• Title/Summary/Keyword: Deformities

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THE USE OF CLASSIFICATION IN PRIMARY AND SECONDARY CLEFT LIP AND NOSE DEFORMITIES IN MEDICAL RECORDS (구순구개열 환자의 의무기록시 분류법의 도입)

  • ChoiI, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.198-204
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    • 1999
  • The treatment of cleft lip and palate patients requires multidisciplinary coorperation, and the involved clinicians rely on the completeness and accuracy of the patient's medical records in developing comprehensive treatment plans. There are so many classifications in cleft lip and palate but each classification has advantages and disadvantages. Furthermore there are few classification or assessment in secondary cleft lip and palate deformities. A modification of Kenahan's Y classification in primary cleft lip and palate and new classification in secondary cleft lip and palate deformities are proposed as a simple and reproducible method. These reproducible classification may be used to facilitate not only storing and analyzing of medical informations in computer but also the planning of secondary repairs

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Ankle Arthrodesis (족관절 유합술)

  • Lee, Jun Young;Park, Sang-Ha
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.147-152
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    • 2014
  • Ankle arthrodesis has been used as standard treatment of ankle arthritis unresponsive to conservative treatment. Transfibular approach was used for ankles with severe deformities and minimally invasive arthroscopic ankle arthrodesis was used for patients with mild deformities. Anterior approach may be used when lateral approach couldn't be performed. Tibiotalocalcaneal arthrodesis is standard treatment for coexisting ankle and subtalar arthritis, and modified Blair arthrodesis can be used if the talus body resection is necessary in severe talar necrosis. In serious infection of ankle arthritis, arthrodesis can be performed as staged operation. In cases with low bone density and severe deformities, Charcot arthropathy should be considered.

Correction of a nasal soft triangle deficiency as a complication of augmentation rhinoplasty

  • Kim, Eon Su;Heo, Jae Won;Yang, Chae Eun;Kim, Jiye;Kim, Sug Won
    • Archives of Craniofacial Surgery
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    • v.22 no.3
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    • pp.161-163
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    • 2021
  • The soft tissue triangle is an easily recognizable subunit of the nose. Therefore, deformities in this region resulting from trauma or complications after cosmetic surgery can have serious cosmetic impacts. Various reconstruction choices exist for deformities such as depression of the soft triangle but choosing the most appropriate treatment in each case remains a challenge. In the case described herein, a patient underwent augmentation rhinoplasty with a silastic implant and experienced implant exposure in the soft triangle area. After implant removal, the patient complained of depression in this area. The authors effectively solved this problem through a de-epithelialized composite tissue graft. In this report, we present this case and review similar cases of reconstruction of the soft triangle.

Reconstruction of temporal hollowing deformities using silicone implants made using a toy-clay model: a report of three cases

  • Kim, Min Wook;Kim, Seung Hyun;Nam, Su Bong;Lee, Jae Woo;Jeong, Dae Kyun;Kim, Young Ha
    • Archives of Craniofacial Surgery
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    • v.23 no.1
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    • pp.34-38
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    • 2022
  • Severe temporal hollowing deformities can occur in patients who undergo craniectomy after intracranial hemorrhage. Reconstruction surgery for cosmetic purposes using silicone implants in patients with temporal hollowing deformities after craniectomy is advantageous because the procedure is simple and rapid, with a short recovery time, resulting in lower overall treatment costs. Of paramount importance, this option yields highly satisfactory results for patients. The authors present three cases of simple and fast surgery using silicone implants where highly satisfactory outcomes were obtained.

Total Ankle Arthroplasty in Ankle Arthritis with Coronal Plane Deformity (관상면 변형이 동반된 족관절염에서의 인공관절 치환술)

  • Yeo Kwon, Yoon;Kwang Hwan, Park;Jae Yong, Park
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.157-162
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    • 2022
  • Total ankle arthroplasty has become a viable motion-preserving alternative to ankle arthrodesis, especially in the last two decades. Recent improvements have been achieved in the strength of implant design and surgical technique. Nevertheless, addressing preoperative deformities is essential for successful outcomes of total ankle arthroplasty. Residual malalignment can produce instability and edge loading, causing acceleration of polyethylene wear, followed by osteolysis and an increased risk of revision surgery. Therefore, the accompanying deformities and their correction techniques need to be comprehensively elucidated and understood. In this article, we provide a review of the application of total ankle arthroplasty in arthritis with coronal plane varus and valgus deformities.

The Effect of Operative Treatment for Lessor Toes Deformity Concomitant with Hallux Valgus on Clinical Outcomes (무지 외반증과 동반된 소족지 기형에 대한 수술적 교정치료가 임상 결과에 미치는 영향)

  • Park, Ji-Kang;Kim, Yong-Min;Kim, Dong-Soo;Park, Kyoung-Jin;Cho, Byung-Ki;Jeong, Ho-Seung
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.3
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    • pp.225-233
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    • 2013
  • Purpose: This study was performed to evaluate the impact of the lesser toe operation on the overall clinical outcomes, and to analyze the clinical results of concomitant surgery for hallux valgus and lesser toe deformities. Materials and Methods: Forty-six cases underwent surgery for hallux valgus with concomitant lesser toe deformities were followed up for at least 1 year. Lesser toe deformities consisted of 9 crossover toes, 10 claw toes, 12 hammer toes and 15 bunionettes. Clinical evaluation was performed according to AOFAS (American Orthopaedic Foot and Ankle Society) score, patient's satisfaction score, and pain VAS (visual analogue scale) score. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and period to union were measured. Preoperative expectation about lesser toe deformities, postoperative satisfaction, complication rate, hospitalization period, medical expenses, and frequency of outpatient follow-up were analyzed. Results: AOFAS score, VAS score, HAV and IMA had improved significantly. On preoperative expectation of patients, correction of lesser toe deformities was ranked third, following the improvement of big toe(bunion) pain and the correction of hallux valgus. Patient's satisfaction score was average 92.8 points, and the importance of lesser toe operation was 30.2%. When compared to hallux valgus operation only, there were average 2.5 days of additional hospitalization, 2.4 times of additional outpatient follow-up, 386000 won of additional medical expenses. Conclusion: Combined operation for hallux valgus and concomitant lesser toe deformities showed good clinical results. When compared to hallux valgus operation only, there were longer hospitalization, more frequent follow-up, more medical expenses, more complications. However, lesser toe deformity correction in patients underwent hallux valgus operation is considerable, because of high preoperative expectation and postoperative satisfaction.

Complete Septal Extension Graft using Porous High-Density Polyethylene Sheet or Septal Cartilage in Unilateral Cleft Lip Nasal Deformities: Photogrammetric Analysis (전비중격연장이식술을 이용한 일측 구순열비변형교정술: 다공성 고밀도폴리에틸렌 판과 비중격연골의 사진계측학적 비교)

  • Han, Ki-Hwan;Jeong, Jin-Wook;Park, Mu-Sik;Kim, Jun-Hyung;Son, Dae-Gu
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.400-408
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    • 2010
  • Purpose: Complete septal extension grafts have been widely used in rhinoplasty for effective projection of the short retruded columella in Asian patients. Autologous septal cartilages and porous high-density polyethylene sheets are frequently used as septal extension grafts. This study was conducted to compare the postoperative results of porous polyethylene sheets and septal cartilages used for correction of unilateral cleft lip nasal deformities by using photogrammetric analysis. Methods: This study investigated a total of 49 patients with cleft lip nasal deformities who underwent corrective surgery, and were followed up for at least 6 months. Septal cartilages were used in 39 patients, and porous polyethylene sheets were used in 10 patients. In all patients, through the open rhinoplasty, complete septal extension grafts were sutured to the caudal margin of the septal cartilage, and the alar cartilage was sutured with suspension. The cleft side alar cartilage was overcorrected by approximately 3 - 5 mm. Postoperative outcomes were evaluated by using photogrammetric analysis. Five indices and 4 angles were measured on their photographs taken before and after the surgery. In patients with unilateral cleft lip nasal deformities, symmetry was also evaluated by means of columellar length index. Results: The postoperative values obtained in photogrammetric analysis showed improvements in comparison with the preoperative ones. The polyethylene group produced more improved outcomes than the septal cartilage group but also resulted in more complications at the same time. Conclusion: The results of this study indicates that complete septal extension grafts are efficient for the correction of unilateral cleft lip nasal deformities. However, since postoperative complications occur more frequently in the polyethylene group than in the septal cartilage group, caution is advised in using porous high-density polyethylene sheets in patients with cleft lip nasal deformities.

The Signs and Treatment of the Leprosy (나병의 증상과 치료)

  • Lee Kyung-Hee;Song Yong-Wha;Hong Wan-Sung
    • The Journal of Korean Physical Therapy
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    • v.4 no.1
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    • pp.95-100
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    • 1992
  • Due to the selectivity of the involvement by the M, leprae, the deformities are characteristic ones. It is estimated that from $25\%\;to\;88.4\%$ of the patients with leprosy possess deformities are numerous and often multiple. The chief modalities employed in physical therapy of the leprosy are : Paraffin baths, oil massages, foot baths, exercises, splinting.

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A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures

  • Nakamura, Masahiro;Yanagita, Takeshi;Matsumura, Tatsushi;Yamashiro, Takashi;Iida, Seiji;Kamioka, Hiroshi
    • The korean journal of orthodontics
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    • v.46 no.6
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    • pp.395-408
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    • 2016
  • We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

Alar Base Augmentation by Various Methods in Secondary Lip Nasal Deformity (다양한 방법을 이용한 이차성 구순열 비변형의 비익기저 증대술)

  • Kwon, Ino;Kim, Yong Bae;Park, Eun Soo;Jung, Sung Kyun
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.287-292
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    • 2005
  • The definitive correction of secondary lip nasal deformities is a great challenge for plastic surgeons. To rectify the secondary lip nasal deformities, various procedures and its modifications have been reported in many centers. However, no universal agreement exist to correct the various components of secondary nasal deformities. The secondary nasal deformity of the unilateral cleft lip has its own characteristic abnormalities including the retroplaced dome of the ipsilateral nasal tip, hooding of the alar rim, a secondary alar-columellar web, short columella, depressed alar base and so forth. Among these components of secondary nasal deformity, maxillary hypoplasia, especially in the area of piriform aperture, and alveolar bone defect can make the alar base depressed, which in turn, leads to wide and flat nasal profile, obtuse nasolabial angle coupled with subnormal nasal tip projection in aspect of aesthetic consideration. Moreover, the maxillary hypoplasia contributes to reduced size of the nasal airway in combination with other component of external nasal deformity and therefore the nasal obstruction may be developed functionally. Therefore, the current authors have performed corrective rhinoplasty with the augmentation of alar base with various methods which include rearrangement of soft tissue, vertical scar tissue flap and use of allogenic or autologous materials in 42 patients between 1998 and 2003. The symmetric alar base could be achieved, which provides the more accurate evaluation and more appropriate management of the various component of any coexisting secondary nasal deformity. In conclusion, the augmentation of alar base, as a single procedure, is a basic and essential to correct the secondary lip nasal deformities.