• Title/Summary/Keyword: proximal methods

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IMMEDIATE RECONSTRUCTION USING VERTICAL RAMUS OSTEOTOMY AND BONE SLIDNG AFTER CONDYLECTOMY DUE TO OSTEOCHONDROMA: A CASE REPORT (골연골종으로 인한 과두절제 후 하악지 수직 골절단술 및 bone sliding을 통한 즉시 재건: 증례보고)

  • Jang, Ji-Young;Oh, Jae-Kyung;Cha, Du-Won;Baek, Sang-Heum
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.233-240
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    • 2007
  • Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and proximal metaphysis of the tibia. However, it occurred rarely on the facial skeleton. The coronoid and condylar processes have been considered to be the most common sites of occurrence for osteochondroma of the facial skeleton. The first treatment of osteochondroma is condylectomy, whereas extirpation was done by excision with condyle salvage. Condylectomy presents decrease of vertical dimension, jaw deviation, malocclusion. So, reconstruction is need. Methods of reconstruction are as follows: no reconstruction, condyloplasty, discectomy, costochondral graft, discplication or coronoidectomy, eminoplasty, alloplastic spacer placement, Le Fort I level maxillary osteotomy, extraoral and intraoral vertical ramus osteotomy. This is a case report of a 28-year old woman who had facial asymmetry, malocclusion and temporomandibular joint pain. We obtained moderate functional and cosmetic results with surgical removal of the osteochondroma by condylectomy and concomitant reconstruction of condyle by vertical ramus osteotomy with sliding technique.

CONSIDERATION OF TRANSVERSE MOVEMENT OF POSTERIOR MAXILLA IN ORTHOGNATHIC SURGERY OF FACIAL ASYMMETRY : CASE REPORTS (안모 비대칭 환자의 악교정수술에서 상악 후방부의 수평이동에 대한 고려)

  • Chang, Hyun-Ho;Yoon, Seok-Chae;Rhyu, Sung-Ho;Kim, Jae-Seung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.172-178
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    • 2000
  • When we establish treatment planning of facial asymmetry, we must predict each asymmetrical element that will be changed upon coronal, axial, sagittal plane. At the visual point, prediction of the change of coronal plane is most important. It is important difference between Rt. and Lt. mandibular angle belonging to posterior coronal plane, as well as anterior coronal plane, such as upper and lower incisor, or midline of chin point. Several methods for control bulk of mandibular angle are additional angle shaving after osteotomy, grinding contact area between proximal and distal segment for decrease the volume, or bone graft for increase the volume. But, at the point of bimaxillary surgery, transverse position of posterior maxilla is an important factor for control it. So, we would report transverse movement of posterior maxilla for decrease asymmetry on the posterior coronal plane of face, that is, asymmetry of mandibular angular portion.

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The result of endoscope-assisted open reduction and internal fixation (EAORIF) of lateral overridden subcondyle fracture (Lateral override 과두하골절에서 내시경을 이용한 관혈적 정복술 및 내고정의 결과)

  • Choi, Eun-Joo;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.62-66
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    • 2011
  • Introduction: Endoscope-assisted open reduction and internal fixation (EAORIF) reduces the amount of facial scaring, but limitations, such as the possibility to convert to the open technique and the large learning curve, remain. Materials and Methods: The medical records of 19 patients diagnosed as lateral overridden subcondyle fractures and treated with endoscope-assisted open reduction and internal fixation at Yonsei University Health System from December 2006 to August 2010 were reviewed. Results: 11 patients underwent temporary discomfort or pain such as limitation of mouth opening, temporomandibular joint discomfort, lip paresthesia or facial weakness, but the symptoms disappeared within 3 months. There was no severe long-term complication except 2 patients with re-fractures of operated subcondyles. Conclusion: Subcondyle fracture with lateral overridden proximal segment is a better indication of endoscope-assisted open reduction and internal fixation than a condylar head/neck fracture, or medial overridden subcondyle fracture: allowing an anatomic reduction.

Minimal-incision tenorrhaphy in flexor tendon injury (굴곡건 손상에서 최소절개 건 봉합술)

  • Jang, Ju Yun;Oh, Sang Ah;Kang, Dong Hee;Lee, Chi Ho
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.516-518
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    • 2009
  • Purpose: To retrieve the retracted flexor tendon, additional incision and wide dissection are conventionally required. We introduce minimal - incision tenorrhaphy using 1 cm - length incision and minimal dissection. Methods: Transverse incision about 1 cm - length is made over the level of retracted tendon. Nelaton's catheter is advanced into tendon sheath from distal primary laceration wound to emerge proximally through the incisional wound. Catheter is sutured to proximal tendon in end - to - end fashion. By gently pulling the catheter, retracted tendon is delivered to distal wound. Tenorrhaphy with core suture and epitendinous suture is then carried out. Results: This retrieving technique provides minimal incision, minimal dissection, minimal bleeding, minimal injury to tendon end, and shorter operation time with preservation of vincula tendinum and pulley system. Conclusion: In case of flexor tendon rupture with retraction, this operative method is believed to allow reliable and effective tenorrhaphy and excellent postoperative outcomes.

The Effect of Stair Exercise with Restriction Blood Flow on Knee Extensor Muscle (하지혈류제한과 병행한 계단운동이 무릎 폄근에 미치는 영향)

  • Jun, Je-Yoon;Park, Min-Chull
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.4
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    • pp.9-14
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    • 2015
  • PURPOSE: Low-intensity exercise with restriction of blood flow has been proposed as an alternative exercise to secure the disadvantage of a high-intensity resistance exercise. However, studies of how affects the muscle using functional exercise are lacking. Thus, the purpose of this study was to investigate knee extensor muscle strength during stair exercise of functional exercise with leg blood flow restriction. METHODS: Twenty two healthy young adults with no history of musculoskeletal or neurogical disorder were participated in this study. participant were randomized into either non-restriction group(11 subject) or restriction group (11 subject). The restriction blood cuff attached to the proximal end of the leg. Measurement of knee extensor strength was used by cybex dynamometer. Data analyzed in independent t-test and paired t-test. RESULTS: Knee extensor muscle strength was significantly different between groups. Also, there were significant differences in the strength of knee extensor within the group. CONCLUSION: This study found that stair exercise with restriction of blood flow did influence to knee extensor muscle strength. These results will also be able to promote the effect of increasing the muscle power applied to functional exercise. Henceforth, studies will be made in the intervention method that can be applied to health vulnerable person.

A Case Report of Hypospadias Repaired by Radial Forearm Free Flap (요측전완유리피판을 이용한 요도하열의 교정 1례 보고)

  • Park, Sung Ho;Chung, Chul Hoon;Lee, Jong wook
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.225-228
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    • 2009
  • Purpose: Urethral reconstruction following failed hypospadias repair is difficult because of a severe shortage of the skin on ventral surface of the penis. We experienced a successful reconstruction of a failed hypospadias repair using the radial forearm free flap. So we present our case. Methods: A 16 - year - old boy had a proximal shaft hypospadias and had been taken a transverse preputial island flap but it completely broke down. There was no spare skin on the shaft of the penis. So we reconstructed a neo - urethra and the ventral skin of the penis with the radial forearm free flap. Results: Postoperatively he made relatively good process. The urethral catheter was maintained for 10 days and self - voiding was started. The suprapubic catheter was removed at the postoperative 30th day after control of cystitis. The postoperative appearance of the penis is acceptable and a straight erection is achieved. Conclusion: In the scarred penis with hypospadias, the radial forearm free flap transfer is a reliable reconstructive method for the neo - urethra and the ventral skin of the penis.

Histological and histochemical study on the growth plate of the axis in developing Miniature Schnauzers (성장중인 소형개 (Miniature Schnauzers)에 있어서 축추골의 골성장판에 대한 조직학적, 조직화학적 연구)

  • Kim, Soo-myung
    • Korean Journal of Veterinary Research
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    • v.33 no.2
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    • pp.189-198
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    • 1993
  • The present study was undertaken to provide basic data on endochondral ossification for the axis in developing Miniature Schnauzers. This study was determined to the morphological features and development of growth plast in the axis of this experimental animals by histological and histochemical methods. The axis from 2 healthy Miniature Schnauzers(postnatal 6hr, 5week) was used. The obtained results were as follows : 1. In 5-week-old Miniature Schnauzer, the axis consisted of 4 separate ossification centers : centrum l, intercentrum 2, centrum 2 and epiphysis. Intercentrum 2 was intercalated between centrum 1 cranially, centrum 2 caudally. 2. The space of centrum 1 was more broader than the other ossification centers. 3. The zone of reserved chondrocytes was more extensive than the zone of proliferative chondrocytes, trabeculation was weakly observed, however, the proximal epiphyseal plate of axis was actively trabeculation observed in the zone of calcified chondrocytes. 4. Eighteen columns of chondrocytes were observed in the centrum 1 and five to seven columns of chondrocytes were observed in the centrum 2 of Miniature Schnauzer(postnatal 5 week) 5. A positive reaction to alcianophility was observed in all the territorial matrix at the zone of hypertrophic chondrocytes in this experimental animals.

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A successful conservative management of traumatic thoracic esophageal rupture (흉부둔상에 의한 식도파열의 성공적인 보존적 치료)

  • 노태훈
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.169-174
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    • 1988
  • Thoracic esophageal rupture caused by blunt trauma is often not recognized until late because of the vague symptoms in the initial state as well as its rare incidence, which can easily lead to fulminant mediastinitis with frequent fatal outcome. Once extensive mediastinitis occurs, the primary surgical repair of the esophageal tear is considered to be practically impossible. Various methods have been proposed for the management of these desperately ill patients, but no one provides an acceptable good result yet. The purpose of this article is to report the successful result obtained in the treatment of a patient with fulminant mediastinitis from traumatic esophageal rupture by continuous transesophageal irrigation. A 27 year-old male patient was brought to the emergency room of our hospital complaining of dyspnea and chest pain after blunt trauma. The diagnosis of esophageal rupture in the thorax was made late, about 46 hours after the initial injury, when mediastinitis had already progressed. The transesophageal irrigation method was immediately instituted which consisted of profuse transesophageal irrigation of the mediastinum with orally ingested fluid and/or by Levin tube, positioned proximal to the site of the rupture, and drainage of the irrigation fluid by thoracoscopically accurately positioned chest tubes connected to a well suctioning system. With subsiding inflammatory signs and symptoms, the esophagogram, obtained 54 days after the treatment, showed no evidence of the mediastinal leakage of contrast material which contrasted previous esophagograms with definitive dye collections in the mediastinum. Additional endoscopic finding confirmed complete healing of the esophageal mucosa, previously ruptured. He has been followed up without any problem until recently, 6 months after discharge.

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Central Core Disease : Clinical Characteristics of Family Members Manifested by Autosomal Dominant Pattern through Three Generations (중심핵병 : 삼대에 걸쳐 상염색체 우성 양식으로 발현된 가계 환자들의 임상적 특징)

  • Park, Kee Hyung;Shin, Dong Jin;Kim, Seung Hyun
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.23-28
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    • 2006
  • Background: central core disease is one of the non-progressive benign congenital myopathies characterized by the presence of cores in muscle fibers, which was originally described by Shy and Magee (1956). We describe clinical charcteristics of central core disease in a Korean family manifested by autosomal dominant pattern through three generations. Methods: Clinical, serologic, and electrophysiologic profiles were evaluated in eleven members among 22 family members through three generations. Results: Six family members were symptomatic and five were non-symptomatic. Instead of proximal muscle weakness, musculoskeletal manifestations including non-specific joint pain and stiff sense were the most frequent symptoms. Muscle biopsy performed in two symptomatic patients revealed that type I fiber showed central halo, which is charactreristics of central core disease. No remarkable findings were present in serologic study including CPK level and electromyographic findings suggesting myopathic pattern were only present in two patients among 11 symptomatic group. Conclusions: In evaluating non-specific musculoskeletal complaints from the familial members showing genetic trait, central core disease should be considered to one of the possible diagnosis.

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A Heterotopic Ossification in the Subscapularis Muscle - Case Report - (견갑하근에 발생한 이소성 골화 -증례보고-)

  • Kim Taik-Seon;Kim Young-Bae;Park Chi-Ho;Lee Woo-Seung
    • Clinics in Shoulder and Elbow
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    • v.8 no.1
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    • pp.43-48
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    • 2005
  • We report the case of a heterotopic ossification in the subscapularis muscle. A 30-year-old woman was diagnosed as a heterotopic ossification in the right subscapularis muscle. X-rays, a CT scan and a MRI showed bone-like lesions in the muscle. The location of the ossification was both inferior and anterior to the joint. The mass nearly bridged between the proximal humerus and the inferior portion of the coracoid process. Symptoms did not respond to rest, NSAIDs for 3 months and to stretching exercises treatment for 6 months. Excision and biopsy was performed through deltopectoral approach. Disodium Etidronate was administered during the postoperative period. She regained normal range of motion postoperatively and improved in the shoulder pain after performing strengthening exercises with Therabands. We think that a cause of limitation of the shoulder was impingement between the mass and the coracoid process, and that another cause was adhesion between the mass and the joint capsule. We conclude that excision and postoperative rehabilitation exercises are good methods for a heterotopic ossification in the subscapularis muscle for those that are nonresponsive to nonoperative treatments.