• Title/Summary/Keyword: revision surgery

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Reverse Total Shoulder Arthroplasty: Where we are? "Principles" (견관절 역행성 인공관절 치환술의 원칙)

  • Noh, Kyu-Cheol;Suh, Il-Woo
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.105-110
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    • 2011
  • Purpose: The purpose of this article is to identify and understand the complications of RTSA and to review the current methods of preventing and treating this malady. Materials and Methods: Previous constrained prostheses (ball-and-socket or reverse ball-and-socket designs) have failed because their center of rotation remained lateral to the scapula, which has limited of the motion of the prostheses and produced excessive torque on the glenoid component, and this leads to early loosening. The Grammont reverse prosthesis imposes a new biomechanical environment for the deltoid muscle to act, thus allowing it to compensate for the deficient rotator cuff muscles. Results: The clinical experience does live up to the lofty biomechanical concept and expectations: the reverse prosthesis restores active elevation above $90^{\circ}$ in patients with a cuff-deficient shoulder. However, external rotation often remains limited and particularly in patients with an absent or fat-infiltrated teres minor. Internal rotation is also rarely restored after a reverse prosthesis. Failure to restore sufficient tension in the deltoid may result in prosthetic instability. Conclusion: Finally, surgeons must be aware that the results are less predictable and the complication/revision rates are higher in revision surgery than that in the first surgery. A standardized monitoring tool that has clear definitions and assessment instructions is surely needed to document and then prevent complications after revision surgery.

The treatment of malocclusion after open reduction of maxillofacial fracture: a report of three cases

  • Lee, Sung-Suk;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;You, Jae-Seek
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.91-95
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    • 2014
  • The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.

Pretibial Cyst After Arthroscopic Revisional Anterior Cruiate Ligament Reconstruction - A Case Report - (전방 십자 인대 재재건술 후 발생한 전경골 낭종 - 증례 보고 -)

  • Kim, Ha-Kyung;Yoon, Jung-Ro;Kim, Taik-Sun;Yeo, Eui-Dong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.225-228
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    • 2008
  • Pretibial cyst formation is a rare occurrence after anterior cruciate ligament (ACL) reconstruction. We report this complication after ACL revision surgery using tibialis anterior allograft. This complication seems to be the consequence of a direct communication between the joint and the cyst through the tibial tunnel. In the present study, the authors report that there is a pretibial cyst formation after a revisional ACL reconstruction.

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Delayed Progressive Extradural Pneumatocele due to Incomplete Sealing of Opened Mastoid Air Cell after Micro-Vascular Decompression

  • Hong, Ki-Sun;Park, Kwan
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.477-479
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    • 2010
  • A case of delayed progressive extradural pneumatocele after microvascular decompression (MVD) is presented. A 60-year-old male underwent MVD for hemifacial spasm; the mastoid air cell was opened and sealed with bone wax during surgery. One month after surgery, the patient complained of tinnitus, and progressive extradural pneumatoceles without cerebrospinal fluid (CSF) leakage was observed. Revision surgery was performed and the opened mastoid air cell was completely sealed with muscle patch and glue. The patient's symptoms were resolved, with no recurrence of pneumatoceles at 6 month follow up. Progressive extradural pneumatocele without CSF leakage after posterior fossa surgery is a very rare complication. Previous reports and surgical management of this rare complication are discussed.

Extensive calcific myonecrosis of the lower leg treated with free tissue transfer

  • Kim, Tae Gon;Sakong, Yong;Kim, Il Kug
    • Archives of Plastic Surgery
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    • v.48 no.3
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    • pp.329-332
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    • 2021
  • Calcific myonecrosis is a rare condition in which hypoperfusion due to compartment syndrome causes soft tissue and muscle to become calcified. As calcific myonecrosis gradually deteriorates, secretions steadily accumulate inside the affected area, forming a cavity that is vulnerable to infection. Most such cases progress to chronic wounds that are unlikely to heal spontaneously. After removing the calcified tissue, the wound can be treated by primary closure, flap coverage, or a skin graft. In this case, a 72-year-old man had extensive calcific myonecrosis on his left lower leg, and experienced swelling and increasing tenderness. After removing the muscle calcification, we combined two anterolateral thigh free flaps, which were harvested from the patient's right and left thigh, respectively, to reconstruct the wound with a dead-space filler and skin-defect cover at the same time. The patient recovered without revision surgery or major complications.

Is It Possible to Replace Microendoscopic Discectomy with Percutaneous Transforaminal Discectomy for Treatment of Lumbar Disc Herniation? A Meta-Analysis Based on Recurrence and Revision Rate

  • Zhao, Xiao-ming;Yuan, Qi-ling;Liu, Liang;Shi, Ya-ming;Zhang, Yin-gang
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.477-486
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    • 2020
  • Objectives : Due to recent developments and the wide application of percutaneous transforaminal discectomy (PTED) in China, we herein compare its clinical effects with microendoscopic discectomy (MED) for the treatment of lumbar disc herniation in terms of recurrence and revision rates. Methods : Six databases, namely, PubMed, EMBASE, Cochrane Library, Ovid, China National Knowledge Infrastructure and Wanfang, were searched by computer. The literature was screened according to inclusion and exclusion criteria, and the quality of the included literature was evaluated. After extracting the data from the papers, Review Manager 5.2 software (Cochrane Collaboration, Oxford, UK) was applied to analyze these data. Finally, sensitivity and publication bias analyses of the results were conducted. Results : A total of 12 studies consisting of 2400 patients were included in this meta-analysis. A comparison of PTED with MED revealed higher postoperative recurrence and postoperative revision rates for PTED (odds ratio [OR] recurrence, 1.60; 95% confidence interval [CI], 1.01 to 2.53; p=0.05 and OR revision, 1.77; 95% CI, 1.18 to 2.64, p=0.006). Conclusion : PTED has a number of advantages because it is a minimally invasive surgery, but its recurrence and revision rates are higher than MED. Therefore, MED should not be completely replaced by PTED.

Periareolar Augmentation Mastopexy with Interlocking Gore-Tex Suture, Retrospective Review of 50 Consecutive Patients

  • Franco, Johnny;Kelly, Emma;Kelly, Michael
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.728-733
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    • 2014
  • Background Periareolar Augmentation Mastopexy is one of the most challenging operations in plastic surgery. Problems with scar quality, areolar widening, and distortion are frequent problems that interfere with a predictable result. Methods A retrospective review was performed on fifty consecutive patients who underwent a periareolar augmentation mastopexy with the interlocking approach. Of the 50 patients, 30 had both preoperative and postoperative photographs and were the basis of the study. Results The age of the patients ranged from 19 to 56 years with the average age being 39 years. The postoperative follow-up averaged 9.5 months and the implants averaged 316 mL. There were no deaths, pulmonary embolism, deep vein thrombosis, or infected implants. Four patients had complications following surgery for an overall complication rate of 13%. Two patients developed an infected Gore-Tex suture. Two of these complications were treated with revision surgery. Five patients required reoperation for an overall reoperative rate of 16% (one patient was converted to a full mastopexy). Conclusions As a result of this retrospective study, we have found the interlocking approach to periareolar augmentation/mastopexy to be a safe and reliable operation.

Extracorporeal Pedicles for Free Flap Reconstruction in Diabetic Lower Extremity Wounds

  • Alejandro R. Gimenez;Daniel Lazo;Salomao Chade;Alex Fioravanti;Olimpio Colicchio;Daniel Alvarez;Ernani Junior;Sarth Raj;Amjed Abu-Ghname;Marco Maricevich
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.782-784
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    • 2022
  • Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

Revision of Failed Shoulder Instability Repair (실패한 견관절 불안정증의 봉합술에 대한 재수술)

  • Park, Jin-Young;Park, Hong-Geun;Oh, Jeong-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.135-140
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    • 2006
  • Diagnosis and treatment of the unstable shoulder is one of the more difficult problems in orthopaedic surgery. There is confusion between the normal laxity with translation and subluxation of the humeral head relative to the glenoid and an abnormal amount of laxity, leading to pain and dysfunction. Unfortunately, there is no single treatment that applied to all lesions that cause the instability. It is imperative, therefore, that an accurate diagnosis be made, including the directions and degree of shoulder instability as well as any coexisting problems. Anatomical defects must be defined. Common factors that could most readily compromised instability repair are examined. These include techniques for making an accurate diagnosis with identification of the precise anatomical pathology, and the rationale for appropriate surgical treatment with the avoidance of technical complication such as unnecessary hardware or exposures that might lead to residual instability, arthritis, and nerve or vascular injuries. Additional injuries may be prevented by careful rehabilitation postoperatively to restore shoulder stability, flexibility, and endurance prior to an individual's return to stressful sports or work.

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