• Title/Summary/Keyword: Conservative surgery

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

  • Park Jin Soo;Chung Moon Sang;Yoon Kang Sub;Baek Goo Hyun;Lee Ji Ho;Kang Seung Baek;Kim Dong Wook
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.187-198
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    • 1999
  • Purpose: The authors compared the results of Ender nailing for the proximal humerus fractures with those of the conservative methods radiographically. Materials and Method: Nine patients(mean age: 69 years.) received Ender nailing, and the other nine patients, conservative treatments(mean age: 73 years). All fractures were 2 part fractures. The Ender nails were inserted either through posterior elbow approach or transepicondylar approach. A simple Velpeau bandage was applied to the conservative treatment group. The average follow-up was 15 months. Results: The initial status of the anatomical reduction, i.e., the values of the medial shift, overlapping and the varus agulation, were little changed at follow-up radiographs in both the Ender nailing group and the conservative treatment group. There was no significant difference for the status of anatomical reduction between the Ender nailing group and the conservative treatment group. The stability of fixation by Ender nails, i.e., the degree of fanning out of the nails was poor in most cases. Not a few problems/complications happened in cases of Ender nailing group; back­ing out of the nail in three cases, penetration of the nails into the humeral heads in 3, fractures or cracking of the humerus around the nail insertion area in 4 and reduction loss in one. Conclusion: We could not get better results with the use of Ender nail. We use no longer Ender nails for the proximal humerus fractures. Further studies are needed for the better option for the proximal humerus fractures.

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CONSERVATIVE TREATMENT OF BILATERAL CONDYLAR FRACTURE BY A SIMPLIFIED TECHNIQUE OF MAXILLOMANDIBULAR FIXATION (단순악간고정법을 이용한 양측성 하악과두골절의 보존적 치료)

  • Kim, Jong-Pil;Ahn, Sang-Hun;Chang, Heon-Soo;Park, Jae-Bum;Jo, Byung-Woan;Ann, Jye-Jynn
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.2
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    • pp.171-179
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    • 1995
  • The conservative treatment of the condylar fracture has been used for a long time because of its simplicity, good prognosis and less complication. Traditionally the conservative treatment has been carried out by maxillomandibular fixation using arch bar and wire. But a simplified technique of maxillomandibular fixation introduced here is a procedure that 4 bone screws are placed above the apecies of the maxillary and mandibular canines and then ipsilaterally placed maxillary and mandibular bone screws are linked by a loop of wire each other. This procedure has several advantages compared with the traditional maxillomandibular fixation method. 1) it provides simplicity for the operators. 2) it sustains maxillomandibular fixation more rigidly compared with arch bar technique. 3) it keeps stable maxillomandibular fixation in the region of the anterior teeth so that anterior open bite tendency can be remarkably minimized. 4) it does not injure the periodontal tissue because the teeth are not engaged and causes less discomfort to the patient. 5) it decreases the possibility of operator's AIDS infection through inadvertent skin puncture. 6) it is highly recommended for the patients whose teeth are available for maxillomandibular fixation. The two male patients were diagnosed as bilateral condylar and symphyseal fracture of the mandible. They restored stable occlusion and functional mandibular movement only by a simplified technique of maxillomandibular fixation.

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Conservative infection control on acute pericoronitis in mandibular third molar patients referred from the prison (교도소에서 의뢰된 급성 하악 지치 주위염의 보존적 감염관리: 증례보고)

  • Lee, Chun-Ui;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Kim, Ha-Rang;Mo, Dong-Yub;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.1
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    • pp.57-61
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    • 2010
  • In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.

The Analysis of Conservative Treatment in Midshaft Fractures of Clavicle (쇄골 간부 골절의 보존적 치료 분석)

  • Cha, Seung-Do;Chung, Soo-Tai;Kim, Yong-Hoon;Park, Sang-Jun
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.27-33
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    • 2010
  • Purpose: Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. Materials and Methods: We evaluated factors that have an effect on bone union and bone function after union. We evaluated age, fracture site, comminution, displacement, shortening and other factors. Among 523 clavicular midshaft fractures that presented between January 2004 and Jun 2009 at our Department of Orthopaedic Surgery, we identified 270 who had conservative treatment and 173 patients who had surgical treatment. Results: The period required for bone union increased with the degree of displacement. For the group below 12 years of age, and the group without comminution, it took half the time to achieve bone union compared with the other groups. Displacement mostly occurred within 2 weeks after conservative treatment. Conclusion: In patients with a comminuted clavicular midshaft fracture, we might, because of expected delays in bone union, delay the start of rehabilitation until patients are more than 13 years old. Because the degree of displacement may be increased within 2 weeks during conservative treatment, we can think about surgical treatments.

Hydronephrosis during Conservative Treatment for a Renal Injury Patient

  • Kim, Maru;Kim, Joongsuck;Kim, Sung Jeep;Cho, Hang Joo
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.47-50
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    • 2017
  • A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications.

Traumatic subcutaneous emphysema after liposuction

  • Kim, Keun Tae;Sun, Hook;Chung, Eui Han
    • Archives of Craniofacial Surgery
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    • v.20 no.3
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    • pp.199-202
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    • 2019
  • Traumatic subcutaneous emphysema, which is the infiltration of air into subcutaneous tissues due to trauma, is caused by various factors such as chest and/or abdominal trauma, facial fractures, and barotrauma caused by mechanical ventilation. In this case report, a 32-year-old woman developed traumatic subcutaneous emphysema after undergoing abdominal liposuction at a local clinic. She was subsequently admitted to Busan Paik Hospital, and with early diagnosis and conservative treatment, she was discharged on the seventh day of hospitalization with no complications. However, because traumatic subcutaneous emphysema may accompany other injuries for various reasons, radiological examination and various tests should be performed to prevent serious complications and sequelae.

Rare complication of skin necrosis after endoscopic debridement and cutaneo-fascial suture for a massive Morel-Lavallée lesion in Korea: a case report

  • Youngmin Kim;Jayun Cho;Myung Jin Jang;Kang Kook Choi
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.304-309
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    • 2023
  • A Morel-Lavallée lesion (MLL) is a pathologic fluid collection within an abnormally formed space, resulting from an internal degloving injury between the muscle fascia and subcutaneous fat layer. Due to its resistance to conservative treatments such as drainage or compression dressing, various therapeutic methods have been developed for MLL. However, no standardized guidelines currently exist. Recently, endoscopic debridement and cutaneo-fascial suture (EDCS) has been introduced for the treatment of MLL, particularly for large lesions resistant to conservative approaches. While this procedure is known to be effective, limited reports are available on potential complications. The authors present a case of skin necrosis following EDCS for a massive MLL.

Retrograde filling with Lid technique in periapical surgery: case report (Lid technique을 활용하여 치근단 수술에서 역충전을 시행한 증례 보고)

  • Yoon-Joo Lee;Kyung-Mo Cho;Se-Hee Park;Yoon Lee;Jin-Woo Kim
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.1
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    • pp.45-51
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    • 2023
  • Apical sealing with proper retrograde filling material and technique is the key factor for successful apical surgery. In order to provide impeccable apical sealing and healing, various mechanical and chemical characteristics of retrograde filling material is required. MTA has been used as the gold standard of retrograde filling due to its unprecedented advantages. As MTA has long setting time and difficult handling properties, premixed putty type bioceramic material has been newly developed. For efficient retrofilling with premixed putty type biocreamic material, 'Lid technique' was also proposed. The following cases present apical surgery using newly developed premixed putty type bioceramic material with Lid technique.

Clinical Analysis of Tennis Elbow - 148 Cases -

  • Cho Duck Yun;Hahm Young Gil;Lee Joon Myoug
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1995.05a
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    • pp.22-22
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    • 1995
  • One hundred and forty-eight cases of tennis elbow were treated by conservative managements firstly such as rest, medication, immobilization, physical therapy and local steroid injection, from Jan. 1985 to Jun. 1994 at Department of Orthopaedic Surgery, National Medical Center. Among the 148 cases, 16 cases who failed conservative managements, were treated with Nirschl & Pettrone operation. The results were summarized as follows, 1. Among the 148 cases, 110 cases$(74\%)$ were female, and 61 cases$(41.2\%)$ were in the age group 41 to 50, and mean age was 42.3 2. Ninety-nine cases were housewives and only 15 cases were related to sports. 3. The results 116cases$(78\%)$, of conservative treatment were excellent and good 10 fair and failure in 32 cases$(22\%)$, by Nirschl and Peettrone assessment. 4. Among the 16 cases who were treated with Nirschl and Pettrone operation, excellent result was obtained 10 7cases, good in 3 cases, fair in 4cases and failure in 2 cases. 5. Recurrence was developed in 18 cases$(12.2\%)$, and we obtained excellent & good result in 17 cases with both conservative and operative treatment. Above results suggest that the term, tennis elbow is a misnomer because it occurs more commonly in non-athletes such as housewives than in tennis players. So it seems to be a occupational disease rather than sports injury. Now, we propose eliminate of the term, elbow and substitute with terminology that described the true understanding and therapeutic orientation of it.

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The Role of Conservative Surgery and Radiation Therapy for the Extremity Soft Tissue Sarcomas (사지 악성 육종에서 보존적 수술후 방사선 치료의 역할)

  • Kim Woo Cheol;Suh Chang Ok;Kim Gwi Eon;Park Kwang Hwa;Shin Dong-Hwan;Lee Kyung Hee
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.411-419
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    • 1993
  • A total of 44 patients with extremity soft tissue sarcomas had received conservative surgery and radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between Jan. 1980 and Dec. 1990. Initial surgical treatment consisted of intracapsular excision in 33 patients $(75\%),$ marginal excision in 9 patients, and wide excision in two patients. Total radiation doses were between 40Gy and 65Gy (median 60 Gy). Median follow-up period was 47 months. Overall actuarial 5-year survival rate was $76.9\%$ and 5-year recurrence free survival rate was $39.3\%.$ There was no statistically significant prognostic factors but the 5-year survival rates tended to be decreased in the patients with high grade tumors and treated with narrow surgical extent. Sixteen patients recurred during fellow-up (16/31, $51.6\%).$ The incidence of initial local recurrence was $22.6\%$ (7/31) and distant metastasis was $29\%(9/31).$ Of the 7 who did not have metastasis at diagnosis of local recurrence, 5 were submitted to a salvage treatment. All of them achieved local control and distant metastasis appeared in three of them. In conclusion, conservative surgery and radiation therapy in the patients with extremity soft tissue sarcomas was the effective treatment modality.

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