• Title/Summary/Keyword: Conservative surgery

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Treatment of Flatfoot Deformity (편평족의 치료)

  • Lee, Dong-Oh;Jung, Hong-Geun
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.6-11
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    • 2016
  • Flatfoot deformity, defined as loss of medial longitudinal arch, sometimes involves symptoms such as medial arch pain or Achilles tendon tightening, etc. Whether the etiology of deformity is congenital or acquired, i.e., posterior tibial tendon dysfunction, symptoms are largely resolved with conservative treatment including medication, orthoses, and activity modification. Surgery should be considered in cases of failure of conservative treatment and clinicians can select an appropriate technique among many surgical options including calcaneal osteotomy or flexor digitorum longus tendon transfer. Principles of corrective surgery include the recovery of alignment and the preservation of joint motion.

Conservative Deep Lobe Parotidectomy with Preservation of Superficial Lobe on Pleomorphic Adenoma in Deep Lobe of Parotid: a Case Report (이하선 심층엽에 발생한 다형선종의 보존적 심층엽 이하선 절제술: 증례보고)

  • Ahn, Sang-Wook;Song, Jin-Woo;Jung, Eu-Gene;Lee, Ju-Min;Song, Won-Wook;Shin, Sang-Hun;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.588-591
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    • 2010
  • Parotid deep lobe tumors usually has been treated by total parotidectomy. But there is functional and aesthetic side effects such as post parotidectomy depressions, variable aesthetic deformities, facial nerve injury and Frey's syndrome. Conservative limited deep parotidectomy may result in fewer side effect. Preservation of the superficial lobe for deep lobe tumors could decrease the incidence of complications without any problems in the treatment effect. Additionally, the parotid function preservation and cosmetic appearance after operation also satisfy both the patients and surgeons. We report a case of pleomorphic adenoma of the deep lobe which has been successfully treated by conservative deep parotidectomy.

Phase II Study on Breast Conservative Surgery Plus Chemo- and Radiotherapy in Treating Chinese Patients with Early Staged Breast Cancer

  • Liu, Yang-Chen;Zhou, Shao-Bing;Gao, Fei;Yin, Xiao-Xiang;Zhao, Ying;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3747-3750
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    • 2013
  • Purpose: To evaluate the efficacy of conservative surgery plus chemo-, radio-therapy in treating patients with early stage breast cancer. Patients and Methods: Eligible patients were treated by postoperative chemotherapy as well as whole-breast irradiation with tumor bed boost. Postoperative radiotherapy consisted of 6 MV whole breast linear accelerator irradiation with two tangential half fields to a total dose of 45~50 Gy, followed by $10{\sim}15MeV{\beta}$ boost irradiation to tumor bed for 10~20Gy, total dose 56~66Gy. Results: Fifty-two patients were enrolled. Overall 1-, 2- and 3 year survival rates were 98.1%, 92.3%, and 90.4%, respectively, with a local recurrence rate of 5.77%. Cosmetic results were evaluated as good by doctors in 90.4% of patients. Conclusions: Breast conservative surgery combined with chemo- radio-therapy could be a treatment option for Chinese patients with early stage breast cancer.

Conservative Management and Postoperative Rehabilitation of Chronic Lateral Ankle Instability (만성 외측 족관절 불안정성의 보존적 치료와 수술적 치료 후의 재활운동)

  • Park, Young Hwan;Kim, Hak Jun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.6-11
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    • 2019
  • As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

Conservative Treatment of Nondisplaced Fifth Metatarsal Base Zone I and II Fractures (제5 중족골 기저부 제 I, II구역 비전위성 골절의 보존적 치료)

  • Sung, Ki-Sun;Koh, Kyoung-Hwan;Koo, Kyung-Hyo;Park, Jae-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.185-188
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    • 2008
  • Purpose: Zone I fractures of the fifth metatarsal bone can generally be treated by conservative methods while both surgical and conservative methods are used for zone II fractures. However, the clinical results of conservative treatment have been rarely reported. The purpose of this study is to report the clinical results of conservative treatment for zone I and II nondisplaced fractures. Materials and Methods: Between July 2007 and August 2008, consecutive thirty seven patients (38 fractures) with zone I and II fractures of the fifth metatarsal bone were treated with tolerable weight bearing and minimum duration of immobilization based on pain on weight bearing. We evaluated the duration of immobilization, time to clinical and radiographic union, and time to pre-injury activity level. Results: Clinical and radiological union were achieved in all patients without any complications including malunion or nonunion. The mean duration of immobilization was 28.7 days. The mean 33.1 days and 48.9 days were required for clinical union and radiographic union respectively, after the initial injury. The mean time to pre-injury activity level was 4.8 months. Conclusion: Our study shows that the acute nondisplaced zone I, II fracture of fifth metatarsal bone can be treated effectively using tolerable weight bearing and minimum duration of immobilization, which is based on the pain on weight bearing.

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Inter-rater agreement among shoulder surgeons on treatment options for proximal humeral fractures among shoulder surgeons

  • Kim, Hyojune;Song, Si-Jung;Jeon, In-Ho;Koh, Kyoung Hwan
    • Clinics in Shoulder and Elbow
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    • v.25 no.1
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    • pp.49-56
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    • 2022
  • Background: The treatment approach for proximal humeral fractures is determined by various factors, including patient age, sex, dominant arm, fracture pattern, presence of osteoporosis, preexisting arthritis, rotator cuff status, and medical comorbidities. However, there is a lack of consensus in the literature regarding the optimal treatment for displaced proximal humeral fractures. This study aimed to assess and quantify the decision-making process for either conservative or surgical treatment and the choice of surgical method among shoulder surgeons when treating proximal humeral fractures. Methods: Forty sets of true anteroposterior view, scapular Y projection view, and three-dimensional computed tomography of proximal humeral fractures were provided to 12 shoulder surgeons along with clinical information. Surveys regarding Neer classification, decisions between conservative and surgical treatments, and chosen methods were conducted twice with an interval of 2 months. The factors affecting the treatment plans were also assessed. Results: The inter-rater agreement was fair for Neer classification (kappa=0.395), moderate for the decision between conservative and surgical treatments (kappa=0.528), and substantial for the chosen method of surgical treatment (kappa=0.740). The percentage of agreement was 71.1% for Neer classification, 84.6% for the decision between conservative and surgical treatment, and 96.4% for the chosen method of surgical treatment. The fracture pattern was the most crucial factor in deciding between conservative and surgical treatments, followed by age and physical activity. Conclusions: The decision between conservative and surgical treatment for proximal humeral fractures showed good agreement, while the chosen method between osteosynthesis and arthroplasty showed substantial agreement among shoulder surgeons.

FUNCTIONAL RECOVERY OF MANDIBULAR HIGH CONDYLAR FRACTURE PATIENT WITH IMMEDIATE PROVISIONAL IMPLANT: CASE REPORT (Immediate provisional implant를 이용한 하악골 high condylar fracture환자의 기능회복: 증례보고)

  • Jang, Bo-Young;Ahn, Mi-Ra;Ahn, Kyung-Mi;Lee, Won-Hyuk;Shon, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.1
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    • pp.82-88
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    • 2005
  • Treatment methods of mandibular condylar fracture were conservative and surgical method. Surgical method of mandibular high condylar fracture was very difficult because approach and internal fixation of small size fracture fragment were difficult. So there is a tendency to select conservative method over surgical method for guiding a stable occlusion and avoiding TMJ disorder and growth disturbance, minimizing pain and deviation during function. But, in case of mandibular high condylar fracture patient who has no biting teeth on posterior teeth area, guiding a stable occlusion and conservative functional treatment were very difficult. In this case, patient was 62years old male. He had fracture of mandibular symphysis, right mandibular body, left mandibular high condyle. We treated the patient for mandibular symphysis and right mandibular body fracture area with surgical method. But left mandibular high condylar fracture area was difficult to treat with surgical method. So we selected a conservative functional method on left mandibular high condylar fracture area. We intended recovery of vertical dimension and stable occlusion with implantation of immediate provisional implant on maxillar and mandibular posterior teeth area, and temporary crown. And then patient did mandibular functional movement and his mandibular function was recoverd.

Clinical results of conservative management in patients with full-thickness rotator cuff tear: a meta-analysis

  • Karasuyama, Masaki;Gotoh, Masafumi;Tahara, Keiji;Kawakami, Junichi;Madokoro, Kazuya;Nagamatsu, Takashi;Imai, Takaki;Harada, Nobuya;Kudo, Yu;Shiba, Naoto
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.86-93
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    • 2020
  • Background: Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined. Methods: PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36 questionnaires. The meta-analysis used a linear mixed model weighted with the variance of the estimate. Results: The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months), and 24.8 mm (12 months) (P<0.05); active abduction: 153.2° (2 months), 159.0° (6 months), 168.1° (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 questionnaires "vitality" section: 57.0 points (6 months) to 70.0 points (12 months) (P<0.05). Conclusions: Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.