• Title/Summary/Keyword: Essential Surgery

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Total Ankle Arthroplasty in Ankle Arthritis with Coronal Plane Deformity (관상면 변형이 동반된 족관절염에서의 인공관절 치환술)

  • Yeo Kwon, Yoon;Kwang Hwan, Park;Jae Yong, Park
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.157-162
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    • 2022
  • Total ankle arthroplasty has become a viable motion-preserving alternative to ankle arthrodesis, especially in the last two decades. Recent improvements have been achieved in the strength of implant design and surgical technique. Nevertheless, addressing preoperative deformities is essential for successful outcomes of total ankle arthroplasty. Residual malalignment can produce instability and edge loading, causing acceleration of polyethylene wear, followed by osteolysis and an increased risk of revision surgery. Therefore, the accompanying deformities and their correction techniques need to be comprehensively elucidated and understood. In this article, we provide a review of the application of total ankle arthroplasty in arthritis with coronal plane varus and valgus deformities.

Ultrasound and clinical findings in the metacarpophalangeal joint assessment of show jumping horses in training

  • Yamada, Ana Lucia M.;Pinheiro, Marcelo;Marsiglia, Marilia F.;Hagen, Stefano Carlo F.;Baccarin, Raquel Yvonne A.;da Silva, Luis Claudio L.C.
    • Journal of Veterinary Science
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    • v.21 no.3
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    • pp.21.1-21.14
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    • 2020
  • Background: Physical exercise is known to cause significant joint changes. Thus, monitoring joint behavior of athletic horses is essential in early disorders recognition, allowing the proper management. Objectives: The aims of this study were to determine the morphological patterns, physical examination characteristics and ultrasound findings of show jumping horses in training and to establish a score-based examination model for physical and ultrasound follow-ups of metacarpophalangeal joint changes in these animals. Methods: A total of 52 metacarpophalangeal joints from 26 horses who were initially in the taming stage were evaluated, and the horses' athletic progression was monitored. The horses were evaluated by a physical examination and by B-mode and Doppler-mode ultrasound examinations, starting at time zero (T0), which occurred concomitantly with the beginning of training, and every 3 months thereafter for a follow-up period of 18 months. Results: The standardized examination model revealed an increase in the maximum joint flexion angles and higher scores on the physical and ultrasound examinations after scoring was performed by predefined assessment tools, especially between 3 and 6 months of evaluation, which was immediately after the horses started more intense training. The lameness score and the ultrasound examination score were slightly higher at the end of the study. Conclusions: The observed results were probably caused by the implementation of a training regimen and joint adaptation to physical conditioning. The joints most likely undergo a pre-osteoarthritic period due to work overload, which can manifest in a consistent or adaptive manner, as observed during this study. Thus, continuous monitoring of young athlete horses by physical and ultrasound examinations that can be scored is essential.

Hand Surgery Fellowship Selection Criteria: A National Fellowship Director Survey

  • Egro, Francesco M.;Vangala, Sai K.;Nguyen, Vu T.;Spiess, Alexander M.
    • Archives of Plastic Surgery
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    • v.44 no.5
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    • pp.428-433
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    • 2017
  • Background Candidate characteristics for hand surgery fellowship training remains unknown, as very little data is available in the literature. This study aims to provide information on the criteria that are employed to select candidates for the hand surgery fellowship match. Methods A 38-question survey was sent in April 2015 to all Accreditation Council for Graduate Medical Education recognized hand surgery fellowship program directors (n=81) involved in the U.S. match. The survey investigated factors used for the selection of applicants, including medical school, residency training, research experience, fellowship interview, and candidate characteristics. A 5-point Likert scale was used to grade 33 factors from "not at all important" (1) to "essential in making my decision" (5); or for five controversial factors from "very negative impact" (1) to "very positive impact in making my decision" (5). Results A total of 52% (42 out of 81) of responses were received from hand surgery fellowship program directors. The most important influential factors were interactions with faculty during interview and visit ($4.6{\pm}0.6$), interpersonal skills ($4.6{\pm}0.5$), overall interview performance in the selection process ($4.6{\pm}0.6$), professionalism and ethics ($4.6{\pm}0.7$), and letters of recommendation from hand surgeons ($4.5{\pm}0.7$). Factors that have a negative impact on the selection process include visa requirement ($2.1{\pm}1.2$), graduate of non-plastic surgery residency program ($2.4{\pm}1.3$), and graduate of a foreign medical school ($2.4{\pm}1.1$). Conclusions This study provides data on hand surgery fellowship directors' perception on the criteria important for fellowship applicant selection, and showed that interview-related criteria and letters of recommendation are the important factors.

Surgical approach for venous malformation in the head and neck

  • Ryu, Jeong Yeop;Eo, Pil Seon;Lee, Joon Seok;Lee, Jeong Woo;Lee, Seok Jong;Lee, Jong Min;Lee, Sang Yub;Huh, Seung;Kim, Ji Yoon;Chung, Ho Yun
    • Archives of Craniofacial Surgery
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    • v.20 no.5
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    • pp.304-309
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    • 2019
  • Background: Treatment for venous malformations of the head and neck includes sclerotherapy, surgical resection, or a combination of both. Surgical resection can remove or reduce the volume of vascular lesions; however, surgery can cause postoperative scarring and potential surgical complications. This study sought to determine the effectiveness of surgery for the treatment of venous malformations of the head and neck. Methods: A retrospective review of the medical records of patients who received surgeries for venous malformations of the head and neck from January 2011 to July 2019 was performed. Using clinical photographs, preoperative and postoperative Doppler ultrasonography, outpatient clinic records, and operation records, the postoperative result and complications were evaluated for each case. Results: Among patients who visited our vascular anomalies clinic, 43 patients (ratio of male to female= 24:19) received surgeries for venous malformations of the head and neck. Twenty-nine patients had undergone surgery only, five patients received sclerotherapy after surgery, and nine patients received surgery after preoperative sclerotherapy. In postoperative evaluations, the result was excellent in 24 patients, good in 18 patients, and poor in one patient. Four patients experienced a recurrence of lesions with lagophthalmos, drooping of the corner of the mouth, partial wound necrosis, and scar widening found in one patient each. Conclusion: Because the head and neck region is the most exposed area in the body, more active implementation of surgical treatments with or without sclerotherapy is essential to reduce the functional and cosmetic impairments associated with venous malformations.

Evaluation and treatment of facial feminization surgery: part I. forehead, orbits, eyebrows, eyes, and nose

  • Dang, Brian N.;Hu, Allison C.;Bertrand, Anthony A.;Chan, Candace H.;Jain, Nirbhay S.;Pfaff, Miles J.;Lee, James C.;Lee, Justine C.
    • Archives of Plastic Surgery
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    • v.48 no.5
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    • pp.503-510
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    • 2021
  • Facial feminization surgery (FFS) incorporates aesthetic and craniofacial surgical principles and techniques to feminize masculine facial features and facilitate gender transitioning. A detailed understanding of the defining male and female facial characteristics is essential for success. In this first part of a two-part series, we discuss key aspects of the general preoperative consultation that should be considered when evaluating the prospective facial feminization patient. Assessment of the forehead, orbits, hairline, eyebrows, eyes, and nose and the associated procedures, including scalp advancement, supraorbital rim reduction, setback of the anterior table of the frontal sinus, rhinoplasty, and soft tissue modifications of the upper and midface are discussed. In the second part of this series, bony manipulation of the midface, mandible, and chin, as well as soft tissue modification of the nasolabial complex and chondrolaryngoplasty are discussed. Finally, a review of the literature on patient-reported outcomes in this population following FFS is provided.

Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure (급성신부전이 발생한 중증 외상 환자에서 저분자량헤파린 투여 후 발생한 심각한 출혈 합병증)

  • Kyoung, Kyu-Hyouck;Kim, Woon-Won;Park, Sung-Jin;Kim, Ki-Hoon;Kim, Jin-Soo;Park, Jong-Kwon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.164-167
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    • 2011
  • Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

A Simulation System of Total Knee Replacement Surgery for Extracting 3D Surgical Parameters (슬관절 전치환술용 3차원 시술변수 추출 시스템)

  • Jun, Yong-Tae
    • Korean Journal of Computational Design and Engineering
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    • v.16 no.5
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    • pp.315-322
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    • 2011
  • The goal of total knee replacement (TKR) surgery is to replace patient's knee joint with artificial implants in order to restore normal knee joint functions. Since mismatched knee implants often cause a critical balancing problem and short durability, designing a well-fitted implant to a patient's knee joint is essential to improve surgical outcomes. We developed a software system that three-dimensionally (3D) simulates TKR surgery based upon 3D knee models reconstructed from computed tomography (CT) imaging. The main task of the system was to extract precise 3D anatomical parameters of a patient's knee that were directly used to determine a custom fit implant and to virtually perform TKR surgery. The virtual surgery was simulated by amputating a 3D knee model and positioning the determined implant components on the amputated knee. The test result shows that it is applicable to derive surgical parameters, determine individualized implant components, rehearse the whole surgical procedure, and train medical staff or students for actual TKR surgery. The feasibility and verification of the proposed system is described with examples.

Thoracic Sympathectomy for Facial Hyperhidrosis (안면다한증에서의 흉부교감신경 절제술)

  • Kim, Hae-Gyun;Lee, Du-Yeon;Baek, Hyo-Chae;Jo, Hyeon-Min
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1129-1132
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    • 1996
  • Excessive sweating of the face has a strong negative impact on the quality of life for many persons. We have experienced 10 patients with facial hyperhidrosis among the 150 essential hyperhidrosis patients They were 9 male and 1 fatale patients and their age range was 20 to 47 years(mean age 33.8 years). All patients, except one, received bilateral thoracic sympathectomy via VATS. One patient was done via minithoracotomy due to severe pleural adhesion. During the followup period, there was no recurence of facial sweating. Hone of the patients showed Horne 's syndrome.

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Chest Wall Lipoblastoma in a Nineteen-months-old Boy -A case report- (19개월 된 남아에서 발견된 흉벽 내 지방모세포종 - 1예 보고 -)

  • Lee, Jong-Mo;Kwon, Jong-Bum;Moon, Mi-Hyoung;Park, Kuhn
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.395-397
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    • 2007
  • Lipoblastoma is a rare benign mesenchymal tumor that occurs primarily in infancy and childhood. There are two types of lipoblastoma: focal or diffuse (lipoblastomatosis). This is typically located in the extremities, and less frequently in the trunk, head and neck, and the retroperitoneum. Lipoblastoma is a tumor with a good prognosis with no reported metastasis, despite of its potential for local invasion, local recurrence and rapid growth. Complete surgical resection is essential for treatment, and long term follow up is needed.

Erysipelas of the Upper Extremity Following Surgical Therapy for Breast Cancer (유방암 치료 후 발생한 상지의 단독)

  • Kwon, Ho;Kim, Hyung Jun;Jung, Sung No;Yim, Young Min
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.134-136
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    • 2007
  • Purpose: Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin, and erysipelas of upper extremity following breast cancer treatment has never been reported in the Korean literature. Methods: 39-year-old female presented to our hospital complaining of fever and painful swelling of her left upper extremity. She had a history of breast cancer and was treated with breast conserving surgery with axillary lymph node dissection, chemotherapy, and radiation. On physical examination, her left upper extremity showed vesicle, bullae, local heatness and erythema with well-defined margin. With these distinctive features of a skin lesion, we gave a diagnosis of erysipelas and started treatment with intravenous antibiotics. Results: Resolution of the signs and symptoms of erysipelas occurred after 7 days of treatment. Conclusion: The diagnosis of erysipelas with distinctive feature of skin lesion is essential and we emphasize that the prevention of any trauma are very important in these patients for prophylactic measures.