• 제목/요약/키워드: Conservative surgery

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아킬레스 건병증의 수술 전략 (Surgical Strategies for Achilles Tendinopathy)

  • 박현우
    • 대한족부족관절학회지
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    • 제25권2호
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    • pp.95-99
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    • 2021
  • The surgical treatment of Achilles tendinopathy can be considered after the failure of conservative treatment, and the surgical methods may be divided into two groups; treatments for insertional and non-insertional tendinopathy. In the case of insertional tendinopathy, debridement including tendon and calcification of the diseased lesion, reattachment of the tendon, and calcaneal ostectomy of the Haglund lesion are the primary treatments. If reattachment is not possible, reconstruction should be performed by other methods such as tendon transfer. As a result of surgery for insertional tendinopathy, there is an improvement in the pain and function after surgery, but there are some patients whose pain does not completely disappear. Some residual pain may persist; therefore, the overall success rate of the surgery can be expected to be 80% to 90%. For the patients of non-insertional tendinopathy, conservative treatment through eccentric exercise is the primary treatment, and most of them have reported good results. In case of failure after various conservative treatments, debridement of the diseased lesion and repair of the remaining tendon would be the primary surgical treatments. If the remaining tendon is not sufficient, reconstruction such as tendon transfer should be considered.

하악골에 발생한 법랑아세포종의 임상통계학적 분석 (The Clinico-Statisitical Analysis of Ameloblastoma of Mandible)

  • 유경환;김수관;문성용;오지수;이정훈;김진하
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권6호
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    • pp.551-557
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    • 2010
  • Purpose: In this study, we evaluated the relation between surgical methods and reccurrence rate by investigating clinical, radiological aspects and histopathological patterns of 26 patients who were diagnosed with amelobalstoma. Patients and Methods: In this study, we retrospectively investigated 26 patients who were diagnosed with ameloblastoma and treated at the Department of Oral and Maxillofacial Surgery of Chosun University Dental Hospital from January 2000 to December 2008. Results: The patients comprised 12 males (46.1%) and 14 females (53.9%), and their ages ranged from 10 to 69 years (average, 37.3 years). All cases presented a mandibular location, and in particular, 13 cases (50%) demonstrated an occurrence in the mandibular body. Clinically, 8 cases (30.8%) presented no symptoms, and the most prevalent chief complaint was swelling in 13 cases (50%). Radiographically, a unilocular type appeared in 14 cases (53.8%), and a multilocular type was observed in 10 cases (38.5%). Histopathologically, there were 8 follicular types (30.8%) and 7 plexiform types (26.9%). Conservative treatment was performed in 5 cases (19.2%), and radical treatment was performed in 21 cases (80.8%). The follow-up period ranged from 1 to 10 years. The total recurrence rate was 15.4%, and the mean duration of recurrence was 6.7 years. Three of the 5 cases (60%) that received conservative treatment demonstrated a recurrence, as compared to 1 of the 21 cases (4.8%) that underwent radical treatment. Conclusion: The radical treatment was more effective than the conservative treatment for recurrence prevention. We should consider a continuous follow-up check after operation.

Conservative Treatment Using Marsupialization for Cysts Occurring in the Jaw of Adolescents: A Case Report

  • Yun, Sun-Ung;Jung, Hai-Won;Cho, Byung-Yong;Choi, Byung-Joon;Lee, Baek-Soo;Kwon, Yong-Dae;Ohe, Joo-Young;Lee, Jung-Woo
    • Journal of Korean Dental Science
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    • 제7권1호
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    • pp.31-37
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    • 2014
  • Dentigerous cyst (DC) is an odontogenic cyst associated with the crown of an impacted, embedded, unerupted, or developing tooth. It is the second most common type of odontogenic cysts, accounting for 14% to 24% of all jaw cysts. Although these cysts occur more frequently during the second and third decades of life, they can also be found in children and adolescents in the mixed dentition stage. Treatment of the odontogenic cyst involves enucleation or marsupialization/decompression methods. The latter approach is preferred for larger cysts, and it is especially helpful in adolescent patients in conserving the unerupted permanent successors. The aim of treatment for DC is the complete elimination of pathology and maintenance of dentition with minimal surgical intervention. Recently defined criteria for the selection of treatment modality include the cyst size and location of the cyst, patient age, dentition involved, stage of root development, position of the tooth involved in the jaw, and relationship with the surrounding vital structure. Marsupialization or decompression technique has been advocated by several authors for treating DCs among young patients. In this conservative technique, the creation of an accessory cavity helps relieve intra-cystic pressure and accelerate the healing of cystic lesion. This technique has been successfully performed and is indicated for growing children and adolescents. Here, we report a large cyst lesion in the mandible treated by marsupialization for conservative management. In conclusion, successful reduction in size was achieved, and intraoperative complication could be prevented.

조기 치근관 배농술을 이용한 하악 골절선상 감염치아들의 보존적 관리: 증례보고 (The conservative care by early endodontic drainage of infected teeth in the line of a mandibular fracture: report of a case)

  • 모동엽;유재하;최병호;설성한;김하랑;이천의
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권4호
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    • pp.309-313
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    • 2010
  • The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

옥트레오타이드를 이용한 수술 후 유미흉의 보존적 치료 -1예 보고- (Conservative Management of Postoperative Chylothorax Using Octreotide - A case report-)

  • 김건일;박종운;박상현;이재웅;홍기우;최영진;이원용
    • Journal of Chest Surgery
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    • 제38권2호
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    • pp.172-174
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    • 2005
  • 유미흉은 드물지만 심각한, 잘 알려져 있는 흘부 및 심장 수술의 합병증이다. 동맥관 개존증 결찰 및 대동맥 축착증 교정술을 시행 받은 3개월 된 남자 환아에서 수술 후 유미흉이 발생하였다. 환자는 흉강 배액과 함께 옥트레오타이드 주사요법과 중쇄지방산 분유를 이용한 보존적 방법으로 성공적으로 치료되었다. 이에 저자들은 수술 후 발생한 유미흉 환자에서 옥트레오타이드를 사용한 보존적 치료로 좋은 결과를 치험하였기에 보고하는 바이다.

Temporomandibular Joint Disorder and Occlusal Changes: Case Reports

  • Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • 제11권1호
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    • pp.21-31
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    • 2018
  • Occlusion may change spontaneously but dental treatment or trauma in the patients with temporomandibular disorders (TMDs) may also alter occlusion. This report presents three cases displaying occlusal changes. Review of literature emphasizes the significance of TMD treatment. Conservative treatment modalities such as counseling, medication, physical therapy and splint therapy may be selected as initial treatment options. Irreversible or invasive treatment, such as orthodontic, prosthodontic, and occlusal adjustment should not be attempted early. In case there is no response to conservative treatment, joint injection, muscle injection, arthrocentesis or arthroscopic surgery might be performed.

식도피부루의 치험;2례 보고 (Treatment of Esophaocutaneous Fistula -2Cases Report-)

  • 최승호
    • Journal of Chest Surgery
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    • 제26권7호
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    • pp.583-585
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    • 1993
  • An esophagocutaneous fistula following anterior cervical fusion is rare.We had experienced two cases of postoperative cervical esophagocutaneous fistula, which one case was treated with nonoperative management and the other with operative management.The operation was tried when the conservative treatment seemed to be unsuccessful.They were eventually recovered with conservative treatment, whitch consisted of wound drainage and intravenous administration of antibiotics and operative management with the transposition of sternocleidomastoid muscle flap respectively.

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Cervical Radiculopathy due to Cervical Degenerative Diseases : Anatomy, Diagnosis and Treatment

  • Kim, Kyoung-Tae;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • 제48권6호
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    • pp.473-479
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    • 2010
  • A cervical radiculopathy is the most common symptom of cervical degenerative disease and its natural course is generally favorable. With a precise diagnosis using appropriate tools, the majority of patients will respond well to conservative treatment. Cervical radiculopathy with persistent radicular pain after conservative treatment and progressive or profound motor weakness may require surgery. Options for surgical management are extensive. Each technique has strengths and weaknesses, so the choice will depend on the patient's clinical profile and the surgeon's judgment.

하악골에 광범위하게 발생한 백악-골 이형성증의 치험례 (Cemento-Osseous Dysplasia Largely Occurring in the Mandible: Case Report)

  • 김신근;박종욱;남종훈;복성철;이영만;박기남;최동주
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권5호
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    • pp.454-458
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    • 2011
  • Cemento-Osseous dysplasia is a benign condition of the jaw known to orginate from the periodontal ligament or medullary bone. Its treatment can be categorized according to clinical symptom. If there is no pain or other discomfort, a regular recall examination and having patients maintain proper oral hygeine are the best management. However, if clinical symptoms do exist, proper treatments such as resectioning of the mandible or mandibulectomy are needed. This clinical report describes a rare symptomatic case of cemento-osseous dysplasia which was treated with a conservative surgical method. Using this method, we obtained satisfactory results without additional grafts.

상완골 근위부 골절의 Erlder 정을 이용한 치료 결과-방사선학적 분석 - (The Results of Ender Nailing for the Proximal Humerus Fractures - Radiological Evaluation -)

  • 박진수;정문상;윤강섭;백구현;이지호;강승백;김동욱
    • Clinics in Shoulder and Elbow
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    • 제2권2호
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    • pp.187-198
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    • 1999
  • 목적 상완골 근위부 골절환자들을 대상으로 Ender 정을 삽입한 군과 보전적 치료를 한 군간의 비교 연구를 하였다. 대상 및 방법 : Ender 정 삽입군의 경우 9례에서 삽입하였으며 평균 연령은 69세였고, 보전적 치료군의 경우 9례였으며, 평균 연령은 72례로 두군간의 연령의 통계적 차이는 없었다(p=0.450). 모든 예가 2분 골절이었다. Ender 정은 상완골 원위부 또는 양측 외상과부를 통하여 삽입하였으며 보전적 치료군의 경우 Velpeau 붕대 고정으로 치료하였다. 평균 추시기간은 15개월이었다. 결과 해부학적 정복의 정도는 원위부의 내측 전위, 골편의 중첩, 골절부의 내반각 변형등을 기준으로 평가하였는데, 두 군 모두 초기의 해부학적 정복 정도는 추시상 변화가 없었으며, 이러한 해부학적정복의 정도의 두 군간의 차이는 없었다. Ender 정의 경우 고정의 안전도는 대부분의 례에서 불량한결과를 보여주었고, Ender 정의 삽입부로의 후방전위(3례) 및 그로 인한 주관절 통증 및 운동제한,골두의 천공(3례), Ende, 정 상입부에서의 상완골 원위부의 피질골 파열 또는 골절(4례), 골절 정복후 재전위(1례) 등의 문제점들이 있었다. 고찰 및 결론 : Ender 정의 역행성 삽입후의 결과는 보전적 치료군에 비해 별다른 차이점을 보이지않았으며, 오히려 많은 문제점들을 가지고 있었다.

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