• Title/Summary/Keyword: Deformity correction

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Correction of Saddle Nose Deformity using Autogenous Cartilage Graft (자가연골이식을 이용한 안장코의 교정)

  • Cheon, Ji Seon;Kim, Gyu Bo;Yang, Jeong Yeol;Shin, Myung Seok;Lee, Seung Chan
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.81-87
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    • 2007
  • Purpose: Correction of saddle nose remains problematic both in the technique of reconstruction and in the choice of implant material for nasal augmentation. A large variety of graft materials have been used for the reconstruction of the saddle nose deformity. The purpose of this study is to determinate an algorithm for deciding alternative graft materials used in correction of saddle nose deformity. Methods: Six patients with saddle nose who were corrected using by auricular cartilage and costal cartilage at Chosun university hospital were analyzed. Results: After a mean interval of 12 months, all patients were satisfied with the esthetic and functional result. Conclusion: Auricular cartilage is an excellent graft material for esthetic and functional reconstruction of mild to moderate saddle nose deformity.

Combination of Nasal Ostectomy and Augmentation Rhinoplasty in the Correction of Traumatic Nasal Deformity (골절제술과 융비술의 동시 시행에 의한 외상성 비변형의 교정)

  • Kim, Sung Nam;Kim, Eui Sik;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong;Cho, Bek Hyun
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.555-560
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    • 2005
  • The nose is shaped as a pyramid and is the most prominent portion of the face. Nasal bone fractures are thus more frequent than those of the maxilla and zygoma. Whether the nasal bone fractures are corrected or not due to unnecessity of surgical treatment, the incidence of posttraumatic deformity occurs frequently. In Asian patients, even the corrected noses look low-lying and flat. To resolve these problems, we corrected the posttraumatic deformity of the nose with a combined procedure of nasal ostectomy and augmentation rhinoplasty. From 2000 to 2004, this procedure was performed in fifteen patients with posttraumatic nasal deformity. There were four female and eleven male patients with an average age of 32 years(range 19 to 52 years). All patients had previous trauma history. Of these, closed reduction was performed on 13 patients and no treatment was 2 patients. The deformed noses were corrected through lower columellar incision, by ostectomy or osteomy, and augmentation with silicone implant. We gained satisfactory results of correcting the deformed noses, except one case with implant deviation. Our method for the correction of traumatic nasal deformity proves to be simple and safe. The camouflage effect with silicone implant overcomes an unsatisfactory correction and brings a excellent cosmetic results.

Correction of the deviated tip and columella in crooked nose

  • Suh, Man-Koon
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.495-504
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    • 2020
  • The primary procedural components of deviated nose correction are as follows: osteotomy to correct bony deviation, septal deviation correction, manipulation of the dorsal septum to correct upper lateral cartilage deviation, and correction of functional problems (manipulation for correction of internal valve collapse and hypertrophy of the inferior turbinate). The correction of tip and nostril asymmetry cannot be overemphasized, because if tip and nostril asymmetry is not corrected, patients are unlikely to provide favorable evaluations from an aesthetic standpoint. Tip asymmetry, deviated columella, and resulting nostril asymmetry are primarily caused by lower lateral cartilage problems, which include deviation of the medial crura, discrepancy in the height of the medial crura, and asymmetry or deformity of the lateral crura. However, caudal and dorsal septal deviation, which is a more important etiology, should also be corrected. A columellar strut graft, correction of any discrepancy in the height of the medial crura, or lateral crural correction is needed to correct lower lateral cartilage deformation depending on the type. In order to correct caudal septal deviation, caudal septal shortening, repositioning, or the cut-and-suture technique are used. Surgery to correct dorsal septal deviation is performed by combining a scoring and splinting graft, a spreader graft, and/or the clocking suture technique. Moreover, when correcting a deviated nose, correction of asymmetry of the alar rim and alar base should not be overlooked to achieve tip and nostril symmetry.

Platysma Flap with Z-Plasty for Correction of Post-Thyroidectomy Swallowing Deformity

  • Jeon, Min Kyeong;Kang, Seok Joo;Sun, Hook
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.425-432
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    • 2013
  • Background Recently, the number of thyroid surgery cases has been increasing; consequently, the number of patients who visit plastic surgery departments with a chief complaint of swallowing deformity has also increased. We performed a scar correction technique on post-thyroidectomy swallowing deformity via platysma flap with Z-plasty and obtained satisfactory aesthetic and functional outcomes. Methods The authors performed operations upon 18 patients who presented a definitive retraction on the swallowing mechanism as an objective sign of swallowing deformity, or throat or neck discomfort on swallowing mechanism such as sensation of throat traction as a subjective sign after thyoridectomy from January 2009 till June 2012. The scar tissue that adhered to the subcutaneous tissue layer was completely excised. A platysma flap as mobile interference was applied to remove the continuity of the scar adhesion, and additionally, Z-plasty for prevention of midline platysma banding was performed. Results The follow-up results of the 18 patients indicated that the definitive retraction on the swallowing mechanism was completely removed. Throat or neck discomfort on the swallowing mechanism such as sensation of throat traction also was alleviated in all 18 patients. When preoperative and postoperative Vancouver scar scales were compared to each other, the scale had decreased significantly after surgery (P<0.05). Conclusions Our simple surgical method involved the formation of a platysma flap with Z-plasty as mobile interference for the correction of post-thyroidectomy swallowing deformity. This method resulted in aesthetically and functionally satisfying outcomes.

Surgical Correction of an Antebrachial Deformity with Severe External Rotation in Two Dogs (심각한 외측 회전을 동반한 전완 기형의 외과적 교정 치료 2 증례)

  • Yoon, Hun-Young;Roh, Mi-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.328-331
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    • 2011
  • Two dogs presented to the Dueckso Animal Hospital with a history of intermittent lameness of the left forelimb. On physical examination, a visible antebrachial deformity that resulted in gross external rotation of approximately $90^{\circ}$ was observed in two dogs. Medial-lateral radiographic views revealed distal ulnar subluxation, cranial bowing of the radius, radial and ulnar shortening, and external rotation of the paw. A distal ulnar ostectomy and distal radial closing wedge osteotomy were performed in two dogs. A proximal ulnar osteotomy was performed, adjacent to the elbow joint in case 1. Then, the osteotomized site was supported with an intramedullary pin. A T-plate and cortical screws were applied to the proximal and distal radial segments after derotating the distal segment internally. Postoperative radiographic view verified the correction of the angular deformity in two dogs. The follow-up was completed by physical examination 6 and 10 months after surgery respectively. There was no evidence of lameness of the left forelimb in two dogs. Gross observation of the limb revealed an apparent appropriate correction of the rotational and angular deformity in two dogs.

One Stage Correction of the Severe Secondary Cleft Lip Nasal Deformities in Foreigners (외국인에서 발생한 심각한 이차 입술갈림코변형에 대한 한 단계 수술)

  • Kim, Seok-Kwun;Kim, Ju-Chan;Park, Su-Sung;Lee, Keun-Cheol
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.102-106
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    • 2011
  • Purpose: It is accepted universally that correction of the cleft lip nasal deformity requires multiple stages of surgery. Following primary lip repair in infancy or early childhood, secondary surgery to improve the deformity of the lip and nose is frequently necessary. A suitable surgical procedure to correct the accompanying deformity, such as cleft palate and alveolus, must be carried out at an appropriate age. In developing countries, it is common for patients with cleft lip nasal deformity to present severe secondary deformities in adolescence, because of poor follow-up and inappropriate surgery. Methods: The first patient was a 12 year old Mongolian boy. He presented prominent lip scar, short lip, wide columella, asymmetric nostril, palatal fistula, cleft alveolus, and velopharyngeal incompetence. He underwent cheilorhinoplasty, transpositional flap, alveoloplasty by iliac bone graft, and sphincter pharyngoplasty. On follow-up, a bilateral maxillary hypoplasia and a class III malocclusion developed. He underwent LeFort I osteotomy and maxillary advancement at the age of 16 years. The second patient was an 18 year old Eastern Russian girl. She presented with a deviated nose, right alar base depression, short lip, protrusion on vermilion, large palatal fistula, and severe VPI due to short palate. She underwent the combined procedure of cheilorhinoplasty, corrective rhinoplasty, tongue flap for palatal fistula, and superiorly based pharyngeal flap. And the tongue flap was detached at postoperative 3 weeks. Results: The overall results have been extremely pleasing and satisfactory to patients. There were no postoperative complications. Conclusion: We discovered the one stage operation for radical correction was sufficient procedure to provide excellent clinical outcomes in patients with severe cleft lip nose deformity.

Computer Simulation based Pre-operative Planning of Fracture Fixation and Deformity Correction (컴퓨터 시뮬레이션 기반 골절고정 및 기형교정수술 예비계획)

  • Kim, Yoon-Hyuk;Kwon, Young-Ha;Heo, Yu
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.06a
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    • pp.698-700
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    • 2003
  • This paper presents a model and analysis techniques for a unilateral external fixator to achieve fracture reduction and deformity correction in long bones precisely. through fixator joint adjustment. Combining the kinematic analysis with a graphic model of the tibia and the fixator allowed 3D simulation and visualization of the adjustments required to reduce fracture or correct bone deformity after osteotomy. The model and analysis technique can be used for fixator evaluation and clinical application planning.

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Resection Arthroplasty on Lessor Toe Deformity (소족지 변형에서 시행한 관절 절제 성형술)

  • Kim, Ji Hoon;Park, Hyung Jun;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.153-158
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    • 2014
  • Purpose: The objective of this study was to examine the clinical results and effectiveness of resection arthroplasty for correction of lesser toe deformity. Materials and Methods: From January 2000 to November 2012, 92 cases of resection arthroplasty for lesser toe deformity were reviewed. Hammer toe was the most common type of deformity, accounting for 44 toes (33 patients). Hallux valgus was the most common comorbid illness. Second toe was the most commonly affected toe and proximal interphalangeal joint was the most common location of resection arthroplasty (69 toes, 75.0%). We also analyzed the alignment of phalanges using the last follow-up weight bearing radiographic image. The analysis included clinical evaluation with American Orthopaedic Foot and Ankle Society (AOFAS) score as well as subjective satisfaction. Results: Flexor tenotomy (19 cases) was the most common combined surgery. Floating toe (4 cases) was the most common complication. The last follow-up alignment of phalanges was better than good in 71 toes (77.2%) in anteroposterior view and in 69 toes (75.0%) in lateral view. Sixty one cases (85.9%) resulted in better satisfaction than 'good' and the final average AOFAS score was 87.4. Conclusion: Resection arthroplasty is a valuable surgical option for treatment of lesser toe deformity, with high patient satisfaction, easy surgical technique and remarkable correction of deformity.

Corrective Rhinoplasty with Combined Use of Autogenous Auricular Cartilage and Porcine Dermal Collagen in Cleft Lip Nose Deformity

  • Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.5
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    • pp.230-236
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    • 2014
  • Esthetic reconstruction of cleft lip nose deformity is a challenging task in surgical management of patients with orofacial cleft. The author reconstructed cleft lip nose deformity effectively using autogenous auricular cartilage and a relatively new graft material of porcine dermal collagen, $Permacol^{TM}$. After correction of the deformed lower third of the nose with patient's auricular cartilage, we applied $Permacol^{TM}$ to augment the entire nasal dorsum. Three patients were treated and followed for up to five years. All patients improved in nose aesthetics without any inflammatory or immunogenic reaction. The author suggests that the use of $Permacol^{TM}$ for nasal profile augmentation in the treatment of cleft lip nose deformity is an alternative surgical strategy with minimal surgical invasiveness. The author report long-term experience with combined use of auricular cartilage and $Permacol^{TM}$ in nasal reconstruction for cleft lip nose deformity.

Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees

  • Kim, Chang-Wook;Hyun, Seung-Jae;Kim, Ki-Jeong
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.843-852
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    • 2021
  • The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.