• Title/Summary/Keyword: corrective osteotomy

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Tibia Vara Caused by Focal Fibrocartilaginous Dysplasia(FFCD) - Case Report - (국소적 섬유연골성 이형성증(FFCD)에 의한 경골 내반 - 증례 보고 -)

  • Lee, Sang-Soo;Hwang, Ho-Yeun;Lee, Dong-Hee;Nam, Il-Hyun;Paik, Ae-Lan;Sohn, Kyung-Rak;Lee, Sang-Un
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.106-111
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    • 2000
  • Focal fibrocartilaginous dysplasia(FFCD) is an uncommon, benign condition associated with unilateral tibia vara among young children. FFCD has a typical plain radiographic finding, which has a concave radiolucent defect in the metadiaphyseal junction of medial aspect of the proximal tibia. The varus deformity occurs at the site of the lesion. Spontaneous remodeling and resolution of bony defect may be expected, but the corrective osteotomy may also be needed in some cases. The authors described a case of unilateral tibia vara caused by FFCD, diagnosed by excisional biopsy and treated with dome-shaped proximal tibial osteotomy and bone graft.

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Treatment of Congenital Elbow Luxation using the Ilizarov Technique of Distraction Osteogenesis in a Dog

  • Kim, Byung-ju;Han, Kyung-Jin;Hong, Young-chae;Park, Ji-young;Jeong, Seong-Mok;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.34 no.4
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    • pp.287-290
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    • 2017
  • A 6-month-old, 4.1 kg female Dachshund dog presented with intermittent non-weight bearing lameness of the right thoracic limb. Radiographs revealed caudolateral luxation of the right radial head and a shortened right ulna compared to the contralateral limb. Bone lengthening by distraction of the ulna using the Ilizarov technique was performed following ulnar osteotomy. The rate of distraction was 1.5 mm per day, adjusted a total of 3 times daily for a total distraction distance of 10 mm. The Ilizarov fixator was removed four weeks after surgery. The patient showed knuckling due to radial nerve injury that occurred during limb-lengthening. Corrective osteotomy was performed using a plate and pin for the luxation and deformity of the right radial head. The luxation of the radial head was successfully reduced following surgery. However, the knuckling persisted after surgery. Rehabilitation for radial nerve injury was performed using heat therapy, massage, a passive range of motion exercises, water treadmill exercises, neuromuscular electrical stimulation, leash-walking, and acupuncture. 15 months after surgery, the patient showed satisfactory weight-bearing ambulation without recurrence of lameness. The use of the Ilizarov technique is a good surgical option for the treatment of a patient with congenital elbow luxation.

Surgical Treatment of Freiberg's Disease (Freiberg병의 수술적 치료)

  • Chung, Duke-Whan;Lee, Yong-Wook;Lee, Sang-Hun
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.23-29
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    • 1997
  • Freiberg's disease is a pathologic condition of the second or third metatarsal head, rarely the forth or fifth metatarsal head, and it becomes abnormally enlarge due to avascular necrosis of subchondral cancellous bone. From Nov. 1982 to Sep. 1994, we treated surgically 10 cases of the disease who complained the continuous symptoms inspite of proper conservative management. Metatarsal head excision was done in 8 cases and resurfacing of the cartilagenous portion of the metatarsal head in 2 cases. During the average follow up of 55 months, the pain was relieved in all patients who were underwent surgical intervention but the stiffness of the metatarsophalangeal joint was remained in most of cases. It seems to be a logical treatment of choice in younger and active patients that conservative management is the initial treatment but more ablative procedure is needed for the continued symptoms. We can propose the metatarsal head excision or resurfacing of the involved joint is effective treatment method with simple procedure and minimize morbid period than other procedures such as corrective osteotomy.

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Treatment of Forearm Deformity caused by Hereditary Osteochondromatosis using Free Vascularized Fibular Epiphyseal Transplantation (생비골 성장판 이식술을 이용한 선천성 다발성 골연골증에서 전완부 변형의 치료)

  • Han, Chung-Soo;Yoo, Myung-Chul;Chung, Duke-Whan;Han, Hyun-Soo;Han, Soo-Hong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.60-67
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    • 1995
  • It is difficult to manage the growing deformity of forearm bone caused by hereditary osteochondromatosis in children, because deformity and discrepancy of limb length is progressive. The are many treatment methods of these problems including excisio of osteochondroma, lengthening of ulna, shortening of radius, corrective osteotomy with or without lengthening apparatus. Among many treatment methods, we tried free vascularized epiphyseal transplantation with the proximal fibular epiphysis in 3 patients of hereditary osteochondromatosis for inducement of continuous bone growth and deformity correction. The average duration of follow up was 7 years and 1 month, the shortest duration being to 4 years and 5 months and the longest 10 years and 8 months. Serial radiologic and clinical evaluation were carried out during follow up and there were satisfactory length gain, deformity correction and improvement of adjacent joint motion in 2 cases. According to our follow up evaluation, free vascularized epiphyseal transplantation is valuable procedure in forearm deformity of hereditary osteochondromatosis although it needs skillful and experienced operative technique.

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Determination of Pelvic Limb Alignment in Small-breed Dogs (소형견종의 후지정렬 측정)

  • Kim, Jooho;Heo, SuYoung;Na, Jiyoung;Kim, Namsoo;Lee, Kichang;Jeong, Seongmok;Lee, HaeBeom
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.481-485
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    • 2015
  • The present study determined the normal reference ranges for overall pelvic limb alignment of small-breed dogs. For this purpose, 60 cadaveric canine pelvic limbs from normal small-breed dogs (Maltese, Poodle, Shih Tzu, Yorkshire Terrier). A frontal full-limb radiograph of each pelvic limb was obtained, and mechanical tibiofemoral angle (mTFA), mechanical metatarsotibial angle (mMTTA), mechanical axis-femur angle (MAFA), and mechanical axis-metatarsus angle (MAMTA) were measured from each radiograph, along with mechanical deviation of the stifle (SMAD) and tarsal joints (TMAD). The 95% CI for radiographic values of all pelvic limbs were mTFA, 5.7-7.4; mMTTA, $-2.2--0.8^{\circ}$; MAFA, $3.5-4.5^{\circ}$; MAMTA, 1.0-2.0; SMAD, 2.1-2.7%; TMAD, 0.5-1.0%. There values varied among the breeds, except for mTFA. The reference ranges can be used for diagnosing pelvic limb deformities in small-breed dogs and for planning corrective osteotomies.

Surgical Treatment of Neglected Adult Monteggia Fracture - 2 Cases Report - (성인의 만성 Monteggia 골절의 수술적 치료 - 2예 보고 -)

  • Shon, Hyun-Chul;Kim, Weon-Yoo;Park, Sang-Eun;Kim, Young-Yul;Yoon, Jong-Seoung;Ji, Jong-Hun
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.235-241
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    • 2006
  • Neglected adult Monteggia fracture could induce the pain, instability and malformation of elbow. Especially, compared with the chronic Monteggia fracture of child, that of adult is difficult to treat and could concur with valgus instability and deformity, limitation of range of motion and tardy ulnar nerve palsy. But recently, the chronic Monteggia fracture of adult could be treated by the 3.5 mm compression plate (DCP) or 3.5 mm pelvic reconstruction plate, so that the result improved more and more. The treatment of choice of the chronic Monteggia fracture of adult is the corrective osteotomy and reduction of radial head or resection of radial head. We experienced two patients who had neglected Monteggia fracture over 1 year 6 months and 25 years respectively and we want to report the result of surgical treatment of chronic Monteggia fracture of adult.

Analysis of Bone Fixation Methods in Digital Replantation

  • Lee, Seung Woo;Lee, Dong Chul;Kim, Jin Soo;Roh, Si Young;Lee, Kyung Jin
    • Archives of Plastic Surgery
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    • v.44 no.1
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    • pp.53-58
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    • 2017
  • Background Adequate fixation of replanted digits is essential not only for short-term healing but for long-term function. Various bony fixation methods using Kirschner (K-) and intraosseous wire are available in replantation. We examined clinical and radiographic outcomes of fixation methods on bone union after digital replantation. Methods A single institutional retrospective review identified 992 patients who had undergone 1,247 successful replantations between July 2009 and September 2015. Exclusion criteria included amputations of the distal phalanx, comminuted fractures, and intra-articular fractures. Patients were classified according to 5 categories of fixation methods: single K-wire, double longitudinal K-wires, cross K-wires, wire with, and wire without K-wire support. Bone union was evaluated by 5-month postoperative X-ray and fixation outcomes were compared across the 5 groups. Results The exclusion criteria were applied, and 88 patients with 103 replanted digits remained for analysis. Single K-wire fixation was used in 40 digits, double longitudinal K-wires in 30, and cross fixation in 14. Wire with and without K-wire support was required in 15 and 4 digits. Nonunion was observed in 32 digits (31.1%), of which 13 required additional operations such as bone graft or corrective osteotomy. The highest percent of nonunion was observed after cross fixation (35.7%) and the lowest after wire alone (25.0%). Conclusions In this study, contrary to general knowledge, we found that single K-wire fixation was not associated with poorer outcomes. Successful bone union outcomes may be achieved by careful selection of bone fixation methods. This study provides useful information for planning bone fixation in digital replantation.

Determination of Femoral and Tibial Joint Reference Angles in Small-breed Dogs

  • Kim, Jooho;Heo, Suyoung;Na, Jiyoung;Kim, Namsoo;Kim, Minsu;Jeong, Seongmok;Lee, HaeBeom
    • Journal of Veterinary Clinics
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    • v.33 no.6
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    • pp.340-345
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    • 2016
  • The present study determined the normal reference ranges for the femoral and tibial joint orientation angles of small-breed dogs. For this purpose, 60 each of cadaveric canine femurs and tibias from normal small-breed dogs (Maltese, Poodle, Shih Tzu, Yorkshire Terrier) were examined with radiographs and photographs. Axial and frontal radiographs and photographs of each bone were obtained, from which anteversion and inclination angles, anatomic lateral proximal and distal femoral angles (aLPFA and aLDFA), mechanical lateral proximal and distal femoral angles (mLPFA and mLDFA), and mechanical medial proximal and distal tibial angles (mMPTA and mMDTA) were measured. The 95% CI for radiographic values of all femurs and tibiae were anteversion angle, $23.4-27.4^{\circ}$; inclination angle, $128.4-130.4^{\circ}$; aLPFA, $117.8-122.1^{\circ}$; aLDFA, $93.7-95.2^{\circ}$; mLPFA $113.8-117.3^{\circ}$; mLDFA $99.2-100.5^{\circ}$; mMPTA $96.8-98.5^{\circ}$; mMDTA $89.4-90.7^{\circ}$. The Maltese had a larger anteversion angle than the Poodle and the Yorkshire Terrier and a larger mLPFA than the Poodle. In the comparison between the radiographs and the photographs, significant differences were found in the anteversion angle, mLPFA, mMPTA, and mMDTA. The established normal reference values might be useful for determining whether a valgus or varus deformity of the femur or the tibia is present and if so, the degree of angular correction needed.

Treatment of Shepherd's Crook Deformity with Huckstep's nail in Fibrous Dysplasia - A Case Report - (섬유성 골이형성증에서 Huckstep 정을 이용한 Shepherd's Crook 변형의 치료 - 증례 보고 -)

  • Whang, Kuhn-Sung;Kim, Tae-Seung;Kim, Byoung-Hoon;Lee, Jong-Min
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.27-31
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    • 2002
  • Clinical symptoms of fibrous dysplasia in proximal femur include pain, limping, and leglength discrepancy. Occasionally varus deformity, which may range from mild coxa vara to a marked shepherd's crook deformity was developed. Surgical intervention generally is considered advisable in the presence of persistent pain unresponsive to conservative treatment or significant or progressive deformity. Depending on the lesion size, lesion site, and deformity, several treatment methods have been used. This is a report on one case of bilateral shepherd's crook deformity in fibrous dysplasia, which was treated with corrective osteotomy by Huckstep nail.

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A RETROSPECTIVE STUDY ON THE CLINICAL MANEFESTATIONS, ETIOLOGIC FACTORS OR SURGICAL CORRECTION METHODS OF THE MAXILLOFACIAL DEFORMITY PATIENTS (악안면 기형 환자들의 발현 양상, 원인 요소 및 외과적 교정 방법에 관한 역학적연구)

  • Hyeon, Chung-Hwan;Yim, Chang-Joon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.233-242
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    • 1997
  • Recently the goal of orthognathic surgery has been focused on esthetic improvement of the patients. Also early corrective surgery was favorable selected by most of the oral and maxillofacial surgeons. We should consider the etiologic factor of the patient's dentofacial deformities when treatment is planned, because this is the major factor in estimating the predictability or stability of result. The more researches were carried on the etiologic factors of the dentofacical deformities, The more possibility of the early surgical correction will be increased. The authors analyzed about etiologic factors and epidemiologic studies of the forth patients who had received the orthognathic surgery. The analyzed results were as follows: 1. The predilection ration between male and female was 17:23, and 32 patients (80%) of 40 patients were aged twenties. 2. 26patients(65%) complained estetic problems as well as functional problems. 10 patients(25%) complained only esthetic problems, and 4 of 40 patients complained only functional problems. 3. Mandibular prognathism was found to be done most frequently(25, 39%). Facial asymmetry (13, 20%) and angle hypertrophy were found to be next in sequence. 4. Sagittal split ramus ostetomy was done most frequently(27, 35%). Lefort I osteotomy(13, 17%), angle reduction (12,16%), and genioplasty(11, 15%) were done also. 5. The number of the cases due to nonspecific etiologic factor was 22(55%), that of cases due to inhertied tendency was 12(30%), that of cases due to congenital anomaly was 3(7.5%), and that of cases due to trauma was 3(7.5%). 6. The number of patients who got only maxilliary surgery was 2(5%), that of patients who got only mandibular surgery was 23(57.5%), and that of patients who got simultaneous two jaw surgery was 15(37.5%).

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