• Title/Summary/Keyword: Bone deformity

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Reconstruction of Suborbital area using Composite Radial Forearm Free Flap with Palmaris Longus Tendon immediately after Wide Excision of Skin Cancer (피부 악성 종양 절제 후 장장근건을 포함한 복합 요골 전완 유리 피판술을 이용한 중안면부의 재건)

  • Lee, Hyun-Taek;Minn, Kyoung-Won
    • Archives of Reconstructive Microsurgery
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    • v.10 no.1
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    • pp.60-63
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    • 2001
  • The reconstruction of the suborbital area followed by resection of skin cancer has been used many methods including skin graft, local flaps, free flaps, and skin expansion. The radial forearm free flap has become a workhorse flap in this area because of its lack of bulk, ease of dissection, malleability, and hairlessness. When the suborbital defect especially including full-thickness defect of lower lid was reconstructed with many free flaps, the ectropion and the deformity of medial and lateral canthal area were common problems encountered as late complication due to gravitational descent. To improve the final aesthetic result in patients with suborbital defect, the radial forearm free flap was elevated as a composite radial forearm - palmaris longus free flap, in which the vascularized palmaris longus london was included and anchored to the periorbital bone with $mitek^{(R)}$ as sling, to suspend the flap against gravity and inferior descent, and thereby creating a more natural cheek contour. Two clinical cases were presented as an example of this procedure. Postoperative results emphasize the importance of suspension sling with palmaris longus tendon using $mitek^{(R)}$ in reconstruction of the suborbital defect with radial forearm free flap.

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The Function and Symptoms of Ankle Joint in the Distal Tibial Fractures Treated by Nailing (족관절 기능과 증상을 중심으로 평가한 경골 원위부 골절에서의 금속정 치료 결과)

  • Kim, Byoung-Min;Bae, Su-Young;Roh, Jae-Young
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.86-92
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    • 2008
  • Purpose: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. Materials and Methods: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. Results: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. Conclusion: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.

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Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture (외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술)

  • Bae, Jang-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.234-242
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    • 1996
  • Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and hone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient arc remained back pain. According to above results we concluded that anterolateral internal fixation combined with hone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.

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Post-traumatic Back Pain Revealed as Tuberculous Spondylitis -A Case Report-

  • Kim, Bum-Suk;Shin, Jeong-Hee;Moon, Ho-Sik;Chon, Jin-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.74-77
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    • 2010
  • Tuberculous spondylitis is a very rare disease, but it can result in bone destruction, kyphotic deformity, spinal instability, and neurologic complications unless early diagnosis and proper management are done. Because the most common symptom of tuberculous spondylitis is back pain, it can often be misdiagnosed. Atypical tuberculous spondylitis can be presented as a metastatic cancer or a primary vertebral tumor. We must make a differential diagnosis through adequate biopsy. A 30-year-old man visited our clinic due to back and chest pain after a recent traffic accident. About 1 year ago, he had successfully recovered from tuberculous pleurisy after taking anti-tuberculosis medication. We performed epidural and intercostal blocks but the pain was not relieved. For the further evaluation, several imaging and laboratory tests were done. Finally, we confirmed tuberculous spondylitis diagnosis with the biopsy results.

DISTRACTION OSTEOGENESIS IN CASE OF CLEFT LIP AND PALATE PATIENT WITH SEVERE MAXILLARY DEFICIENCY (구순구개열로 인한 심한 중안면부 성장부전환자에서 골신장술의 치험례)

  • Lee Baek-Soo;Oh Jung-Hwan;Yoon Byong-Wook;Song Sang-Hun;Ryu Dong-Mok
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.2
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    • pp.131-135
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    • 2003
  • Severe maxilla1y deficiency can be caused by cleft lip and palate(CLP), other craniofacial deformities, atrophy in the edentulous maxilla, and trauma. Patients with maxillary deficiency present a difficult treatment challenge. Traditionally, this skeletal deformity has been treated by Le Fort osteotomy, skeletal repositioning, and fixation with mini-plates and screws. The drawbacks of this method include a limited amount of anterior maxillary advancement often requiring simultaneous mandibular setback, the inability to create new bone, and minimal soft tissue adaptation to the new position, all of which increase the potential of relapse in case of large advancement. The alternative method of maxillary distraction osteogenesis offers promising results for successfully treatment of these patients while potentially minimizing the risk of relapse.

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Cherubism: Review of 2 Cases (체루비즘: 2예 보고)

  • Kwak, Juhee;Kim, Ji-Youn;Kim, Myung-Rae;Kim, Sun-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.357-362
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    • 2012
  • Cherubism is a rare familial disease of childhood, characterized by proliferative lesion, which is within the maxilla and mandible. In a typical case, painless symmetric expansile lesions develop in the jaws. It shows substitution of the bone by proliferating fibrous tissue exhibiting mature fibroblasts and a number of multinucleated giant cells within an intercellular matrix. Usually, the disease manifests in early childhood, and becomes more marked until puberty, at which time the bony lesions begin to regress. As such, conservative approaches to management are advisable. However, excision of tissue through enucleation or curettage appears to be necessary in more aggressive cases, to reduce the maxillofacial deformity after puberty and to ensure a successful outcome without the risk of progression, requiring additional resection. This report describes 2 cases of manifestation of cherubism of oral and maxillofacial region. We present diagnosis, radiological - histopathologic features, and treatment of cherubism.

Early-diagnosed silent sinus syndrome and cone-beam computed tomography in a pediatric patient: a case report

  • Leidens, Natali;Franco, Ademir;Santos, Marco C.J.;Makeeva, Irina M.;Fernandes, Angela
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.2
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    • pp.155-159
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    • 2020
  • Chronic maxillary atelectasis (CMA) is a progressive alteration in the volume of the maxillary sinuses that may result in facial asymmetry. CMA in asymptomatic patients is known as silent sinus syndrome (SSS) and is a rare entity, especially in pediatric patients. This study reports a case of SSS in a pediatric patient who received an early diagnosis through cone-beam computed tomography (CBCT). An asymptomatic 12-year-old female patient in orthodontic treatment presented with opacification of the left maxillary sinus on a panoramic radiograph. Clinically, the patient had discrete hypoglobus and enophthalmos. CBCT and nasal video-endoscopy revealed ostiomeatal obstruction with bone deformity, leading to diagnosis of SSS. Endonasal endoscopic maxillary sinusotomy was performed. Two years later, the patient remained asymptomatic, and a second CBCT exam confirmed a stable condition. This case highlights the role of optimal radiographic interpretation for early diagnosis of maxillofacial alterations in pediatric patients.

Juvenile Hemangioma Occurred in Distal Femoral Epiphysis (소아의 대퇴골 원위부 골단에 발생한 혈관종)

  • Kim, Tai-Seung;Lee, Chang-Hoon;Park, Chan-Keum
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.37-41
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    • 2010
  • A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.

Development of 2D-3D Image Registration Techniques for Corrective Osteotomy for Lower Limbs (하지기형 교정 수술을 위한 2D-3D 영상 정합기술)

  • Rha, In Chan;Bong, Jae Hwan;Park, Shin Suk
    • Journal of the Korean Society for Precision Engineering
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    • v.30 no.9
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    • pp.991-999
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    • 2013
  • Lower limbs deformity is a congenital disease and can also be occurred by an acquired factor. This paper suggests a new technique for surgical planning of Corrective Osteotomy for Lower Limbs (COLL) using 2D-3D medical image registration. Converting to a 3D modeling data of lower limb based on CT (computed tomography) scan, and divide it into femur, tibia and fibula; which composing the lower limb. By rearranging the model based on the biplane 2D images of X-ray data, a 3D upright bone structure was acquired. There are two ways to array the 3D data on the 2D image: Intensity-based registration and feature-based registration. Even though registering Intensity-based method takes more time, this method will provide more precise results, and will improve the accuracy of surgical planning.

RADIOGRAPHIC STUDY ON TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증에 관한 방사선학적 연구)

  • You Dong Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.10 no.1
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    • pp.47-55
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    • 1980
  • The author analysed the routine radiographic changes and clinical symptoms of 205 cases of temporomandibular joint arthrosis. The clinical symptoms of the patients were classified and the morphological ylar head, articular eminence, and articular fossa were analized and discussed view point. The positional changes of condylar head and articular fossa relatation in TMJ arthrosis were observed. The frequencies of coincidence between the site of complaints and the site of the abnormal images which could be detected were examined. The results were obtained as follows; 1. Bone erosion, deformity, marginal proliferation and sclerosis were selected from many abnormal images as the radiographic diagnostic criteria of TMJ arthrotic lesions. 2. Abnormal radiographic findings were revealed in 150 cases (73.9%) of 205 total TMJ arthrosis cases and site with abnormal findings coincided with the site of complaints in 106 cases (70.7%) of 150 cases and coincidence rates were higher above fourth decades than below third decades. 3. Sclerosis of the abnormal radiographic findings could be found more often below third decades than above fourth decades. 4. The positional changes of condylar head were revealed in 176 cases (85.9%) of 205 total cases. 5. Pain complaints were revealed in 170 cases(82.9%) and clicking sounds were revealed in 120 cases (58.6%) of clinical symptoms of TMJ arthrosis. 6. No tendency was found so far the differential diagnosis between pain dysfunction syndrom and osteoarthrosis of TMJ.

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