• Title/Summary/Keyword: Distal end

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Reconstruction of Coracoclavicular Ligament with Semitendinosus Tendon Graft - Technical Note - (반건양근을 이용한 오구쇄골 인대의 재건술(수술 수기))

  • Choi Nam-Hong;Bae Sang-Wook;You Soo-Geun
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.138-142
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    • 1999
  • Coracoclavicular ligament is main restraint to superior instability of the distal clavicle. Coracoacromial ligament, extensor tendon of toe, palmaris longus tendon, and Dacron tape have been used to reconstruct coracoclavicular ligament. We used semitedinosus tendon to reconstruct coracoclavicular ligament. The semitendinosus tendon was harvested as a usual fashion. After the distal clavicle and coracoid process were exposed, a hole of six millimeter diameter was made on the center of whole thickness of the distal clavicle. A malleolar screw was fixed from distal clavicle to coracoid process to maintain the reduced position of the acromioclavicular joint. The leading suture of tendon graft was passed through the hole of the distal clavicle and looped under the coracoid process. After leading portion of ten­don graft was looped over the clavicle, sutures were made between each end of the tendon graft with nonabsorbable suture materials.

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Treatment of Displaced Fracture of the Distal Clavicle in Children- Report of 2 Cases (소아 쇄골 원위부 전위골절의치료- 2례보고-)

  • Park Tae-Soo;Kim Jong-Heon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.159-162
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    • 2002
  • We presented two cases of unstable fracture of the distal clavicle in children associating superior displacement of the ipsilateral distal clavicle and widening of the coracoclavicular (CC) interval. They obtained good osteosynthesis and reduction of the CC interval by conservative treatment. The primary conservative treatment should be considered for the treatment of the unstable distal clavicular fracture with widening of the CC interval in children.

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Microsurgical Reconstruction of Giant Cell Tumor of Distal Epiphysis of Radius (미세 수술을 이용한 광범위한 요골 원위 골단부 거대세포종의 재건술)

  • Kwon, Boo-Kyung;Chung, Duke-Whan;Han, Chung-Soo;Lee, Jae-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.100-107
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    • 2007
  • Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. But the management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle or anterior tibial vessel as living bone graft. From April 1984 to July 2005, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 14 cases, using Vascularized Fibular Graft, which occur at the distal radius. VFG with peroneal vascular pedicle was in 8 cases and anterior tibial vessel was 6 cases. Recipient artery was radial artery in all cases. Method of connection was end to end anastomosis in 11 cases, and end to side in 3 cases. An average follow-up was 6 years 6 months, average bone defect after wide segmental resection of lesion was 6.8 cm. All cases revealed good bony union in average 6.5 months, and we got the wide range of motion of wrist joint without recurrence and serious complications. Grafted bone was all alive. In functional analysis, there was good in 7 cases, fair in 4 cases and bad in 1 case. Pain was decreased in all cases but there was nearly normal joint in only 4 cases. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence.

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The Surgical Treatment of Esophageal Atresia with Tracheoesophageal Fistula -Report of 2 Cases- (선천성 식도폐쇄 및 기관식도루 수술치험 2례)

  • 한동기
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.244-250
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    • 1994
  • Early recognition, vigorous preoperative preparation, sophisticated supportive care, control of sepsis, and intensive care nursing have produced remarkably improved results in the management of esophageal atresia. Successful surgery for esophageal atresia and tracheoesophageal fistula was carried out recently. Two neonates with esophageal atresia and distal tracheoesophageal fistula were type C. Transpleural end-to-end repair was carried out after gastrostomy due to low birth weight in case I associated with ventricular septal defect. Case 2 underwent primary retropleural end-to-end repair. A simple one-layer anastomosis with the sutures passing through all layers of`the esophagus was performed in all cases.

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Utilization of end to side inverted mattress pancreaticojejunostomy for Duval procedure: A case report

  • Hyun Jeong Jeon;Sang Geol Kim
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.412-416
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    • 2022
  • Although a pancreaticojejunostomy (PJ) is not required after a distal pancreatectomy in most cases, it needs to be performed to prevent atrophy of the remnant pancreas when the proximal duct is obstructed by a tumor, stone, or etc. In these conditions, the critical postoperative pancreatic fistula (POPF) gives surgeons cause to hesitate before performing a PJ. We previously presented the modified technique of Mattress PJ named "inverted mattress PJ" (IM-PJ) and published improved outcomes in the aspects of POPF after a pancreaticoduodenectomy and a central pancreatectomy. Recently, we had a case of a patient who has chronic pancreatitis with a proximal pancreatic duct obstruction, requiring a distal pancreatectomy and PJ. Based on the previous report, we decided to apply the "inverted mattress PJ" (IM-PJ) technique for a Roux-en Y PJ after a distal pancreatectomy. The patient was discharged after surgery without complications. We reviewed a case of a patient requiring PJ following a distal pancreatectomy and discussed the safety of our technique.

Implant-Supported Fixed Prostheses for the rehabilitation of distal free end in periodontally compromised dentitions Number of fixtures affecting bone tissue change (치주질환에 이환된 환자에서 구치 상실 치열 수복을 위한 임플란트 수복)

  • Yi, Seung-Won;Kim, Young-Soo
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.53-63
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    • 2005
  • Number of fixtures supporting prosthesis for rehabilitation of partial edentulism in distal area is an important factor in distal area to the bone tissue response around dental implant. Optimal number and optimal positioning of dental implant has leaded to the stable condition of bone tissue and successful long-term treatment outcome. This clinical and radiographic study was performed to document and evaluate the short-term result of occlusal rehabilitation by means of implant-supported fixed prostheses (ISPs) especially for partial edentulism in distal area in patients treated for advanced periodontal disease and to verify the number of fixture affecting the bone tissue response. A total of 30 consecutive patients referred because of advanced periodontal disease were included. Before the implant therapy was initiated, periodontal treatment was performed and the outcome evaluated during at least a 6-month period. An individual maintenance care program was designed for each patient. All 75 implants were placed using a 2-stage surgical approach. The patients were divided into 2 groups, in one of which two fixtures were placed and in the other of which three fixtures were placed with tripodal geometry. Following installation of the ISPs, all patients underwent a baseline examination including evaluation of i) oral hygiene, and ii) periodontal/ peri-implant conditions, and iii) radiographs. These examinations were repeated annually during the 1 or 2-year observation period. The results were as follows: 1.No single implant was lost during the observation follow-up period. 1.The percentage of plaque harboring surfaces and bleeding units upon probing were found to be low (<10%), and no soft tissue complications were recorded. 1.Two-fixture group showed bone destruction ranged from 0.0mm to 1.5mm and the mean was 0.31mm. Three-fixture group showed more bone destruction of 0.51mm. There was no statistically difference between two groups. These results suggested that the factor for success is not the number of fixture but the strict maintenance of peri-implant tissue health and initial stability of fixture.