• Hip & pelvis
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• 제35권1호
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• pp.24-31
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• 2023

Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

• 대한족부족관절학회지
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• 제12권2호
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• pp.145-149
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• 2008

Purpose: The purpose of this study is to determine the results of conservative treatment of osteochondral lesion of talus (OLT). This study would be helpful to determine the treatment methods for OLT patients. Materials and Methods: We have established 69 cases of osteochondral lesion of talus, from December 2004 to June 2006 in a period of 18 months. Symptoms were confirmed through survey and a medical examination by interviewing patients. Diagnosis was made through physical examination, simple radiography and MRI. AOFAS score of all the patients were measured. When the patients did not get improved with conservative treatment, surgical operation was done. Results: 27 out of the 69 patients were treated using conservative treatment. Initial AOFAS scored was $66.37{\pm}8.89$ points. After treatment, AOFAS scores had increased to $83.78{\pm}8.48$ points. In cases of surgery, AOFAS scores had increased from $64.17{\pm}13.43$ points preoperatively to $80.45{\pm}8.67$ points. Conclusion: 60% of conservative treatment was useless in treating OLT patients. Surgical operation is still needed to be performed. Therefore, treatment should be done with sufficient understanding of the results.

• Restorative Dentistry and Endodontics
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• 제41권2호
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• pp.137-142
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• 2016

We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권1호
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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.

• 대한족부족관절학회지
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• 제22권3호
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• pp.83-90
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• 2018

Chronic lateral ankle instability occurs in 10% to 20% of individuals after acute ankle sprain. The management of chronic lateral ankle instability is traditionally conservative treatment in the acute phase. On the other hand, surgical intervention is considered if conservative treatment fails and the symptoms are ongoing. This review focuses on the surgical approaches to treatment of chronic lateral ankle instability, including $Brostr{\ddot{o}}m$ surgical techniques, with a review of the traditional procedure and newer techniques.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.757-766
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• 2020

Objective : Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA. Methods : Patients treated for SEA in the authors' department between 2007 and 2016 were included for analysis and retrospectively analyzed for basic clinical parameters and outcome. Pre- and postoperative neurological status were assessed using the American Spinal Injury Association Impairment Scale (AIS). The self-reported quality of life (QOL) based on the Short-Form Health Survey 36 (SF-36) was assessed prospectively. Surgery was defined as "early", when performed within 12 hours after admission and "late" when performed thereafter. Conservative therapy was preferred and recommend in patients without neurological deficits and in patients denying surgical intervention. Results : One hundred and twenty-three patients were included in this study. Forty-nine patients (39.8%) underwent early, 47 patients (38.2%) delayed surgery and 27 (21.9%) conservative therapy. No significant differences were observed regarding mean age, sex, diabetes, prior history of spinal infection, and bony destruction. Patients undergoing early surgery revealed a significant better clinical outcome before discharge than patients undergoing late surgery (p=0.001) and conservative therapy. QOL based on SF-36 were significantly better in the early surgery cohort in two of four physical items (physical functioning and bodily pain) and in one of four psychological items (role limitation) after a mean follow-up period of 58 months. Readmission to the hospital and failure of conservative therapy were observed more often in patients undergoing conservative therapy. Conclusion : Our data on both clinical outcome and QOL provide evidence for early surgery within 12 hours after admission in patients with SEA.

• Restorative Dentistry and Endodontics
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• 제43권2호
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• pp.16.1-16.9
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• 2018

Objectives: Understanding the reason for an unsuccessful non-surgical endodontic treatment outcome, as well as the complex anatomy of the root canal system, is very important. This study examined the cross-sectional root canal structure of mandibular first molars confirmed to have failed non-surgical root canal treatment using digital images obtained during intentional replantation surgery, as well as the causative factors of the failed conventional endodontic treatments. Materials and Methods: This study evaluated 115 mandibular first molars. Digital photographic images of the resected surface were taken at the apical 3 mm level and examined. The discolored dentin area around the root canal was investigated by measuring the total surface area, the treated areas as determined by the endodontic filling material, and the discolored dentin area. Results: Forty 2-rooted teeth showed discolored root dentin in both the mesial and distal roots. Compared to the original filled area, significant expansion of root dentin discoloration was observed. Moreover, the mesial roots were significantly more discolored than the distal roots. Of the 115 molars, 92 had 2 roots. Among the mesial roots of the 2-rooted teeth, 95.7% of the roots had 2 canals and 79.4% had partial/complete isthmuses and/or accessory canals. Conclusions: Dentin discoloration that was not visible on periapical radiographs and cone-beam computed tomography was frequently found in mandibular first molars that failed endodontic treatment. The complex anatomy of the mesial roots of the mandibular first molars is another reason for the failure of conventional endodontic treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.520-527
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• 2010

Introduction: This study examined the treatment patterns of temporomandibular disorders (TMD) including conservative and surgical procedures. Materials and Methods: Patients with TMD who visited Gangnam Severance Hospital from June 2007 to May 2008 were enrolled in this study. All patients were examined from the orthopantomogram, temporomandibular joint (TMJ) tomography, and a clinical examination. The patients who required a further evaluation were examined by magnetic resonance imaging and/or computed tomography. The treatment patterns were divided into counseling, medication, splint therapy, botulinum toxin injection (BTI) and surgical treatment. Results: Among the 2,464 patients, the average age was 31.8 years (ranging from 6 to 93); 764 (31.0%) were male and 1,700 (69.0%) were female. 2,355 (95.6%) patients were treated with conservative therapy; 1,460 (62.0%) patients were treated with medication, 931 (39.5%) patients were treated with splint, and 46 (2.0%) were treated with BTI. There were 109 (4.4%) patients treated surgically. Eight (0.3%) patients were treated with total temporomandibular joint replacement surgery. Conclusion: Almost all patients with TMD were treated using conservative methods. Those patients who received surgical treatment because of an ineffective response to conservative treatment had definite problems with the internal derangement and/or osteoarthritis or had severe clinical symptoms.

• 대한족부족관절학회지
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• 제5권1호
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• pp.35-42
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• 2001

Purpose: To analyze the results of conservative or surgical treatment after computed tomograhy(CT) classification in intraarticular calcaneal fractures. Materials and methods: From January 1996 to May 1999, we prospectively analyze 23 cases of intraarticular calcaneal fractures who were treated conservatively or operated by open reduction and internal fixation by extensive L-shaped lateral approach after CT classification. Results: A functional scoring system of 0-100 points which was based upon the responses to AOFAS Ankle-Hindfoot Scale for the operative group was at 82.8, compared with 73.2 for the non-operative group, and these were meaningful statistically(P<0.05). Of type I fracture, in the operative group there were 2 excellent results and in the non-operative group there were 2 excellent results, 1 good result. or type II fractures, in the operative group there were 2 excellent results, 3 good results, 1 fair result and in the non-operative group there were 1 good result, 1 fair result, 2 poor results. Of type III fractures, in the operative group there were 2 fair results, 2 poor results and in the non-operative group there were 1 fair result, 3 poor results. Bohler angles of subtalar joint were changed from initial average $13.3^{\circ}$ to postoperative average $20.9^{\circ}$ for the operative group compared with from initial average $15.5^{\circ}$ to follow-up average $14.8^{\circ}$ of the non-operative group(P<0.01). Conclusions: Computed tomography in the evaluation of intraarticular calcaneal fractures is effective tool. We believed that open reduction and internal fixation in all Crosby & Fitzgibbons type II and according to degrees of comminution reducible type III for the intraarticular calcaneal fractures is more effective method than conservative treatment.

• 혜화의학회지
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• 제15권1호
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• pp.53-58
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• 2006

Objectives: The object of this study is to report a clinical effect regarding the conservative treatment of the patients who were diagnosed as the herniated intervertebral lumbar disc(HIVD). Methods: The patients were treated by the oriental medical conservative treatment (Acupuncture, Moxibustion, oriental medicine, and Chu-na therapy). Result of conclusions: 1) Oriental medicine conservative treatment proved its effectiveness during the treatment of HIVD, patients. Especially, Chu-na therapy was superior on pain relive. 2) Treatment of HIVD, took less than 3 months in most cases except protruded or extruded disc. 3) In case of seniors who cannot have a surgical operation because of organ and muscle wickness, the oriental treatment was effective in terms of strengthening muscle and organs.