• Title/Summary/Keyword: Orthopedic procedure

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Discomfort on Wearing Thigh-Length Compression Stockings in Orthopedic Surgical Patients (정형외과 수술환자의 대퇴길이 압박스타킹 착용 불편감)

  • Jung, Yun-Hwa;Min, Hye-Sook
    • Journal of muscle and joint health
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    • v.19 no.2
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    • pp.184-196
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    • 2012
  • Purpose: This study aimed to investigate the degree of discomfort and to identify factors related with discomfort in patients wearing thigh-length compression stockings after orthopedic surgery. Methods: The participants were 105 patients wearing thigh-length compression stockings after orthopedic surgery at two hospitals in B city. Data were collected by the scale of discomfort in wearing compression stockings from July 5 to October 20, 2011. Results: Mean score of discomfort on wearing compression stockings was significantly higher at post-op. day 3 than day 1 (t=-2.30, p=.004). Discomfort scores for 'itching skin' and 'tightened leg' items were higher than others. There was significant difference in discomfort at post-op. day 1 according to surgical regions. The total score of discomfort at post-op. day 3 was positively related with the body mass index (r=.20, p=.041). Conclusion: Wearing thigh-length compression stockings to prevent deep vein thrombosis may cause physical and psychological discomfort for orthopedic surgical patients. To reduce discomfort in wearing compression stockings, nurses need to intervene discomfort and problems related to the stockings post-operatively.

Treatment of Forearm Deformity caused by Hereditary Osteochondromatosis using Free Vascularized Fibular Epiphyseal Transplantation (생비골 성장판 이식술을 이용한 선천성 다발성 골연골증에서 전완부 변형의 치료)

  • Han, Chung-Soo;Yoo, Myung-Chul;Chung, Duke-Whan;Han, Hyun-Soo;Han, Soo-Hong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.60-67
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    • 1995
  • It is difficult to manage the growing deformity of forearm bone caused by hereditary osteochondromatosis in children, because deformity and discrepancy of limb length is progressive. The are many treatment methods of these problems including excisio of osteochondroma, lengthening of ulna, shortening of radius, corrective osteotomy with or without lengthening apparatus. Among many treatment methods, we tried free vascularized epiphyseal transplantation with the proximal fibular epiphysis in 3 patients of hereditary osteochondromatosis for inducement of continuous bone growth and deformity correction. The average duration of follow up was 7 years and 1 month, the shortest duration being to 4 years and 5 months and the longest 10 years and 8 months. Serial radiologic and clinical evaluation were carried out during follow up and there were satisfactory length gain, deformity correction and improvement of adjacent joint motion in 2 cases. According to our follow up evaluation, free vascularized epiphyseal transplantation is valuable procedure in forearm deformity of hereditary osteochondromatosis although it needs skillful and experienced operative technique.

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Traumatic Dynamic Hallux Varus (A Case Report) (외상성 역동적 무지 내반증(1예 보고))

  • Yim, Soo-Jae;Lee, Young-Koo;Kim, Jin-Su;Kim, Chan-Ho;Kang, Hee-Kyung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.193-196
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    • 2009
  • The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

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Secondary Septic Arthritis Due to Lateral Malleolar Bursitis -A Case Report- (외과 점액낭염에서 발생한 2차적 화농성 관절염 -증례보고 1예-)

  • Ji, Jong-Hoon;Kim, Weon-Yoo;Lee, Yean-Soo;Park, Sang-Eun;Ra, Ki-Hang;Kwon, Oh-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.274-278
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    • 2006
  • Lateral malleolar bursitis rarely progresses to septic arthritis. In our case, the 27 year old man visited due to progressive left ankle pain, despite the antibiotics treatment of lateral malleolar bursitis. 8 years ago, modified Brostrom procedure was performed owing to chronic ankle instability. Previous surgery altered anatomical structure of lateral ankle bursa, so it may cause the infection to spread to the ankle joint. We reported rare case of secondary septic arthritis caused by lateral malleolar bursitis.

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Percutaneous screw fixation and external stabilization as definitive surgical intervention for a pelvic ring injury combined with an acetabular fracture in the acute phase of polytrauma in Korea: a case report

  • Hohyoung Lee;Myung-Rae Cho;Suk-Kyoon Song;Euisun Yoon;Sungho Lee
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.298-303
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    • 2023
  • Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

Pyrocarbon hemiarthroplasty and the shoulder: biomechanical and clinical results of an emerging treatment option

  • Mohamad Y. Fares;Jaspal Singh;Peter Boufadel;Matthew R. Cohn;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.117-125
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    • 2024
  • While shoulder hemiarthroplasty is still used to treat young patients with shoulder pathology, the use of this procedure has substantially declined in recent years due to its significant complication profile. Glenoid wear with arthrosis is one of the major postoperative complications following shoulder hemiarthroplasty, and efforts to prevent this complication led many scientists to explore alternative weight-bearing surfaces on arthroplasty implants to decrease joint wear and improve patient outcomes. Pyrolytic carbon, or pyrocarbon, is a material that has better biocompatibility, survivorship, strength, and wear resistance compared to the materials used in traditional shoulder hemiarthroplasty. Pyrocarbon implants have been used in orthopedics for over 50 years; recently, their utility in shoulder hemiarthroplasty has garnered much interest. The purpose behind the use of pyrocarbon in shoulder hemiarthroplasty is to decrease the risk of progressive glenoid wear, especially in young active patients in whom joint preservation is important. Promising survivorship and outcomes have been demonstrated by recent studies, including limited glenoid wear following pyrocarbon hemiarthroplasty. Nevertheless, these clinical studies have been limited to relatively small case series with limited long-term follow-up. Accordingly, additional research and comparative studies need to be conducted in order to properly assess the therapeutic efficacy and value of pyrocarbon hemiarthroplasty.

Subcutaneous Fascial Pedicled Lateral Supramalleolar Flap (피하 근막 혈관경을 사용한 외측 과상부 피판술)

  • Rhee, Seung-Hwan;Chung, Moon-Sang;Baek, Goo-Hyun;Lee, Young-Ho;Gong, Hyun-Sik;Lee, Sang-Ki;Kim, Ji-Yeong;Park, Jong-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.68-74
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    • 2007
  • Soft-tissue reconstruction of the foot and ankle has long been a challenge for reconstructive surgeons. Limitations in the available local tissue and donor-site morbidity restrict the options. In an effort to solve these difficult problems, the authors have begun to use a subcutaneous fascial pedicled lateral supramalleolar flap. This report presents the authors' experience with five patients treated with this flap. The patients’ ages ranged from 26 to 72 years; four of the patients were male and one was female. The cause of the soft-tissue defects involved acute trauma and malignant melanom. All flaps survived and provided satisfactory coverage of the defect. Compared with the classic lateral supramalleolar flap, when the perforating branch is interrupted in its course, it is possible to elevate this subcutaneous fascial pedicled flap. The distally based flap with a compound pedicle which is continuous with a vascular axis and a band of subcutaneous fascial pedicle has long pedicle. This procedure is valuable for remote defect of the foot. It is believed that this flap is versatile and effective and is a good addition to the available techniques used by reconstructive surgeons for coverage of the foot and ankle.

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Morbidity of the Foot as a Free-Flap Donor Site (유리 피판 공여부로서 족부의 이병률)

  • Lee, Kwang-Suk;Wie, Dae-Gon;Han, Sang-Won
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.39-46
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    • 1997
  • The methods of clinical applications of the foot as a free-flap donor site includes microvascular toe-to-finger transfer, free neurovascular flap transfer, first web space flap transfer, and osteocutaneous free flap transfer. We have evaluated the results of treatment for 35 patients to be undergone a microvascular reconstructive procedure with the foot as a donor site from January 1982 to June 1996. The performed operations were 16 cases of thumb reconstruction with wrap around procedure, 3 cases of tenocutaneous flap transfer, 10 cases of dorsalis pedis flap transfer, 2 cases of first web space free flap and 4 cases of toe-to-finger transfer. The follow up study was 69 months in average. Regarding to the various donor sites, morbidity was divided into five different categories: Cosmesis, Functional loss, Sensory loss, Wound complication, and Pain. According to the results of examination(35 patients), the results was excellent(25), good(9), fair(1), and poor(0). Among the categories, morbidity was higher at cosmesis. The patients under 50 years were better outcome. Among the operative methods from the foot as a donor site, thumb reconstruction with wrap around procedure showed poorest outcomes. So, We conclude that the foot as a free flap donor site is a good source for the microvascular reconstructive surgery. But, Preoperative donor site evaluation, adequate operative technique and post operative management are essential to decrease the morbidity of donor site.

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The effects of a single-dose subacromial injection of a nonsteroidal anti-inflammatory drug in geriatric patients with subacromial impingement syndrome: a randomized double-blind study

  • Kim, Youngbea B;Lee, Woo-Seung;Won, Jun-Sung
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.4-8
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    • 2021
  • Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs. Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. The steroid group received a mixture of 1 mL of triamcinolone acetonide (40 mg/mL) and 1 mL of lidocaine hydrochloride 2%, while the NSAID group received a mixture of 1 mL of Ketorolac Tromethamine (30 mg/mL) and 1 mL of lidocaine hydrochloride 2%. The patients were assessed before and at 3, 6, and 12 weeks after the procedure. Shoulder scores from visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) were used for evaluation. Results: Both groups showed improvements in the clinical outcomes. Overall VAS, ASES, and UCLA scores improved from 6.9, 32.7, and 16.0 before the procedure to 2.0, 1.2, and 1.1; 81.5, 87.6, and 88.5; and 29.7, 31.8, and 32.0 at weeks 3, 6, and 12 weeks after the procedure, respectively. Twenty-six patients (86.7%) in the steroid group and 28 (93.3%) in the NSAID group reported satisfactory treatment outcomes. There were no significant differences in the outcomes between the two groups (p=0.671). Conclusions: Subacromial injection of NSAIDs for rotator cuff tendinitis with shoulder pain had equivalent outcomes with those of steroid injection at the 12-week follow-up.

Hemiarthroplasty for Osteosarcoma of Proximal Tibia (근위 경골의 골육종에 시행한 반관절성형술)

  • Jeon, Dae-Geun;Cho, Wan-Hyeong;Kim, Jin-Wook-;Koh, Han-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.9-14
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    • 2006
  • Purpose: The proximal tibial sarcoma patients, especially in their growing ages have problems of reconstruction. This study is to devise a methodology which can circumvent this limitations. Materials and Methods: Four cases of proximal tibial osteosarcoma underwent hemiarthroplasty. The mean age was 13 years (11~15) with a mean follow-up of 64 months (47~89). The procedure consists of ultrahigh molecular weight polyethylene (UHMWPE) liner as an substitute for the joint surface and this piece was fixed to the remaining tibial bone stock with Ender nail and bone cement. Results: Final functional score was 23.5 (78.3% of control) by MSTS criteria. All the cases showed stable joint without pain. Hemiarthroplasty related complications were absent. By saving the femoral physis, expected leg length discrepancy could be minimized by this procedure. Conclusions: Hemiarthroplasty of proximal tibia can be an option in pediatric sarcoma patients.

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