• Archives of Plastic Surgery
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• 제41권4호
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• pp.398-402
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• 2014

Background Non-incisional blepharoplasty is a simple, less invasive method for creating a more natural-appearing double eyelid than classical incisional blepharoplasty. However, in aging patients, non-incisional blepharoplasty is not effective due to more severe blepharochalasis. Traditionally, incisional blepharoplasty is a common surgical method used for older patients, but blepharoplasty in elderly patients typically results in prolonged recovery times, and final blepharoplasty lines may be located in unintended or asymmetrical positions. Here, we introduce a new modified combination technique for geriatric blepharoplasty. Methods A total of ten patients were treated from July 2010 through July 2012 using the combination method. First, we performed non-incisional blepharoplasty using tarsodermal fixation. Then, incisional blepharoplasty with additional elliptical excision of the upper eyelid skin was performed. We removed pretarsal tissue, fat, the orbicularis oculi muscle, and orbital fat. Telephone surveys were administered to all patients for follow-up. The questionnaire was composed of eight questions that addressed recurrence and satisfaction with aesthetics and the procedure. Results A total of nine patients (90%) responded to the telephone survey. All cases of moderate to severe blepharochalasia were corrected and there were no major complications. Patients who underwent blepharoplasty had higher satisfaction scores. All patients were satisfied with the postoperative shapes of their eyelids. Conclusions The advantages of the proposed technique include: ease of obtaining a natural-looking fold with symmetry at the desired point; reproducible methods that require short operation times; fast postoperative recovery that results in a natural-appearing double-eyelid line; and high patient satisfaction.

• 대한정형외과스포츠의학회지
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• 제4권2호
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• pp.133-137
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• 2005

주두 골절에 대한 치료적 수술 방법으로 장력대 강선 고정법은 골절의 고정과 유합에 유용한 방법으로 알려져 있으며, 이의 합병증으로 불유합, 운동 장애 및 강선의 피하 돌출 등이 보고되고 있으나 그 빈도는 많지 않다. 그 중 주관절의 회전 운동 장애에 대한 보고된 예가 없어 저자들은 전완 회내전과 회외전 장애를 각각 1례 경험하였기에 문헌고찰과 함께 보고하고자 한다.

• The Korean Journal of Pain
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• 제1권2호
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• pp.199-202
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• 1988

Secure fixation is essential for continous epidural catheterization on a long-term-basis. Adhesive tape or surgical knots were commonly used for those patients, but the surgical knot method has a tendency to cause strangulation of catheter. Another invasive technique, subcutaneous tissue tunnelling is more safe than other methods but requires sophisticated technique and time. We employed a simple device using a blood transfusion set for patients who have epidural catheters placed safely un their backs. In 120 patients treated for postoperative and chronic pain by means of this technique, the results were as follows: 1) Five of 120 patients (4.2%) developed backache and pruritus, but there were no instances of respiratory depression, local infection and headache. 2) Nine of 120 patients (7.5%) failed booster-injections, but two cases were due to be non-technical errors. 3) The duration of fixation was 1~3 days in most cases (85%), the longest being for 21 days.

• Clinics in Shoulder and Elbow
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• 제20권1호
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• pp.49-56
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• 2017

Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.

• Journal of Korean Neurosurgical Society
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• 제55권2호
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• pp.73-77
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• 2014

Objective : The purpose of this study was to evaluate the efficacy of implant removal of percutaneous short segment fixation after vertebral fracture consolidation in terms of motion preservation. Methods : Between May 2007 and January 2011, 44 patients underwent percutaneous short segment screw fixation due to a thoracolumbar burst fracture. Sixteen of these patients, who underwent implant removal 12 months after screw fixation, were enrolled in this study. Motor power was intact in all patients, despite significant vertebral height loss and canal compromise. The patients were divided into two groups by degree of osteoporosis : Group A (n=8), the non-osteoporotic group, and Group B (n=8), the osteoporotic group. Imaging and clinical findings including vertebral height loss, kyphotic angle, range of motion (ROM), and complications were analyzed. Results : Significant pain relief was achieved in both groups at final follow-up versus preoperative values. In terms of vertebral height loss, both groups showed significant improvement at 12 months after screw fixation and restored vertebral height was maintained to final follow-up in spite of some correction loss. ROM (measured using Cobb's method) in flexion and extension in Group A was $10.5^{\circ}$ ($19.5/9.0^{\circ}$) at last follow-up, and in Group B was $10.2^{\circ}$ ($18.8/8.6^{\circ}$) at last follow-up. Both groups showed marked improvement in ROM as compared with the screw fixation state, which was considered motionless. Conclusion : Removal of percutaneous implants after vertebral fracture consolidation can be an effective treatment to preserve motion regardless of osteoporosis for thoracolumbar burst fractures.

• 대한족부족관절학회지
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• 제9권1호
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• pp.99-104
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• 2005

Purpose: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. Materials and Methods: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. Results: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. Conclusion: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.346-352
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• 2012

Objective : We compared the radiological and clinical outcomes between patients who underwent posterior fixation alone and supplemented with fusion following the onset of thoracolumbar burst fractures. In addition, we also evaluated the necessity of posterolateral fusion for patients treated with posterior pedicle screw fixation. Methods : From January 2007 to December 2009, 46 consecutive patients with thoracolumbar burst fracture were included in this study. On the basis of posterolateral fusion, we divided our patients into the non-fusion group and the fusion group. The radiological assessment was performed according to the Cobb's method, and results were obtained at immediately, 3, 6, 12 months after surgery. The clinical outcomes were evaluated using the modified Mcnab criteria at the final follow-up. Results : The demographic data and the mean follow-up period were similar between the two groups. Patients of both groups achieved satisfactory clinical outcomes. The mean loss of kyphosis correction showed that patients of both groups experienced loss of correction with no respect to whether they underwent the posterolateral fusion. There was no significant difference in the degree of loss of correction at any time points of the follow-up between the two groups. In addition, we also compared the effect of fixed levels (i.e., short versus long segment) on loss of correction between the two groups and there was no significant difference. There were no major complications postoperatively and during follow-up period. Conclusion : We suggest that posterolateral fusion may be unnecessary for patients with thoracolumbar burst fractures who underwent posterior pedicle screw fixation.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.265-268
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• 2023

Ankle fractures with syndesmotic injuries often require fixation, where metal screw fixation is a popular method. However, as the patient begins weight-bearing, most syndesmotic screws tend to loosen or break, and removal of such screws has been challenging for the surgeons, as the available techniques require predrilling or trephination and are associated with risks of bone damage. This study presents a case with technical tip for the removal of broken tricortical-fixed non-cannulated syndesmotic screws. It implements the generation of a small cortical window in the medial distal tibia and the use of pliers to engage the screw tip and remove through the medial side. The technique presented in the current study overcomes these limitations and facilitates minimal bone damage and reduced exposure to radiation.

• 대한족부족관절학회지
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• 제5권1호
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• pp.35-42
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• 2001

Purpose: To analyze the results of conservative or surgical treatment after computed tomograhy(CT) classification in intraarticular calcaneal fractures. Materials and methods: From January 1996 to May 1999, we prospectively analyze 23 cases of intraarticular calcaneal fractures who were treated conservatively or operated by open reduction and internal fixation by extensive L-shaped lateral approach after CT classification. Results: A functional scoring system of 0-100 points which was based upon the responses to AOFAS Ankle-Hindfoot Scale for the operative group was at 82.8, compared with 73.2 for the non-operative group, and these were meaningful statistically(P<0.05). Of type I fracture, in the operative group there were 2 excellent results and in the non-operative group there were 2 excellent results, 1 good result. or type II fractures, in the operative group there were 2 excellent results, 3 good results, 1 fair result and in the non-operative group there were 1 good result, 1 fair result, 2 poor results. Of type III fractures, in the operative group there were 2 fair results, 2 poor results and in the non-operative group there were 1 fair result, 3 poor results. Bohler angles of subtalar joint were changed from initial average $13.3^{\circ}$ to postoperative average $20.9^{\circ}$ for the operative group compared with from initial average $15.5^{\circ}$ to follow-up average $14.8^{\circ}$ of the non-operative group(P<0.01). Conclusions: Computed tomography in the evaluation of intraarticular calcaneal fractures is effective tool. We believed that open reduction and internal fixation in all Crosby & Fitzgibbons type II and according to degrees of comminution reducible type III for the intraarticular calcaneal fractures is more effective method than conservative treatment.

• 대한의용생체공학회:의공학회지
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• 제25권6호
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• pp.531-536
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• 2004

외고정장치를 이용한 골절 치료에서, 골절 부위에서의 절골편간 운동은 골절의 치유과정에 다양한 영향을 미친다고 알려져 있고, 이 미세 운동은 외고정장치-절골편 시스템의 강성과 밀접한 관련이 있다. 그렇기 때문에 최적의 골절 치유 과정을 부여하기 위하여 외고정장치 시스템의 구성 인자와 강성과의 연관성에 대한 이해가 필요하다. 본 연구에서는 장골 골절의 외고정술에 대한 유한요소 해석에서 외고정장치 시스템의 구성인자가 시스템 강성에 미치는 영향을 조사하였다. 이를 위하여, 시스템 정렬, 재료 비선형성, 조인트 유연성 및 가골형성 등을 해석 인자로 선정하였다. 개발된 유한요소 모델은 실험 결과와 유사한 시스템 강성을 나타내었고, 조인트 유연성 및 재료 비선형성의 고려는 시스템 강성 결과를 더욱 정확하게 반영하였다. 시스템 비정렬상태, 조인트 유연성 및 재료 비선형성은 시스템 강성의 감소를, 그리고 골절 부위의 가골형성은 시스템 강성의 증가를 나타내었다. 본 연구 결과는 외고정술시 시스템 강성을 증가시키기 위한 프레임 구성이나 기구 설계 등의 도구로 사용될 수 있을 것으로 기대된다.