• Title/Summary/Keyword: Surgical fixation

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Results after Operative Treatment for Maisonneuve Fracture (Maisonneuve 골절에서 수술적 치료의 결과)

  • Lee, Jun-Young;Ha, Sang-Ho;Sohn, Hong-Moon;Lee, Kwang-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.72-78
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    • 2007
  • Purpose: This study is to analysis the outcome of patient with surgically treated Maisonneuve fracture and find out the factors that might influence the outcome. Material and methods: 20 patients who had surgical treatment due to Maisonneuve fracture between February, 2001 to March, 2005 were studied. The patients were followed for at least 1 year and average follow up period was 25 months. The average age was 41 years, 16 were male and 4 were female. Mechanism of injury according to Rouge-Hansen classification was supination-external rotation. In all cases, percutaneous screw fixation was applied proximal to tibiofibular syndesmosis. The screws were removed after 8 weeks under local anesthesis. Clinical, functional and radiographic results were evaluated. Results: 17 cases (85%) showed satisfying clinical and radiographic results. The mean functional score according to Ankle Scoring System was 91 (83 to 95). Complication occurred in 1 case with underlying systemic disease and 2 cases with initial ankle joint dislocation. Conclusion: Surgical treatment of Maisonneuve fracture showed relatively satisfying result. However, initial injury state and accompanying disease seem to have great effect on the result.

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Surgical Repair of Rostral Hemimandibular Fractures with Canine Tooth Luxation in a Dog (개에서 견치 탈구를 동반한 앞쪽 하악골 골절의 수술적 정복 1례)

  • Yoon, Hun-Young;Kang, Myung-Gon;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.359-361
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    • 2009
  • A sexually intact female Alaskan Malamute, 5-year-old weighing 25.2 kg presented to the Hangang Animal Hospital, following hit-by-car. On initial presentation, the dog had severe salivation and the right canine tooth luxation. Radiographs revealed fractures of the right rostral hemimandible with the right canine tooth luxation and symphyseal separation. Surgical repair of fractures was performed by use of an interdental wiring technique and external fixation technique that included pins, an acrylic connecting bar, and polymethyl methacrylate bone cement. Post-operative radiographs revealed that bridging callus was well formed over cortices of the fracture area. Pins and an acrylic connecting bar were removed 7 weeks post-operatively. The dog exhibited evidence of normal mastication.

The Symptomatic Os Subfibulare (증세가 있는 비골하 부 골)

  • Lee, Woo-Chun;Ko, Han-Suk;Kwon, Kang-Jin;Kim, Sung-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.136-141
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    • 2001
  • Purpose: To investigate clinical features and treatment of os subfibulare Materials and Methods: This is a retrospective study on twenty-eight patients who have symtoms associated with os subfibulare. We reviewed charts and radiographs. Thirteen patients were treated surgically and fifteen patients were treated conservatively. We analysed clinical results in 25 patients who were followed for more than one year. Results: Duration from the onset of symtoms to treatment was more than six months in twelve of thirteen surgically treated cases, and in only two of fifteen conservative treated cases. Surgical procedures were internal fixation of the os subfibulare in two patients, and resection of os subfibulare and ligament reconstructions in eleven patients. Clinical results were excellent in six, good in three and poor in two of operatively treated patients. In conservatively treated patients, five excellent, five good, one fair and one poor clinical results were obtained. Conclusion: Os subfibulare is not necessarily a cause of instability and pain, but in cases with chronic pain and/or instability, surgical treatment would result in satisfactory result.

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Comparison of Antiglide Plate Fixation and Lateral Plate Fixation for Danis-Weber Type B Isolated Lateral Malleolar Fractures (족관절 외과의 Danis-Weber B형 단독 골절에 있어서 활주 방지 금속판고정술과 외측 금속판고정술의 비교)

  • Ha, Joong-Won;Kim, Hyoung-Bok;Ko, Min-Suk;Yoon, Han-Kook
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.153-158
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    • 2011
  • Purpose: This study was performed retrospectively and to compare the clinical outcomes of the surgical management using Antiglide plating and lateral plating for Danis-Weber type B isolated lateral malleolar fractures. Materials and Methods: Between March 2004 and March 2009, 92 patients were followed up for more than 6 months after surgical treatment. 49 patients were treated with Antiglide plating, whereas the remaining 43 patients underwent lateral plating. The results of the two groups were analyzed both radiographically and clinically using Ankle scoring system. Results: Both groups were comparable for age, sex distribution, time to surgery, and operation time. Bone union was noted at average of 8 weeks in all fractures. The mean ankle score was similar in both groups (94% versus 93%). Conclusion: Antiglide plating for Danis-Weber type B isolated lateral malleolar fracture is one of the good methods which has some advantages such as early ankle motion, ambulation and smaller operative incision.

Correction of Lowerlid Entropion by Using Skin-tarsal Fixation Method (피부검판 고정술을 이용한 하안검 내반증의 교정)

  • Hong, Jung Soo;Kim, Han Koo;Kim, Woo Seob;Kim, Seung Hong
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.397-402
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    • 2005
  • For its lowerlid entropion correction, nonsurgical eyelid suture or surgical eyelid suture can be employed. Different types of surgical eyelid suture such as the Hotz method and the Callahan method, are generally performed, but were not sufficient for correcting of entropion. In our hospital we performed modified skin-tarsal fixation on 15 patients, 5 male and 10 female from January 20, 1999 to December 16, 2002. We corrected lower eyelid entropion with the excision of the skin and orbicularis oculi muscle and buried suture of tarsal plate and dermis which is a variant of the Callahan method. All the patients were satisfied with the operation results, and there was no case of recurrence of the lower eyelid pricking the cornea. During the 6 months period after the operation, the lower eyelids slightly turned inward but there was no further progression. The correction was performed excessively, therefore there was no case of recurrence after the operation and the results were satisfactory. There developed a dimple at the suture margin caused by skin contraction but it usually disappeared within 2 months after the operation. To avoid recurrence and to achieve satisfactory results, the orbicularis oculi muscle must be totally resected at the ciliary margin. We resected ciliary as well as pretarsal portion of orbicularis oculi muscle. Also, since most of the recurrences are originated from the medial side, the medial portion of skin flap must be tightly fixed to avoid recurrence and the upper part of the dermis should be fixed tightly to the lower border of the tarsal plate.

Redoable Tie-Over Dressing Using Multiple Loop Silk Threads

  • Jo, Hyeon Jong;Kim, Jun Sik;Kim, Nam Gyun;Lee, Kyung Suk;Choi, Jae Hoon
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.259-262
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    • 2013
  • After skin grafting, to prevent hematoma or seroma collection at the graft site, a tie-over dressing has been commonly used. However, although the conventional tie-over dressing by suture is a useful method for securing a graft site, refixation is difficult when repeated tie-over dressing is needed. Therefore, we recommend a redoable tie-over dressing technique with multiple loops threads and connecting silk threads. After the raw surface of each of our cases was covered with a skin graft, multiple loop silk thread attached with nylon at the skin graft margin. We applied the ointment gauze and wet cotton/fluffy gauze over the skin graft, then fixed the dressing by connecting cross-counter multiple loop thread with connecting silk threads. When we opened the tie-over dressing by cutting the connecting silk threads, we repeated the tie-over dressing with the same method. The skin graft was taken successfully without hematoma or seroma collection or any other complications. In conclusion, we report a novel tie-over dressing enabling simple fixation of the dressing to maintain proper tension for wounds that require repetitive fixation. Further, with this reliable method, the skin grafts were well taken.

Recent trend and surgical management for panfacial fracture (범안면골 골절의 최근 경향 및 수술개념)

  • Kim, Jin-Wook
    • The Journal of the Korean dental association
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    • v.54 no.10
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    • pp.811-819
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    • 2016
  • Panfacial fracture is extremely difficult to manage facial injuries but concomitant injuries and severe complications including facial esthetic and functional problems can make it harder. Thorough evaluation and closed co-work with other specialists is needed when reduction and fixation cannot be achieved quickly. Emergency bony support and soft tissue key suture provide the patients with airway integrity, hard and soft tissue vitality. A systemic treatment plan must be made by 3D CT image. This plan include airway management for surgery, sequence of reduction and fixation, approach method, soft tissue resuspension and reconstruction of lost tissue like inferior orbital wall, zygomaic buttress and soft tissue. From known to unknown structures, accurate reduction and fixation will provide proper occlusion, facial projection, width, hight and function. Consideration about facial retaining ligaments must be given to prevent soft tissue sagging.

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Orthognathic surgery for patients with fibrous dysplasia involved with dentition

  • Udayakumar, Santhiya Iswarya Vinothini;Paeng, Jun-Young;Choi, So-Young;Shin, Hong-In;Lee, Sung-Tak;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.37.1-37.7
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    • 2018
  • Background: Fibrous dysplasia (FD) is characterized by the replacement of normal bone by abnormal fibro-osseous connective tissue and typically treated with surgical contouring of the dysplastic bone. When dysplastic lesions involve occlusion, not only is surgical debulking needed, orthognathic surgery for correction of dentofacial deformity is mandatory. However, the long-term stability of osteotomized, dysplastic bone segments is a major concern because of insufficient screw-to-bone engagement during surgery and the risk of FD lesion re-growth. Case presentation: This case report reviewed two patients with non-syndromic FD that presented with maxillary occlusal canting and facial asymmetry. Le Fort I osteotomy with recontouring of the dysplastic zygomaticomaxillary region had been performed. The stability of osseous segments were favorable. However, dysplastic, newly formed bone covered the previous plate fixation site and mild bony expansion was observed, which did not influence the facial profile. Including the current cases, 15 cases of orthognathic surgery for FD with dentition have been reported in the literature. Conclusion: The results showed that osteotomy did not appear to significantly reduce the long-term stability of the initial fixation insufficiency of the screw to the dysplastic bone. However, based on our results and those of the others, long-term follow-up and monitoring are needed, even in cases where the osteotomized segment shows stable results.

Surgical Treatment Using Anchor Suture of Coracoid Process Fracture with Acromioclavicular Joint Dislocation - A Case Report - (견봉-쇄골관절 탈구를 동반한 오구 돌기 골절의 봉합나사를 이용한 수술적 치료 - 증례 보고 -)

  • Jeong, Woon-Seob;Lee, Sang-Soo;Yoo, Yon-Sik;Kim, Do-Young;Park, Keun-Min
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.240-244
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    • 2009
  • Purpose: This study examined the outcomes of closed reduction and fixation of the coracoid process fracture using a suture anchor in a patient with combined acromioclavicular dislocation for which the coraco-clavicular ligament was intact. Materials and Methods: A 26 year-old male patient with a coracoid process fracture that was associated with a type III acromioclavicular joint dislocation was operated on with anchor suture fixation. This is the first trial of this operative procedure. Results: At the postoperative follow-up at 3 months, complete union of the coracoid process fracture was seen. The shoulder had a full range of motion and the shoulder function was normal. Conclusion: Closed reduction and fixation using one suture anchor for treating coracoid process fracture is a safe, effective procedure.

Sequencing of panfacial fracture surgery: a literature review and personal preference

  • Jae Hee, Yoon;Dong Hee, Kang;Hyonsurk, Kim
    • Archives of Craniofacial Surgery
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    • v.23 no.6
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    • pp.256-261
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    • 2022
  • Background: Treating panfacial fractures (PFFs) can be extremely difficult even for experienced surgeons. Although several authors have attempted to systemize the surgical approach, performing surgery by applying a unidirectional sequence is much more difficult in practice. The purpose of this study was to review the literature on PFF surgery sequence and to understand how different surgical specialists-plastic reconstructive surgery (PRS) and oral maxillofacial surgery (OMS)-chose sequence and review PFFs fixation sequence in clinical cases. Methods: The PubMed and Google Scholar databases were scoured for publications published up until May 2020. Data extracted from the studies using standard templates included fracture part, fixation sequence, originating specialist, and the countries. Bibliographic details like author and year of publication were also extracted. Also, we reviewed the data for PFFs patients in the Trauma Registry System of Dankook University Hospital from 2011 to 2021. Results: In total, 240 articles were identified. This study comprised 22 studies after screening and full-text analysis. Sixteen studies (12 OMS specialists and 4 PRS specialists) used a "bottom-top" approach, whereas three studies (1 OMS specialist and 2 PRS specialists) used a "top-bottom" method. However, three studies (only OMS specialists) reported on both sequences. In our hospital, there were a total of 124 patients with PFF who were treated during 2011 to 2021; 64 (51.6%) were in upper-middle parts, 52 (41.9%) were in mid-lower parts, and eight (6.5%) were in three parts. Conclusion: Bottom-top sequencing was mainly used in OMS specialists, and top-bottom sequencing was used at a similar rate by two specialists in literature review. In our experience, however, it was hard to consistently implement unidirectional sequence suggested by a literature review. We realigned the reliable and stable buttresses first with tailoring individually for each patient, rather than proceeding in the unidirectional sequence like bottom-top or top-bottom.