• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.95-99
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• 2013

We introduce arthroscopic Bankart repair technique using antegrade suture passer that can effectively restore detached anteroinferior capsulolabral complex for shoulder anterior instability. After diagnostic arthroscopy is performed using posterior, anteroinferior and anterosuperior portals, we confirm Bankart lesion and perform debridement and decortications of anteroinferior glenoid edge and neck. Suture anchor is inserted through anteroinferior portal at 2 mm medial side of glenoid edge (4:30 direction). Scorpion$^{TM}$ loaded suture is directly advanced to detached and retracted anteroinferior capsulolabral complex and the suture is passed at 10~15 mm medial side of detached anteroinferior capsulolabral complex (5:30 direction). The suture is retrieved by Scorpion's hook and then is tied using samsung medical center (SMC) sliding knot technique. Then suture anchors are serially inserted (2:30, 3:30) and capsulolabral complex repair is performed using suture hook and suttle-relay technique. This technique that can obtain anatomical restoration of anteroinferior glenohumeral ligament with proper tension is useful technique to reduce postoperative recurrence and makes it possible for less experienced surgeons.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.1-5
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• 2011

Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after operative treatment using endobuttons for unstable distal clavicle fractures. Materials and Methods: Between October 2007 and September 2009, 9 consecutive patients who were followed up for at least more than 12 months after operative treatment using a TightRope$^{(R)}$ were studied. The radiologic results on the serial plain radiographs and the clinical results according to the American Shoulder Elbow Surgeons (ASES) score were analyzed. Result: Bony union was shown in 8 cases (88.9%) and the average time to union was 12.9 (range: 9~16) weeks. The average coracoclavicular distances at the postoperative and final follow-up were 5.6 mm and 6.2 mm, respectively, with no statistically significant difference (p>0.05). The average ASES score was 90.3 (range: 78~96) and the clinical outcomes were 6 excellent, 2 good and one fair. There were no complications such as implant failure or infection except for one case of nonunion due to loss of the initial reduction. Conclusion: A major advantage of TightRope$^{(R)}$ fixation for unstable distal clavicle fractures is that no further surgery is needed to remove the implant. We suggest that this technique provides an alternative for fracture with a distal fragment, which is difficult to fix.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.136-141
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• 2021

Background: Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery. Methods: This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016. Results: AKI occurred in 13 (3.7%) of the 351 patients. The patients' preoperative estimated glomerular filtration rate (eGFR) was 66.66 ±34.02 mL/min/1.73 m² in the AKI group and 78.07±21.23 mL/min/1.73 m² in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02-0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61-0.89; p=0.002). Conclusion: Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.201-206
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• 1998

We reviewed 240 patients with facial bone fractures treated at the department of oral and maxillofacial surgery between Jan. 1. 1997 to Dec. 31. 1997. These results were obtained as follows : 1. The ratio of men to women was 3.5 : 1 2. The age frequency was highest for people in their 20's 34.2%, in their 10's 21.63%, and in their 30's 20.41%. 3. The fractures were at the highest incidence in September at 13.3%, followed by in May at 11.25%. 4. The frequent causes were traffic accidents 47.9%, fisticuffs 20%, accidents caused by falling or slipping 16.25%, working traumas 8.75%, and sports 7.1%. 5. The most common location of facial bone fractures was the mandible 67.2%. The frequent fracture sites of the mandible were symphysis, angle, condyle, and body in the order. 6. The associated injuries of facial bone fractures were neurosurgry, orthopedic surgery, cardiothoracic surgery, ophthalmic surgery and general surgery. 7. In respect of treatment, open reduction used 84.3% of the time. 8. Post operation complicatins were as follows : neurological problem 2.08%, malunion 1.67%, facial asymetry 0.83%, malocclusion 0.83%, and infection 0.41%.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.217-227
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• 1998

Calcium sulfate(plaster of Paris) has been used in dental and orthopedic surgery for about 100 years. It is well known that the plaster is bioresorbable, biocompatible, defect conformable and moldable. The purpose of this study is to evaluate two effects of calcium sulfate on bone regeneration, that is, the effects of graft materials and barrier for bone regeneration. Cortical bone defects were formed for recipient site on the femurs of 19 Sprague-Dawley rats. The autogenous particulated bone and calcium sulfate were grafted to the defects. Calcium sulfate paste, $Gore-Tex^R$ membrane(W.L. GORE & ASSOCIATES LTD., U.S.A.) and rubber sheet were used for the shielding materials. The results were as follows : 1. Calcium sulfate that had been grafted in the cortical bone defect was almost resorbed before bone remodeling, resultantly had little effect on bone regeneration. 2. Resoption process of calcium sulfate grafted on the bone grafting area tends to be accelerated, as being divided into numerous small particles progressively. Under the situation where the calcium sulfate was protected, with the coverage of fascia, $Gore-Tex^R$ membrane or rubber sheet, new bone formation was confirmed with presence of calcium sulfate particles over 6 weeks after grafting. 3. In the case of calcium sulfate covered with membrane, distinct bone formation was observed on the marrow space of femur adjacent to the plaster mass. 4. Rubber shielded plaster group revealed new bone trabeculae under the rubber sheet, but it showed ischemic degeneration of superficial cortical bone.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.479-483
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• 2018

Malignant peripheral nerve sheath tumor (MPNST) is a very rare type of sarcoma, with an incidence of 0.001%. MPNST has a 5-year survival rate near 80%, so successful reconstruction techniques are important to ensure the patient's quality of life. Sarcoma of the forearm is known for its poor prognosis, which leads to wider excision, making reconstruction even more challenging due to the unique anatomical structure and delicate function of the forearm. A 44-year-old male presented with a large mass that had two aspects, measuring $9{\times}6cm$ and $7{\times}5cm$, on the dorsal aspect of the right forearm. The extensor compartment muscles (EDM, EDC, EIP, EPB, EPL, ECRB, ECRL, APL) and invaded radius were resected with the mass. Tendon transfer of the entire extensor compartment with skin defect coverage using a $24{\times}8cm$ anterolateral thigh (ALT) perforator free flap was performed. The patient was discharged after 18 days without wound complications, and has not complained of discomfort during supination, pronation, or wrist extension/flexion through 3 years of follow-up. To our knowledge, this is the first report of successful reconstruction of the entire forearm extensor compartment with ALT free flap coverage after resection of MPNST.

• Physical Therapy Korea
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• v.5 no.2
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• pp.91-97
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• 1998

The purpose of this study is to introduce prosthetic discipline and ambulation training after hemipelvectomy due to osteosarcoma. Over the past years, when the malignant bone tumors occurs in the extremities amputation is not enough to prevent a part recurrence and distal transformation resulting in fatal prognosis. On the other hand, these procedures could bring about a difficulty in rehabilitation in curing patient who have had hemipelvectomy. However the recent development of chemotherapy and diagnostic facility have permitted the orthopedic surgeons to many try amputations for the treatment of the malignant bone tumors. Unfortunately, there has not been many researches on hemipelvectomy. Since there is no studies found on hemipelvectomy either. Therefore, we introduce successful procedures for rehabilitation through the ambulation training for patients who have had amputation. One of our patients, who is an eighteen years old male, has had hemipelvectomy on the eighteenth of June in 1997 after his anticancer treatment over 12 times. He has had physical therapy of prosthetic ambulation training at the department of rehabilitation medicine Yonsei University Medical Center from the fifteenth of October to December '2nd in 1997.

• Journal of Korean Clinical Nursing Research
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• v.18 no.1
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• pp.99-110
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• 2012

Purpose: The purpose of this study was to examine the puncture incidence of surgical gloves in an operational setting. Methods: The 277 surgical gloves were used collecting at one general hospital located in Seoul from February 1, 2011 to April 3. The data were analyzed by $x^2$ test, Fisher's exact test, and multiple logistic regression. Results: In the dental and orthopedic department, the puncture incidence were significantly higher than others. The time of wearing gloves demonstrated significant difference: The group 181-240 minutes had a significantly higher than those with under 90, 91-180, or over 240 minutes. The influencing factors were as follows. Compared to that of the 2nd assistants, the puncture incidence rates of the surgeons were 9.91 times, scrub nurses were 8.39 times higher respectively. The participants in work experience under 1 year showed a 4.58 times higher than those with over 7 years. In addition, compared to the puncture incidence rate of neurosurgery department, the 17.41 times in cardio-thoracic surgery, 13.89 times in dental surgery, 4.93 times in gynecology, and 4.97 times in orthopedics higher respectively. Conclusion: There is a need for training operational room personnels to occasionally exchange the gloves even during the procedure and to use double surgical gloves.

• Journal of Korean Neurosurgical Society
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• v.51 no.1
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• pp.66-70
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• 2012

Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thoracic spine without any radiographic guidance and present the results of pedicle screw placement analyzed by computed tomographic scan in two human cadavers. This free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.

• Archives of Reconstructive Microsurgery
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• v.25 no.1
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• pp.12-14
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• 2016

In cases of replantation, accurate closure of all structures, including bone, tendons, arteries, nerves, and veins is essential. Among these, the vein is a weaker structure and is damaged severely in most amputation cases. After fixation of bone, repair of tendons, nerves, and arteries, surgeons often experience difficulty in performing venous anastomoses. We found that in such cases, venous anastomosis is easy to perform using an additional incision after closure of the original wound. In a 33-year-old male patient with amputation of all four fingers at the metacarpophalangeal joint level, venous anastomoses were performed with dorsal veins using additional incisions after completion of the fixation of bones and repair of all other structures and closure of the skin due to surgical site tension.