• Title/Summary/Keyword: Proximal phalanx

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

  • Young, Ki-Won;Lee, Kyung-Tai;Kim, Jae-Young;Cha, Seung-Do;Kim, Eung-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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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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The Usefulness of the Artificial Nail for Treatment of Fingertip Injuries (손가락끝 손상의 치료 시 인조손톱의 유용성)

  • Choi, Hwan-Jun;Kwon, Joon-Sung;Tark, Min-Seong
    • Archives of Plastic Surgery
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    • v.37 no.6
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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.

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

  • Han, Chung-Soo;Jeong, Bi-O;Kim, Man-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.138-141
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    • 2004
  • Osteochomdromas, which are uncommon in the hand, are encountered most frequently with hereditary multiple exostosis. They can occur away from the epiphyseal plate region at the distal end of the proximal and middle phalanges. But little has been written about exostosis that occur at the distal end of the distal phalnges. We report one case of hereditary multiple exostosis that arose at the distal end of the distal phalnges. Complete excision was done and the patient was disease-free of 4 years follow-up.

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

  • Suh, Dong-Hyun;Park, Yong-Wook;Kim, Do-Young;Lee, Sang-Soo;Seo, Young-Jin;Park, Hyun-Chul;Kang, Seung-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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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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Avascular Necrosis of the Fifth Metatarsal Head - A Case report - (제 5 중족골 두 무혈성 괴사 - 1례 보고 -)

  • Park, In-Heon;Song, Kyung-Won;Muhn, Young-Wan;Joe, Myoung-Il
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.1
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    • pp.44-47
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    • 2000
  • Freiberg's infarction involving the fifth metatarsal head is very rare condition. The authors experienced a case of avascular necrosis of the fifth metatarsal head and base of the proximal phalanx in a 27-year-old female patient. Involved bones were excised and internally fixed with 2 K-wires after autogenous cancellous bone grafting. Pain was relieved, and an excellent clinical result was obtained at the follow-up examination six months after the surgery.

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

  • Lee, Jong-Im
    • The Korean Journal of Cytopathology
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    • v.19 no.1
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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.

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

  • Yong-Uk Kwon;Young-Chae Seo;Ga-Won Jeon;Hyo-Young Lee
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.1
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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.

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

  • Kim, Suk Hoon;Chung, Kyu Rhim
    • The korean journal of orthodontics
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    • v.20 no.1
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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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Treatments of the Compartment Syndrome of the Foot after the Calcaneal Fractures (종골 골절후 발생한 족부 구획 증후군의 치료)

  • Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Jun, Deuk-Soo;Hwang, Pil-Sung
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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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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Surgical Treatment of Congenital Brachymetatarsia According to the Number of Affected Rays (이환된 열 수에 따른 선천성 중족골 단축증의 수술적 치료)

  • Chung, Moon-Sang;Baek, Goo-Hyun;Gong, Hyun-Sik;Oh, Joo-Han;Lee, Young-Ho;Yoon, Pil-Whan;Kim, Ji-Hyeung
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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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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