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Modified Direct W-incision with Silicone Sheet to Minimize Operation Scar in Reconstruction of Mild to Moderate Symptomatic Medial Orbital Wall Fracture (경중도 안와 내벽 골절의 수술 시 흉터 최소화를 위한 변형된 직접 W-절개법과 실리콘판을 이용한 재건)

  • Jung, Jae A;Gong, Jung Sik;Kim, Yang Woo;Kang, So Ra
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.30-35
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    • 2013
  • Background: For reconstruction of the mild to moderate medial orbital wall fractures, various surgical approaches have been used. Prior existing W-shaped incision was a direct local approach through a 3 cm incision on the superior medial orbital area with a titanium mesh implant. In this study, the authors modified W-shaped incision and reconstructed the defect with silastic sheet to improve the result and the postoperative scar. Methods: This study included 20 patients who had mild to moderate size of medial wall defect and therefore relatively suitable for reconstruction with silastic sheets from July, 2009 to December, 2011. A modified W-shaped skin incision approximately 1.2 to 1.5 cm in length was made along the superior medial orbital rim from approximately 1 cm medial to the medial canthus to the lower border of the medial eyebrow. The angles of the limbs of the W ranged from 150 to 160 degrees. Results: By using soft flexible silastic sheet, the authors reduced the incision from 3 to 1.5 cm, and by widening the angle of the W limbs, scars were more effectively hided in the relaxed skin tension line. Scar assessment was done with modified patient and observer scar assessment scale and mean score from patients was 2.08 and mean score from observers was 2.12. Conclusion: Although this method will not be suitable for every case, it can be a consistent method to obtain the surgical goal in treatment of mild to moderate blowout fractures of the medial orbital wall.

Consideration of Various Medial Capsulorrhaphy Methods in Hallux Valgus Surgery (무지 외반증의 수술 중 시행하는 내측 관절낭 봉합술의 방법에 대한 고찰)

  • Choi, Sung-Jong;Kim, Byung-Cheol;Eun, Il-Soo;Huh, Jung-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.9-13
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    • 2008
  • Purpose: Medial capsulorrhaphy is additional hallux reduction method following various hallux reduction procedures and we are going to report author's opinion about several methods of medial capsulorrhaphy. Materials and Methods: We performed three kinds of medial capsulotomy and imbricatory capsulorrhaphy in hallux valgus surgery. Through 8 cadavar study, we compared the easiness of sesamoid reduction and hallux valgus angle reduction. Also, we measured thickness of capsule in various portions. Results: Longitudinal capsule incision and imbrication was useful in sesamoid reduction and vertical procedures was useful in hallux valgus angle reduction. The capsule thickness was measured thickest in dorsal and distal portioin. Conclusion: The methods of medial capsulorrhaphy should be planned preoperatively considering individual hallux deformities. These selected medial capsulorrhaphy can help the reduction of hallux valgus deformity correction and its maintenance.

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MEASUREMENT AND ANALYSIS OF THE RESISTANT MUSCLE FORCE OF MEDIAL PTERYGOID MUSCLE IN THE MANDIBULAR PROGNATHIC PATIENTS (하악전돌증 환자에서 내측 익돌근 근력측정 및 분석)

  • Hong, Jong-Rak;Kang, Na-Ra;Choung, Pill-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.131-135
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    • 2004
  • The purpose of this study was to evaluate the resistant force of medial pterygoid muscles against the mandibular advancement and distraction to anterior, and inquire into the relationship between medial pterygoid muscles and cephalometric variables. Sixty six patients with class III malocclusion underwent bilateral sagittal splitting of ramus with intraoralvertico-sagittal ramus osteotomy for mandibular set-back. The spring scale was used to measure the resistance of medial pterygoid muscles after splitting of ramus. Skeletaldental cephalometric analysis was made and statistic package was used for correlation between resistance and cephalometric variables. The resistant force of the right medial pterygoid muscle was greater than the left one in Koreans with class III malocclusion, and the force had a linear regression relationship with facial depth. The results suggested that facial depth has significant correlation with the resistance of medial pterygoid muscle, which can be acquired from patient's cephalometric analysis.

Relationship between Hip Medial Rotation Range of Motion and Weight Distribution in Patients with Low Back Pain

  • Kim, Sang-Kyu;Kim, Won-Bok;Ryu, Young-Uk
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.3
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    • pp.279-284
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    • 2014
  • PURPOSE: This study intended to verify whether there was actual correlation between weight-bearing asymmetry and a limitation in hip joint rotation range in patients with low back pain. METHODS: Thirty five low back pain patients voluntarily participated this study. For each participant, hip joint medial rotation symmetry rate and the weight-bearing symmetry rate were calculated. The correlation between the two variables was investigated. RESULTS: A decrease in the left hip joint medial rotation range of motion (ROM) was observed more often than a reduction in the right hip joint medial rotation ROM. However, similar number between right and left side was observed in ground reaction force more weighted. The coefficient between the passive hip joint medial rotation symmetry rate and the weight loading symmetry ratio was -0.19 (p < 0.05). CONCLUSION: The present study demonstrated a weak correlation between the hip joint medial rotation ROM and the weight distribution of both feet. Such result suggests that careful evaluation by separating each element is needed in treating patients with low back pain. Future research should take into account asymmetric alignment and abnormal movement in different joints of the body as well as asymmetry in the bilateral hip joint rotation and the unilateral weight supporting posture.

Medial Axis Detection of Stripes Using LoG Scale-Space (LoG Scale-Space를 이용한 라인의 중심축 검출)

  • Byun, Ki-Won;Nam, Ki-Gon;Joo, Jae-Heum
    • Journal of the Institute of Convergence Signal Processing
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    • v.11 no.3
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    • pp.183-188
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    • 2010
  • In this paper we propose a detection method of the medial axis of the continuous stripes on the LoG scale-space. Our method detects the medial axis of continuous stripes iteratively by varying the scale of LoG operator. Small-scale LoG operator detects two +/- pole pairs centered on the edge positions of stripe by the zero-crossing detection. The more increase the scale of LoG scale-space, the more close two poles to the medial axis of stripe. The medial axis of continuous stripe is the position where two poles is overlapped. The proposed method detected robustly the medial axis of continuous stripes stronger than the thinning methods used to binary image.

CORA Based Leveling Osteotomy with Tibial Tuberosity Transposition for Cranial Cruciate Ligament Rupture with Concurrent Medial Patellar Luxation in Two Small Breed Dogs

  • Shin, Seo-Hyun;Kang, Jin-Su;Lee, Dong-bin;Lee, Hae-Beom;Kim, Nam-Soo;Heo, Su-Young
    • Journal of Veterinary Clinics
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    • v.36 no.5
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    • pp.285-288
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    • 2019
  • A 5-year-old 6 kg male mongrel (case 1) and a 7-year-old 4.3 kg male yorkshire terrier (case 2) were presented to Chonbuk animal medical center (CAMC). Both animals had non-weight bearing hind limb lameness. Case 1 had complete rupture of cranial cruciate ligament with grade 3 medial patellar luxation. Case 2 had complete cranial cruciate ligament rupture with grade 4 medial patellar luxation. During surgery, in both cases, trochlear block recession was performed followed by CORA based leveling osteotomy (CBLO) and tibial tuberosity transposition (TTT). General soft tissue reconstructions for medial patellar luxation including medial releasing and lateral imbrication were also performed. Postoperatively, both animals demonstrated excellent recovery and regained normal weight bearing of the affected hind limb without any recognizable complication. CBLO followed by TTT can be a curative surgical option without complications in cases of cranial cruciate ligament rupture with high-grade medial patellar luxation in small breed dogs.

Foot Reconstruction by Reverse Island Medial Plantar Flap Based on the Lateral Plantar Vessel

  • Moon, Min-Cheol;Oh, Suk-Joon;Cha, Jeong-Ho;Kim, Yoo-Jeong;Koh, Sung-Hoon
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.137-142
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    • 2010
  • Purpose: Tumor ablation and traumatic intractable ulceration of the plantar surface of the foot results in skin and soft tissue defects of the weight-bearing sole. Simple skin grafting is not sufficient for reconstruction of the weight-bearing areas. Instead, the island medial plantar flap (instep flap) and distally-based island medial plantar flap was used for proper reconstruction of the weight bearing area. However, there are some disadvantages. In particular, an island medial plantar flap has a short pedicle limiting the mobility of the flap and the distally-based island medial plantar flap is based on a very small vessel. We investigated whether good results could be obtained using a reverse island medial plantar flap based on the lateral plantar vessel as a solution to the above limitations. Methods: Three patients with malignant melanoma were cared for in our tertiary hospital. The tumors involved the lateral forefoot, the postero-lateral heel, and the medial forefoot area. We designed and harvested the flap from the medial plantar area, dissected the lateral and medial plantar artery and vena comitans, and clamped and cut the vessel 1 cm proximal to the branch from the posterior tibial artery and vena comitans. The medial plantar nerve fascicles of these flaps anastomosed to the sural nerve, the 5th interdigital nerve, and the 1st interdigital nerve of each lesion. The donor sites were covered with skin grafting. Results: The mean age of the 3 subjects was 64.7 years (range, 57 - 70 years). Histologically, all cases were lentiginous malignant melanomas. The average size of the lesion was $5.3\;cm^2$. The average size of the flap was $33.1\;cm^2$. The flap color and circulation were intact during the early postoperative period. There was no evidence of flap necrosis, hematomas or infection. All patients had a normal gait after the surgery. Sensory return progressively improved. Conclusion: Use of an island medial plantar flap based on the lateral plantar vessel to the variable weight-bearing sole is a simple but useful procedure for the reconstruction of any difficult lesion of the weight-bearing sole.

Diagnostic Value of Sonographic Medial Meniscal Extrusion (초음파적 내측 반월상 연골 탈출의 진단 가치)

  • Kim, Jung-Man;Lee, Dong-Yeob;Koh, In-Jun;Lee, Un-Bong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.1
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    • pp.7-12
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    • 2009
  • Purpose: The purpose of this study was to correlate the degree of sonographic medial meniscal extrusion with MRI and arthroscopic findings. Materials and Methods: Out of these 32 patients, with medial meniscal tear who went on arthroscopic surgery, 14 patients had the medial meniscal tear and 18 patients had both lateral and medial meniscal tear. The extent of meniscal extrusion without meniscal tear was assesed in 24 patients who did not show meniscal tear on MRI. The extent of meniscal extrusion was measured between tibial medial joint line (excluded osteophyte) and the outer margin of the medial meniscus. Kellgren-Lawrence grading scale was assessed in plain X-ray image and the location of lesion was assessed during arthroscopic surgery. We also measured the extent of meniscal extrusion on MRI and sonography respectively, and compared each other. Results: There was significant difference between patients with medial meniscal tear and both lateral and medial meniscal tear, patients with medial meniscal tear, patients with both medial and lateral meniscal tear, patients without meniscal tear (P value<0.05). Conclusion: The Meniscus tear must be considered when sonography shows the meniscal extrusion more than 5 mm in length.

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A useful additional medial subbrow approach for the treatment of medial orbital wall fracture with subciliary technique

  • Kim, Seung Min;Kim, Cheol Keun;Jo, Dong In;Lee, Myung Chul;Kim, Ji Nam;Choi, Hyun Gon;Shin, Dong Hyeok;Kim, Soon Heum
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.101-108
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    • 2019
  • Background: To date, a variety of surgical approaches have been used to reconstruct the medial orbital wall fracture. Still however, there is still a controversy as to their applicability because of postoperative scars, injury of anatomical structures and limited visual fields. The purpose of this study was to introduce a useful additional medial subbrow approach for better reduction and securement more accurate implant pocket of medial orbital wall fracture with the subciliary technique. Methods: We had performed our technique for a total of 14 patients with medial orbital wall fracture at our medical institution between January 2016 and July 2017. All fractures were operated through subciliary technique combined with the additional medial subbrow approach. They underwent subciliary approach accompanied by medial wall dissection using a Louisville elevator through the slit incision of the medial subbrow procedure. This facilitated visualization of the medial wall fracture site and helped to ensure a more accurate pocket for implant insertion. Results: Postoperative outcomes showed sufficient coverage without displacement. Twelve cases of preoperative diplopia improved to two cases of postoperative diplopia. More than 2 mm enophthalmos was 14 cases preoperatively, improving to 0 case postoperatively. Without damage such as major vessels or extraocular muscles, enophthalmos was corrected and there was no restriction of eyeball motion. Conclusion: Our ancillary procedure was useful in dissecting the medial wall, and it was a safe method as to cause no significant complications in our clinical series. Also, there is an only nonvisible postoperative scar. Therefore, it is a recommendable surgical modality for medial orbital wall fracture.

A Study on the Duration of Korean medial fortis by Japanese Speakers (일본인 학습자의 국어 어중 경음 지속 시간 연구)

  • Noh, Seok-Eun
    • Proceedings of the KSPS conference
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    • 2005.04a
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    • pp.67-70
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    • 2005
  • The purpose of this paper is the comparison of the Korean medial fortis duration between Korean native speaker and Japanese native speaker who study Korean language. For this purpose, I selected words with medial fortis from the SITEC DB. The Korean medial fortis of Japanese tends to have longer closure/friction duration than Korean native speakers in 3 syllables words. There are no distinct differences in 2 syllables words. This might be owing to the different timing unit of Korean and Japanese.

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