• Title/Summary/Keyword: orthopedic procedure

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Percutaneous two unilateral iliosacral S1 screw fixation for pelvic ring injuries: a retrospective review of 38 patients

  • Son, Whee Sung;Cho, Jae-Woo;Kim, Nam-Ryeol;Cho, Jun-Min;Choi, Nak-Jun;Oh, Jong-Keon;Kim, HanJu
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.34-42
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    • 2022
  • Purpose: Percutaneous iliosacral (IS) screw fixation for pelvic ring injuries is a minimally invasive technique that reduces the amount of blood loss and shortens the procedure time. Moreover, two unilateral IS S1 screws exhibit superior stability to a single IS screw and are also safer for neurological injuries than an S2 screw. Therefore, this study aimed to evaluate fixation using percutaneous two unilateral IS S1 screws for pelvic ring injuries and its subsequent clinical outcomes. Methods: We retrospectively reviewed 38 patients who underwent percutaneous two unilateral IS S1 screw fixation for pelvic ring injuries. The procedure time, blood loss, achievement of bone union, radiological outcomes (Matta and Tornetta grade), and postoperative complications were evaluated. Results: The mean procedure time, hemoglobin loss, bone union rate, and time to union were 40.1 minutes (range, 18-102 minutes), 0.6 g/dL (range, 0.3-1.0 g/dL), 100%, and 153.2 days (range, 61-327 days), respectively. The Matta and Tornetta grades were excellent, good, and fair in 24 (63.1%), 11 (28.9%), and three patients (7.9%), respectively, and the postoperative complications were S1 screw loosening, widening of the symphysis pubis (2.3 and 2.5 mm), lumbosacral plexopathy, and S1 radiculopathy in one (2.6%), two (5.3%), one (2.6%), and one patient (2.6%), respectively. However, all neurological complications recovered spontaneously. Conclusions: Percutaneous two unilateral IS S1 screw fixation was useful for treating pelvic ring injuries. In particular, it involved a short procedure time with little blood loss and also led to 100% bone union and good radiological outcomes.

Partial Tear of Upper Portion of Subscapularis (견갑하근 상 1/3 파열)

  • Kim Dong-Hui;Kim Kug-Jin;Moon Young-Lae
    • Clinics in Shoulder and Elbow
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    • v.8 no.1
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    • pp.9-13
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    • 2005
  • An isolated tear of the subscapularis is uncommon, and there are a few literatures regarding the treatment of this problem. But, the incidence has increased with development of the arthroscopic techniques. An all-arthroscopic rotator cuff repair is a challenging procedure that can be effectively performed for treatment of subscapularis tendon tears. Often, tears of the subscapularis tendon do not involve entire tendon, and retraction of the torn edge is within to 2 cm of its attachment site. Occasionally, the entire tendon is torn and retracted medially to the glenoid. This article outlines the examination, preoperative planning and details the steps necessary to perform this procedure on upper third of subscapularis tears.

Operative Treatment for Bilateral Chronic Recurrent Dislocation of the Peroneal Tendon: A Case Report (양측 족관절에 발생한 만성 재발성 비골건 탈구의 수술적 치료: 증례 보고)

  • Na, Hwa-Yeop;Song, Woo-Suk;Lee, Joo-Young
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.161-164
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    • 2020
  • A peroneal dislocation is a rare disease that is often misdiagnosed as a simple sprain and can be treated inadequately in the acute phase. For this reason, it is important to have an appropriate diagnosis in the early stages because it can progress to chronic and recurrent conditions. Surgical treatment is considered mainly when progressing to chronic recurrent dislocation. Recently, patients with an acute peroneal dislocation tend to prefer surgical treatment, so accurate initial diagnosis and management are very important. This paper reports a case of chronic recurrent peroneal tendon dislocation in both ankle joints, which was treated by a superior peroneal retinaculum reconstruction and a groove deepening procedure.

Surgical Treatment of Tuberculous Achilles Tendinitis - Case Report - (결핵성 아킬레스 건염의 수술적 치료 -증례보고-)

  • Cha, Seung-Do;Kim, J-Young;Lee, Kyung-Tai;Young, Ki-Won;Kim, Eung-Su;Park, Shin-Yi
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.201-203
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    • 2005
  • Although Achilles tendinitis is a relatively common disease, tuberculous involvement of Achilles tendon is rare. We report a case of tuberculous Achilles tendinitis, which was successfully treated with chemotherapy and a combined surgical procedure (Achilles tendon parital excision and FHL tendon transfer).

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Operative Treatment of Symptomatic Os Subfibulare (증세가 있는 비골하 부 골의 수술적 치료)

  • Jung, Hwa-Jae;Shin, Hun-Kyu;Ko, Chun-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.11-17
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    • 2006
  • Purpose: To evaluate the clinical results of resection of os subfibulare and lateral ligament reattachment or modified Brostrom procedure in patients with symptomatic os subfibulare. Materials and Methods: This is a retrospective study on fourteen patients (14 ankles) who have symptoms associated with os subfibulare. Between August 1999 and July 2004, they underwent 4 resection of os subfibulare and lateral ligament reattachment for ankle pain due to os subfibulare or 10 resection of os subfibulare and modified Brostrom procedure available for ankle instability due to os subfibulare. Follow-up period is averaged for 17.6 months (12-24 months). Clinical results were graded according to the AOFAS clinical rating system. Results: Clinical results were rated as good in 4 ankles after resection of os subfibulare and lateral ligament reattachment, excellent in 5, good in 4, and fair in 1 ankle after the resection of os subfibulare and modified Brostrom procedure. In the last follow up period, 1 case of anterolateral ankle instability, 1 case of ankle pain and 1 case of inversion limitation were present postoperatively, but all symptoms were improved progressively. Conclusion: Resection of os subfibulare and modified Brostrom procedure is a good surgical technique for chronic ankle instability due to os subfibulare. But if just the ankle pain is present, resection of os subfibulare and lateral ligament reattachment is a sufficient procedure.

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The Free Musculocutaneous Flap in the Treatment of Chronic Osteomyelitis (유리 근피부판을 이용한 만성 골수염의 치료)

  • Chung, Duke-Whan;Cho, Chang-Hyun;Jung, Ki-Woong
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.163-169
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    • 1999
  • Purpose : To evaluate the efficacy of free musculocutaneous flap in the treatment of chronic osteomyelitis with drain sinus. Materials and Methods : Eighteen patients (sixteen male and two female) whose average age was 42.6 years were followed for an average of 3.5 years after free musculocutaneous flap for chronic osteomyelitis with drain sinus tract. The period of time between the initial injury and this procedure was average 10.6 years. The patients had an average of 4.1 prior surgical procedure before it. Results : Sixteen(88.9%) of the eighteen free musculocutaneous flap survived, including thirteen of latisimus dorsi flap, three of scapular free flap with muscle, two of medial plantar flap with abductor muscle. Sixteen cases had no evidence of recurrence at follow up. Conclusion : Free musculocutaneous flap is an extremely successful and reliable procedure for the treatment of chronic osteomyelitis with drain sinus. This flap with microvascular anastomses is highly vascularized through its own intrinsic blood vessels, which has the advantage of obliterating dead space and providing improved vascularity to the relatively ischemic recipient site and covering the skin defect.

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Surgical Treatment for Diffuse Pigmented Villonodular Synovitis of the Ankle by A Combined Open and Arthroscopic Synovectomy: A Case Report (발목관절의 미만형 색소 융모 결절성 활액막염에서 관절경적 및 개방적 활액막 절제술을 이용한 수술적 치료: 증례 보고)

  • Choi, Jun-Cheol;Song, Woo-Suk;Byun, Chan-Woong;Kim, Jin;Han, Eun-Mee
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.139-142
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    • 2019
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.

Medial Horizontal Suture Fixation of the Akin Osteotomy: A Technical Report (Akin 절골술의 내측 횡 봉합사 고정: 술기 보고)

  • Yune, Young-Phil;Kim, Sanghwan
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.197-200
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    • 2015
  • The Akin osteotomy is a complimentary procedure in hallux valgus surgery. Surgical techniques may vary depending on the operators or fixation devices. Suture fixation, for which a removal procedure is not necessary, can often be recommended. However, there is a risk of failure due to the thin cortex of the phalanx. We describe a new technique using Ethibond suture fixation in Akin osteotomy, which can lower the risk of phalangeal cortical failure and articular cartilage irritation. First, the Akin osteotomy was performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. Then bone holes were drilled from dorsum to plantar parallel to osteotomy with the Kirschner wire. The final procedure involved passing the Ethibond sutures connected to a straight needle through the holes and tying it. This fixation method offers an effective and easy technique for performance of Akin osteotomy.

Short-Term Surgical Outcome of the Partial Nail Extraction in Ingrown Nail of Military Trainee: Is Matrixectomy Necessary? (훈련병에게 처음 발생한 내향성발톱에서 부분 발톱 절제술의 단기 추시 결과: 기질 절제술이 꼭 필요한가?)

  • Kim, Jaeyoung;Kim, Yoon Seok;Yi, Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.2
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    • pp.52-57
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    • 2019
  • Purpose: An ingrown nail is common in military trainees who are exposed to highly demanding activities. Although the matrixectomy procedure has been the main treatment modality, several drawbacks may follow after the procedure, such as infection, periostitis, and continued pain that causes a delayed return to duty. This study examined the outcomes of a simple partial nail extraction with the hypothesis that this procedure may bring an earlier return to duty, lower the perioperative complications, and produce a comparable recurrence rate. Materials and Methods: The medical records of patients who had surgical treatment for an ingrown nail in the authors' institution between April 2016 and December 2017 were reviewed retrospectively. Under the inclusion and exclusion criteria, 28 patients with a simple partial nail extraction (group A) and 29 patients with a partial nail extraction with matrixectomy (group B) were investigated. As the clinical outcome, the visual analogue scale (VAS) and satisfaction score, time to return to duty, complications, and recurrence rate were checked and compared between the groups. Results: The VAS scores of group B were significantly higher during the first (p<0.001) and second (p=0.026) follow-up week than group A. The time to return to duty was shorter in group A (7.8 days) than group B (10.1 days), and this difference was significant (p<0.001). Group B had five patients with complications, whereas group A had none (p=0.028). No differences in the recurrence rate (p=0.197) and patient satisfaction (p=0.764) were found between the groups. Conclusion: In this study, simple partial nail extraction in military trainees resulted in lower postoperative pain, lower complication rates, and earlier return to duty than the procedure with matrixectomy. Military trainees are temporarily exposed to highly demanding activities. Thus, a satisfactory outcome would be expected with simple partial nail extraction without performing a radical procedure, such as a matrixectomy.

Pseudoaneurysm after Proximal Metatarsal Osteotomy for Hallux Valgus Correction: A Case Report

  • Lee, Kyung Tai;Park, Young Uk;Jegal, Hyuk;Roh, Young Tae;Hong, Kee Yong
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.80-82
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    • 2014
  • Occurrence of pseudoaneurysm in the foot and ankle is rare, and is usually caused by traumatic injury or by iatrogenic intervention. Iatrogenic pseudoaneurysms in the foot and ankle have been observed after rearfoot and ankle fusions, ankle arthroscopy, endoscopic and open plantar fasciotomy, tibial osteotomy with limb lengthening, midfoot amputation, and Lapidus procedure. We report on a patient who developed a pseudoaneurysm of the dorsal metatarsal artery following correction of hallux valgus. The patient underwent proximal chevron osteotomy and Akin phalangeal osteotomy. The feeding artery was ligated and the pseudoaneurysm was excised.