• Title/Summary/Keyword: Conservative Treatments

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Ultrasonographic Guidance in Acute Achilles Tendon Rupture (급성 아킬레스 건 파열에서의 초음파 이용)

  • Lee, Tae-Hoon;Lee, Hee-Dong;Kim, Hak-Jun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.8 no.1
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    • pp.26-30
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    • 2015
  • There are many traumatic foot and ankle problems in orthopaedic fields. Though it is not life-threatening problems, a delay in accurate diagnosis and treatments can danger limb function and therefore correct diagnosis can prevent long-term complications. Achilles tendon rupture is relatively common injury for active sports people. Ultrasonography is cost-effective, irradiation -free, effective for evaluation of soft tissues and dynamic analysis. It has been growing importance in Achilles tendon rupture. Ultrasonography is a diagnostic tool in Achilles tendon rupture. Physical examination and patient history is needed to diagnose Achilles tendon without image, but it is missed up by 20% in private clinic. Discontinuity of normal fibrillar architecture seen on an ultrasonographic image is diagnostic for Achilles tendon rupture, and can be accentuated by the performance of dorsi-flexion and plantar flexion, while observing in real time. And ultrasonography is a reliable method for serial observation after surgical treatment or conservative treatment.

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Sports Injuries of the Wrist (손목의 스포츠 손상)

  • Kim, Jong-Pil;Kim, Sung-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.8-16
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    • 2012
  • With the increase of participation in the sport activities, there has been a commensurate rise in the number of sport injuries. A more commonly encountered injured region in the upper-extremity is the wrist. Sport injuries are often characterized as overuse and traumatic. Traumatic injuries include fractures, dislocations, and ligament tears often seen in contact or collision sports. Overuse injuries, represented damages by a level of repetitive microtrauma sufficient to overwhelm the tissues$^{\circ}{\O}$ ability to adapt, include inflammatory conditions such as De Quervain$^{\circ}{\O}s$ disease, extensor carpi ulnaris tendinitis, intersection syndrome. Also included is a traumatic problem such as stress fractures of the hook of the hamate, subluxation of the extensor carpi ulnaris tendon, chronic scapholunate instabilities, and degenerative triangular fibrocartilage tears. This review will focus on both overuse and traumatic injuries of the wrist in the athletes. A significant emphasis will be placed on the evaluation, pearls and pitfalls of conservative and operative treatments.

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Outcomes of Secondary Laminoplasty for Patients with Unsatisfactory Results after Anterior Multilevel Cervical Surgery

  • Liu, Hong-Wei;Chen, Liang;Xu, Nan-Wei;Yang, Hui-Lin;Gu, Yong
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.36-41
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    • 2015
  • Objective : To investigate the causes for failed anterior cervical surgery and the outcomes of secondary laminoplasty. Methods : Seventeen patients failed anterior multilevel cervical surgery and the following conservative treatments between Feb 2003 and May 2011 underwent secondary laminoplasty. Outcomes were evaluated by the Japanese Orthopaedic Association (JOA) Scale and visual analogue scale (VAS) before the secondary surgery, at 1 week, 2 months, 6 months, and the final visit. Cervical alignment, causes for revision and complications were also assessed. Results : With a mean follow-up of $29.7{\pm}12.1$ months, JOA score, recovery rate and excellent to good rate improved significantly at 2 months (p< 0.05) and maintained thereafter (p>0.05). Mean VAS score decreased postoperatively (p<0.05). Lordotic angle maintained during the entire follow up (p>0.05). The causes for secondary surgery were inappropriate approach in 3 patients, insufficient decompression in 4 patients, adjacent degeneration in 2 patients, and disease progression in 8 patients. Complications included one case of C5 palsy, axial pain and cerebrospinal fluid leakage, respectively. Conclusion : Laminoplasty has satisfactory results in failed multilevel anterior surgery, with a low incidence of complications.

A Clinical Review of Surgically Treated 115 Cases of Lung Abscess (외과적 치료를 가한 폐농양 115례에 대한 임상적 관찰)

  • 문한배;이호일
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.3-12
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    • 1969
  • Prior to availability of antibiotics, lung abscess has been recognized as one of the most serious pulmonary disease, and despite of diminished morbidity and mortality rate with the advent of antibiotics and development of better technique in the fields of surgery on pulmonary disease it continues to be a virulent form of pulmonary supuration. It is the purpose of this paper to present a clinical review of 115 lung abscess treated by surgically at "The National Medical Center" during past 9 years. 1. The most common age of occurrence is between the age of 30 and 50, and 105 cases were male and 31 cases occurred in female. 2. Numerous etiological factors may play a role in the formation of a pulmonary abscess; aspiration in 36 patients of which 2 patients had diabetes, 54 patients had preceding URI or pneumonia, and 5 patients followed liver abscess, one of which in hematogenous route. In 20 patients, no predisposing factor could be determined- 3. Clubbing digits were presented in 26 of 1315 patients suggesting chronicity of the disease, and gastric ulcer were combined in 3 of 136 patints. 4. Apparently the onset was insidious, and the progress was masked by indiscriminate administration of antibiotics for URI and TB remedies under impression of pul. tbc. Previous TB treatments were done in 56.%[76 cases] for one week to two years and administration of antibiotics in 51 cases. 5. 89 cases were on tbe right and 2t5 cascs were on the left side. 51 cases of pneumonectomy and 8 of open drainage, of which 4 of Monaldi procedure, were made and operative mortality rate was 5.2%. Numerous complications such as 8 of empyema, 4 of each bleeding and atelectasis, 2 of BPF, 1 of esophageal fistula and one of pneumothorax which were responded well to prolonged treatment with good results, were obtained. 6. The incidence of Klebsiella and Pseudomonas were increased recently. In these results, we submit the surgery should be performed if the conservative therapy had failed. The resection was most favorable operation for pulmonary abscess though drainage procedure may be of value in certain patients with grave systemic menifestations. In chronic long standing abscess, more complications and high mortality rate were assumable although the prognosis has been improved with the advent of antibiotics, the development of improved surgical technique and complete preoperative care.

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A CASE REPORT OF EAGLE'S SYNDROME WITH TMJ INTERNAL DERANGEMENT (악관절내장증을 동반한 Eagle's Syndrome)

  • Park, Kwang-Ho;Kim, Hyung-Gon;Yoon, Jung-Ho;Jeong, Sang-Hoon;Park, Jung-Hyun;Kim, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.458-463
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    • 1994
  • A thirty two year-old male was referred with a chief complaint of mouth opening limitation, and maxillofacial pain including left TMJ area. The patient had been treated in a private clinic with medications and conservative treatments, without any improvements in symptoms. MRI findings showed a limitations in condylar head movements, and signs of disc adhesion without the Positional change. Panoramic views showed elongation of stylohyoid process. Brain C-T was taken due to the patient's complaint of headache, facial pain, and paresthesia of tongue, and the result showed no abnormalities. The first surgery included meniscoplasty and the removal of disc adhesion of left TMJ under the preliminary diagnosis of internal derangement with adhesion, and the patient displayed marked improvements in opening movements despite of persistent hemiparesthesia of left facial areas and tongue, and mild dysphasia. Therefore, the second surgery was carried out with the preliminary diagnosis of Eagle's Syndrome, and a resolution of neurologic symptoms was obtained. The final diagnosis of this case was Eagle's Syndrome with internal derangement, and the difficulties in diagnosis and treatment might be due to the existence of two separate diseases with similar symptoms.

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A case report of a long-term abandoned torn lingual nerve injury repaired by collagen nerve graft induced by lower third molar extraction

  • Fujita, Shigeyuki;Mizobata, Naoki;Nakanishi, Takashi;Tojyo, Itaru
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.60.1-60.6
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    • 2019
  • Background: The lingual nerve plays an important role in multiple functions, including gustatory sensation and contact sensitivity and thermosensitivity. Misdiagnosed conservative treatments for serious lingual nerve (LN) injuries can induce the patient to serious mental disability. After continuous observation and critical diagnosis of the injury, in cases involving significant disruption of lingual nerve function, microneurosurgical reconstruction of the nerve is recommended. Direct anastomosis of the torn nerve ends without tension is the recommended approach. However, in cases that present significant gaps between the injured nerve ends, nerve grafts or conduits (tubes of various materials) are employed. Recently, various reconstruction materials for peripheral nerves were commercially offered especially in the USA, but the best method and material is still unclear in the world. There currently exists no conventional protocol for managing LN neurosensory deficiency in regard to optimal methods and the timing for surgical repair. In Japan, the allograft collagen nerve for peripheral nerves reconstruction was permitted in 2017, and we tried to use this allograft nerve and got a recommendable result. Case presentation: This report is a long-term abandoned torn LN reconstructed with allograft nerve induced by the lower third molar extraction. Conclusions: In early sick period, with the exact diagnosis, the LN disturbance should be managed. In a serious condition, the reconstruction with allograft nerve is one of the recommendable methods.

Delayed-Onset Methicillin-Resistant Staphylococcus aureus Infection at 18 Months after Absorbable Plate Fixation for Zygomaticomaxillary Complex Fracture

  • Lee, Hyun Rok;Shin, Hea Kyeong;Lee, Dong Lark;Jung, Gyu Yong
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.229-232
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    • 2016
  • None of the reports of delayed infection mentioned a latent period exceeding 13 months. we report an infection that developed 18 months after implantation of an absorbable plate. A 16-year-old adolescent girl had undergone reduction and fixation with an absorbable plate for Lefort I and zygomaticomaxillary complex fractures 18 months prior at our hospital. In her most recent hospital visit as an outpatient, abscess was observed in periocular area. Computed tomography revealed sinusitis with an abscess above the infraorbital rim. Wound culture yielded methicillin-resistant Staphylococcus aureus. Despite conservative treatments, wound state did not improve. Therefore, our department decided to perform surgery. Absorbable plate had been mostly absorbed but remained a bit. Bony depression of infraorbital rim and mucosal exposure of maxillary sinus anterior wall were observed. After the surgery, the patient recovered. We believe that the reason the wound infection and sinusitis manifested at the same time is because of several factor such as alcohol abuse, smoking, and mucosal exposure of maxillary sinus anterior wall. Absorbable plate takes 9 months to 3 years to be completely absorbed, thus we suggest studies with a follow-up of at least 3 years be undertaken to determine the outcomes of patients with many risk factors.

Development of modern dentistry in Korea (한국 현대 치의학의 발전 1946-1969년 논문, 증례보고, 종설 및 학술강연회 연제를 중심으로)

  • Shin, Yooseok;Shin, Jaeeui
    • The Journal of the Korean dental association
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    • v.53 no.11
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    • pp.817-843
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    • 2015
  • Korean dentist's new mission was extended in dental practice field since the National Liberation Day of Korea. Modern dentistry development were due to the introduction of american dentistry, the development of Military dentistry, the unified academic activities koreans dental Association and improvement of korean dentist system. Modern dentistry development factors were as follows, First, Seoul National University's professors have been sent for studying abroad since May 1954. Thanks to this advanced system, each dental department established branch academy. Researchers and academic activities were increased in Seoul National University, Second, from January 1954, the military started training program to the korean dentists in the United States, and also the korean dentists were sent to the US Army hospital in korea for practical training courses (On the Job Training) so they could get chances to learn the advanced dentistry. During the korean war, the oral surgery dentists enlarged treatments to the maxillofacial field. Third, korean Dental academy meeting, special lectures and tables clinic from 1947 were contributing to the development of modern dentistry in the transmission of knowledge and skills. Since 1955 "Dentistry(齒學)" with a focus on the translation of foreign literature also developed modern dentistry. Since 1958 the International dental conference could broaden dental knowledge, it also provided opportunities to communicate with the world dentistry. On Oct 11, 1962, revised the Articles of association in Korean Dental academy and korean dental association unified meeting and enhanced the conferences. Improvement of korean dentist system in 1964 unified the dentists as new dentist education. Articles, case reports, review articles and academic meetings of korean dental association from 1946 to 1969 analyzed to demonstrate the development of korean modern dentistry, The titles and lectures were classified according to department and they were organized by topic.

A Case Report on Gait Pattern Change of Unilateral Knee Pain Patient Treated by Korean Medicine: Focused on Gait Analysis Results. (편측 슬관절 통증을 호소하는 환자의 증상 개선에 따른 보행 척도의 변화 보고: 보행 분석을 중심으로)

  • Chu, Hong-Min;Kim, Kwang-Ho;Lee, Young-Ung;Park, Kyung-Tae;Jang, Jong-Won;Kim, Sun-Kyung;Lim, Hyeon-Seo;Kim, Cheol-Hyun;Lee, Sang-Kwan;Sung, Kang-Keyng
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.147-155
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    • 2020
  • Objectives : The aim of this study was to analyze changes in the gait pattern of a unilateral knee pain patient after treatment with Korean Medicine therapy. Methods : We conducted gait analysis 4 times over 11 days to analyze changes in gait parameters using gait analysis systems. Results : Velocity, cadence, step length, and stride length were all increased. On the collateral side, both stance phase and double support (%) decreased. These results are similar to those of hemiplegic patients with improvement patterns. Conclusions : Gait analysis could be used as a good evaluation tool for tracking improvements in knee pain.

A Case Report on Heat Sensation in Both Feet Caused by Restless Leg Syndrome Using Conservative Korean Medical Treatment (양 족부 열감을 호소하는 하지불안증후군 환자 치험 1례)

  • Kim, Gyeong-muk;Suh, Won-joo;Kim, Su-bin;Jung, Woo-sang;Mun, Sang-kwan;Kwon, Seung-won;Cho, Ki-ho
    • The Journal of Internal Korean Medicine
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    • v.39 no.2
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    • pp.116-129
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    • 2018
  • Objectives: The purpose of this study is to evaluate the effectiveness of electroacupuncture on heat sensation of the feet of a 61-year-old female patient with restless leg syndrome. Methods: Electroacupuncture was performed at four acupoints (KI3 (太谿), KI6 (照海), LR3 (太衝), LR2 (行間)) selected to reduce heat sensation in both feet. The patient's symptoms were assessed using the VAS (Visual Analogue Scale), the SF-MPQ (short-form McGill Pain Questionnaire), and the IRLS (International Restless Legs Scale). The treatment was performed from April 20, 2010 to April 24, 2010. Results: During five sessions of electroacupuncture treatments, the VAS, SF-MPQ, and IRLS scores improved throughout the treatment period and afterwards. Conclusions: The results suggest that electroacupuncture at KI3(太谿), KI6(照海), LR3(太衝), LR2(行間) can be effective for reducing hot flush in both feet.