• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.254-261
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• 2000

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regenerated bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1994 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

• Clinics in Shoulder and Elbow
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• v.19 no.1
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• pp.43-47
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• 2016

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.75-78
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• 2023

During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixation when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.255-258
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• 2006

For the adequate intraarticular exposure in medial talar dome lesions, medial malleolar osteotomy is necessary in some cases. Many operative techniques including transverse, oblique, inverted V-shape, crescentic and step-cut osteotomies of the medial malleolus have been described previously. But their techniques have several problems such as nonunion, rotation and limited access to lesions. So we introduce the new reverse chevron medial malleolar osteotomy which provides excellent access to lesions, good stability and a broad cancellous surface for rapid healing.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.104-110
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• 2012

Purpose: Who may dare to state that optimal choice of treating nasal bone fracture is closed reduction? Few decades of authors' experience in nasal bone fracture has lead to believe that more active and assertive approach in nasal bone fracture by performing simultaneous lateral osteotomy may be applied in proper indications to acquire more accurate reduction and cosmetically satisfying result. Methods: From May 2008 to October 2009, among 241 nasal bone fracture patients, 20 patients underwent simultaneous lateral osteotomy with nasal bone fracture reduction. Followed by rigid septal correction, nasal cavity is packed to stabilize the fracture segment for safer osteotomy. Through intranasal incision, in selected cases of difficult reduction or for cosmetic purposes, various types of lateral osteotomy was performed corresponding to the fracture anatomy, conditions of the nasal cavity. Postoperative nasal packing was retained for one week and nasal dorsum splint for 3 weeks. Results: Lateral osteotomy was utilized for difficult cases of closed reduction, for correction of wide nose, hump and deviation in 9, 5, 2, and 4 cases, respectively. Patient satisfaction was scaled 90% in satisfaction and moderate in 10% (2 cases), complaining of mild nasal tip deviation. Physicians detected 2 cases of apparent deformity with patient recognition; one patient with mild step deformity at the osteotomy site and the other patient with minimal implant mobility. Conclusion: By accompanying profound understanding of the fracture anatomy, more active and assertive approach in nasal fracture reduction can be coincide with simultaneous lateral osteotomy to reduce the rate of secondary deformity and to obtain more cosmetically satisfying result.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.499-530
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• 2010

Purpose: Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. Methods: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously. Results: This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw. Conclusion: This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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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.

• The korean journal of orthodontics
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• v.38 no.1
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• pp.13-30
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• 2008

Objective: The objective of this study was to evaluate the displacement pattern and the stress distribution of the finite element model 3-D visualization during symphyseal widening according to the osteotomy position, osteotomy type, and distraction device. Methods: The kinds of distraction devices used were tooth-borne type, hybrid type, bone-borne type and tooth-borne type $30^{\circ}$ angulated, and the kinds of osteotomy design were vertical osteotomy line between the central incisors and step osteotomy line through the symphysis. Results: All reference points of the mandible including the condyles were displaced laterally irrespective of the osteotomy position, osteotomy method and distraction device. The anteroposterior or vertical displacements showed small differences between the groups. The widening pattern of the osteotomy line in the tooth-borne type of device was v shaped, and that of bone-borne type was a reverse v shape. However, the pattern in the hybrid type was parallel. The lateral displacement of the mandibular angle by the bone-borne device was more remarkable than the other types of devices. The displacement by the $30^{\circ}$ angulated tooth-borne type was different between the left and right sides in both the transverse and anteroposterior aspects. Conclusion: The design of the distraction devices and osteotomy line can influence the displacement pattern and the stress distribution during mandibular symphyseal distraction osteogenesis procedures.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.209-213
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• 1999

It is well known that tardy ulnar nerve palsy occurs with cubitus valgus deformity as a late complication after a nonunion of lateral condyle fracture of the humerus in childhood. On the other hand, cubitus varus deformity often results from malunion of supracondylar fractures of the humerus. However, reports of tardy ulnar nerve palsy in cubitus varus deformity are few. We report a patient with bilateral cubitus varus deformities with bilateral tardy ulnar nerve palsy which was confirmed with EMG. She was treated by step cut osteotomy(DeRosa and Graziano) with sub­cutaneous anterior transposition of ulnar nerve.

• The Journal of the Korean dental association
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• v.23 no.11 s.198
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• pp.979-986
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• 1985

This is a case report of orthognathic surgery for the correction of maxillary retrusion and mandibular protrusion. The summary and results are as follows, 1. The maxillary retrusion was corrected by LeFort I osteotomy. 2. The mandibular protrusion was corrected by sagittal split osteotomies in the rami. 3. And, for the correction of the discrepancy between max8llary and mandibular arches, the mandibular arch was widened by the midsymphyseal step osteotomy. 4. The ratios of horizontal changes of soft tissue to hard tissue at the points, Subnasale (Sn), Labrale superius (Ls), Labrale inferius (L9), and Supramentale (B) were 67.6%, 43.2$, 70.2% and 87.7%, respectively.