• 대한족부족관절학회지
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• 제8권2호
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• pp.126-130
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• 2004

Purpose: In this study, we tried to develop the technique of osteotomy for hallux valgus. The new modified technique of osteotomy was accomplished with even more greater stability, accurate correction of the deformity and more effective than 'chevron' osteotomy in terms of correction of the deformity. Materials and Methods: Between March 1998 and December 2001, 55 cases of new modified osteotomy for hallux valgus were performed for 39 patients, 16 of whom underwent operation of both feet. Operations were made for 34 women and 5 men whose average age was 46 years old (range, $20{\sim}71$ years). Average follow up period was three years (range, $2{\sim}5$ years), and during the follow up, the patients underwent physical examination and assessment with use of the American Orthpaedic Foot and Ankle Society's hallux-metatarso-phalangealinterphalangeal scale and standard foot radiographic measurements. Results: 37 patients (53 cases) out of 39 patients (55 cases) had no pain, good cosmesis, and all of the patients were satisfied with the results of the operation. Two had occasional mild discomfort. The average score according to the hallux-metatarso-phallangeal-interphalangeal scale was 93.2 points (range, $78{\sim}100$ points). The average preoperative intermetatarsal angle was $14.4^{\circ}$, which was decreased to $7.9^{\circ}$ after the osteotomy with an average correction of $6.5^{\circ}$ and The average preoperative hallux valgus angle was $34.1^{\circ}$, which was decreased to $11.1^{\circ}$ after the osteotomy with an average correction of $23^{\circ}$. This new modified technique would prevent the angulation or shortening at the osteotomy site and it was also even more stable at osteotomy site, and could do even more effective and accurate correction of the deformity than conventional Chevron osteotomy. Conclusion: New modified chevron osteotomy for the treatment of symptomatic hallux valgus was done in 55 cases, and the results were satisfactory in all cases. This method was more stable at the osteotomy site than conventional Chevron osteotomy and was also possible to do more accurate and more effective correction of the deformity. It was also easy to control the distal fragment of first metatarsal bone.

• 대한족부족관절학회지
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• 제14권1호
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• pp.11-15
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• 2010

Purpose: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. Materials and Methods: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. Results: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged $2.3{\pm}1.1$ rum postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). Conclusion: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.

• 대한족부족관절학회지
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• 제9권1호
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• pp.69-73
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• 2005

Purpose: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. Materials and Methods: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. Results: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. Conclusion: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

• 대한족부족관절학회지
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• 제9권1호
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• pp.87-93
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• 2005

Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

• 한국임상수의학회지
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• 제37권3호
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• pp.163-167
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• 2020

A 13-month-old, 3.3 kg castrated male Shih-tzu presented with right hindlimb lameness. The physical examination revealed atrophy of the right thigh muscles, hyperextension of the stifle joint and external torsion of the tibia. On the radiographic examination, patella alta and genu recurvatum were observed. A biapical deformity of the tibia and external torsion of the distal tibia were detected by computed tomography (CT). A three-dimensional (3D) printed bone model was designed and constructed for the preoperative plan prior to surgery. Rectus femoris muscle transposition, femoral shortening ostectomy and open wedge osteotomy of the distal tibia were performed using hybrid external skele/t0al fixation (hybrid-ESF). A dynamic stifle flexion apparatus was used to prevent recurrence of a quadriceps contracture (QC). Intense physiotherapy was administered postoperatively. The dog began to use the affected limb one week after surgery. Functional improvement in the affected limb was observed, and full weight-bearing was possible at 3 months after surgery. Union of the osteotomy lines was observed at 3 months, and the stifle joint was fully movable at 7 months after surgery. Regarding the treatments for QC, these methods may be excellent candidates, as they do not lead to severe damage to the limb or amputation.

• 대한족부족관절학회지
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• 제6권1호
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• pp.73-79
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• 2002

Purpose: To evaluate the effectiveness of callotasis using the external fixator for the treatment of brachymetatarsia. Materials and Methods: Eleven patients(15 cases) who underwent callotasis were available. Follow-up averaged 23 months(15-38 months). Both the patients' postoperative satisfaction and the postoperative radiographic results were retrospectively evaluated. Results: The duration from applying the external fixator to remove averaged 15 weeks (8-21 weeks). We did osteotomy again in two cases because of early consolidation at the osteotomy site during distraction period. All cases were evaluated mild claw toe deformity and motional pain in metatarsophalangeal joint, but all patients satisfied the postoperative results except one complained motional pain and stiffness in metatarsophalangeal joint. The metatarsal shortening averaged 13mm(9-18mm) before operation. The amount of distraction for shortened metatarsals averaged 15mm(5-22mm). We found the 6 cases of narrowing of the metatarsophalangeal joint, 2 cases of subluxation of the metatarsophalangeal joint. Conclusion: We think that callotasis with external fixator is good operative method for the brachymetatarsia.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.204-210
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• 2000

The mandibular contour determines the shape of the lower part of the face and thus influences the appearance of the face. A patient with a large, squarish, or broad face who desires a small, round, or slender face can undergo mandibular contouring surgery to reduce the width of the lower face. The successful correction of a prominent mandibular angle by conventional angle ostectomy has been reported. But, in the majority of patients with a widened facial appearance, both the mandibular angle and part of the mandibular body anterior to it are protuberant laterally, so both must be resected. The purpose of this study is to introduce a new method of performing mandibular contouring surgery, more effectively and easily, and to reduce postoperative complication and evaluate its results. We treated 6 patients who has prominent mandibular angle using multiple step osteotomy with angle-splitting ostectomy. The advantages of this new method are as following. (1) easily performable (2) effective mandibular contouring surgery by reducing the width of lower face (3) producing a natural relief of the mandibular angle (4) low risk of soft tissue damage and complications (5) shortening of the operation time. etc.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.539-544
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• 2011

Maxillary canting and vertical shortening of the unilateral mandibular ramus height is common in cases of severe facial asymmetry. Normally, mandibular distraction osteogenesis (DO) with horizontal osteotomy at the ascending ramus is used for vertical lengthening of the mandibular ramus to correct facial asymmetry with an absolute shortened ascending ramus. In this case report, vertical lengthening of the ascending ramus was performed successfully with unilateral DO and sagittal split ramus osteotomy (SSRO), where the posterior part of the distal segment can be distracted simultaneously in an inferior direction with maxillary DO, resulting in a lengthening of the medial pterygoid muscle. This case describes the acquired unilateral mandibular hypoplasia caused by a condylar fracture at an early age, which resulted in abnormal mandibular development that ultimately caused severe facial trismus. The treatment of this case included two-stage surgery consisting of bimaxillary distraction osteogenesis for gradual lengthening of the unilateral facial height followed by secondary orthognathic surgery to correct the transverse asymmetry. At the one year follow-up after SSRO, the vertical length was maintained without complications.

• 한국임상수의학회지
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• 제28권3호
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• pp.328-331
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• 2011

간헐적 전지 파행을 보이는 두 마리 개가 내원하였다. 신체 검사에서 약 $90^{\circ}$ 외측 회전을 동반한 전완 기형을 두 마리 모두에서 확인 하였다. 일반 방사선 사진에서 척골 원위부 아탈구, 요골 앞쪽 휨 현상, 짧아진 요골 척골, 및 앞발의 외측 회전을 확인하였다. 외측 회전을 동반한 전완 기형의 교정을 위해 척골 원위부 골절제와 요골 원위부 쐐기형 절골술 및 요골 원위부 내측 회전을 실시 하였다. 관절 부조화를 예방하기 위해 척골 근위부 절골술을 첫 번째 개에서 실시 하였다. 수술 후 정기 검진은 수의사의 신체 검사를 통해 실시 되었으며 두 마리 모두에서 수술과 관련한 합병 증상 및 파행이 없음을 확인하였다.

• 한국임상수의학회지
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• 제20권3호
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• pp.403-405
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• 2003

A 11 month-old Shihtzu was referred to the Veterinary Medical Teaching Hospital, Seoul National University. Clinical signs of this patient were lameness, shortening limb, angular deformity, rotation of foot, subluxaion of elbow joint and restricted range of movement of left forelimb. For the evaluation of the abnormalities of left forelimb, radiographic examination was carried out. Radiographic findings were characteristics of premature closure of distal ulna such as closure of distal ulna growth plate and cranial bowing of radius. With radiographic signs and physical examination, it was diagnosed as premature closure of growth plate of the left forelimb. After osteotomy of the radius and ostectomy of the ulna, radiographic evaluation of limb about angulation of elbow joint was performed every 2-3 weeks for 3 months. In case of premature closure of distal growth plate of ulna, radiography was very useful for diagnositic method of premature closure of distal ulna and monitoring of healing process.