• 제목/요약/키워드: nonoperative management

검색결과 47건 처리시간 0.019초

스포츠와 관련된 족부 및 족관절 손상에 대한 비수술적 치료 (Nonoperative Management of Foot and Ankle Injury Related to Sports)

  • 곽희철;서승석;김창완
    • 대한정형외과스포츠의학회지
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    • 제3권2호
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    • pp.118-127
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    • 2004
  • The foot and ankle are one of the most common sites for acute musculoskeletal injuries related to sports activity. Foot and ankle injury includes ligament injury, tendon injury, bone and osteochondral injury, nerve injuy, heel pain syndrome, phalangeal injury. This is a article about nonoperative management of foot and ankle injury. Therefore, this article includes various exercise technique, range of motion, stretching for muscle relaxation, proprioception training for rehabilitation. We recommend that orthopedic surgeon should discuss with patient and specialist for treatment plan after foot and ankle injury

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아킬레스 건병증의 비수술적 치료 (Nonoperative Treatment of Achilles Tendinopathy)

  • 정재중
    • 대한족부족관절학회지
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    • 제25권2호
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    • pp.66-71
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    • 2021
  • Achilles tendinopathy has seen good results with conservative management. However, the management of Achilles tendinopathy lacks evidence-based support, and tendinopathy patients are at risk of long-term morbidity with unpredictable clinical outcomes. Data suggests that 29% of tendinopathy patients required surgical intervention during the follow-up period. Chronic pain after damage to the Achilles tendon is a result of incomplete recovery of fibrous tissue. Recently, many procedures, including various injection treatments, have been tried without understanding proper preservation techniques and procedures for faster tendon recovery, especially for patients who want to quickly return to their daily lives. This article is an extensive literature review on nonoperative management of Achilles tendinopathy.

소아 장중첩증에서 임상양상과 수술소견과의 관계에 관한 분석 (Analysis of Clinical Factors and Operative Findings in Childhood Intussusception)

  • 최금자
    • Advances in pediatric surgery
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    • 제2권2호
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    • pp.81-87
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    • 1996
  • Although nonoperative reduction plays a major role in the management of uncomplicated intussusception in the pediatric age group, surgical treatment is still a necessary alternative when nonoperative reduction is unsuccessful. The author analyzed the clinical features of 68 patients requiring operation in order to identify factors which might influence the type of operative management. A nine-year experience at Ewha Womans University Hospital was reviewed, and the findings compared to previous reports. Barium was used for the initial reduction attempt in 33 cases, saline in 35. Manual reduction by milking at operation achieved success in 41 cases(60.3%). Fifteen cases(22.1%) required resection of bowel, and 12 patients(17.6%) were found to have spontaneous and complete reduction of the intussusception at operation. Two cases had pathologic leading points. There were no perforations due to nonoperative reduction. There were no significant differences in demographic data, clinical findings, laboratory data, and anatomic type of intussusception between barium and saline reduction groups. However, a significant number of cases with spontaneous reduction were in saline reduction group(p<0.05). There was a slight chance of spontaneous reduction in infants under 6 month of age(p<0.001). Age under 6 month. body temperature over $38^{\circ}C$, symptom over 24 hours, and ileo-colic and ileo-ileo-colic intussusception contributed significantly to the necessity for bowel resection(p<0.05-0.001). The author believes that the age, body temperature, duration of illness, and anatomic type of intussusception strongly influence operative management.

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소아 복부둔상에 의한 간장손상의 치료 (Management of Liver Injuries Following Blunt Abdominal Trauma in Children)

  • 박진영;장수일
    • Advances in pediatric surgery
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    • 제3권1호
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    • pp.32-40
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    • 1997
  • A clinical review was done of 31 children with blunt liver injury who were admitted to the Department of Surgery, Kyungpook National University Hospital between 1981 and 1990. Seventeen of the 31 children required laparotomy(11 primary repairs, 4 lobectomies, 2 segmentectomies). There were two deaths after laparotomy, one due to associated severe head injury and another due to multiorgan failure. The remaining 14 children, who were hemodynamically stable after initial resuscitation and who did not have signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal clinical evaluations, laboratory studies, and monitoring of vital signs. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography of 7 patients showed resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.

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Successful nonoperative management of a simultaneous high-grade splenic injury and devascularized kidney in Australia: a case report

  • Peter Thanh Tam Nguyen;Jeremy M. Hsu
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.431-434
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    • 2023
  • Severe blunt injuries to isolated solid abdominal viscera have been previously managed nonoperatively; however, management algorithms for simultaneous visceral injuries are less well defined. We report a polytrauma case of a 33-year-old man involved in a motorbike collision who presented with left-sided chest and abdominal pain. Initial imaging demonstrated multiple solid organ injuries with American Association for the Surgery of Trauma (AAST) grade V splenic injury and complete devascularization of the left kidney. The patient underwent urgent angioembolic coiling of the distal splenic artery with successful nonoperative management of simultaneous grade V solid organ injuries.

비장둔상의 수술적 치료를 대체하는 혈관색전술의 유용 (Use of Angioembolization to Replace Operative Management for Blunt Splenic Injury)

  • 송유정;김가정;정상호;정치영;주영태;정은정;이영준;최상경;하우송;박순태;홍순찬
    • Journal of Trauma and Injury
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    • 제23권1호
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    • pp.43-48
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    • 2010
  • Purpose: Over the past few decades, the treatment of traumatic splenic injuries has shifted to nonoperative management from surgical intervention. Although some nonoperative management failure have been reported, in most trauma centers, nonoperative management is now believed to be the treatment of choice in hemodynamically stable patients. Then, in this study, we have retrospectively evaluated our experience with traumatic splenic injury. Methods: From January 2005 to July 2009, 150 patients with blunt splenic injuries were managed in our hospital. Patients' charts were retrospectively reviewed to analyze their treatment, the patients were grouped according to those who had been admitted before October 2006, defined as the "early group", and those who had been admitted after October 2006, defined as the "late group". After the patients had been divided into two group, physiologic parameters and differences between the treatments were compared. Results: 150 patients were admitted to our hospital with blunt splenic trauma. In late group, both the surgical management rate and the nonoperative management failure rate were lower than they were in the early group. Conclusion: We expect angioembolization to effectively replace surgery for the treatment of selected patients with blunt splenic injury and to result in fewer complications.

Nonoperative management of colon and mesocolon injuries caused by blunt trauma: three case reports

  • Naa, Lee;Euisung, Jeong;Hyunseok, Jang;Yunchul, Park;Younggoun, Jo;Jungchul, Kim
    • Journal of Trauma and Injury
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    • 제35권4호
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    • pp.291-296
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    • 2022
  • The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.

Current Concept of Management of Partial-thickness Rotator Cuff Tear

  • Lim, Tae Kang;Park, Jae Hyun
    • Clinics in Shoulder and Elbow
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    • 제17권4호
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    • pp.209-217
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    • 2014
  • Most studies on the pathophysiology, natural history, diagnosis by imaging and outcomes after operative or nonoperative treatment of rotator cuff tear have focused on those of full-thickness tears, resulting in limited knowledge of partial-thickness rotator cuff tears. However, a partial-thickness tear of the rotator cuff is a common disorder and can be the cause of persistent pain and dysfunction of the shoulder joint in the affected patients. Recent updates in the literatures shows that the partial-thickness tears are not merely mild form of full-thickness tears. Over the last decades, an improved knowledge of pathophysiology and surgical techniques of partial-thickness tears has led to more understanding of the significance of this tear and better outcomes. In this review, we discuss the current concept of management for partial-thickness tears in terms of the pathogenesis, natural history, nonoperative treatment, and surgical outcomes associated with the commonly used repair techniques.

Very large haematoma following the nonoperative management of a blunt splenic injury in a patient with preexisting liver cirrhosis: a case report

  • Jeong, Euisung;Jo, Younggoun;Park, Yunchul;Kim, Jungchul;Jang, Hyunseok;Lee, Naa
    • Journal of Trauma and Injury
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    • 제35권1호
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    • pp.66-70
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    • 2022
  • The spleen is the most commonly injured organ after blunt abdominal trauma. Nonoperative management (NOM) is the standard treatment for blunt splenic injuries in haemodynamically stable patients without peritonitis. Complications of NOM include rebleeding, new pseudoaneurysm formation, splenic abscess, and symptomatic splenic infarction. These complications hinder the NOM of patients with blunt splenic injuries. We report a case in which a large haemorrhagic fluid collection that occurred after angio-embolisation was resolved by percutaneous drainage in a patient with liver cirrhosis who experienced a blunt spleen injury.