• Title/Summary/Keyword: Conservative Surgery

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CONSERVATIVE TREATMENT OF CHRONIC SUPPURATIVE OSTEOMYELITIS ON MANDIBULAR BODY TO CONDYLE AREA: A CASE REPORT (하악 체부에서 과두부까지 이환된 만성 화농성 골수염 환자의 보존적 외과술식을 이용한 치험례)

  • Lee, Dae-Jeong;Choi, Moon-Ki;Oh, Seung-Hwan;Lee, Jong-Bok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.474-480
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    • 2009
  • These is a cases of chronic suppurative osteomyelitis occurred in the mandibular body to condyle of 48-year-old male patient. Extensive bone destruction was noted on the right mandibular body, angle, ascending ramus, mandibular notch and condylar region. We made a treatment plan that radicular mandibular resection from body to condyle and mandibular reconstruction with vascularized fibular flap at first time. But, we could observe marked bone regeneration with only mild curettage, local wound care and massive antibiotic therapy. So we preserved the anterior ramus portion of mandible. Defected mandibular condyle was reconstructed with costochondral graft. In this paper we present the case of a patient who has chronic osteomyelitis in mandibular area.

Melorheostosis with Synovial Chondromatosis of the Foot: A Report of Two Cases (족부에 발생한 활막 연골종증을 동반한 유선상 과오종: 2예 보고)

  • Lee, Chae Chil;Kim, Sang Woo;Choi, Hye Jeong;Hwang, Il Yeong;Kim, Min Seok
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.193-196
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    • 2015
  • Melorheostosis is a rare disease, belonging to the sclerotic bone dysplasia group. Initially described by Leri and Joanny in 1922, its etiology remains unknown. Onset is usually insidious, with deformity of the extremity, pain, limb stiffness, and limitation of motion in the joints. The typical radiographic appearance consists of irregular hyperostotic changes of the cortex, resembling melted wax dripping down one side of a candle. Treatment is usually symptomatic and conservative; however, conservative treatment is unsatisfactory due to functional issues when involving the distal extremity. We report on two cases of melorheostosis with synovial chondromatosis of the foot treated by mass excision.

Arthroscopic Treatment of Chronic Calcific Tendinitis of the Shoulder (견관절 만성 석회화 건염의 관절경적 치료)

  • Kim Jin Sub;Yoo Jung Han;Yoo Sun Oh
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.6-11
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    • 1998
  • Shoulder is a common site for calcific deposit and is frequently asymptomatic. There is a general agreement that calcific tendinitis should be initially treated nonoperatively and excision reserved for cases unresponsive to the conservative measures. There are several reports that arthroscopic excision of symptomatic calcific deposit is proved to be efficient in the calcific tendinitis refractory to nonoperative management. The results of arthroscopic treatment of chronic resistant calcific tendinitis of the shoulder in eleven patients were evaluated. Each patient had shoulder pain for more than one year prior to the arthroscopic surgery. The average age of the patients was 48 years(range 35-70). Arthroscopic calcium removal and subacromial bursectomy was performed in all patients. Arthroscopic acromioplasty was additionally done in four patients. The results turned out to be good in nine patients with full range of motion and complete pain relief. One patient with full motion and occcasional episodes of pain was satisfactory. One patient with persistent pain was unsatisfactory which converted to satisfactory six months later after subacromial injection. So we conclude that the arthroscopic treatment is a reasonable alternative in treatment of the chronic calcific tendinitis resistant to conservative treatment.

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The Symptomatic Os Subfibulare (증세가 있는 비골하 부 골)

  • Lee, Woo-Chun;Ko, Han-Suk;Kwon, Kang-Jin;Kim, Sung-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.136-141
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    • 2001
  • Purpose: To investigate clinical features and treatment of os subfibulare Materials and Methods: This is a retrospective study on twenty-eight patients who have symtoms associated with os subfibulare. We reviewed charts and radiographs. Thirteen patients were treated surgically and fifteen patients were treated conservatively. We analysed clinical results in 25 patients who were followed for more than one year. Results: Duration from the onset of symtoms to treatment was more than six months in twelve of thirteen surgically treated cases, and in only two of fifteen conservative treated cases. Surgical procedures were internal fixation of the os subfibulare in two patients, and resection of os subfibulare and ligament reconstructions in eleven patients. Clinical results were excellent in six, good in three and poor in two of operatively treated patients. In conservatively treated patients, five excellent, five good, one fair and one poor clinical results were obtained. Conclusion: Os subfibulare is not necessarily a cause of instability and pain, but in cases with chronic pain and/or instability, surgical treatment would result in satisfactory result.

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Atlantoaxial Rotatory Fixation in Adults Patient

  • Jeon, Sei-Woong;Jeong, Je-Hoon;Moon, Seung-Myung;Choi, Sun-Kil
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.246-248
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    • 2009
  • Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine' motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

A Case Report on a Patient of Pain after Core Decompression Surgery on Avascular Necrosis of Femur Head Treated with Korean Medicine Treatments (대퇴골두 무혈성 괴사 감압술 시술 후 발생한 고관절 통증 환자의 치험 1례)

  • Cho, Sung Woo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.55-65
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    • 2019
  • Objectives : The aim of this study was to report the improvements in pain that a woman experienced after receiving Korean medicine treatments for the pain associated with core decompression surgery due to avascular necrosis (AVN) of both femur heads. Methods : The patient was diagnosed as having AVN in both femur heads and underwent core decompression surgery. After operation, she had pain on her right inguinal region and her range of motion (ROM) was restricted. She was treated with Korean medicine including, herbal medicine, acupuncture, Chuna Manual Therapy and bee venom acupuncture (BV). This study was measured by using the Visual Analogue Scale (VAS) and the ROM scale. Results : After conservative treatment, the patient's pain was reduced and ROM was increased. Daily living quality had improved. Conclusions : In this case, Korean conservative medicine therapy with Chuna Manual Therapy had a positive effect on the symptoms after core decompression surgery due to avascular necrosis of the femur head.

Freiberg's Disease and Metatarsophalangeal Joint Instability (프라이버그병과 중족지 관절 불안정)

  • Young, Kiwon;Kim, Jinsu;Joh, Joowon
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.11-16
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    • 2013
  • Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

A case of Thyroid Hematoma Managed by Conservative Treatment (갑상선 혈종의 보존적 치료 1예)

  • Jung, Young-Do;Kim, Deok Su;Son, Ho Jin;Kim, Jeong Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.45-47
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    • 2018
  • Thyroid hematoma secondary to a blunt trauma is a rare problem. Despite the rarity, it can be a life-threatening condition with tracheal compression. Both surgical exploration and conservative management have been suggested for thyroid hematoma. However, there is still controversy on the optimal treatment. A 67-year old man who progressed severe dyspnea and neck swelling was transferred to the emergency department with a blunt anterior neck trauma after traffic accident. Contrast enhanced neck computed tomography scan showed huge hematoma within the right thyroid gland and slight tracheal deviation without prominent airway obstruction. One day later, anterior neck swelling was aggravated and the patient was intubated to prevent airway obstruction. After 3 days, hematoma resolution was revealed and extubation was done. We report this case with a review of literature.

Current Trends for Treating Lateral Epicondylitis

  • Kim, Gyeong Min;Yoo, Seung Jin;Choi, Sungwook;Park, Yong-Geun
    • Clinics in Shoulder and Elbow
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    • v.22 no.4
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    • pp.227-234
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    • 2019
  • Lateral epicondylitis, also known as 'tennis elbow', is a degenerative rather than inflammatory tendinopathy, causing chronic recalcitrant pain in elbow joints. Although most patients with lateral epicondylitis resolve spontaneously or with standard conservative management, few refractory lateral epicondylitis are candidates for alternative non-operative and operative modalities. Other than standard conservative treatments including rest, analgesics, non-steroidal anti-inflammatory medications, orthosis and physical therapies, nonoperative treatments encompass interventional therapies include different types of injections, such as corticosteroid, lidocaine, autologous blood, platelet-rich plasma, and botulinum toxin, which are available for both short-term and long-term outcomes in pain resolution and functional improvement. In addition, newly emerging biologic enhancement products such as bone marrow aspirate concentrate and autologous tenocyte injectates are also under clinical use and investigations. Despite all non-operative therapeutic trials, persistent debilitating pain in patients with lateral epicondylitis for more than 6 months are candidates for surgical treatment, which include open, percutaneous, and arthroscopic approaches. This review addresses the current updates on emerging non-operative injection therapies as well as arthroscopic intervention in lateral epicondylitis.

Conservative enucleation for physiologic space closure in adenomatoid odontogenic tumor

  • Kezia Rachellea Mustakim;Mi Young Eo;Hye-Jung Yoon;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.3
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    • pp.170-174
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    • 2024
  • Adenomatoid odontogenic tumor (AOT) is a rare, asymptomatic, slow-growing benign tumor that can be divided into three variants: follicular, extrafollicular, and peripheral. By treating AOT using an enucleation and curettage approach, recurrence can be avoided. We report a case of a 24-year-old female who presented with a lump in the right mandibular premolar area along with diastema between displaced teeth #43 and #44 and was diagnosed with extrafollicular AOT. The patient was managed with enucleation-curettage surgery without additional bone graft procedure along with routine follow-up. A successful outcome without recurrence was achieved, and diastema closure with repositioning of the displaced teeth did not require orthodontic treatment. AOT should be managed via enucleation and curettage to obtain successful outcomes without recurrence. Spontaneous bone regeneration following enucleation can be achieved without guided bone regeneration. Also, diastema closure and repositioning of displaced teeth can occur without orthodontic interventions through physiologic drift.