular notching was not determined by bone defect at the inferior of glenosphere as Sirveaux's classification, but scapular notching at the site where the rotational route of the polyethylene of humeral implant met the scapular neck were examined. The results were compared with conventional method. Results: By conventional method, scapular notching was observed in 10 cases (45.5%) in medialized RSA, 12 cases (33.3%) in BIO-RSA, and none in metal-RSA. By new method, it was observed in 9 cases (40.9%) in medialized RSA, 10 cases (27.8%) in BIO-RSA, and none of metal-RSA. The site of scapular notching was apart from glenoshpere in 18 cases, and at inferior of glenosphere in 1 case. Absorption of bone graft was observed in 4 (11.1%) out of 36 cases of BIO-RSA. Conclusions: It is hard to distinguish scapular notching from absorption of bone graft in BIO-RSA, and bone absorption at the lateral lower end of glenoid in medialized RSA. Thus, it is considered useful to assess scapular notching at the site where the rotational route of the polyethylene insert meets scapular neck.

청소년기 특발성 척추측만증의 중재에 관한 연구 (A Study of Intervention for Adolescent Idiopathic Scoliosis)

  • 김승준
    • The Journal of Korean Physical Therapy
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    • 제16권1호
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    • pp.60-69
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    • 2004
  • Many methods have been described for the early intervention of adolescent idiopathic scoliosis. Adolescent idiopathic scoliosis is lateral and rotational spinal curvature in absence of associated congenital or neurologic abnormalities, the most common type of scoliosis observed in child and young adults, and refers to curves that develop after the age of $10{\sim}18$. The curves of adolescent idiopathic scoliosis have the potential to progress rapidly during growth. Curves are currently universally measured by the Cobb's method and Ferguson method. Some curves do not remain small, these may be mildly or severely progressive and the ribs on the convex side of the curve separate, and those on the concave side ribs approximate so rib undergoes deformation with rib humping. The latter may make angles that can affect vestibular system, balance, sensory, especially cardipulmonary function. Intervention for adolescent idiopathic scoliosis is based on the patient's age, the angular value of the curve, the maturity of their skeleton, and the topography. The purpose of intervention for adolescent idiopathic scoliosis consists of knowing how to go to the best approach the correction of the lateral curve and rotational deformity holding the achieved for the remainder of spinal growth, preventing significant cosmetic abnormality, pain and cardiopulmonary complication, control the muscle imbalance and proprioceptive postural disturbances, be less need for radical surgery to avoid early surgery.

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퇴행성 골관절염 환자에서 시행한 근위 경골 절골술 후 대퇴골의 회전과 임상결과의 상관관계 (Correlation between femoral rotation and clinical results after high tibial osteotomy in primary osteoarthritis patient)

  • 박상은;문상원
    • 대한정형외과스포츠의학회지
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    • 제10권2호
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    • pp.100-104
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    • 2011
  • 이 연구의 목적은 근위 경골 절골술 후 대퇴골의 회전각도와 슬관절 운동범위 및 주관적 환자 만족도 사이의 상관 관계를 분석하는 것이다. 2004년 6월부터 2008년 8월까지 고위 경골 절골술을 시행한 15명의 원발성 골 관절염 환자들이 연구 대상으로 수술 전 후 슬관절 CT를 시행하였다. 9명은 여자였으며 6명은 남자였다. 수술 전 후 슬관절의 CT를 촬영하여 대퇴골 회전 각도(TEA (Fig. 1) 및 Akagi's line (Fig. 2)으로 측정)를 백분율로 환산하여 분석하였으며 수술 후 슬관절 운동 각도와 주관적 만족도(Lysholm)의 상관관계를 확인하였다. 통계적 기법은 Kendall's 및 Spearman's nonparameter correlation coefficient 로 검정하였다. 결과상 대퇴골회전 정도와 수술 후 슬관절의 운동 각도는 의미 있는 상관 관계가 없으며 대퇴골 회전 정도와 수술후 환자의 주관적 만족도와는 의미 있는 상관 관계가 있었다. 따라서 이런 점을 알고 수술적 계획을 세운다면 보다 좋은 임상결과를 얻을 수 있을 것이다.

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Transbilayer Effects of Chlorpromazine.HCl on Rotational Mobility of Synaptosomal Plasma Membrane Vesicles Isolated from Bovine Brain

  • Ahn, Ki-Weon;Choi, Chang-Hwa;Kim, Inn-Se;Chung, In-Kyo;Cho, Goon-Jae;Jang, Hye-Ock;Yun, Il
    • BMB Reports
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    • 제33권6호
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    • pp.541-547
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    • 2000
  • Fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene (DPH) was used to evaluate the effects of chlorpromazine HCl on the range of the rotational mobility of bulk bilayer structure of the synaptosomal plasma membrane vesicles (SPMV) isolated from a bovine brain. In a dose-dependent manner, chlorpromazine HCl increased the anisotropy (r), limiting anisotropy ($r_{\infty}$) and order parameter (S) of DPH in the membranes. Cationic 1-[4-(trimethylammonio)-phenyl]-6-phenylhexa-1,3,5-hexatriene (TMA-DPH) and anionic 3-[p-(6-phenyl)-1,3,5-hexatrienyl]-phenylpropionic acid (PRO-DPH) were utilized to examine the range of transbilayer asymmetric rotational mobility of the neuronal membranes. The anisotropy (r) of TMA-DPH in the inner monolayer was 0.034 greater than the value of PRO-DPH in the outer monolayer of the membranes. Both cationic TMA-DPH and anionic PRO-DPH were also used to examine the transbilayer asymmetric effects of chlorpromazine HCl on the range of rotational mobility of the membranes. Chlorpromazine HCl have a decreasing effects on the rotational mobility of the bulk bilayer structures and have a greater decreasing effect on the mobility of the inner monolayer as compared to the outer monolayer of the membranes. It has been proven that chlorpromazine HCl exhibit a selective rather than nonselective fluidizing effect within the transbilayer domains of the SPMV.

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하악전돌증 환자의 양악 수술 시 상악골 후상방 회전이동 여부에 따른 안면부 경조직 변화량에 대한 비교 연구 (A comparative study on the change of postoperative facial hard tissue profile after maxillary rotational surgery)

  • 김욱규;이성탁;김태훈;송재민;황대석;정인교
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권4호
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    • pp.264-271
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    • 2011
  • Purpose: This study evaluated retrospectively the postsurgical facial hard tissue profile of a Le Fort I osteotomy with/without posterior impaction and rigid internal fixation to correct mandibular prognathism. After observing a difference between the two groups, this measurement was used to prepare a treatment plan for 2-jaw surgery. Patients and Methods: Thirty patients who had undergone orthognathic surgery in Pusan National University Dental Hospital were enrolled in this study. Fifteen patients were treated using a Le Fort I osteotomy with posterior impaction and mandibular setback bilateral sagittal split ramus osteotomy, and the other fifteen patients were treated without posterior impaction. The preoperative (T0), immediate postoperative (T1) and six-month follow-up period (T2) cephalograms were taken and difference between T1-T0 and T2-T2 was analyzed. Results: Both groups was FH-ABp, SNB and ANB showed significant changes in the measurement, whereas only the posterior impaction group showed a change in the SN-U1, occlusal plane, posterior facial height, surgical movement difference from the L1 and B-point. There was no significant statistical change between the immediate postoperative (T1) and six-month follow-up (T2) hard tissue analysis in the two groups. Conclusion: A Le Fort I osteotomy with posterior impaction is considerable for patients with a flat occlusal plane angle, large posterior facial height, prominent B-point, pogonion and labioversed incisal inclination if the indications are well chosen.

구강내 결손부에 적용된 연조직 재건술식들에 대한 임상적 고찰 (CLINICAL REVIEW OF SOFT TISSUE RECONSTRUCTIVE METHODS ON INTRAORAL DEFECTS)

  • 김욱규;이승환;황대석;김용덕;신상훈;김종렬;정인교
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권6호
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    • pp.527-537
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    • 2007
  • To evaluate criteria, indications, and prognosis of the various reconstructive methods on the patients with intraoral soft tissue defect who had been treated at Dept. of Oral and Maxillofacial Surgery, Pusan National University Hospital from 2003 to 2005, we have reviewed the clinical data of the patients and analysed. The results were as follows: 1. Tongue flaps have been mainly applied on anterior portion of palate and maxilla. The survival rate was high percent, but the cooperation of patient was inevitable for the success. 2. Palatal mucosa rotational flaps were available on relative large defect on palate, oroantral fistula site. The side effect was a scaring band from secondary healing on denuded donor palate site. Sometimes the band came to be a hinderance to swallowing, phonation. 3. Forearm free flap was a workhorse flap for everywhere in intraoral defects. We had used the flap on cheek, floor of mouth, tongue without any significant complications. But the application of the flap was required for long operation time, which was disadvantageous to the old, weak patients. 4. Cervical platysmal flap could be easily applicable for buccal cheek, floor of mouth after excision of the cancer lesion. The design of the flap could be made simultaneously on neck dissection, but the danger of cancer remnants on the flap always might be remained. 5. Buccal fat pad pedicled flap must have been a primary flap for repair of oroantral fistula especially on posterior maxilla. The flap survival will be expected if the considerations for above reconstructive methods on site, size, condition of defects primarily could be made.

Vulvar Reconstruction Using Keystone Flaps Based on the Perforators of Three Arteries

  • Yunjae Lee;Sanghun Lee;Dongkyu Lee;Hyeonjung Yeo;Hannara Park;Hyochun Park
    • Archives of Plastic Surgery
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    • 제49권6호
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    • pp.724-728
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    • 2022
  • Various flaps are used to reconstruct skin and soft tissue defects of the vulva following resection of malignancies. Whenever possible, reconstruction using local flaps is the standard treatment. Here, we describe vulvar defect reconstruction using keystone flaps. Standard keystone flaps are based on randomly located vascular perforators. However, we designed a keystone flap that includes perforators of three named arteries (the anterior labial artery of the external pudendal artery, cutaneous branches of the obturator artery, and posterior labial artery of the internal pudendal artery) and the pudendal nerve, which accompanies the internal pudendal artery. Four patients with squamous cell carcinoma and extramammary Paget's disease of the vulva underwent radical vulvectomy and keystone flaps including perforators of three arteries. Depending on the morphology of the defects, keystone flaps were used with different designs. For elliptical and unilateral vulvar defects, a standard keystone flap was designed, and for defects on both sides of the vulva, a double opposing keystone flap was used. For oval defects, the omega variant keystone flap was designed, and when the morphology of the defect needed rotation of the flap, a rotational keystone flap was designed. All the patients showed good function and sensation, with an acceptable cosmetic appearance.

Rotational Vertebral Artery Compression : Bow Hunter's Syndrome

  • Go, Gyeongo;Hwang, Soo-Hyun;Park, In Sung;Park, Hyun
    • Journal of Korean Neurosurgical Society
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    • 제54권3호
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    • pp.243-245
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    • 2013
  • Bow hunter's syndrome (BHS) is rare cause of vertebrobasilar insufficiency that arises from mechanical compression of the vertebral artery by head rotation. There is no standardized diagnostic regimen or treatment of BHS. Recently, we experienced 2 cases resisted continues medication and treated by surgical approach. In both cases, there were no complications after surgery and there were improvements in clinical symptoms. Thus, we describe our cases with surgical decompression with a review of the relevant medical literature.

Cranial Defect Overlying a Ventriculoperitoneal Shunt: Pressure Gradient Leading to Free Flap Deterioration?

  • Joo, Jae Doo;Jang, Jin-Uk;Kim, Hyonsurk;Yoon, Eul-Sik;Kang, Dong Hee
    • 대한두개안면성형외과학회지
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    • 제18권3호
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    • pp.186-190
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    • 2017
  • We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months' outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.