• Title/Summary/Keyword: Deformity

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Approach for the Treatment on Hallux Valgus (무지 외반증의 치료에 대한 고찰)

  • Lee, Sung-Hyun;Lee, Yeong-Chang
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.143-148
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    • 2019
  • Although many patients who undergo bunion repair do well and have satisfactory results, a critical evaluation of these results shows the potential for improvement. Metatarsal deformity of the hallux valgus is a 3-dimensional deformity, including rotation in the coronal plane. Theoretically, it is important to understand the 3-dimensional displacement of the first metatarsal for correcting the deformities of valgus rotation in the frontal plane. Yet the current methods of metatarsal osteotomy principally attempt to correct the deformity in the transverse plane. The modified technique for the Lapidus procedure can be used in a variety of hallux valgus conditions and severities, and the early results suggest that a powerful correction can be maintained. In addition, efforts have been made to correct the 3-dimensional deformity by performing metatarsal shaft osteotomy. In the case of degenerative arthritis, first metatarsophalangeal joint arthrodesis is a good option to correct the 3-dimensional deformation. Correction of the 3-dimensional deformity, including a rotational deformity in the frontal plane of the metatarsals, should be considered when selecting surgical treatment and is essential for achieving a good prognosis for patients with hallux valgus. This article reviews the classification and treatment of hallux valgus for correction of the 3-dimensional deformity.

Can Angular Deformity Due to Sacrococcygeal Fracture Cause Permanent Impairment? : Current State and Problems in Korea

  • Cho, Dosang
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.173-179
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    • 2022
  • Disabilities can emerge due to traumatic spinal fractures. In terms of sacrococcygeal spine, because of its unique anatomic structure with minimal movement, the possibility for it to have a disability is relatively low. In Korea, unlike most disability criteria, private insurance companies acknowledge angular deformities caused by vertebral fractures as disabilities according to their degree, so there were several cases where patients required compensation, arguing angular deformity caused by sacrococcygeal fracture, which in some cases led to legal conflicts. Except the Act Welfare of Persons with Disabilities which recognizes only severe angular deformity affecting internal organs as disability and the industrial accident disability evaluation which does not recognize coccygeal fracture as disability but rarely recognizes sacral vertebra deformity equivalent to compressive deformation, there is little or no case where angular deformity is recognized as disability. Given the impairment evaluation standards in social insurance, McBride system, American Medical Association (AMA) guides, and newly proposed standards by the Korean Academy of Medical Sciences (KAMS), the most contentious point in the general terms and conditions of private insurance is spinal deformity. To overcome controversy over disability evaluation, the private insurance sector is now applying criteria for axial skeleton to sacrococcygeal vertebrae through revision of standards. Under these circumstances, it is fair to recognize sacrococcygeal fracture as impairment in terms of the pelvis only when the fracture leaves serious deformity and neurological symptoms with clear relevancy. Though it may not be easy to develop accurate disability evaluation standards, improvement is necessary to remove any irrationalities and make the standards as objective as possible.

Surgical correction of cleft lip lower-lip deformity: a report of three cases

  • Ci Young, Kim;Sung-Ho, Ha;Jin-Young, Choi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.390-396
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    • 2022
  • Cleft lip lower-lip deformity is a secondary deformity in patients who underwent primary cheiloplasty of the upper lip, characterized by an enlarged and anteriorly rotated lower lip. In these cases, soft-tissue imbalances remain even after skeletal correction with orthognathic surgery, and additional soft tissue treatment is required for lip harmony and esthetic facial balance in CLP (cleft lip palate) patients. This study describes three cases of transverse myomucosal excision of the lower lip for correction of cleft lip lower-lip deformity to restore facial esthetic balance. Each patient underwent orthognathic surgery, rhinoplasty, or upper lip revision cheiloplasty according to condition. Postoperatively, volume of the lower lip decreased and lip harmony was improved in all three patients. The surgeon should fully understand the anatomical structure around the lips and be able to evaluate overall harmony of the soft tissue. When a lower lip deformity is present, careful surgical planning and execution are important for each patient.

Correction of the secondary nasal deformity using Bardach' s technique (Bardach씨 술식을 통한 이차성 구순열비변형의 교정)

  • Kim Su-Gwan
    • Korean Journal of Cleft Lip And Palate
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    • v.2 no.1_2
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    • pp.23-28
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    • 1999
  • The author presents Bardach' s technique for the residual unilateral cleft lip nasal deformity, The key to a successful and stable correction of the nasal deformity is to lengthen the columella on the cleft side and to mobilize alar cartilage from its surrounding tissue, creating a symmetric shape and length, The major advantages of the technique are lengthening of the cleft columella and creation of a symmetric and well-projected nasal tip.

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Prosthodontic rehabilitation of a patient with bilateral auricular deformity

  • Mantri, Sneha Shivkumar;Thombre, Ram U.;Pallavi, Daigavane
    • The Journal of Advanced Prosthodontics
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    • v.3 no.2
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    • pp.101-105
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    • 2011
  • Maxillofacial prosthodontics is an art and science which provides life like appearance to the person with facial deformity. Maxillofacial prosthetic rehabilitation for acquired defects has become more complex and sophisticated with advancement in techniques and materials. This case report describes the clinical and laboratory procedure for fabricating an auricular prosthesis for a patient with trauma related bilateral auricular deformity. Ear prosthesis was fabricated in two parts taking retention from external auditory canal.

Selective tendon lengthening in the management of acquired claw toes (후천성 갈퀴족 변형의 선택적 건연장술 - 증례 보고 4례 -)

  • Choi, Joong-Geun;Choi, Sung-Woo;Lee, Kyung-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.274-278
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    • 2003
  • Rare complications of distal tibia fracture are claw-toe deformity, cavus deformity and checkrein deformity. These complications may be due to contracture of the muscles of the deep posterior compartment of the leg after a compartment syndrome. These 4 cases were treated by selective tendon lengthening of flexor tendon at the retromalleolar level.

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Treatment of Iatrogenic First Metatarsal Dorsiflexion Deformity After Hallux Valgus Surgery -A Case Report- (무지 외반증 환자의 근위부 절골술 후 발생한 의인성 제 1 중족골의 족배 굴곡증의 치료 -1예 보고-)

  • Lee, Kyung-Tae;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do;Son, Sang-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.199-203
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    • 2004
  • Purpose: We report a case that iatrogenic dorsiflexion deformity after hallux valgus surgery treated successfully with crescenteric plantar flexion metatarsal osteotomy. Materials and Methods: 43 years old female who suffered from left fore foot pain and deformity after hallux valgus surgery was evaluated. Results: Preoperatively she did not put on ordinary shoes and had had persistent pain and discomfort on 1st metatarsal area. She also had a callus on plantar surface of 2nd metatarsal head. Simple AP and Lateral x-ray identified that 1st metatarsal bone had a 23 degree dorsiflexion deformity. For correction of deformity, plantarflexion crescenteric osteotomy was performed on proximal 1st metatarsal area. After operation, All of symptom eliciting patient was gone and 43 points of AOFAS scale preoperatively improve 100 points and the patient very satisfied. Post operative x-ray was showing complete correction of deformity. Conclusion: As a treatment of iatrogenic dorsiflexion deformity after hallux valgus surgery, the crescenteric plantar flexion osteotomy can be good and safe modality for correction.

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Reconstruction of Philtral Column with Overlapping of Orbicularis Oris Muscle Flap in Secondary Cleft Lip Nose Deformity (이차성 구순열 환자에서 상구순 구륜근 피판중첩을 이용한 인중주의 재건)

  • Kwon, Seok Min;Park, Jun;Yang, Won Yong;Yoo, Young Cheun;Kang, Sang Yoon
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.574-580
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    • 2008
  • Purpose: Philtral deformity is a stigma of secondary cleft lip nose. It occurs from the false arrangement of orbicularis oris muscle and the scar of previous operation. Various methods have been used to correct this deformity. We successfully corrected philtral deformity using overlapping of orbicularis oris muscle flap. Methods: From November 2000 to August 2007, we performed 39 cases of correction of philtral deformity in secondary cleft lip nose with overlapping of orbicularis oris muscle flap. Their age ranged from 5 to 53 years old. Existing scar tissue of previous operation was deepithelialized and preserved as scar flap. Lateral orbicularis oris muscle flap was elevated, advanced and overlapped upon medial muscle flap after dissection of orbicularis oris muscle of both sides. Reconstruction of philtral column was made from overlapping area by fixation of end part of lateral muscle flap to the point between philtral dimple and column. The degree of muscle flap advancement was decided by correction state of lateral muscle bulging. Correction of nostril floor depression or whistle deformity was also performed with preserved scar flap, if necessary. Results: Realignments of orbicularis oris muscle were possible in the majority of the patients and final results of philtral reconstruction were satisfactory mostly. Correction of nostril floor depression and whistle deformity was also achieved. Additional correction was performed later to 4 patients in whom insufficient reconstruction was noted. No significant complication was observed. Conclusion: More natural and symmetric philtrum was acquired with overlapping of orbicularis oris muscle flap. To the authors' knowledge, it is an easy and effective method for correction of philtral deformity through anatomical rearrangement of distorted orbicularis oris muscle with relatively simple procedure.

Complications of the Nasal Bone Fractures according to the Stranc Classification (Stranc 분류법에 따른 비골골절 정복술 후 합병증)

  • Lee, Jun-Ho;Park, Won-Yong;Nam, Hyun-Jae;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.62-66
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    • 2008
  • Purpose: Although nasal fractures are often discussed as minor injuries but the incidence of post-traumatic nasal deformity remains high. For decrease the incidence of post-traumatic nasal deformity which require the guideline to optimize the management of acute nasal bone fracture. The aim of this study is analysis of post-traumatic nasal deformity according to Stranc classification. Method: We reviewed 310 patients with nasal bone fracture treated at our hospital from January of 2005 to December of 2006. Result: Post-traumatic complication were divided septal deviation, nasal bone deformity, temporary hyposmia and synechia. Nasal bone deformity include nasal bone deviation, hump, flat nose and minimal nasal bone irregularity. The incidence of total complication rate was 36.4%. The most common complication was nasal deformity(22.9%) followed by septal deviation(19.7%). The most common complication was septal deviation(20%) in frontal impact. The most common complication was nasal deformity(19.5%) in lateral impact. In frontal impact, the incidence of complication rate was plane II(68.8%) followed by plane I(29.9%) and plane III(16.7%). In lateral impact, the incidence of complication rate was plane II (78.8%) followed by plane III(61.5%) and plane I(42.7%). Conclusion: This result can be used to improve longterm results and to reduce the incidence of post-traumatic nasal deformity by predict complication of nasal bone fracture according to Stranc classification.

Outcomes of Ankle Arthroplasty with Preoperative Varus Deformity of More Than 20 Degrees: Comparison with the Group of Varus Deformity of Less Than 20 Degrees (20도 이상의 술전 내반 변형이 있었던 족관절에서 인공관절 치환술의 결과: 내반 변형 20도 미만 군과의 비교)

  • Kim, Hyunho;Lee, Myoungjin
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.1
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    • pp.19-22
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    • 2016
  • Purpose: We compared the results of total ankle arthroplasty in patients with preoperative varus deformity of more than $20^{\circ}$ with those of patients with varus deformity less than $20^{\circ}$. Materials and Methods: From January 2005 to January 2013, 9 ankles with preoperative varus deformity of more than $20^{\circ}$ (varus group) and 31 ankles with varus deformity less than $20^{\circ}$ (control group) underwent total ankle arthroplasty. Clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score, and radiographic results were assessed using tibiotalar varus angle in standing anteroposterior radiographs taken preoperatively and at the last follow-up. Results: The mean duration of clinical follow-up was 42.8 months (14~60 months). The AOFAS score was improved by a mean 47.0 points in the varus group and 37.6 points in the control group. Statistically significant difference was observed between the two groups (p=0.041). Tibiotalar varus angle measured at the last follow-up radiograph was $2.5^{\circ}$ in the varus group and $1.0^{\circ}$ in the control group and the difference was not statistically significant (p=0.820). Conclusion: Satisfactory clinical and radiographic results can be achieved in patients with varus deformity more than $20^{\circ}$ by precise bone resection and soft tissue release.