• 제목/요약/키워드: Surgical instability

검색결과 195건 처리시간 0.028초

Good functional results with open reduction and internal fixation for locked posterior shoulder fracture-dislocation: a case series

  • Nicolas Moran;Michael Marsalli;Mauricio Vargas;Joaquin De la Paz;Marco Cartaya
    • Clinics in Shoulder and Elbow
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    • 제25권4호
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    • pp.288-295
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    • 2022
  • Background: There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment. Methods: Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography. Results: Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis. Conclusions: Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.

견관절 인공관절 재치환술의 원인과 치료 (Etiology and Treatment of Revision Shoulder Arthroplasty)

  • 김영규;정규학
    • 대한정형외과학회지
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    • 제54권2호
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    • pp.100-109
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    • 2019
  • 견관절 인공관절 성형술의 빈도가 빠른 속도로 증가함에 따라 일차적 인공관절 성형술과 관련된 다양한 형태의 합병증이 발생하고, 이로 인해 재치환술 역시 증가하고 있는 추세이다. 견관절 인공관절 재치환술은 여러 원인에 의해 발생되는 것으로 알려져 있는데 일차적 인공관절 성형술 후 나타난 회전근 개 파열, 관절와 상완 관절의 불안정성, 관절와 또는 상완골 치완물의 해리, 인공 치환물의 실패, 치환물 주위 골절, 감염 등이 있다. 재치환술은 술기적으로 어려운 과제이다. 실패한 견관절 인공관절 성형술은 해결할 수 있는 외과적 선택이 많지 않다. 특히 관절와 골 결손 또는 봉합 불가능한 회전근 개 파열이 있는 경우에는 더욱 어렵다. 또한 재치환술의 결과는 일차적 성형술의 결과에 비해 항상 좋지 않다. 결국 외과의는 수술을 결정하기 전에 일차적 인공관절 성형술이 실패한 원인을 잘 파악하여야 한다. 따라서 본 논문에서는 실패한 일차적 인공관절 성형술 후 재치환술의 적응증에 대해 살펴보고 실패의 원인에 따른 재치환술의 술기에 대해 논의하고자 한다.

임상가를 위한 특집 4 - 턱교정수술에서 선수술접근 :적응증과 한계 (Surgery First Approach in Orthognathic Surgery : Indication and limitation)

  • 황대석
    • 대한치과의사협회지
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    • 제50권11호
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    • pp.682-688
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    • 2012
  • Surgery first approach in orthognathic surgery is to proceed the orthognathic surgery without preoperative orthodontic treatment. This approach has many advantages, which include a shorter total treatment period, a high level of patient satisfaction due to immediate post-surgical facial improvement, easy postoperative orthodontic treatment due to early normalization of skeletal muscle, and the rapid tooth movement reflecting the regional accelerated phenomenon. However instability due to transient occlusal interference after surgery make worse of long-term skeletal stability. Especially increasing of vertical occlusion caused by interference of interbicupid and molar happen postsurgical skeletal change. Until now, there is no common consensus about treatment protocol of surgery first approach in orthognathic surgery. The purpose of this paper is to introduce our treatment protocol of the surgery first approach and to evaluate indication and limitation with case analysis.

Gunshot Injury to the Anterior Arch of Atlas

  • Park, Jun-Hee;Kim, Hyeung-Sun;Kim, Seok-Won;Do, Nam-Yong
    • Journal of Korean Neurosurgical Society
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    • 제51권3호
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    • pp.164-166
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    • 2012
  • Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.

불안정 협심증의 외과적 치험;11례 보고 (Surgical Treatment of Unstable Angina; a Report of 11 Cases)

  • 최필조
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.349-354
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    • 1993
  • From July 1992 through January 1993, 11 patients with unstable angina received aorto-coronary bypass surgery at Dong-A University Hospital. There were 5 males and 6 females whose age ranged from 36 to 76 years old. Of the 11 patients, 3 were Functional class IL 5 were Functional class 111.3 were Functional class IV. Preoperative coronary angiography showed a significant stenosis of the left anterior descending artery in 9 cases, of its diagonal branch in I case, of the circumfiex artery in 3 cases, and of its obtuse marginal branch in 2 cases, of the right coronary artery in 4 cases, and of left main coronary artery in 3 cases. There were 4 cases of single vessel disease, 1 double vessel disease, 3 triple vessel disease and 3 left main disease. A single graft was placed in 1 patient, a double graft in 5, a triple graft in 2, and a quadriple graft in 3 patients. Left internal mammary artery plus saphenous vein graft were used in 4 patients. Postoperative complications were mediastinitis in 1, sternal instability in 2, pneumonia in 1, arrythmia in I case.

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An Introduction to the Septal Extension Graft

  • Kim, Myung-Hoon;Choi, Jeong-Hwan;Kim, Min-Su;Kim, Seok-Kwun;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • 제41권1호
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    • pp.29-34
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    • 2014
  • The septal extension graft is a very useful method of controlling nasal lengthening and tip projection, rotation, and shape by fixing a graft to the septum, which leads to a strong supporting structure. Enhancing graft stability is important for better long-term outcomes and minimizing complications or relapse, and even more efficient application of these methods is needed for East Asians who lack enough cartilage to be harvested in addition to possessing a weak cartilage framework. In this paper, the methods for overcoming the drawbacks of the septal extension graft, such as instability, a fixed tip, and insufficiency of cartilage, are presented, and the applications of each method for greater satisfaction with surgical outcomes are also discussed.

Surgical Tips to Preserve the Facet Joint during Microdiscectomy

  • Park, Man-Kyu;Kim, Kyoung-Tae;Cho, Dae-Chul;Sung, Joo-Kyung
    • Journal of Korean Neurosurgical Society
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    • 제54권4호
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    • pp.366-369
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    • 2013
  • Lumbar microdiscectomy (MD) is the gold standard for treatment of lumbar disc herniation. Generally, the surgeon attempts to protect the facet joint in hopes of avoiding postoperative pain/instability and secondary degenerative arthropathy. We believe that preserving the facet joint is especially important in young patients, owing to their life expectancy and activity. However, preserving the facet joint is not easy during lumbar MD. We propose several technical tips (superolateral extension of conventional laminotomy, oblique drilling for laminotomy, and additional foraminotomy) for facet joint preservation during lumbar MD.

Spinal Subdural Hemorrhage as a Cause of Post-Traumatic Delirium

  • Se, Young-Bem;Chun, Hyoung-Joon;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • 제43권5호
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    • pp.242-245
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    • 2008
  • A 64-year-old man with TBI was admitted to our institute. In following days, he showed unusual behavior of agitation, restlessness, emotional instability and inattention. Post-traumatic delirium was tentatively diagnosed, and donepezil was given for his cognitive dysfunction. Although there was partial relief of agitation, he sustained back pain despite medication. Lumbar magnetic resonance image revealed SDH along the whole lumbar spine, and surgical drainage was followed. Postoperatively, his agitation disappeared and further medication was discontinued. We report a unique case of post-traumatic delirium in a patient with concomitant TBI and spinal subdural hemorrhage (SDH) that resolved with operative drainage of spinal hemorrhage.

Pulmonary Artery Embolization of Intravenous Leiomyomatosis Extending into the Right Atrium

  • Lee, Sak;Kim, Do-Kyun;Narm, Kyoung-Shik;Cho, Sang-Ho
    • Journal of Chest Surgery
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    • 제44권3호
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    • pp.243-246
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    • 2011
  • A 43-year-old woman was diagnosed with an intravenous leiomyomatosis at a previous hospital and transferred to our hospital to undergo surgical treatment. Emergency one-stage operation for coincidental removal of intra-abdominal, right atrial, and intravenous masses were planned. Upon arriving at the operating room, she suffered a sudden onset of severe dyspnea and showed hemodynamic instability. Intraoperative TEE showed pulmonary embolization of a right atrial mass. Removal of the pulmonary artery mass and the intra-abdominal mass, and the cardiopulmonary bypass were performed without any complications.

거대설 치료를 위한 혀 중앙부 절제술 : 증례보고 (CENTRAL TONGUE REDUCTION FOR MACROGLOSSIA Il-Hyuk Chung, Seung-Il)

  • 정일혁;송승일;김은석
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권3호
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    • pp.191-194
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    • 2003
  • Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.