• Title/Summary/Keyword: Scaphoid

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Anterior Screw Fixation using Herbert Screw for Type II Odontoid Process Fractures

  • Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.5
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    • pp.345-349
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    • 2005
  • Objective: Anterior screw fixation provides the best anatomical and functional results for type II odontoid process fracture (type II-A, II-N, and II-P) with intact transverse ligament. The purpose of this study is to evaluate the usefulness of the 4.5mm diameter, cannulated Herbert screw in anterior screw fixation. Methods: From Jan. 2003 to Feb. 2004, consecutive 10cases of type II odontoid process fractures were treated with anterior screw fixation using a Herbert screw. The Herbert screw has double threads, with different pitches on the distal and proximal ends. It has no head, so it can be inserted through articular cartilage and buried below bone surface. It was originally developed for treating scaphoid fractures. Results: There were 8male and 2female patients whose ages ranged from 15 to 67years (mean 42.1years). The fracture type was type II-A in 4patients, II-N in 3 patients, and II-P in 3 patients. The fracture line was oblique downward and backward in 6cases, oblique downward and forward in 1 case, and horizontal in 3cases. The range of follow-up was 5 to 18months (mean 12months). Bone fusions were achieved in all cases without any instrumental failures or postoperative complications. Conclusion: The Herbert screw is very useful in anterior fixation for type II odontoid process fracture. This series showed successful results also in type II-A odontoid fracture when treated with the Herbert screw, but further more studies are required.

Correction of Cryptotia by Triangular V-Y Advancement Flap and Rhomboid Flap (삼각형 V-Y피판 및 장사방형피판을 이용한 매몰귀의 교정)

  • Lee, Joon-Moon;Seo, Dong-Lin;Dhong, Eun-Sang;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.639-643
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    • 2010
  • Purpose: Cryptotia is a congenital deformity in which the upper third of the auricle is buried under the temporal skin. It is rare in Caucasians, yet it is more common in Asians. Although a variety of methods to treat cryptotia have been introduced, there is still no acceptable single procedure that can successfully manage this deformity in its entity. We present a triangular V-Y advancement flap and rhomboid flap for correcting cryptotia that can overcome the diverse shortcomings of the conventional methods. Methods: This operative method was used to correct 18 auricles in patients ranging in age from 4 to 33 years. A triangular flap was prepared over the auricle by making a skin incision according to Ohmori's method. Then a rhomboid flap with a side length of about 8 to 10 mm that sets the lower portion as a pedicle in the anterior region was prepared to supplement the contracted portion of the helix. The cartilage deformity was corrected by the banner flap or the radiating cartilage incisions with cartilage graft or high density polyethylene graft. Results: We have treated 16 patients with severe cryptotia using this method and have obtained good aesthetic results. All cases showed widened scaphoid fossa and smooth triangular fossa of antihelix. There were no major postoperative complications, such as necrosis or infection of the flaps. Conclusion: Correction of cryptotia using the triangular V-Y advancement flap and rhomboid flap is useful a method for certain conditions, when a severe contraction of the helix is present.

White radish and swine scapular cartilage models for auricular framework carving training

  • Hwang, Kun
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.225-228
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    • 2020
  • Background: The aim of this study is to develop a two-stage training module using radish and swine scapular cartilage for carving ear cartilage. Methods: In the first stage, white radish was cut in 3-6 mm thick slices. The ear cartilage framework was carved using a graver and the helix and antihelix were fixed with pins. In the second stage, swine scapular cartilage was obtained. The thickness varied 3-6 mm. The ear cartilage framework was made. And triangular fossa and scaphoid fossa were carved with graver. A curvilinear cartilage for helix was assembled to the framework by pin fixing. Six participants were recruited for an ear reconstruction training workshop and figures of the cartilage framework were provided. Participants were asked answer the pre-workshop questionnaire and post-workshop questionnaire on a Likert scale to rate their satisfaction with the outcome. Results: On the pre-workshop questionnaire, participants indicated that they did not have sufficient knowledge and skill for fabricating the ear cartilage framework (1.5±0.5 using white radish; 1.3±0.5 using swine scapular cartilage). On the post-workshop questionnaire, participants responded that they had learned useful knowledge from this workshop, reflecting a significant improvement (3.8±1.0 using white radish; 4.0±1.1 using swine scapular cartilage). They also indicated that they had become somewhat confident in this skill (4.2±0.8 using white radish; 4.3±0.5 using swine scapular cartilage. The participants generally found the workshop satisfactory (practically helpful, 4.7±0.5; knowledge improved, 4.8±0.4; satisfied with course, 4.5±0.5; would recommend to others, 4.8±0.4). Conclusion: This model can be useful for ear reconstruction training for medical personnel.

Correction of Cup Ear using the Mattress suture (매트리스봉합을 이용한 수축귀의 교정)

  • Jang, Soo Won;Lee, Jang Hyun;Choi, Seung Suk;Tak, Min Sung
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.118-121
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    • 2009
  • Purpose: Constricted ear, which is named by Tanzer includes lop ear, cup ear, and sort of prominent ear. It has classified three groups by Tanzer, especially grou I and IIA have been corrected by banner flap, Musgrave's technique, tumbling concha - cartilage flap, reversed banner flap and others. However, these techniques were too invasive for correcting mild degree of deformity. Therefore, we corrected the ear with mattress suture which is simple and less invasive. Method: The operations were done against 5 patients from 2005 March to 2008 April. All the cases were unilateral ears with constriction included helix and scaphoid fossa without difference in length between both ears. Though a posterior auricular skin incision, the folded cartilage is exposed and two parallel incisions on superior crus were made. After mattress suturing in cartilage, the superior crus of antihelix was formed and its force enables the folded portion to be in a normal anatomic position. Result: All of 5 patients got satisfactory results. There were no complications like hematoma or skin necrosis, and no recurrence during follow - up period(the average period was 9 months). And we couldn't recognize the difference between height of both auricles. Conclusion: Mattress suture is simple, less invasive, and suitable on correcting mild deformity of constricted ear with better result, so here we suggest the method.

Study of Suitable Angle of Tibia-Foot and X-ray Tube for Navicular in Foot X-ray Examination (족부 X선 검사에서 주상골 관찰에 용이한 Tibia-Foot angle과 X-ray tube 각도에 대한 연구)

  • Moon, Joo-Wan;Han, Jae-Bok;Choi, Nam-Gil
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.39-46
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    • 2018
  • The purpose of this study was to determine suitable angle of Tibia-foot and the X-ray tube for scaphoid in foot X-ray examination. A total of twenty patients(mean age $32.12{\pm}years)$ are participated in this study. In the positions of Foot AP, internal and external oblique, tibia-foot angle was defined as $90^{\circ}$ and $135^{\circ}$, and x-ray tube angle was defined as $0^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$ and $20^{\circ}$ respectively. The image quality was evaluated with blind test yielding scores ranging from 0 to 5 by the evaluation team consisted of 2 radiogical technologists, 2 radiologists, and 2 orthopedic surgeons. In case of Foot AP position, the degree of overlap between cuneiform and navicular was 3% and the blind test result was 4.89 at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle. When the tibia-foot angle is $135^{\circ}$, the degree of overlap was 5%, also the blind test result was 4.30 at $15^{\circ}$ X-ray tube angle. The degree of overlap and blind test result were 30% and 3.75 respectively at $0^{\circ}$ X-ray tube angle. In case of internal oblique position, at tibia-foot angle of $90^{\circ}$ and $0^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test result was 4.70. The 5% overlapping and highest score as 4.55 were obtained on tibia-foot angle of $135^{\circ}$ and $0^{\circ}$ X-ray tube angle. In case of external oblique position, at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test score was 4.85. The 5% overlapping and highest score as 4.75 were obtained on tibia-foot angle of $135^{\circ}$ and $15^{\circ}$ X-ray tube angle. In conclusion, we confirmed suitable angle of tibia-foot and X-ray tube for scaph46oid in foot X-ray examination in this study. These findings will be helpful for us to reading for navicular fracture.

Clinical Analysis of Fractures by Inline Skating Injury (인라인 스케이트시 발생된 골절의 임상적 고찰)

  • Choi Hyung Suk;Doh Hyun Woo;Lee Byung Ill;Min Kyung Dae;Rah Soo Kyun;Kim Yeon Ill;Seo Yoo Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.87-91
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    • 2004
  • Purpose: The purpose of this study is to investigate the incidence and patterns of fractures occurred in Inline skating accident. Materials and Method: We evaluated 20 patients, 20 cases(from september 2002 to August 2003) with fractures occurred during Inline skating. The incidence, sex, age, fracture site, associated injuries, causes of Inline skating injuries were analysed. The cases were male in 18(90$\%$), and female in 2(10$\%$). The most common distribution of age was in twenties and thirties. Result: The patients(12cases 60$\%$) with upper extremity fracture were more common than patients(8cases 40$\%$) with lower extremity fracture. Patients who had fracture in ankle were 35$\%$(7cases), forearm 20$\%$(4cases), wrist 20$\%$(4cases), elbow 15$\%$(3cases), thigh 5$\%$(1cases). According to the The Lauge-Hansen classification in ankle fractures there were four patients of supination-external rotation type, two patients of supination-abduction type, and 1 patient of pronation-external rotation type. In forearm and hand fractures, there were three distal radius fractures, one radio-ulnar shaft fracture, 2 scaphoid fractures, and two meta-carpal fractures. In elbow fractures, there were two supracondyle fractures, and one lateral condyle fracture. There were three epiphyseal plate injuries (Salt-Harris type II) in children, and all of them were treated by conservative method. Six fractures were intra-articular fractures. The most common associated injury was contusion(8cases 42.1$\%$). The number of patients who only rode Inline skating less than 3months(8cases 40$\%$) was the greatest. The number of non-contact injury(14cases, 70$\%$) in Inline skating was more than contact(6cases,30$\%$) injury. 11cases(55$\%$) had operative treatment, and 9cases(45$\%$) had conservative treatment, and there was not any complication. The more detailed study is required since the materials were only limited to fracture patients, and the follow up period was short. Conclusion: The most common age for fracture in Inline skating was in twenties, and thirties, and ankle was the most common fracture site.

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