• Title/Summary/Keyword: Conservative surgery

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A Case Series of Symptomatic Distal Biceps Tendinopathy

  • Lee, Jung Hyun;Kim, Kyung Chul;Lee, Ji-Ho;Ahn, Kee Baek;Rhyou, In Hyeok
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.213-219
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    • 2018
  • Background: The study of conservative and surgical treatment of distal biceps tendinopathy and associated biceps tendon partial rupture. Methods: Twenty-one cases with distal biceps tendonitis and partial ruptures were studied who visited Pohang Semyeong Christianity Hospital from June 2010 to August 2017. The mean age was 57.1 years (39-69 years), 14 males and 7 females. The mean duration of symptom at the time of first visit was 4.9 months (0.2-14 months). Ultrasonography and magnetic resonance imaging were performed for patients with severe symptoms. According to the severity of the symptoms, splint immobilization, oral nonsteroidal anti-inflammatory drugs, and ultrasound-guided steroid injection were performed. Surgical treatment was performed if the patient did not respond to conservative treatment for 3 to 6 months or longer. Results: There were 9 cases of partial rupture of the distal biceps tendon associated with distal biceps tendinopathy on imaging studies. Conservative treatment showed symptomatic improvement in 16 of 21 cases. In 4 cases with a relatively mild symptom, anti-inflammatory analgesics and intermittent splinting showed good result. In 12 cases, symptoms improved after ultrasonography-guided steroid injection. Surgical treatment was performed on 5 cases that did not respond to conservative treatment. Conclusions: Conservative treatment of distal biceps tendinopathy may promise good results. However, in case of partial tear of the distal biceps tendon and refractory to conservative treatment, surgical treatment may be needed.

The Treatment of Thoracic Outlet Syndrome (흉곽 출구 증후군의 치료)

  • Lee, Yoon-Min;Song, Seok-Whan;Choi, Ki-Bum;Rhee, Seung-Koo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.102-107
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    • 2011
  • Purpose: As clinical manifestations of thoracic outlet syndrome are vague pain or symptoms in upper extremity, the diagnosis of the disease is delayed or misdiagnosed as cervical HNP, shoulder pathologies, or peripheral neuropathies. In that reason, many patients spend time for unnecessary or ineffective treatments. We report the results of our thoracic outlet syndrome cases, which were treated by conservative care or surgical treatment. Materials & Methods: Twenty five cases, diagnosed as thoracic outlet syndrome since 1999, were reviewed retrospectively. Physical examinations including Adson's and reverse Adson's test, hyperabduction test, costoclavicular maneuver, and Roo's test, plain radiography of shoulder and cervical spine, MRI of neck or brachial plexus, and EMG were checked. If subjective symptoms were not improved after conservative treatments over three months, surgical treatment were performed. Nine patients were performed operative treatment and the others had conservative treatment in outpatient clinic. Postoperative improvement of symptoms and the follow up period, and the results of conservative care were reviewed. Results: Among five physical examinations, mean 1.75 tests were positive, and EMG has little diagnostic value. MRI were performed in twenty cases and compression of brachial plexus were found in 6 cases (30%). Ten patients out of 16 conservative treatment group had excellent improvement of symptoms, and 5 had good results. Eight patients out of 9 operative treatment group had excellent improvement with mean 5.1 months of follow-up period. Conclusion: Diagnosis of thoracic outlet syndrome is difficult due to bizarre and vague symptoms. However if the diagnosis is suspected by careful physical examinations, radiologic studies, or nerve conduction studies, conservative care should be done as initial treatment and at least after three months, reassess the patient's condition. If the results of conservative treatment is not satisfactory and still the thoracic outlet syndrome is suspected, surgical treatment should be considered. Conservative treatment and operative technique are the valuable for the treatment of this disease.

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Factors Affecting on Conservative Treatment of Morton's Neuroma (지간 신경종 보존적 치료에 영향을 미치는 인자)

  • Yoo, Seong-Ho;Kim, Bu-Hwan;Chu, In-Tak;Chang, Yoon-Jong
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.131-134
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    • 2005
  • Purpose: The purpose of this study was to investigate the clinical results of conservative treatment for Morton's neuroma and to analyze the factors which influenced on the results. Materials and Methods: In this retrospective study, 101 cases of 83 patients with interdigital neuroma were conservatively treated with follow-up period of at least 6 months. There was no significant difference in results among different age groups, sxes, and lesion sites. However, the results were significantly better if the treatment was started within 6 months after onset. Results: We had 28 excellent results (28%), and 13 good results (13%). Patients were grouped by sex, age, duration of symptom before treatment, affected location. The result of treatment was evaluated by comparing the subject pain and discomfort score of the first vist and last follow-up. Conclusion: There are excellent results over 41% by conservative treatment. The results of conservative treatment were not related to age, sex, and lesion site, but were related to pre-treatment period. The shorter the pretreatment period was, the better the results.

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Comparative Study of Surgical Treatment for Concomitant Ankle Joint Injury in Tibia Shaft Fracture (경골 간부 골절에서 족관절 손상에 대한 수술적 치료의 비교 연구)

  • Jinho Park;Seungjin Lee;Hyobeom Lee;Gab-Lae Kim;Jiwoo Chang;Heebum Hahm
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.3
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    • pp.87-92
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    • 2023
  • Purpose: Concomitant ankle injuries associated with tibial shaft fractures can affect postoperative ankle joint pain and various postoperative ankle complications. This study compared the clinical outcomes between surgical treatment and conservative treatment of concomitant ankle injuries associated with tibial shaft fractures. Materials and Methods: From January 2015 to June 2020, a retrospective study was conducted on 118 tibia shaft fractures at the orthopedics department of the hospital. Associated ankle injuries were analyzed using plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative stress exams. The clinical outcomes were compared using the pain visual analog scale (pain VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score (AOFAS score), and Karlsson-Peterson ankle score (KP score). Results: Seventy-two (61.02%) of the 118 cases were diagnosed with associated ankle injuries. Fifty-six cases underwent surgery for the ankle injury, and 16 cases underwent conservative treatment. The clinical results (according to the pain VAS score, AOFAS score, the KP score) were 1.79±1.26, 94.48±4.03, and 94.57±3.60, respectively, in the surgical treatment group, and 3.00±1.03, 91.06±3.02, and 91.25±3.31, respectively, in the conservative treatment group. Conclusion: Surgical treatment showed better clinical outcomes than conservative treatment in concomitant ankle injury in tibia fractures. Therefore, surgical treatment produces better clinical outcomes than conservative treatment in concomitant ankle injuries in tibia fractures. Hence to improve the clinical outcomes, more attention is needed on ankle joint injury in tibial shaft fractures for selecting suitable surgical treatments for those patients.

Conservative Surgery of Hypopharyngeal Cancer and Intraoperative Radiation Therapy of Neck Recurrence (하인두암의 보존적 수술과 경부 재발의 술중방사선치료 치험 1예)

  • Cho, Woo-Sung;Kim, Yang-Soo;Kim, Moo-Pil;Baek, Seung-Kuk;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.181-184
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    • 2007
  • Hypopharyngeal cancer usually has invasiveness to adjacent tissue and frequent metastasis to cervical lymph node. In addition, because it often accompanies submucosal extension and second primary malignancy, the sacrifice of larynx and postoperative radiation therapy had been performed in the past. However, it has been reported that conservative surgery of hypopharyngeal cancer show good functional and oncologic outcome according to the development of diagnostic tool and reconstructive technique. We report a case of hypopharyngeal cancer that received conservative surgery followed radiation therapy and intraoperative radiation therapy for neck recurrence.

Conservative Treatment of Achilles Tendon Rupture with Ultrasonographic Follow-Up - A Case Report - (초음파를 활용한 아킬레스 건 파열의 보존적 치료 결과 추시 -증례 보고-)

  • Kim, Yoon-Chung;Ahn, Jae Hoon;Shin, Dong-Cheul
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.88-92
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    • 2011
  • The incidence of acute Achilles tendon rupture is increasing as sporting activities are becoming more popular nowadays. There are many reports on the merits and disadvantages of surgical or conservative treatment for the injury. We performed a conservative treatment of acute Achilles tendon rupture with a serial casting and observed the progression of tendon healing ultrasonographically.

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COMPARISON OF CONSERVATIVE AND SURGICAL TREATMENT OF CONDYLAR FRACTURES OF MANDIBLE (하악과두 골절 치료에 있어 보존적 치료와 외과적 치료의 비교)

  • Lee, Cheol-Woo;Yeo, Hwan-Ho;Kim, Young-Gyun;Lee, Hyo-Bin;Byun, Woong-Rae;Park, In-Soon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.79-87
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    • 1994
  • The authors investigated the 17 patients with the condylar fractures of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Chosun University, Dental hospital from 1990 to 1993 and could be taken follow-up above 6 months. Helkimo's clinical dysfunction index and mandibular mobility index were applied to the evaluation of the patients and the obtained results were as follows. 1. Mean maximal mouth opening was 38.4 mm in the conservative group, 41.3 mm in the surgical group and that showed no statistically significant difference.(P>0.05) 2. Clinical dysfunction index was higher in the surgical group than in the conservative group but .that showed no statistically difference.(P>0.05) 3. The extent of maximal mouth opening was increased gradually throughout the follow-up period. 4. Both groups didn't show severe clinically dysfunction.

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Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

  • Cho, Yong-Wook;Kim, Euiseong
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.113-118
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    • 2013
  • Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

Bone remodeling after conservative treatment of nasal bone fracture in pediatric patients

  • Kang, Won Ki;Han, Dong Gil;Kim, Sung-Eun;Lee, Yong Jig;Shim, Jeong Su
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.166-170
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    • 2020
  • Background: The standard treatment of nasal bone fractures in pediatric patients is closed reduction. Conservative treatment is sometimes performed, but poses a risk of nasal deformity. The aim of this study was to evaluate the outcomes of bone remodeling in pediatric nasal fractures. Methods: Information was extracted from the medical records of patients under 12 years of age who received conservative treatment for a nasal bone fracture and underwent follow-up computed tomography (CT) examinations. The initial fracture and its outcomes over time were graded as excellent, good, or fair according to the malalignment, displacement, or irregularity of the fractured segments. The outcomes of remodeling were evaluated through changes in the grade of the fracture between initial and subsequent CT scans. Results: The review identified 16 patients between March 2015 and December 2019. Their mean age was 6.2 years, and the average follow-up period was 4.9 months. Three of the five patients with a plane I frontal impact showed improved outcomes of remodeling from good to excellent, and the remaining two patients, improved from fair to good. Eight of the 11 patients with plane I lateral impacts showed improved outcomes, from good to excellent, while one patient, improved from fair to good, one patient, improved from fair to excellent, and one patient showed no interval changes. Conclusion: In 15 of these 16 patients with non-severe fractures, the bony contour improved through remodeling, without surgical intervention. Therefore, we suggest that conservative treatment is a feasible option for mild pediatric nasal fractures.

A CASE REPORT OF JUVENILE ACTIVE OSSIFYING FIBROMA (JUVENILE ACTIVE OSSIFYING FIBROMA 의 치험례)

  • Choi, In
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.217-221
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    • 1991
  • Ossifying fibroma is a rare benign tumor of the maxilla and the mandible. And its nosology and diagnosis have had many problems. It occurs more common in young adult, especially in female, and there is a predilection for the mandible. The lesion is generally asymptomatic and recurrence is rare after conservative excision. Among ossifying fibroma, juvenile active ossifying fibroma grows rapidly, produces many symptoms, and frequently recurs after conservative excision. Authers experienced a case of juvenile active ossifying fibroma which recurred after two times of conservative surgery, and report is with review of the literatures.

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