• Title/Summary/Keyword: 회전성형술

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석회화 건염

  • Kim, Yang-Su
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2006.11a
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    • pp.76-84
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    • 2006
  • 석회화 건염은 회전근 개중 극상근 건에 석회가 침착되는 질환으로서 진행 양상에 따라 Formative, Resting, Resorptive phases로 나눈다. 치료는 물리 치료, Puncture, 국소 steroid 주사, 체외 충격파 등 보존적 치료에 반응을 잘 하며, 특히 resorptive phases때의 극심한 통증은 석회 침착 부위에 puncture나 needling lavege를 실시하면 즉각적인 동통 감소 효과와 함께 석회 침착의 자연 소실을 기대할 수 있다. 이러한 보존적 치료에 효과가 없을 경우 수술적 처치를 고려할 수 있는데 최근에는 대부분 관절경을 이용한 석회 제거술을 시행한다. 수술전 견관절 충돌 징후가 있거나 수술 소견상 이를 의심할 만한 소견이 있을 경우 견봉하 성형술을 함께 실시하기도 한다.

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Arthroscopic Anterior Acromioplasty for the Treatment of Chronic Impingement Syndrome of the Shoulder (관절경적 전방 견봉 성형술을 이용한 만성 견관절 충돌 증후군의 치료)

  • Park Tae-Soo;Kim Jae-Young
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.49-53
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    • 2000
  • Purpose : The purpose of this study was to evaluate clinical efficacy of the arthroscopic anterior acromioplasty for the treatment of chronic impingement syndrome of the shoulder. Materials and Methods : Between July 1995 and December 1997, twenty seven consecutive shoulders of 26 patients with chronic impingement syndrome of the shoulder were treated by arthroscopic anterior acromioplasty. The patients who had severe osteoarthritis of the shoulder full thickness tear of the rotator cuff, and nonoutlet impingement were excluded. The clinical results were evaluated by using UCLA shoulder rating scale. The average follow-up was 2years 3months(range, 1year 7months to 3years 1 11months). Results : Twenty three patients$(85.2\%)$ were rated as excellent or good results, while four patients$(14.8\%)$ were fair. Twenty six cases$(96.3\%)$ were satisfied with the results of the operations, while one case$(3.7\%)$, who had Parkinsonian syndrome, ossification of posterior longitudinal ligament(OPLL) of the cervical spine, and spinal stenosis of the 5th and 6th cervical spine was not satisfied. Conclusion : Arthroscopic anterior acromioplasty was an effective treatment method, especially for relief of pain, for the treatment of chronic impingement syndrome of the shoulder. If the patient has the combined lesions in the cervical spine and the shoulder, and systemic lesions, these lesions may influence the results of treatment after operation, and cause the unpredictable results.

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THE EFFECT OF LIP ADHESION ON ROTATION-ADVANCEMENT REPAIR IN UNILATERAL COMPLETE CLEFT LIP (구순접합술이 회전신전법에 의한 편측성 완전 구순열 수복에 미치는 영향)

  • Ryu, Sun-Youl;Park, Chung-Youl;Seo, Il-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.323-329
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    • 2003
  • The present study was carried out to evaluate the postoperative results of Millard rotation-advancement repair (MR) and lip adhesion followed by Millard rotation-advancement repair (LAMR) in unilateral complete cleft lip. Twenty patients with unilateral complete cleft lip underwent MR or LAMR at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital over a period of 6 years (January 1994 to December 1999) were analyzed. The surgical results following the operation were assessed on the basis of scoring, vertical lip length, and scar hypertrophy. The mean score was better in LAMR group ($74.74{\pm}1.09$, n=13) than in MR group ($66.50{\pm}1.14$, n=7) for both lip and nose segments. Scar hypertrophy developed in MR group with 28.6% and in LAMR group with 23.1%. No significant difference was noted in the ratio of lip length between LAMR and MR groups ($0.84{\pm}0.08\;and\;0.73{\pm}0.10$). These results suggest that LAMR is better than MR in repairing the unilateral complete cleft lip.

Mitral Valve Replacement with a Pulmonic Autograft (자가 폐동맥 판막을 이용한 승모판막 치환술- 1례 보고 -)

  • 이재원;김건일;정성호;최현정;송명근
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.361-364
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    • 2001
  • 자가 폐동맥 판막을 이용한 대동맥 판막 치환술을 항응고제 복용이 필요없고 내구성이 어느정도 입증되어 늘어나고 있으나, 자가 폐동맥 판막을 이용한 승모판막 치환술은 국내에 보고된 예가 없다. 53세 여자 환자로 류마티스성 승모판막 협차가 및 폐쇄부전, 삼첨판막 폐쇄부전, 만성 심방 세동, 그리고 자회전 관상동맥의 폐색등으로 진단받은 환자에서 자가 폐동맥 판막을 이용한 승모판막 치환술 및 maze 술식, 삼천판막 성형술, 관상동맥 우회수술을 시해하였다. 수술후 특별한 문제없이 회복하였으며 술후 시행한 심초음파 검사상 자가 폐동맥 판막의 이상 소견없이 잘 기능하고 있으며 항응고제 복용없이 잘 지내고 있다.

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Distal Fibular Rotational Plasty for Chronic Peroneal Tendon Recurrent Dislocation: A Technical Report (만성 비골건 재발성 탈구에서 원위 비골 회전 성형술: 술기 보고)

  • Suh, Jae Wan;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.168-172
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    • 2020
  • Chronic recurrent peroneal dislocation often responds poorly to conservative treatment. Surgical treatment has been reported to be more effective than conservative treatment, and various surgical treatment methods are available: superior peroneal retinaculum repair or reattachment, peroneal groove deepening procedures, rerouting procedures, or bone block procedures. Although various treatment options have been reported, there is no consensus regarding which treatment is better. This paper proposes a distal fibular rotational plasty that can prevent recurrent peroneal dislocations and recover its function well by securing a stable peroneal tendon excursion space.

A COMPARATIVE STUDY ON CRONIN TRIANGULAR FLAP AND ROTATION-ADVANCEMENT REPAIR IN UNILATERAL COMPLETE CLEFT LIP (편측성 완전구순열에서 Cronin 삼각피판법과 회전신전법에 의한 수복의 비교)

  • Ryu, Sun-Youl;Yun, Cheon-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.5
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    • pp.415-421
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    • 2001
  • The present study was carried out to compare the postoperative results of Cronin triangular flap and Millard rotation-advancement repair techniques in repairing the unilateral complete cleft lip. Thirteen patients with unilateral complete cleft lip underwent 6 Cronin triangular flap and 7 Millard rotation-advancement repairs at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital over a period of 6 years (January 1994 to December 1999). The surgical results following the operation were assessed on the basis of scoring, vertical lip length and scar hypertrophy. The mean score was better in Cronin triangular flap group($74.77{\pm}0.86$) than in Millard rotation-advancement group($66.50{\pm}1.14$) for both lip and nose segments. Scar hypertrophy developed in the Millard rotation-advancement repair group with 28.6% incidence but not in the Cronin triangular flap group. No significant difference was found in the ratio of lip length between Millard rotation-advancement repair and Cronin triangular flap groups($0.73{\pm}0.10$ and $0.80{\pm}0.96$). These results suggest that Cronin triangular flap shows better results than Millard rotation-advancement repair in repairing the unilateral complete cleft lip.

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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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Repair of Large to Massive Rotator Cuff Tears in the Elderly Patients (65세 이상 고령 환자의 대형 및 광범위 회전근 개 파열에 대한 봉합술)

  • Jung, Hong Jun;Chun, Jae Myeung;Jeon, In-Ho;Kwon, Jun;Ha, Sang-Ho;Yang, Sung Wook;Lee, Ji-Ho
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.91-98
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    • 2012
  • Purpose: The objective of this study is to evaluate the functional outcome and identify prognosis of retear patients in patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear. Materials and Methods: From 1995 September to 2010 March, 147 patients aged 65years or over (40 male, 107 female, with an average age of 69.6) undergoing surgical repair for large to massive full thickness rotator cuff tear (large 67 cases, massive 80 cases). For functional evaluation, preoperative and postoperative 1 year range of motion and muscle power checked. For subjective evaluation, American shoulder and elbow surgeons score and Constant score were checked. For anatomical evaluation, 87 patients were checked shoulder MRI at the time of the postoperative 1 year. Results: ASES score improved from to 50.4 to 88.9, Constant score improved from 47.1 to 75.2. Supraspinatus power improved from 51.1% to 80.8%, external rotator muscle power improved from 64.5% to 83.1%. Forward elevation improved from 117.4 degrees to 153 degrees, external rotation improved from 23.6 degrees to 41.8 degrees. Follow up MRI showed re-tear in 23%, all re-tear patients were from massive tear except one patient. All re-tear patients showed improved clinical outcomes, but supraspinatus and external rotator muscle power were not improved. Conclusions: Patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear showed successful outcomes over 90 percent. Re-tear patients also showed successful clinical outcomes. In elderly patients with large to massive full thickness rotator cuff tear, aggressive surgical repair leads good clinical outcomes.

Facial asymmetry: Critical element of clinical successful treatment (임상가를 위한 특집 4 - 안면비대칭의 외과적 교정)

  • Hong, Jongrak
    • The Journal of the Korean dental association
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    • v.52 no.10
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    • pp.623-632
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    • 2014
  • The facial asymmetries include maxillary, mandibular, and chin asymmetries, although the most common deformity is primarily in the mandible. Common causes of this type of asymmetry can include asymmetric growth of the condyle or the mandible. In these patients, the location of the Me would be deviated to the shorter side because of the asymmetric growth of the mandible, and, commonly, the maxillary occlusal plane would be tilted toward the deviated side because the maxilla likely grows asymmetrically according to the pattern of asymmetric mandibular growth. Three-dimensional CT images are ideal for evaluating the size and location of anatomic structures, and such reconstructed images allow the use of software that can show anatomic structures from numerous angles, allowing actual measurements of distances and angles without problems of magnification, distortion, or superimposition caused by 2-dimensional imaging. In the present study using 3D-CT imaging, the 8 parameters, including measurements of the upper midline deviation, maxillary canting in the canine and first molar regions, width of the upper arch, width of the mandible at the Go, vertical length of the ramus, inclination of the ramus, and deviation of the Me were easily measured. The dentition should be orthodontically decompensated and dental midline should ensure incisor midlines positioned in the midline of each jaw before surgical correction. Surgical correction could be considered such as canting or yawing correction in the frontal or horizontal aspect, respectively.

Reverse Total Shoulder Arthroplasty: Complications (견관절 역형 전 치환 성형술: 합병증)

  • Kim, Young-Kyu
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.111-116
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    • 2011
  • Purpose: The purposes of this article are to review the mid-term results and the complications after reverse total shoulder arthroplasty and to analyze the influence of the etiology on the result. Materials and Methods: We conducted a systemic review of the published literature with the mid-term follow-up after reverse total shoulder arthroplasty was performed. The overall rates of problems, complications, reoperations and revisions were determined. Results: The reported complication rates varied from 0% to 68%. The first series of reverse prosthesis with at least 2 yrs of follow-up confirmed the preliminary results, with excellent functional outcomes. However, a systemic review of the published literature with a mid-term follow-up showed problems in 44% of the cases, complications in 24% of the cases, reoperations in 3.5% of the cases and revision in 10% of the cases. Conclusion: Reverse total shoulder arthroplasty has relatively high complication and revision rates. So, a reverse prosthesis should be used in patients with very disabling arthropathy and a massive cuff tear and who are over seventy (at least sixty-five) years old.