• Title/Summary/Keyword: Deformity correction

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Surgical correction of funnel chest (누두흉 치험 2예)

  • 한균인
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.226-230
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    • 1983
  • Two patients with funnel chest deformity were corrected at the Department of Thoracic Surgery of Chungnam National University Hospital . The first case was 11 year old boy, suffering from exertional dyspnea with asymmetrical funnel chest deformity, of which hollow cavity was measured 80 ml of water. The second case was 6 year old boy, suffering from frequent upper respiratory tract infection with symmetrical funnel chest deformity, of which hollow cavity was measured 50 ml of water. These two cases were corrected by Ravitch method, left lower lobectomy was performed concurrently on the first case. The result was satisfactory.

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Surgical correction of pectus excavatum -2 cases report- (누두흉 치험 2예)

  • 김종진
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.479-483
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    • 1986
  • Two patients with funnel chest deformity were corrected at the Department of Thoracic Surgery of Chosun University Hospital. The first case was 5 year old boy, suffering cosmetic deformity, of which hollow cavity was measured 25ml of water. He was corrected by modified Ravitch method. The second case was 12 year old boy, suffering from exertional dyspnea with symmetrical funnel chest deformity, of which hollow cavity was measured 55ml of water. He was corrected by method of sternal turnover. The surgical results of these cases were satisfactory.

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Surgical Decision for Elderly Spine Deformity Patient (노인 척추 변형 환자의 수술적 결정)

  • Kim, Yong-Chan;Juh, Hyung-Suk;Lee, Keunho
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.1-8
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    • 2019
  • Globally, the elderly population is increasing rapidly, which means that the number of deformity correction operations for elderly spine deformity patient has increased. On the other hand, for aged patients with deformity correction operation, preoperative considerations to reduce the complications and predict a good clinical outcome are not completely understood. First, medical comorbidity needs to be evaluated preoperatively with the Cumulative Illness Rating Scale for Geriatrics or the Charlson Comorbidity Index scores. Medical comorbidities are associated with the postoperative complication rate. Managing these comorbidities preoperatively decreases the complications after a spine deformity correction operation. Second, bone densitometry need to be checked for osteoporosis. Many surgical techniques have been introduced to prevent the complications associated with posterior instrumentation for osteoporosis patients. The preoperative use of an osteogenesis inducing agent - teriparatide was also reported to reduce the complication rate. Third, total body sagittal alignment need to be considered. Many elderly spine deformity patients accompanied degenerative changes and deformities at their lower extremities. In addition, a compensation mechanism induces the deformed posture of the lower extremities. Recently, some authors introduced a parameter including total body sagittal alignment, which can predict the clinical outcome better than previous parameters limited to the spine or pelvis. As a result, total body sagittal alignment needs to be considered for elderly spine deformity patients after a deformity correction operation. In conclusion, for elderly spine deformity patients, medical comorbidities and osteoporosis need to be evaluated and managed preoperatively to reduce the complication rate. In addition, total body sagittal alignment needs to be considered, which is associated with better clinical outcomes than the previous parameters limited to the spine or pelvis.

COMPLEX OSTEOTOMY FOR THE CORRECTION OF POST-TRAUMATIC MIDFACIAL DEFORMITY (외상 후 중안면 기형을 교정하기 위한 복합골 절단술)

  • Lee, Moon-Hoy;Song, Chi-Won;Lee, Dong-Geun;Kim, Seong-Gon;Lee, Yong-Chan;Cho, Byong-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.488-490
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    • 2002
  • The traffic accident was one of most common cause for the facial bone fracture. When it involved the midfacial structures, the nasal bone fracture was usually shown. If the reduction was not done in time, it would result in facial deformity. Simple case could be corrected by simple rhinoplasty. However, severe cases would require more invasive technique. We used triangular osteotomy included the nasal bones, the vomer, and the medial wall of maxilla for the correction of post-traumatic nasal deformity and reported the result with the review of literatures.

Surgical Outcomes and Complications Following All Posterior Approach for Spinal Deformity Associated with Neurofibromatosis Type-1

  • Park, Byoung-Joo;Hyun, Seung-Jae;Wui, Seong-Hyun;Jung, Jong-Myung;Kim, Ki-Jeong;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.738-746
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    • 2020
  • Objectives : The purpose of this study was to evaluate surgical outcomes and complications of spinal deformity associated with neurofibromatosis type-1 (NF-1). Methods : From 2012 to 2018, patients suffering from spinal deformity associated with NF-1 who underwent surgical correction were identified. Demographic data and radiographic measures were retrospectively reviewed. Pre- and postoperative whole spine radiograph images were used to determine both coronal and sagittal Cobb angles. All of patients underwent 3-dimentional computed tomographic scan and magnetic resonance imaging scan to confirm dystrophic features. For evaluation of clinical outcomes, we surveyed the pre- and postoperative scoliosis research society-22r (SRS-22r) score. Results : Seven patients with spinal deformity associated with NF-1 were enrolled in this study. The mean age of patients was 29.5±1.2 years old. The mean follow-up period was 2.8±1.4 years. The apex of the deformity was located in cervicothoracic (n=1), thoracic (n=4), and lumbar region (n=2). Most patients have poor bone quality and decreased bone mineral density with average T-score of -3.5±1.0. All patients underwent surgical correction via posterior approach. The pre- and postoperative mean coronal and sagittal Cobb angle was 61.6±22.6° and 34.6±38.1°, 56.8±18.5° and 40.2±9.1°, respectively. Mean correction rate of coronal and sagittal angle was 44.7% and 23.1%. Ultimate follow-up SRS-22r score (average score, 3.9±0.4) improved comparing to preoperative score (average score, 3.3±0.9). Only one patient received revision surgery due to rod fracture. No serious complication occurred, such as neurological deficit, and viscerovascular injury. Conclusion : The surgical correction of patients having spinal deformity associated with NF-1 is challenging, however the radiographic and clinical outcomes are satisfactory. The all posterior approach can be a safe and effective surgical option for patients having dystrophic curves associated with NF-1.

The Efficacy of Titanium Mesh Cage in Tuberculous Spondylitis Treated with Anterior Intervertebral Fusion (척추 결핵의 전방유합술시 Titanium Mesh Cage의 효과)

  • Jeong, Ju-Ho;Lee, Sang-Gu;Yoo, Chan-Jong;Han, Ki-Soo;Kim, Woo-Kyung;Kim, Young-Bo;Park, Cheol-Wan;Lee, Uhn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.998-1003
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    • 2001
  • Objective : The maintenance of the correction of kyphotic deformity is one of the difficult problem in tuberculous spondylitis after anterior debriment and fusion with tricortical bone graft. The goal of this study is to find out the efficacy of titanium mesh cage impacted with autogenous bone chip in tuberculous spondylitis treated with anterior intervertebral fusion. Materials and Method : Twelve patients were treated with anterior intervertebral fusion using titanium mesh cage for tuberculous spondylitis from January 1996 to June 1999. We analized the changes in the correction of kyphotic deformity, changes of ESR and CRP, fusion state and recurrence after anterior intervertebral fusion with titanium mesh cage. Results : Clinical symptoms were improved in all twelve patients without any neurologic complications. The mean kyphotic angle corrected was 7.3 degrees immediately after operation, but the loss of correction of kyphotic angle was 2.2 degrees after 3 months and 2.6 degrees after 6 months. We found that the loss of correction of kyphotic deformity occurred mainly within the first 3 months after surgery. Only one patient, suffered from acute hepatic failure after first operation and had an insufficient anti-tuberculous medication therapy, showed recurrence of tuberculous spondylitis after 6 months. The patient underwent a second operation with posterior fixation procedure with good outcome. The changes of ESR and CRP were not specifically important factor to reveal recurrence of tuberculosis of the spine in our series. Conclusion : The surgical procedure of tuberculous spondylitis using titanium mesh cage with bone chip seems to be an effective procedure to minimize loss of the correction of kyphotic deformity without any aggravating inflammatory change and recurrence with titanium mesh cage, when sufficient debridement and anti-tuberculous chemotherapy are achieved.

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Correction of Distal Interphalangeal Joint Extension Lag Using Spiral Oblique Retinacular Ligament Reconstruction (나선빗인대 재건을 이용한 원위지관절 신전장애의 교정)

  • Moon, Kyung Hwan;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.480-484
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    • 2006
  • Purpose: A lot of surgical techniques were tried to correct extension lag of distal interphalangeal joint. Spiral oblique retinacular ligament reconstruction is the one of correction techniques. Methods: From January 2004 to January 2005, a total of 13 extension lag of distal interphalangeal joint corrections were performed using spiral oblique retinacular ligament reconstruction for 11 patients. After dorsal incision exposing from base of distal phalanx to proximal phalanx, the new ligament(half of lateral band or graft tendon) lies distally at the dorsum of the distal phalanx and passes volarly and proximally along the side of the middle phalanx and anterior and obliquely across the front of the proximal interphalangeal joint to the opposite side of the digit at the proximal phalanx. Results: 5 of 6 mallet finger deformities and 7 swan neck deformities were corrected, which were both extension lag of distal interphalangeal joint and hyperextension of proximal interphalangeal joint. Conclusion: As a result, spiral oblique retinacular ligament reconstruction is an effective and recommendable method for correction of mallet finger deformity and swan neck deformity.

Surgical correction of nostril base and nostril sill depression in unilateral secondary cleft lip nose deformity (일측성 이차 구순열 비변형에서 비공저와 비공턱 함몰의 수술적 교정)

  • Lee, Soo Hyang;Lee, Kyung Jin;Hwang, Eun A;Choi, Hyun Gon;Kim, Soon Heum;Shin, Dong Hyeok;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.637-641
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    • 2009
  • Purpose: Most unilateral secondary cleft lip nose deformities have depressed nostril base and sill on the cleft side. To obtain a symmetric nose, correction of the recession on nostril is critical. The authors have worked out effective methods to elevate the nostril of the cleft side according to the extent of the depression. Methods: A total of 115 unilateral secondary cleft lip nose deformity patients with nostril depression were evaluated. Data were acquired from patients' charts and photography with special reference to the height difference of the nostrils between the cleft side and the non - cleft side. Patients were divided into three groups based on the difference and operated with various techniques : (1) mild degree(< 1 mm) with graft, (2) moderate degree(1 ~ 3 mm) with C - flap or suspension suture of septal cartilage (3) severe degree(> 3 mm) with graft, C - flap and suspension suture. Follow - up period averaged 21.3 months. Results: Forty - six patients(40 percent) were in mild group, and forty - two(37 percent) were in moderate. In twenty - seven patients(23 percent), nostril recession was more than 3 mm. The elevated nostril base and sill were maintained without height alteration during follow - up. Conclusion: The symmetry of the nostril base, especially projection of nostril sill influences successful correction of unilateral cleft lip nose deformity. Our tolerable techniques can be applied to most deformities with nostril depression and can present a new guideline.

New Modified Chevron Osteotomy for Hallux Valgus (무지 외반증의 새로운 변형 Chevron 절골술)

  • Oh, In-Suk;Kim, Myung-Ku;Choi, Sung-Wook;Ban, Jun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.126-130
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    • 2004
  • Purpose: In this study, we tried to develop the technique of osteotomy for hallux valgus. The new modified technique of osteotomy was accomplished with even more greater stability, accurate correction of the deformity and more effective than 'chevron' osteotomy in terms of correction of the deformity. Materials and Methods: Between March 1998 and December 2001, 55 cases of new modified osteotomy for hallux valgus were performed for 39 patients, 16 of whom underwent operation of both feet. Operations were made for 34 women and 5 men whose average age was 46 years old (range, $20{\sim}71$ years). Average follow up period was three years (range, $2{\sim}5$ years), and during the follow up, the patients underwent physical examination and assessment with use of the American Orthpaedic Foot and Ankle Society's hallux-metatarso-phalangealinterphalangeal scale and standard foot radiographic measurements. Results: 37 patients (53 cases) out of 39 patients (55 cases) had no pain, good cosmesis, and all of the patients were satisfied with the results of the operation. Two had occasional mild discomfort. The average score according to the hallux-metatarso-phallangeal-interphalangeal scale was 93.2 points (range, $78{\sim}100$ points). The average preoperative intermetatarsal angle was $14.4^{\circ}$, which was decreased to $7.9^{\circ}$ after the osteotomy with an average correction of $6.5^{\circ}$ and The average preoperative hallux valgus angle was $34.1^{\circ}$, which was decreased to $11.1^{\circ}$ after the osteotomy with an average correction of $23^{\circ}$. This new modified technique would prevent the angulation or shortening at the osteotomy site and it was also even more stable at osteotomy site, and could do even more effective and accurate correction of the deformity than conventional Chevron osteotomy. Conclusion: New modified chevron osteotomy for the treatment of symptomatic hallux valgus was done in 55 cases, and the results were satisfactory in all cases. This method was more stable at the osteotomy site than conventional Chevron osteotomy and was also possible to do more accurate and more effective correction of the deformity. It was also easy to control the distal fragment of first metatarsal bone.

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