• Title/Summary/Keyword: Surgical instability

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Osborne-Cotterill Lesion a Forgotten Injury: Review Article and Case Report

  • Vargas, Daniel Gaitan;Woodcock, Santiago;Porto, Guido Fierro;Gonzalez, Juan Carlos
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.27-30
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    • 2020
  • Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.

The humeral suspension technique: a novel operation for deltoid paralysis

  • de Joode, Stijn GCJ;Walbeehm, Ralf;Schotanus, Martijn GM;van Nie, Ferry A;van Rhijn, Lodewijk W;Samijo, Steven K
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.240-243
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    • 2022
  • Isolated deltoid paralysis is a rare pathology that can occur after axillary nerve injury due to shoulder trauma or infection. This condition leads to loss of deltoid function that can cause glenohumeral instability and inferior subluxation, resulting in rotator cuff muscle fatigue and pain. To establish dynamic glenohumeral stability, a novel technique was invented. Humeral suspension is achieved using a double button implant with non-resorbable high strength cords between the acromion and humeral head. This novel technique was used in two patients with isolated deltoid paralysis due to axillary nerve injury. The results indicate that the humeral suspension technique is a method that supports centralizing the humeral head and simultaneously dynamically stabilizes the glenohumeral joint. This approach yielded high patient satisfaction and reduced pain. Glenohumeral alignment was improved and remained intact 5 years postoperative. The humeral suspension technique is a promising surgical method for subluxated glenohumeral joint instability due to isolated deltoid paralysis.

Simultaneous Glossectomy with Orthognathic Surgery for Mandibular Prognathism

  • Jung, Young-Wook;On, Sung-Woon;Chung, Kyu-Rhim;Song, Seung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.5
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    • pp.214-218
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    • 2014
  • Macroglossia can create dental and skeletal instability after orthodontic treatment or orthognathic surgery for mandibular prognathism. In relevant literature, partial glossectomy is suggested for a good post-treatment prognosis. Most of the published partial glossectomy cases are two-staged surgery, because of concern about postoperative airway obstruction. As orthognathic surgical techniques and fixation method develop, however, concerns about postoperative airway obstruction have lessened. In this case, mandibular setback surgery and partial glossectomy were performed simultaneously, leading to stable recovery without any postoperative respiratory problems. After surgical technique to preserve the tongue tip, we achieved good outcomes without postoperative side effects of lingual hypoesthesia, pronunciation disorder and dyskinesia. We report this case with a literature review.

Clinical Applications of the Tubular Retractor on Spinal Disorders

  • Kim, Young-Baeg;Hyun, Seung-Jae
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.245-250
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    • 2007
  • Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.

Surgical Treatment of Spontaneous Pneumothorax by Thoracoscopic Wedge Resection with Fibrin Glue (비디오흉강경을 이용한 자연기흉의 치료시 국소적 Fibrin Glue 도포)

  • 신화균
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.812-816
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    • 2000
  • Background ; To evaluate the efficacy of Fibrin glue to decrease recurrence in video-assisted thoracoscopic surgery(VATS) for a treatment of spontaneous penumothorax. Material and Method : All medical records of 17 patients who underwent a thoracoscopic wedge resections of bullae with stapling device with Fibrin glue in our institute between May 1998 and December 1999 were reviewed. variables analyzed include affected sites primary indication of VATS. duration from admission to discharge duration of postoperative stay duration of chest tube drainage recurrence and complication. There were 16 men and 1 woman. Result : There was no evidence of hemodynamic instability or arterial blood gas abnormalities encountered during the procedure. Mean age at the time of the VATS was 26.9 years (range 15 to 61 years) The mean duration from admission to discharge was 7.8 days and mean postoperative stay was 5.1days mean chest tube indwelling period was 4..0 days. There was no recurrence of pneumothorx. Conclusion : Thoracoscopic wedge resections with introduction of fibrin glue are safe and effective and requires only a short hospital stay. We believe that this thoracoscopic technique will further simplify the surgical treatment of pneumothorax.

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Evidence-based Treatment of Acute Lateral Ankle Sprain (근거에 기반한 급성 발목관절 외측 염좌의 치료)

  • Cho, Byung-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.135-144
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    • 2018
  • Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

Extracranial Carotid-Vertebral Artery Bypass Technique and Surgical Outcomes

  • Lee, Jung Koo;Park, Ik Seong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.603-608
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    • 2022
  • Vertebral artery (VA) occlusion is frequently encountered, usually without acute ischemic injury of the brain. However, when it is accompanied by hypoplasia or stenosis of the opposite VA, brain ischemia may develop due to insufficient collateral supply. Both hemodynamic instability and embolic infarction can occur in VA occlusion, which may cause severe symptoms in a patient. Extracranial carotid-VA bypass should be considered for symptomatic VA occlusion patients, especially when the patient has repeated ischemic brain injuries. In this report, the cases of three extracranial carotid-VA bypass patients are introduced, along with a brief description of the surgical techniques. All three cases were treated with different bypass methods according to their disease location.

Three-column reconstruction through the posterior approach alone for the treatment of a severe lumbar burst fracture in Korea: a case report

  • Woo Seok Kim;Tae Seok Jeong;Woo Kyung Kim
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.290-294
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    • 2023
  • Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.

Fractures and Dislocations of the Cervicothoracic Junction

  • Kim, Jin-Wook;Jeong, Ju-Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.211-215
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    • 2007
  • Cervicothoracic junction instability should be stabilized with the circumferential fusion. In addition, cervicothoracic junctional area should be examined carefully in acute traumatic injury not only to confirm hidden lesions but also to make the proper surgical plans. Here, three patients who underwent cervicothoracic arthrodesis at our institution are presented with a review of literature.

Neonatal Cephalohematoma and Epidural Hematoma by Birth Trauma

  • Chung, Seok-Won;Park, Seong-Hyun;Hwang, Sung-Kyoo
    • Journal of Korean Neurosurgical Society
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    • v.39 no.6
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    • pp.464-466
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    • 2006
  • Cephalohematoma with epidural hematoma[EDH] is a known complication of birth trauma and is usually best managed by observation only. However, this complication may jeopardize a neonatal life because of cranial compromise and hemodynamic instability. It should also be recognized that surgical intervention confers undoubted benefits on patients in some cases. We report a case of massive EDH with cephalohematoma and linear skull fracture, successfully treated with a craniotomy and evacuation of the hematoma.