• Title/Summary/Keyword: Surgery, technique

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Surgical Outcome of Achilles Reconstruction Using Allotendon and a Calcaneal Tunneling Technique in Patients with Chronic Achilles Rupture (동종건과 종골 터널을 이용한 만성 아킬레스건 파열 환자의 아킬레스건 재건술의 수술적 결과)

  • Gab-Lae Kim;Sung-Yup Hong;Jung Hyun Cho;Tong Young Yoon
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.15-20
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    • 2024
  • Purpose: Achilles tendon rupture is a frequently encountered ankle pathology associated with a substantial burden of intense pain and functional deficits. Chronic Achilles tendon ruptures with considerable defects pose intricate repair challenges that are often marred by complications such as re-rupture and persistent pain. Various treatment methods, including allograft transplantation, have been proposed, but the literature on this technique is limited. In this study, we propose a surgical approach utilizing allotendon transplantation and a calcaneal tunneling technique and provide clinical evaluation details. Materials and Methods: Fifteen patients with chronic Achilles tendon ruptures treated with allotendon between 2020 and 2022 were included in the study. Patients were evaluated at 1, 3, and 6 months postoperatively using Visual Analog Scale (VAS) scores and Achilles Tendon Total Rupture Scores (ATRSs). Complications were assessed postoperatively. Results: The average VAS score was 7 before surgery, 7.3 immediately after surgery, and 4.3 at 1 month, 2.5 at 3 months, and 1.3 at 6 months after surgery. Because the sample was limited to 15 individuals and distributions were non-normal, the analysis was conducted using the non-parametric Wilcoxon's signed-rank test, and statistical significance was accepted for p-values<0.05. Results showed a significant improvement in ATRS and VAS scores versus preoperative and immediate postoperative values. VAS scores showed a decreasing trend after surgery, whereas average ATRS scores increased from 14 before surgery, 33.8 at 1 month, 82.7 at 3 months, and 93.9 at 6 months. Conclusion: This study suggests that allograft transplantation using the described calcaneal tunnel technique provides an effective treatment for chronic Achilles tendon ruptures. However, extensive research and long-term clinical trials are required to validate and better understand the technique's efficacy.

Development of New Orthognathic Model Surgery Technique Based on the Reference Points onto the Teeth and the Use of Occlusal Index (치아 기준의 악교정 수술용 석고모형 수술, 과연 가능하고 정확한가)

  • Lee, Seung-Hoon;Oh, Seong-Seob;Yi, Choong-Kook;Park, Kyung-Ran;Lee, Sang-Hwy
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.128-136
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    • 2011
  • Purpose: Errors in orthognathic model surgery occur during the planning, measuring and/or moving of the models. However, there has been little effort to find ways to reduce these errors. In this study, we introduce a new orthognathic model surgery technique (Yonsei method) which adopts the tooth point as the reference and the occlusal index as a moving vehicle for the model. Methods: The technique consists mainly of: 1) measuring the three-dimensional lengths of model points, 2) fabricating and moving the occlusal index and 3) verifying the movement. Then we compared the accuracy of the Yonsei method to conventional methods, with special reference made to influencing factors. Results: Errors for the Yonsei method with the occlusal index were reduced to the range of 0.61~1.04 mm in three-dimension, providing a more accurate model surgery technique than conventional methods which have errors ranging from 0.77~3.11 mm. Conclusion: It provided us a more accurate model surgery technique based on the reference points onto the teeth and the use of occlusal index.

Tricuspid Valve Re-Repair in Ebstein Anomaly Using the Cone Technique

  • Kim, Do Jung;Suh, Jee Won;Shin, Yu Rim;Shin, Hong Ju;Park, Han Ki
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.35-38
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    • 2016
  • The management of recurrent tricuspid regurgitation after tricuspid valve repair in patients with Ebstein anomaly is difficult, and tricuspid valve replacement is most commonly performed in such patients. We report two cases of recurrent tricuspid regurgitation in patients with Ebstein anomaly that were successfully re-repaired using the cone technique. The cone repair technique is a useful surgical method for reconstructing a competent tricuspid valve, and can be applied in patients who have undergone previous tricuspid valve repair.

Convenient Suture Technique for Pediatric Facial Lacerations (소아 안면열상 환자의 치료에 있어서 유용한 봉합술)

  • Kim, Jun-Hyung;Kwon, Soon-Beom;Eo, Su-Rak;Cho, Sang-Hun;Markowitz, Bernard L.
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.496-498
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    • 2010
  • Purpose: Lacerations requiring formal wound closure compose a significant number of all childhood injuries presenting to the emergency department. The problem with conventional suture technique are that suture removal is quite cumbersome, especially in children. Unwanted soft tissue damage can result in the process of suture removal, which calls for sedation, stressful for both medical personnel and child. The purpose of this study is to introduce the convenient suture technique for pediatric facial lacerations. Methods: Children under the age of four, presenting to the emergency department with facial lacerations were enrolled in the study. From March 2008 to June 2009, 63 patients (41 males and 22 females) with an average age of 1.4 years were treated with our convenient suture technique using utilized a loop suspended above a double, flat tie. Clean, tension free wounds were treated with our technique, wounds with significant skin defect and concomitant fractures were excluded. Results: The Patients were followed-up in 1, 3 and 5 days postoperatively. On the third hospital visit, suture removal was done by simply cutting the loop suspended above the wound margin and gently pulling the thread with forceps. There were no significant differences in the rates of infection and dehiscence compared with conventional suture technique. Conclusion: The use of our technique was to be simple with similar operative time compared with conventional suture technique. Removal of suture materials were easy without unwanted injuries to the surrounding tissue which resulted in less discomfort for the patient and greater parental satisfaction, minimized the complications. It can be considered as a viable alternative in the repair of pediatric facial lacerations.

Meek Micrografting Technique for Reconstruction of Extensive Necrotizing Fasciitis of the Anterior Abdomen and Bilateral Femoral Region: A Case Report

  • Jyi Cheng Ng;Ahmad Ibrahim Ahmad Zaidi;Jun De Lee;Mohd Faisal Jabar
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.610-614
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    • 2023
  • Necrotizing fasciitis is an uncommon yet fatal soft tissue infection. Current recommended treatment includes antibiotics with repeat surgical exploration and wound debridement followed by reconstruction. In burn patients, the Meek micrograft has demonstrated a higher true expansion ratio, faster reepithelialization rate, more resilient toward infection, and reduced risk of graft failure as compared with meshed graft. To our best knowledge, the use of Meek micrografting technique in reconstruction of postdebridement wounds of necrotizing fasciitis has not been reported. Hereby, we present a case of a 57-year-old gentleman who was referred to us for wound reconstruction after surgical debridement of Fournier's gangrene and extensive necrotizing fasciitis involving the anterior abdomen and bilateral femoral region. Meek micrografting technique was used to reconstruct the anterior abdomen as the wound bed was large. Although the graft was complicated with a small area of localized infection, it did not spread across the entire graft and was successfully treated with topical antibiotics and regular wound dressing. In our case, wound reconstruction using Meek micrografting technique in a patient with extensive necrotizing fasciitis was successful and showed positive outcome. Therefore, we suggest further studies to be conducted to investigate the applications and outcomes of the Meek micrografting technique, especially in patients with extensive wound bed and limited donor site availability.

Long Gap Esophageal Atresia Successfully Treated by Esophageal Lengthening Using External Traction Sutures (간격이 긴 식도 무공증에서 외부 견인술을 이용한 조기 문합 1예)

  • Lee, Doo-Sun;NamGung, Hwan;Yoon, Jung-Suk
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.165-170
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    • 2005
  • The repair of esophageal atresia with a long gap continues to pose difficulties for the surgeon. There is a general agreement that the child's own esophagus is the best, however, primary repair is not always possible. Foker JE et al. (1997) developed a technique of esophageal lengthening using external traction sutures. We successfully treated one patient with a 4.5cm gap esophageal atresia (4 vertebral spaces) using the external traction suture technique.

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New Atrial Anastomosis Technique for an Inadequate Left Atrial Cuff in Lung Transplantation

  • Son, JeongA;Hyun, Seungji;Haam, Seokjin;Kim, Do Hyung
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.425-427
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    • 2022
  • In lung transplantation surgery, the pulmonary veins are anastomosed by connecting each atrium of the donor and recipient. However, occasionally the recipient's left atrium is not suitable for anastomosis for various reasons. In these cases, several techniques for atrial anastomosis have been introduced, but these are somewhat complicated for an inexperienced surgeon. Here, we propose a new atrial anastomosis technique that is easier and safer than previously introduced techniques.

Computer-assisted Virtual Surgery and Splint Fabrication for Paediatric Mandible Fracture

  • Lee, Jung-woo
    • Journal of International Society for Simulation Surgery
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    • v.2 no.2
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    • pp.87-89
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    • 2015
  • Closed reduction using acrylic splints with circummandibular fixation has been known to be useful techniques in pediatric mandibular fractures. However, this technique has some shortcomings, including needs for impression taking or additional laboratory process, which can increase the exposure time of general anesthesia or make an additional sedation visit. Recently, the advancement of computer-aided maxillofacial surgery offers to clinicians to expansion of its application. This case report represents a technique of computer-assisted virtual reconstruction and computer-aided designed splint fabrication in a 2-year-old boy with mandibular body fracture.