• 제목/요약/키워드: Symphyseal distraction osteotomy

검색결과 5건 처리시간 0.02초

골반강 협착증으로 인해 발생한 변비를 가진 고양이에서의 골반강 확장술을 이용한 치료 증례 (Pelvic Symphyseal Distraction Osteotomy for Constipation Management Secondary to Pelvic Stenosis)

  • 오광선;최성진;김남수;김민수;이기창;이해범
    • 한국임상수의학회지
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    • 제31권6호
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    • pp.527-530
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    • 2014
  • 7살 중성화된 수컷 한국집 고양이가 6개월동안 지속된 변비를 주증으로 본원에 내원하였다. 직장검사에서 골반강의 우측 외측부분의 좁아짐을 보였고, 방사선검사에서는 골반골절의 부정유합으로 인한 골반강의 협착을 확인할 수 있었다. 골반강 직경 비율은 0.68이었다. 직장검사와 방사선검사를 기반으로 골반강 협착으로 인한 변비로 진단하였다. 그래서 골반결합을 절골하여 골반강 확장술을 시행하였고 이를 용이하게 하기 위하여 장골 절골술도 함께 시행하였다. 확장된 골반강을 유지하기 위하여 골반결합 사이에 폴리메칠메타크릴레이트를 성형하여 구조물로 삽입하였다. 절골 한 장골은 뼈판과 나사를 이용하여 다시 고정시켜주었다. 방사선 검사에서 술 후 골반강 직경 비율은 0.91로 증가했음을 알 수 있었다. 술 후 처치로는 항생제, 진통소염제, 락툴로오스경구제 투여와 함께 수액요법을 시행하였다. 환자는 골반강 확장술 후 일주일부터 정상적인 배변을 보였고, 그 이후 6개월동안 재발은 없었다. 이 증례를 바탕으로 골반강 확장술은 골반골절의 부정유합으로 인한 골반강 협착에 따라 발생한 변비에서 유용한 치료법으로 사료된다.

하악 이부확장 시 하악골 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구 (A 3-D finite element analysis on the mandibular movement pattern and stress distribution during symphyseal widening)

  • 이도훈;홍현실;채종문;조진형;김상철
    • 대한치과교정학회지
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    • 제38권1호
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    • pp.13-30
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    • 2008
  • 하악 이부확장에서 골 절단선의 위치 및 종류와 견인 장치의 종류에 따른 차이를 알아보고자 삼차원 유한요소법으로 하악골의 이동 양상 및 응력 분포를 조사하였다. 골 견인장치의 종류로는 치아 의존형과 골 의존형, 혼합형, $30^{\circ}$ 기울여 위치한 치아 의존형의 4가지를, 골절단 위치와 방법으로 하악 중절치 간 수직절단과 하악 정중이부를 관통하는 계단식 골절단 등의 2가지를 설정하였다. 연구 결과, 골절단의 위치 및 방법과 견인장치의 종류에 관계없이 과두를 포함한 하악골의 모든 부위에서 외측방 변위를 보였으며 상하적이나 전후방적 변위는 적은 양이었으나 방향에 있어 군간에 차이를 보였다. 치아 의존형 장치에 의한 골절단면 이개 양태는 V형이었으나 골 의존형 장치는 역V형이고 혼합형 장치는 평행하게 확장되었다. 골 의존형 장치에 의한 하악각의 외측 변위량이 다른 장치에 비해 컸다. $30^{\circ}$ 기울여 위치한 치아 의존형에서의 변위는 측방적, 전후방적 면에서 좌우 차이가 인정되었다.

Bone-borne type distractor를 사용한 하악골 정중부 골신장술 (DISTRACTION OSTEOGENESIS ON MANDIBLE SYMPHYSIS WIDENING WITH A BONE-BORNE TYPE DISTRACTOR)

  • 조진형;지영덕
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권4호
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    • pp.356-364
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    • 2006
  • Transverse mandibular deficiency has a many problem in growing patients. Therefore, Mandible symphysis widening is recommended. A new surgical technique has been developed to widen the mandible. The purpose of this study is to report the effect of mandibluar symphyseal distraction osteogenesis by use of bone-borne type distractor. The surgical procedure was accomplished under general anaesthesia with step-line osteotomy. Bone-borne type distractor was used to generally widen the mandible. The expansion achieved in the mandible was 8.31mm at the device, 6.32mm at the canines, 4.06mm at the first molars. The symphyseal distraction gaps were bridged by new bony regeneration. Mandibular symphseal distraction osteogenesis increased mandibular arch width, stabilized occlusion, and corrected dental crowding.

하악 이부 확장술 시 나타나는 합병증의 치험례 (A CASE REPORT OF COMPLICATIONS DURING MANDIBULAR TRANSVERSE SYMPHYSIS WIDENING)

  • 서충환;강경화;최문기
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권5호
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    • pp.480-488
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    • 2008
  • Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

Triple Pelvic Osteotomy and Autograft to the Gap of Ischium for the Treatment of Pelvic Canal Narrowing in a Cat

  • Park, Ji-Hun;Kim, Keun-Yung;Lee, Chae-Yeong;Lee, Si-Eun;Park, Hyojin;Hwang, Tae-Sung;Lee, Hee-Chun;Lee, Dongbin;Lee, Jae-Hoon
    • 한국임상수의학회지
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    • 제38권5호
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    • pp.235-239
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    • 2021
  • Pelvic canal narrowing secondary to pelvic fractures can lead to episodes of recurrent constipation in cats. Triple pelvic osteotomy is considered as a surgical treatment method; however, there is potential for future recurrence of pelvic canal narrowing. This report describes a surgical method using a pelvic symphyseal autograft to keep the distraction of the ischial osteotomy gap to prevent the recurrence of pelvic canal narrowing. A triple pelvic osteotomy was planned to expand the narrow pelvic canal. The cranial ramus of the pubis was cut, and ischiatic and iliac osteotomies were performed. After expanding the ilium, the malunion pelvic symphysis was cut approximately 1 cm and then autografted to the gap of the ischiatic osteotomy line to keep the distraction. The patient showed clinical improvement postoperatively without recurrent pelvic canal narrowing related to triple pelvic osteotomy. However, constipation recurred on post-operative month-5. It was managed conservatively, and subtotal colectomy was performed eventually nine months post-operatively. There were no complications for five months of follow-up.