• Title/Summary/Keyword: Conservative Surgery

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CT Classification and Treatment of Intraarticular Calcaneal Fractures - Conservative vs. Surgical Treatment by Prospective Study - (관절내 종골 골절의 전산화 단층 촬영에 따른 분류 및 치료)

  • Kang, Jae-Do;Kim, Hyung-Chun;Kim, Jin-Hyung
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.1
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    • pp.35-42
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    • 2001
  • Purpose: To analyze the results of conservative or surgical treatment after computed tomograhy(CT) classification in intraarticular calcaneal fractures. Materials and methods: From January 1996 to May 1999, we prospectively analyze 23 cases of intraarticular calcaneal fractures who were treated conservatively or operated by open reduction and internal fixation by extensive L-shaped lateral approach after CT classification. Results: A functional scoring system of 0-100 points which was based upon the responses to AOFAS Ankle-Hindfoot Scale for the operative group was at 82.8, compared with 73.2 for the non-operative group, and these were meaningful statistically(P<0.05). Of type I fracture, in the operative group there were 2 excellent results and in the non-operative group there were 2 excellent results, 1 good result. or type II fractures, in the operative group there were 2 excellent results, 3 good results, 1 fair result and in the non-operative group there were 1 good result, 1 fair result, 2 poor results. Of type III fractures, in the operative group there were 2 fair results, 2 poor results and in the non-operative group there were 1 fair result, 3 poor results. Bohler angles of subtalar joint were changed from initial average $13.3^{\circ}$ to postoperative average $20.9^{\circ}$ for the operative group compared with from initial average $15.5^{\circ}$ to follow-up average $14.8^{\circ}$ of the non-operative group(P<0.01). Conclusions: Computed tomography in the evaluation of intraarticular calcaneal fractures is effective tool. We believed that open reduction and internal fixation in all Crosby & Fitzgibbons type II and according to degrees of comminution reducible type III for the intraarticular calcaneal fractures is more effective method than conservative treatment.

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Management of Intractable Cerebrospinal Fluid Collection after Cerebellar Tumor Resection: A Case Report (소뇌 종양 적출 후 두개강 내 발생한 난치성 뇌척수액 고임의 치험례)

  • Rha, Eun Young;Oh, Deuk Young;Kim, Hye Young;Lee, Jung Ho;Moon, Suk Ho;Seo, Je Won;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.95-98
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    • 2010
  • Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.

CLINICAL STUDY OF FACIAL NERVE INJURY AFTER TMJ SURGERY (악관절 수술후 안면신경 손상에 대한 임상적 연구)

  • Kim, Hyung-Gon;Park, Kwang-Ho;Lee, Eui-Wung;Kim, Joon-Bae;Joo, Jae-Dong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.447-457
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    • 1994
  • Authors have studied retrospectively the facial nerve injury after TMJ surgery through the preauricular approach routine. The study material used was 4 patients of all 113 patients who were diagnosed as internal derangement and have been operated from March 1989 to February 1991 in Youngdong severance hospital, and were induced postoperatived facial nerve injury. The patient group who had the postoperative injured facial nerve was recognized degree of injury using the diagnostic method, Electromyography(EMG) and Nerve conduction test(NCT) which are used widely at present and was treated as conservative care and we identified the recovery time as the same method. The results as follows : 1. The meticulous care and precious surgical technique are needed in both operation and postoperation. During the TMJ surgery, the excessive retraction of the flap and frequent use of nerve stimulator and electric surgical knife should be avoided as possible and postoperative hematoma and swelling should be minimized. 2. The 4 patients were experienced with the postoperative facial nerve injury of all 133 patients who had been operated the TMJ surgery through the routine preauricular approach on our hospital. And the incidence of postoperative facial nerve injury happened was about 0.3% and its incidence was relatively low comparing with any other previous reports. 3. EMG and NCT were considered as useful methods which can diagnose the nerve injury objectively and identified the effect of treatment and recovery time. 4. The faical nerve-injured patients who were induced postoperatively after TMJ surgery, were diagnosed as second-degree nere injury through the EMG and NCT. And the patient group was treated well as conservative physical therapy for about 2 to 4 months.

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Stress Fracture after Arthroscopic Lesser Trochanter Resection: Diagnosis and Therapy

  • Matthieu Baert;Maxence Vandekerckhove;Jan Vanlommel
    • Hip & pelvis
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    • v.36 no.1
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    • pp.70-75
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    • 2024
  • We report on the case of a 52-year-old female who presented with a stress fracture after undergoing an endoscopic resection of the lesser trochanter in ischiofemoral impingement, which was resistant to maximal conservative treatment. To the best of our knowledge, this complication has not been previously described. Non-weight-bearing and intravenous alendronic acid were prescribed for management. No additional surgery was required. The patient was pain free with the ability to perform sports on the same level as before and had no complaints.

Submucosal Dissection of the Esophagus (식도의 점믹하 해리;1례 보고)

  • 김영진
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1093-1097
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    • 1992
  • Injury to the esophagus varies from a minor superficial tear to complete rupture of the esophageal wall. We have recently seen one healthy adult male who sustained submucosal dissection of the esophagus while endoscopy. The diagnosis has been made by esophagogram and chest computed tomogram. The therapy was conservative management and good prognosis without complications.

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