• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.661-668
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• 2018

Among the spinal disorders, the treatment approach for spinal deformities has been discussed least among department of neurosurgery. But nowadays, more and more neurosurgeons are interested in spinal deformities as well as complex spinal disorders and are doing not a few surgeries for these kinds of disease. Nevertheless, it is mandatory to understand the course of spinal deformity, principles of treatment, and surgical outcomes and complications. Understanding of the biology, biomechanics and metallurgy of the spine and instrumentation are also required for successful spinal deformity surgery. We need senior mentors and good surgical and neurophysiologic monitoring team. Knowledge of spinal deformity may be augmented with spine fellowships and surgical experience. Step by step training such as basic knowledge, orthopedic as well as neurosurgical disciplines and surgical skills would be mandatory. Neurosurgeons can have several advantages for spinal deformity surgeries. By high-level technical ability of the spinal cord handling to preserve neurological function and familiarity with microscopic surgery, better synergistic effect could be expected. A fundamental understanding of pediatric spinal deformity and growing spine should be needed for spinal deformity surgery.

• Clinics in Shoulder and Elbow
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• v.19 no.1
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• pp.43-47
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• 2016

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.67-71
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• 2024

Clavicle fractures are frequent injuries accounting for approximately 4% of all fractures in adults with about 35% occurring in the shoulder region among which midshaft fractures are the most common (>66%). Nonsurgical management is the treatment of choice for most clavicle fractures; however, poor functional and aesthetic outcomes may result from nonunion, symptomatic malunion, and aesthetic impairment which are the most common complications. A young woman was referred to our clinic for a "Step Deformity" resulting after primary, nonsurgical treatment of a midshaft clavicle fracture. Residual deformity was corrected with a novel simple and little invasive approach. Midshaft clavicle fractures typically only require conservative nonsurgical treatment, nevertheless suboptimal outcomes may occur. Selective osteotomies and fixation are deemed too invasive when only cosmetic impairment of the clavicle contour is present without any functional or sensitive damage and most patients are discouraged from undergoing surgery. Thus far, no specific focus on this topic, nor exploration of possible correction can be found in the published literature. These residual deformities may be very noticeable sometimes and cause psychological distress and social life impairment. Despite no related functional impairment, this deformity should still be addressed, to improve patients' quality of life.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.209-213
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• 1999

It is well known that tardy ulnar nerve palsy occurs with cubitus valgus deformity as a late complication after a nonunion of lateral condyle fracture of the humerus in childhood. On the other hand, cubitus varus deformity often results from malunion of supracondylar fractures of the humerus. However, reports of tardy ulnar nerve palsy in cubitus varus deformity are few. We report a patient with bilateral cubitus varus deformities with bilateral tardy ulnar nerve palsy which was confirmed with EMG. She was treated by step cut osteotomy(DeRosa and Graziano) with sub­cutaneous anterior transposition of ulnar nerve.

• Physical Therapy Korea
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• v.17 no.1
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• pp.26-35
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• 2010

The purpose of this study is to investigate the effects of improvement in the balance control ability of the elderly affected by Hansen's disease. We tried to compare the effects for the elderly affected by Hansen's disease with and without foot deformity. The subjects consisted of 19 patients 65 years old and older. They participated in a balance training program twice per week for 8 weeks. The following results were obtained from the training program: 1. There were significant improvements in static balance ability in one leg standing (OLS), dynamic balance ability in tandem walk (TW) and four square step (FSS) (p<.05). 2. There was a significant difference between patients with and without single-foot deformity in TW before the program (p<.05). After training, however, the difference became less significant. Also, there was not much difference between recipients with and without single-foot deformity in terms of OLS and FSS. The results of this study suggest that we need to provide training programs and rehabilitation services for the elderly affected by Hansen's disease suffering from nerve injury and disability. Furthermore, further research efforts should be made concerning rehabilitation to overcome various forms of disability.

• Journal of Korean Dental Science
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• v.14 no.2
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• pp.90-100
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• 2021

Purpose: The aim of this study was to evaluate the degree of achievement of anterior tooth movement using a thermoplastic clear aligner by superimposing pretreatment, setup, and post-treatment models and to analyze the factors that influence it. Materials and Methods: Forty patients who underwent clear aligner treatment at the Department of Orthodontics were included in the study. The pretreatment, setup, and post-treatment models were superimposed, and the achievement rates were evaluated. We analyzed the factors that caused changes in achievement rate on each condition. Result: The average achievement rate of total tooth movement was 57.65%. Mesiodistal and anteroposterior displacements were achieved better than vertical displacement and rotation. In each displacement, posterior, mesial, and extrusive movements were better achieved than the rotation. Spacing was better corrected than crowding, especially in the mesiodistal direction. Most of the tooth movements were achieved better when using 3-step thicknesses of aligners were used. Conclusion: The treatment results of clear aligners may differ depending on the type of tooth movement, age and other treatment conditions. Clinicians should consider unfavorable conditions based on the results of this study.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.104-110
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• 2012

Purpose: Who may dare to state that optimal choice of treating nasal bone fracture is closed reduction? Few decades of authors' experience in nasal bone fracture has lead to believe that more active and assertive approach in nasal bone fracture by performing simultaneous lateral osteotomy may be applied in proper indications to acquire more accurate reduction and cosmetically satisfying result. Methods: From May 2008 to October 2009, among 241 nasal bone fracture patients, 20 patients underwent simultaneous lateral osteotomy with nasal bone fracture reduction. Followed by rigid septal correction, nasal cavity is packed to stabilize the fracture segment for safer osteotomy. Through intranasal incision, in selected cases of difficult reduction or for cosmetic purposes, various types of lateral osteotomy was performed corresponding to the fracture anatomy, conditions of the nasal cavity. Postoperative nasal packing was retained for one week and nasal dorsum splint for 3 weeks. Results: Lateral osteotomy was utilized for difficult cases of closed reduction, for correction of wide nose, hump and deviation in 9, 5, 2, and 4 cases, respectively. Patient satisfaction was scaled 90% in satisfaction and moderate in 10% (2 cases), complaining of mild nasal tip deviation. Physicians detected 2 cases of apparent deformity with patient recognition; one patient with mild step deformity at the osteotomy site and the other patient with minimal implant mobility. Conclusion: By accompanying profound understanding of the fracture anatomy, more active and assertive approach in nasal fracture reduction can be coincide with simultaneous lateral osteotomy to reduce the rate of secondary deformity and to obtain more cosmetically satisfying result.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.17-35
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• 1998

Medication used during pregnancy may affect the growth of fetus and maintenance of pregnancy so that it may cause fetal deformity or abortion. Before 1940 it was recognized that only genetic factor could affect the incidence of fetal deformity and the teratogen was protected by placenta barrier. But since the report that Thalidomide caused phocomelia was announced in l962 and 1962, it was acknowledged that the placenta barrier was imperfect. In oriental medical care, there were so many prescription used during pregnancy for nausea, threatened abortion, recurrent spontaneous abortion and it was acknowledged that those medication did not harm both maternity and fetus. Most of them are composed of the material that was not classified as prohibition during pregnancy. But we thought that it should be demonstrated through objective methods that these materials do not affect the incidence of fetal deformity or abortion and have the effect of preventing abortion and maintenance of pregnancy. As the first step of that study we researched 78 prescription and each materials, their kinds and using frequency, used for illness and symptoms during pregnancy written in Dongeuibokam(東醫寶鑑) so that we got to know the tendency about what materials are used for each illness and symptoms.

• Journal of Yeungnam Medical Science
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• v.23 no.1
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• pp.1-9
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• 2006

Breast reconstruction provides dramatic improvement for patients with severe deformity. The reconstruction not only restores aesthetically acceptable breast for patients with mastectomy deformity but also recovers psychological trauma of 'losing feminity' after the cancer mastectomy. There are many options for breast reconstruction from simple prosthetic insertion to a flap operation using autologous abdominal tissue. The choice of operation method depends on the physical condition of the patient, smoking habits, and economic status. Among the many options, the method that uses the lower abdominal tissue is known as the TRAM (transverse rectus abdonimis myocutaneous) flap. Since the introduction of the TRAM flap in 1982 by Hartrampf, the art of breast reconstruction using lower abdominal tissue has been progressively refined to pedicle flap, muscle-sparinga TRAM flap, and recently there have been exciting and revolutionary changes associated with the adoption of the concept of perforator flap. This refined method of breast reconstruction utilizes lower abdominal tissue nourished by the deep inferior epigastric perforator (DIEP). With the DIEP free flap, almost all of the rectus muscle and anterior rectus sheath are preserved and the donor morbidity is minimized. Different from previous flap methods using lower abdominal tissue, DIEP free flap method preserves function of the rectus muscle completely. 1) Understanding the entire progression of breast reconstruction methods using lower abdominal tissue is necessary for plastic surgeons; the understanding of each step of the exciting progression and the review of the past history of the TRAM flap may provide insight for future development.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.254-261
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• 2000

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regenerated bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1994 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.