• 제목/요약/키워드: Deformity correction

검색결과 284건 처리시간 0.026초

Long Face(open-bite) 환자의 수술 교정 치료 (ORTHOPEDIC AND SURGICO-ORTHODONTIC TREATMENT IN THE LONG FACE)

  • 백형선
    • 대한치과교정학회지
    • /
    • 제19권3호
    • /
    • pp.147-160
    • /
    • 1989
  • Long face patients are characterized by excessive anterior facial height, lip incompetence at rest, anterior open bite, and gummy smile. A major problem is an inferior rotation of the posterior maxilla and upper molars. Long face patients have been the most difficult for orthodontist to treat successfully. In growing patients, the methods for impeding excessive vertical growth have been used high pull head gear, functional appliance, and combined type of two. One significant improvement comes from using a full arch splint to deliver force to the maxilla more vertically. In adult patients, orthodontic camouflage treatment is biomechanically difficult and doesn't work when the problem is primarilly vertical. Surgical maxillary impaction provides a means for successfully treating most of problems. Also, superior reposition of the chin via a mandibular inferior border osteotomy is effective in decrease of lower anterior facial height and correction of the poor chin-lip balance. Post-surgical stability and the physiologic response are good. The coordinated orthodontic and surgical treatment is necessary for solution the difficult skeletal deformity.

  • PDF

Ilizarov 술식을 이용한 하지 연장술 및 변형 교정술 후 물리치료 (Physical Therapy Following Leg Lengthening and Deformity Correction by Ilizarov Method : Clinical Commentary)

  • 김태열;황태연
    • 대한물리치료과학회지
    • /
    • 제1권2호
    • /
    • pp.355-365
    • /
    • 1994
  • Ilizarov limb lengthening has been the new method to deal with a variety of orthopaedic problems. Ilizarov apparatus consists of stainless steel rings that surround the limb and are interconnected by threaded rods. Tensioned wires pierce the bone in the plane of each ring and are tightly attached to the ring. Ilizarov has reported distraction osteogenesis with the use of the typical fixator that allows functional loading. The purpose of this commentary is to introduce a four-stage rehabilitation protocol currently used by the authors in the physical therapy management of a post -limb lengthening. Each treament stage corresponds to a medical stage in the lengthening process. Treatment goals for each of the physical therapy treatment stage are presented to guide treatment planning. Two case examples are presented to illustrate the use of the management goals in treatment planning.

  • PDF

PATAU 증후군에 동반된 후두연화증의 $CO_2$LASER를 이용한 수술치험례 ($CO_2$Laser Aryepiglottoplasty for Treatment of Laryngomalacia in Patau Syndrome)

  • 송영호;이동엽;안회영;김영도
    • 대한기관식도과학회지
    • /
    • 제3권1호
    • /
    • pp.128-136
    • /
    • 1997
  • 저자들은 Patau증후군에 동반된 후두연화증으로 심폐정지가 유발된 환아에서 $CO_2$레이저를 이용한 aryepiglottoplasty를 시행하여 극적인 호전을 보였기에 문헌고찰과 함께 치료경험을 보고하는 바이다.

  • PDF

Protecting the tracheal tube cuff: a novel solution

  • Abel, Adam;Behrman, David A.;Samuels, Jon D.
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제21권2호
    • /
    • pp.167-171
    • /
    • 2021
  • We describe the successful insertion of a nasotracheal tube following repeated cuff rupture. The patient was a 55-year-old woman with a history of nasal trauma and multiple rhinoplasties, who underwent elective Lefort I osteotomy and bilateral sagittal split osteotomy for correction of skeletal facial deformity. During fiberoptic bronchoscope-guided nasal intubation after the induction of general anesthesia, the tracheal tube repeatedly ruptured in both nares, despite extensive preparation of the nasal airways. We covered the cuff with a one-inch tape, intubated to the level of the oropharynx, pulled the tracheal tube out through the mouth, and removed the tape. The tracheal tube was then backed out to the level of the uvula, and was successfully advanced.

The Multiple V-Y Advancement Modification for the Surgical Correction of Cryptotia

  • Nguyen Quang Duc;Nguyen Phuong Tien
    • Archives of Plastic Surgery
    • /
    • 제50권1호
    • /
    • pp.26-29
    • /
    • 2023
  • Cryptotia is a rare congenital auricular deformity among Caucasians but more common in Asians. Various operative techniques have been described, such as skin graft, V-Y plasty, Z plasty, and islands skin flap. Among those techniques, V-Y plasty has many advantages and is indicated for severe cases. However, several problems remain when this method is adopted, such as conspicuous scars and lowered hairline. To overcome these problems, the authors have developed a new technique, multiple V-Y advancement modification, which stitches the skin flaps together to a tight, discrete central focal point. This technique has the advantage of hiding scars behind the earlobe, providing enough skin for the deformed areas, minimizing the condition of the hairline being lowered and auriculocephalic sulcus depth.

골다공증이 있는 고령의 환자에서 Scarf 중족골 절골술을 이용한 무지 외반증의 치료 (The Treatment for Hallux Valgus with Scarf Osteotomy in Elderly Patients with Osteoporosis)

  • 황승현;이수찬;남창현;백지훈;안혜선
    • 대한족부족관절학회지
    • /
    • 제21권3호
    • /
    • pp.93-97
    • /
    • 2017
  • Purpose: The aim of this study was to evaluate the radiological and clinical outcomes of scarf osteotomy for hallux valgus (HV) deformity in elderly patient with osteoporosis. Materials and Methods: A total of 58 elderly patients (mean age, 72.6 years) underwent scarf osteotomy for HV deformity between 2008 and 2015. The mean follow-up period was 24.4 months. Of the 58 patients, 42 were diagnosed with osteoporosis and 16 were diagnosed as normal. The radiological and clinical outcomes were assessed preoperatively, postoperatively, and at final follow-up, including HV angle, intermetatarsal (IM) angle, American Orthopaedic Foot and Ankle Society (AOFAS) score, patient satisfaction, visual analogue scale (VAS), and complication. Results: There was no significant difference in HV angle and IM angle between the osteoporosis group and normal bone mineral densitometry group at all time points, preoperative, postoperative, and final follow-up. Moreover, there was no statistically significant difference between the two groups with respect to the AOFAS score and VAS evaluations. In the osteoporosis group, the mean HV angle improved from $36.7^{\circ}$ preoperatively to $11.3^{\circ}$ at the time of final follow-up, and the mean IM angle improved from $13.2^{\circ}$ to $5.7^{\circ}$. The mean AOFAS score improved from 52.6 preoperatively to 89.1 at the time of final follow-up. With respect to satisfaction, 83.4% of patients were very satisfied or satisfied. There were no serious complications, and all cases showed complete union at the osteotomy site. Conclusion: We believed that scarf osteotomy is a safe, effective procedure for the correction of elderly patients with osteoporosis.

무지 외반증의 치료에서 단일 나사못을 이용한 근위 중족골 쐐기 절골술 (Proximal Metatarsal Wedge Osteotomy with Single Screw Fixation in Treatment of Hallux Valgus)

  • 최재열;신헌규;장일성;강동호
    • 대한족부족관절학회지
    • /
    • 제9권1호
    • /
    • pp.87-93
    • /
    • 2005
  • Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

  • PDF

이하선 적출술 후 흉쇄유돌근을 이용한 안모결손부의 외형재건 (CONTOUR RECONSTRUCTION OF FACIAL DEFECT WITH SPLIT STERNOCLEIDOMASTOID MUSCULAR FLAP FOLLOWING PAROTIDECTOMY)

  • 김명진;김택경;유준영
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제13권2호
    • /
    • pp.144-152
    • /
    • 1991
  • 외상이나 종양의 적출 등으로 인하여 악안면부에 발생된 결손이나 안면 경부 기형의 교정을 위하여 여러 근피판을 이용하여 악안면부 재건술이 시행되어지고 있다. 흉쇄유돌근은 안면부의 일차적 혹은 이차적 재건에 안전하고 유용한 근피판 또는 근피부피판으로 널리 사용되고 있다. 이하선부에 발생된 종양의 적출술 후 나타날 수 있는 이하선부의 안모 변형 방지를 위하여 흉쇄유돌근 근피판을 이용하여 안모 재건이나 술후 가상형성으로 발생 가능한 적출부의 감염, 반흔조직 형성과 술후 천충으로 노출되는 안면신경을 보호하는데 사용할 수 있다. 전 흉쇄유돌근 근피판이나 다른 경부 근피판 사용시 이하선부의 과잉돌출, 안면경부 기형 및 경부운동 제한 등의 부작용이 발생될 수 있다. 이러한 단점을 보완하고자 저자등은 부분 흉쇄유돌근 근피판을 형성하여 기능적 이하선 적출술 후 노근피판 전위를 통하여 이하선부 연조직 결손으로 인한 안모 변형이나 사강형성 예방 등을 만족할 만한 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다.

  • PDF

Chin Profile Changes in Skeletal Class III Following Bimaxillary Surgery with or without Advancement Genioplasty

  • Kim, Yoon A;Jung, Hwi-Dong;Cha, Jung-Yul;Choi, Sung-Hwan
    • Journal of Korean Dental Science
    • /
    • 제13권1호
    • /
    • pp.11-20
    • /
    • 2020
  • Purpose: This study sought to identify differences in hard and soft tissue chin profile changes in skeletal Class III patients after bimaxillary surgery, with or without advancement genioplasty. Materials and Methods: The retrospective study was conducted based on cephalometric analysis of skeletal and soft tissue variables. Lateral cephalograms taken at 3 different time points were utilized: pre-operation (T0), immediately post-operation (T1), and at least 6 months (11.0±2.6 months) post-operation (T2). The 2 groups were matched for sample size (n=20 each). Data were analyzed using independent t-tests with Bonferroni correction. Result: Group N (bimaxillary surgery alone) and Group G (bimaxillary surgery with an advancement genioplasty by horizontal sliding osteotomy) did not differ significantly in terms of demographic characteristics. The soft tissue chin thickness of Group G increased more after surgery, followed by a greater decrease during the postoperative period, and was eventually not significantly different from Group N at T2. On the other hand, the mentolabial sulcus depth of Group G (5.5±1.3 mm) was significantly greater than that of Group N (4.4±0.9 mm) (P=0.006) at T2. Conclusion: Although Group G showed a statistically significantly greater decrease in soft tissue chin thickness during the postoperative period, there were no significant intergroup differences in the chin profile for at least 6 months after the surgery, except for the mentolabial sulcus depth, which was greater in Group G than in Group N.

귓볼 하부 전위피판을 이용한 결손형 선천성 귓볼갈림증의 재건 (A One Stage Reconstruction of Defective Type Cleft Earlobe: Infra-auricular Transposition Flap)

  • 정동우;강대훈;김태곤;이준호;김용하
    • 대한두개안면성형외과학회지
    • /
    • 제13권2호
    • /
    • pp.135-138
    • /
    • 2012
  • Purpose: Reconstruction of the cleft earlobe is challenging. Several procedures are available to reconstruct congenital earlobe deformities. However, for large defective type, surgical procedures and designs are complex and tend to leave a visible scar. We present a simple method of reconstruction for defective type congenital cleft earlobe using a one stage technique with infraauricular transposition flap. This allows for easy and accurate size estimation and good aesthetic outcomes. Methods: A 4-year-old male patient has congenital cleft earlobe and antihelical deformity. Otoplasty for antihelical deformity correction and one stage infra-auricular transposition flap for earlobe reconstruction were performed. The flap was designed from the inferoanterior margin of the earlobe. The size of the flap was determined based on the normal side, and the width and length of the flap was 1 cm and 3 cm in size, respectively. An incision was made at the midline of the defective lobule. Further, the elevated flap was inserted. The elevated flap and the incision margins of the lobule were sutured together. Then, the donor site was closed primarily. Results: The volume and shape of the reconstructed earlobe were natural. There was no flap necrosis. The donor site had no morbidities and scar was not easily notable. Conclusion: Infra-auricular transposition flap can be designed easily and offer sufficient volume of earlobe. Furthermore, the scar is inconspicuous. In conclusion, infra-auricular transposition flap can be a good option for reconstructing a large defect type cleft earlobe.