• Title/Summary/Keyword: 봉합법

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The Evaluation for the Usefulness and Clinical Results of Arthroscopic Double Row Repair with UU Stitch for Massive Sized Full Thickness Rotator Cuff Tear (광범위 회전근 개 파열에서 관절경 감시하의 봉합술 - UU stitch를 이용한 이열봉합의 임상 결과 및 유효성 -)

  • Ko, Sang-Hun;Jeon, Hyung-Min;Shin, Seoung-Myung
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.250-259
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    • 2010
  • Purpose: The purpose of this study was to evaluate the usefulness and clinical results of arthroscopic double row repair with UU stitches for massive, full-thickness, rotator cuff tears. Materials and Methods: Between January 2007 and July 2009, we consulted on 36 massive tears in which it was possible to repair the middle area of the greater tuberosity by arthroscopy. One group consisted of 11 cases that had a double row repair with UU stitches. A second group consisted of 20 cases that had a single row repair with simple stitches. We compared the 2 groups for pain, Activities of Daily Living, UCLA score, and KSS score. We did this pre operatively, and at 6 months, 1 year and final follow-ups. Statistical analysis included Student's t test and a paired t est. Mean age was 59 (48~70); mean follow-up was 28 (12~43) months Results: VAS scores decreased from 7.5 pre operatively to 1.5 post operatively at the last f/u in the $1^{st}$ group (p<0.05). In the $2^{nd}$ group, the score decreased from 7.6 in pre op to 1.8 post operatively at the last f/u (p<0.05). There was no significant difference between the two groups (p>0.05). Mean ADL increased from 11.5 to 25.1 at the last f/u in the $1^{st}$ group (p<0.05); in the $2^{nd}$ group the ADL score increased from 11.3 to 27.5 (p<0.05). There was no significant difference between the two groups (p>0.05). The UCLA score increased from 13.9 to 31.6 in the $1^{st}$ group (p<0.05), while in the $2^{nd}$ group the score increased from 13.8 to 30.1 (p<0.05); there was no significant difference between the two groups (p>0.05). Comparing MRIs at 3 and 6 months post op, there were retears in 3 of 9 cases in the first group, and in 8 of 15 cases in the second group; there was no significant difference between the two groups (p>0.05). Conclusion: Arthroscopic double row repair with UU stitches for massive, full-thickness rotator cuff tears showed no differences in clinical results. However, it was associated with a significant difference in the incidence of retears.

CLINICAL STUDY OF BLEPHAROPLASTY USED BY SUTURED METHOD (봉합법을 이용한 중검술의 임상적 연구)

  • Park, Kwang;Seo, Ku-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.353-357
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    • 1996
  • One of the most common cosmetic surgery, the blepharoplasty can be divided two method. there were incisional method and sutured method. Authors try to understand the anatomic difference between the oriental upper eyelids and apply the surgical techniques of constructing upper eyelid crease of oriental case effectively. And we discussed the postoperative complications of the blepharoplasty and proposed the solve of these problems. The sutured method of blepharoplasty was more simple technique than conventional incision method and had low occurrence of complications. Even though slight recurrence, suture method was more esthetic due to no scar formation.

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Mini-open Rotator Cuff Repair Using Anterolateral Approach - Technical Note - (전외측 도달법을 이용한 소절개 회전근 개 봉합술 - 수술 술기 -)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Bae, Ki-Cheor;Lee, Kyung-Jae;Seo, Hyuk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.49-52
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    • 2010
  • Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.

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Medial Retracted Large Rotator Cuff Tears (내측으로 퇴축된 대범위 회전근 개 파열)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Kim, Tae-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.212-219
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    • 2009
  • Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

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Arthroscopic Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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3-Dimensional Analysis of Alveolar Molding Effect of Presurgical Nasoalveolar Molding Appliance and Lip Pressure After Cheiloplasty in Complete Unilateral Cleft Lip and Palate Patients (편측성 구순구개열 환자의 술전 비치조 정형장치와 구순 봉합수술의 치조골 정형효과의 3차원 분석)

  • Kim Na-Young;Kwon Sun-Man;Baek Seung-Hak
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.2
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    • pp.93-106
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    • 2004
  • 본 연구의 목적은 편측성 구순구개열 (UCLP) 환자에서 술전 비치조 정형장치 (presurgical nasoalveolar molding appliance, PNAM) 와 구순 봉합수술의 치조골 정형효과를 3차원 (3-D) 분석을 통하여 평가하는 것이다. 연구대상은 16명의 UCLP 환자 (평균 파열부거리: 10.46mm) 이며 PNAM 장치에 의한 치료와 rotation-advancement법에 의한 구순 봉합수술을 받았다 처음 내원시 (평균연령: $37.0{\pm}27.89$ 일), PNAM 치료를 받고 난 후이며 구순봉합수술 1달 전 (평균연령: $119.25{\pm}40.18$ 일), 구순봉합수술 2달 후 (평균연령: $190.81{\pm}42.78$ 일)에 상악의 인상을 채득하였다. 그 후 laser scanning machine (Orapix, Dimennex, Seoul, Korea) 과 3-D view software (3Dxer, Dimennex) 를 사용하여 3-D모형을 제작하였다. 선, 각도, 정중선변이, 거리, 면적 항목을 3-D 모형상에서 계측하고, 각 시기별의 차이를 비교하기 위하여 Wilcoxon signed rank test를 사용하여 분석하였다. PNAM치료 동안과 구순 봉합수술 후에도 치조골 후방부는 안정된 구조물이었다. PNAM치료에 의한 파열부 거리의 감소는 대분절 (greater segment) 의 내측 굴곡 (bending) 에 의하여 발생하였다. 대분절 (greater segment)의 전방 성장은 PNAM치료에 의하여 억제되었으나, 구순 봉합수술 후에 회복되었다. 구순 봉합수술 후에 대분절과 소분절 사이의 전방부 각도의 증가는 구순 반흔 (lip scar) 의 압력에 의한 치조골 정형 효과 때문으로 생각된다. 정중선변이는 PNAM치료에 의하여 개선되었다. PNAM치료 동안과 구순 봉합수술 후에 구개부 (palatal segment) 의 면적은 계속 증가하였다. 치조골 면적과 거리 항목의 증가는 후방부에서 크게 나타났다. 이러한 결과는 PNAM치료에 의한 치조골 정형효과는 주로 전방부에서 발생하며, 치조골의 성장은 구순 봉합수술 후에 후방부에서 주로 발생한다는 것을 의미한다.

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Arthroscopic Reduction of Subluxed Medial Meniscus using Suture Anchor for Restoration of Hoop Stress - Technical Note - (버팀테응력 회복을 위한 아탈구된 내측 반월상 연골의 Suture anchor를 이용한 정복술 - 술기 보고 -)

  • Kim, Jaw-Hwa;Lee, Yoon-Seok;Kim, Chul;Han, Seung-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.280-284
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    • 2009
  • Purpose: The authors introduce a new technique of arthroscopic reduction of subluxed medial meniscus using suture anchor for the restoration of hoop stress. Operative Technique: Anterolateral, anteromedial, and medial midpatellar arthroscopic portal are used. Arthroscope was inserted through anterolateral portal. Through the scope, we confirmed subluxation of medial meniscus. Transection of menisci including radial and root tear were excluded. We released the anterior horn of medial meniscus through anteromedial and burred the future insertion site of suture anchor. After inserting suture anchor through medial midpatellar portal, we used 90 degree suture hook and no.2 Nylon to retrieve the suture of inserted anchor. We tied the suture by sliding knot-tying method. Weight bearing was limited for 6 weeks postoperatively. Conclusion: Arthroscopic retightening of medial meniscus is less invasive, conserving and progressed method for subluxed meniscus.

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상부 관절순 병변의 최신 지견: 기능적 평가

  • 김승호;하권익;조양범
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.9-14
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    • 2002
  • SLAP 병변의 진단시에는 정상 meniscoid 상부 관절와순과 구분이 중요하다. 병변의 기전은대부분 외 회전손상에 의해 발생하게 되며 불안정한 견관절에서 이차적 안정화 구조물로 작용하게된다. 대부분 이두박근 부하검사법으로 진단할 수 있으며, 봉합나사를 이용한 관절경적 봉합술을 시행하였을 때 투구 동작을 하는 운동 선수를 제외한 대부분의 환자에서 만족스러운 결과를 나타낸다

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