• 제목/요약/키워드: Proximal phalanx

검색결과 53건 처리시간 0.017초

봉합사 고정을 이용한 Akin 절골술 (Fixation with Suture Material in Akin Osteotomy)

  • 양기원;이경태;김재영;차승도;김응수
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.138-141
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    • 2004
  • Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

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손가락끝 손상의 치료 시 인조손톱의 유용성 (The Usefulness of the Artificial Nail for Treatment of Fingertip Injuries)

  • 최환준;권준성;탁민성
    • Archives of Plastic Surgery
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    • 제37권6호
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    • pp.788-794
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    • 2010
  • Purpose: The fingertip is the most commonly injured part of the hand and its injury frequently results in avulsion or crushing of a segment of the nail bed and fracture of the distal phalangeal bone. Restoration of a flat and smooth nail bed is essential for regrowth of a normal nail, which is important not only for cosmetic reasons but also for tactile capability of the fingertip. It is also anatomical reduction of the distal phalanx to promote patient's cosmetics and prevent nail bed deformity. Absence or no replacement of the nail plate results in obliterated proximal skin fold. When the avulsed nail plate cannot be returned to its anatomic position or when it is absent, we use a synthetic material for splinting the nail bed and alternative reductional method for distal phalangeal bone fracture, especially, instead of hardwares. Methods: From January of 2006 to June of 2009, a total of ten patients and fourteen fingers with crushing or avulsion injuries of the fingertip underwent using the artificial nails for finger splint. We shaped artificial nails into the appropriate sizes for use as fingernail plates. We placed them under the proximal skin fold and sutured to the fold proximally and to the lateral and medial edges of the nail bed or to the distal fingertip. Our splints were as hard as K-wire and other fixation methods and more similar to anatomic nail plates. Artificial nails were kept in place for at least 3 weeks. Results: No artificial nail related complication was noted in any of the ten cases. No other nail fold or nail bed complications were observed, except for minor distal nail deformity because of trauma. Conclusion: In conclusion, in order to secure the nail bed after injury and reduce the distal phalangeal bone fracture, preparing a nail bed splint from a artificial commercial nail is a cheap and effective method, especially, for crushed or avulsion injuries of the fingertip.

수부 원위지골 원위부 조갑하에 발생한 유전성 다발성 외골종 - 1례 보고- (Hereditary Multiple Exostosis at Distal Tip of Distal Phalanx -A Case Report-)

  • 한정수;정비오;김만호
    • 대한골관절종양학회지
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    • 제10권2호
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    • pp.138-141
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    • 2004
  • 골연골종은 수부에서는 매우 드문 질환이지만 유전성 다발성 외골종의 경우는 수지골, 특히 성장판 부위의 기저부에 빈번하게 발생하며 수지관절주위에 호발한다. 하지만 원위지골 원위부에 발생한 경우는 매우 드문 것으로 이에 대한 보고는 거의 없다. 저자들은 다발성 외골종의 가족력이 있는 10세 남아가 여러 관절 주위의 골성 종괴를 주소로 내원, 시행한 단순방사선 검사상 수부 원위지골의 원위부에 외골종이 관찰되어 이를 수술적 치료로 제거하고 문헌고찰과 함께 보고하고자 한다.

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동통을 동반한 제2 중족 족지 관절 불안정성의 치료경험 - 1예 보고 - (Surgical Treatment for Painful Instability of the Second Metatarsophalangeal Joint - 1 Case Report -)

  • 서동현;박용욱;김도영;이상수;서영진;박현철;강승완
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.204-207
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    • 2004
  • An unstable second metatarsophalangeal joint may produce pain in the forefoot. Plication of stretched lateral ligament and capsule and transfer of the extensor digitorum brevis under the transverse intermetatarsal ligament performed as the primary procedure to stabilize this painful joint. But the pain was not subsided and the proximal phalanx was resubluxated. So, we osteotomized the second metatarsal to restore a normal alignment of the second toe. Then the symptom was subsided. We report a case of painful instability of the metatarsophalangeal joint of the second toe.

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제 5 중족골 두 무혈성 괴사 - 1례 보고 - (Avascular Necrosis of the Fifth Metatarsal Head - A Case report -)

  • 박인헌;송경원;문영완;조명일
    • 대한족부족관절학회지
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    • 제4권1호
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    • pp.44-47
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    • 2000
  • 중족골 두의 무혈성 괴사는 병의 초기에 보존적 방법으로 치료를 시작하지만 질병이 진행된 상태이거나 보존적 요법에 반응하지 않는 경우 수술적 치료가 효과적이라고 알려져 있으나 수술 방법이 다양하며 중족골 두의 상태에 따라 선택의 여지가 많다. 제 5 중족골 두의 무혈성 괴사는 매우 발생빈도가 낮은 것으로 괴사가 진행되어 제 5 근위지골 기저부와 동반된 1례를 중족 족지 관전 유합술을 시행하여 만족할 만한 곁과를 얻었기에 이를 문헌 고찰과 함께 보고하는 바이다.

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건초거대세포종의 압착도말 및 세포흡인 세포소견 - 1예 보고 - (Touch Imprint and Fine Needle Aspiration Cytology of Giant Cell Tumor of Tendon Sheath - A Case Report -)

  • 이종임
    • 대한세포병리학회지
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    • 제19권1호
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    • pp.57-64
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    • 2008
  • Giant cell tumor of the tendon sheath (GCTTS) is a slowly growing, benign soft tissue tumor. The tumors occur predominantly on the hands and feet. Although the clinical and histopathologic features are well-defined, only a few reports have described the cytologic appearance of this entity. A 26-year-old woman presented with a gradually developing circumscribed soft tissue mass near the proximal phalanx of her left little finger for one year. Imprint and fine needle aspiration (FNA) smears were obtained from the excisional biopsy specimen. The imprint smears were composed of predominantly singly dispersed bland mononuclear cells and several giant cells. The mononuclear cells were polygonal to round, and they showed a histiocyte-like appearance. Osteoclast-type multinucleated giant cells of various sizes were randomly scattered throughout the smears, and these cells contained 3 to 50 nuclei. Nuclear atypia and pleomorphism were absent in both the single and giant cells. Loose aggregates of hemosiderin-laden macrophages and binuclear stromal cells were also seen. The cytologic features of the FNA smears were similar with those of the imprint, Additionally, the FNA smears contained several clumps of densely collagenous stromal tissue that were seldom noted in previously reported cytologic material. The cytologic features were well-correlated with the concurrent histologic findings and the diagnosis of GCTTS was made. When the clinical and radiologic datas are integrated, the diagnosis of GCTTS can be strongly suggested, based on the pre-operative cytologic specimen.

발가락 거대지 환자에게 7년에 걸쳐 시행한 단계적 수술: 증례 보고 (Two-Stage Operation Over a Period of 7 Years for a Patient with Macrodactyly: A Case Report)

  • 권용욱;서영채;전가원;이효영
    • 대한족부족관절학회지
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    • 제27권1호
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    • pp.24-29
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    • 2023
  • Macrodactyly of the toe is a rare congenital anomaly characterized by the overgrowth of a digit/digits in the foot and is one of the most difficult conditions to treat. Since the condition alters functionality and appearance, the treatment goal is to restore function and cosmetically enhance the appearance. Various surgical techniques are used for toe macrodactyly, including amputation, debulking, and epiphysiodesis. Herein, we present a case of a six-year-old patient with a second toe macrodactyly who was successfully treated with a two-stage operation over a seven-year period. We initially performed an ostectomy of the middle phalanx with a fusion of the proximal and distal phalanges and then performed a soft tissue debulking procedure.

정상교합자와 부정교합자의 골성숙도 차이에 관한 연구 (A STUDY ON THE DIFFERENCE OF THE SKELETAL MATURITY IN NORMAL OCCLUSION AND MALOCCLUSION)

  • 김석훈;정규림
    • 대한치과교정학회지
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    • 제20권1호
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    • pp.111-122
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    • 1990
  • To investigate the relationship of skeletal maturity among the normal occlusion group and each malocclusion groups, the author used hand and wrist X-ray of 133 Korean 13 year old boys (normal occlusion 30, Class I malocclusion 35, Class II malocclusion 35 and Class III malocclusion 33) and assessed their skeletal maturity. In this study, fourteen skeletal maturity stages were selected from; Radius, Hamate, Pisiform, Ulnar sesamoid of the metacarpophalangeal joint of the first thumb, proximal phalanges of the first, second and third finger, middle and distal phalanx of the third finger. The difference of skeletal maturity of each malocclusion groups in relative to normal occlusion group and that of each malocclusion groups were analyzed. The findings of this study can be summerized as follows: 1. Average skeletal maturity stage of each groups were MP3cap stage in normal occlusion group, H-2 stage in Class I malocclusion group, midstage between S and H-2 stage in Class II malocclusion group, MP3cap stage in Class III malocclusion group. 2. There was no significant difference in skeletal maturity of Class I malocclusion and Class III malocclusion groups in relative to normal occlusion group. 3. There was significant retardation of skeletal maturity in Class II malocclusion group in relative to normal occlusion group. 4. There was no significant difference in skeletal maturity between Class I and Class II malocclusion groups. 5. There was no significant difference in skeletal maturity between Class I and Class III malocclusion groups. 6. There was significant retardation of skeletal maturity in Class II malocclusion group in relative to Class III malocclusion group.

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종골 골절후 발생한 족부 구획 증후군의 치료 (Treatments of the Compartment Syndrome of the Foot after the Calcaneal Fractures)

  • 박용욱;정영기;유정한;전득수;황필성
    • 대한족부족관절학회지
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    • 제4권2호
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    • pp.93-99
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    • 2000
  • Eleven patients with calcaneal fracture had 2 acute compartment syndrome of the feet and 9 late complication of the compartment syndrome of the feet. An interstitial pressure of more than 30 mmHg in either the central or interosseous compartment was considered pathologic and was treated by fasciotomy performed medially. Rigid claw toe deformity was treated by excision of the head and neck of the proximal phalanx, dorsal capsular release of the metatarsophalangeal joint, and lengthening of the extensor tendon. Patients were evaluated at a mean of 35 months(range, 21 - 44 months) after operation, and the examination was directed specifically toward symptoms and signs of myoneural ischemia, and walking pain. At follow-up, 2 patients with acute compartment syndrome of the foot had no evidence of myoneural ischemia, 9 patients with claw toe deformity had no pain with walking. Based on our clinical observations, we concluded that compartment syndrome of the foot may occur after the calcaneal fracture and fasciotomy is effective treatment for the prevention of the long term sequelae of this debilitating condition.

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이환된 열 수에 따른 선천성 중족골 단축증의 수술적 치료 (Surgical Treatment of Congenital Brachymetatarsia According to the Number of Affected Rays)

  • 정문상;백구현;공현식;오주한;이영호;윤필환;김지형
    • 대한족부족관절학회지
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    • 제10권1호
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    • pp.24-30
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    • 2006
  • Purpose: To present our treatment protocol and surgical outcome for patients with congenital brachymetatarsia in which treatment was decided according to the number of affected rays. Materials and Methods: Sixty-nine metatarsals in 44 patients with single or multiple congenital brachymetatarsia were included in the study. When a single ray was affected in a foot, we performed a one-stage lengthening using an intercalary autogenous iliac bone graft. We overcame excessively short rays by the double level lengthening at the metatarsal and proximal phalanx as one stage. When multiple rays were affected in one foot, we performed a one-stage combined shortening and lengthening procedure without an iliac bone graft. Results: All patients were satisfied with the cosmetic and functional results. The average length gain by one-stage lengthening in 56 metatarsals of 38 patients was 14 (6-21) mm. Six patients with a combined shortening and lengthening procedure regained a nearly normal parabola of the involved foot. Neurovascular complication was not identified. Conclusion: Satisfactory results were achieved for the treatment of patients with congenital brachymetatarsia, by individualizing the surgical options according to the number of affected rays and general foot appearance.

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