• Title/Summary/Keyword: Suture technique

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Treatment of Achilles Tendon Rupture with Absorbable Suture (흡수성 봉합사를 이용한 아킬레스건 파열의 치료)

  • Kang, Chan;Hwang, Deuk-Soo;Hwang, Jung-Mo;Song, Jae-Hwang;Shin, Byung-Kon;Park, Jong-Hwa
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.115-118
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    • 2014
  • Purpose: The purpose of this study is to report on the result of repairing Achilles tendon using absorbable suture under nerve block. Materials and Methods: We retrospectively reviewed 20 patients with acute Achilles tendon rupture who were followed up for at least six months after the operation. We repaired Achilles tendon using two absorbable sutures using the Krackow technique for the proximal stump and the Kessler technique for the distal stump. A programmed postoperative management including non-weight bearing with a short leg cast for four weeks after the operation was applied for all patients. We evaluated clinical results using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) for satisfaction, range of motion of ankle, functional recovery rate, and the starting time of single heel raise. Results: The mean VAS score for satisfaction and AOFAS score was 9.2 and 93.0, respectively. The affected ankle showed a mean dorsiflexion rate of 90% and plantar-flexion rate of 94% compared to the uninjured side. The single heel raise could start at a mean of 3.5 months after the operation. Conclusion: Treatment of Achilles tendon rupture with absorbable suture material using the hybrid suture technique of proximal Krackow and distal Kessler showed sufficient stability and minimal chronic inflammatory reaction.

Arthroscopic Reduction of Subluxed Medial Meniscus using Suture Anchor for Restoration of Hoop Stress - Technical Note - (버팀테응력 회복을 위한 아탈구된 내측 반월상 연골의 Suture anchor를 이용한 정복술 - 술기 보고 -)

  • Kim, Jaw-Hwa;Lee, Yoon-Seok;Kim, Chul;Han, Seung-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.280-284
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    • 2009
  • Purpose: The authors introduce a new technique of arthroscopic reduction of subluxed medial meniscus using suture anchor for the restoration of hoop stress. Operative Technique: Anterolateral, anteromedial, and medial midpatellar arthroscopic portal are used. Arthroscope was inserted through anterolateral portal. Through the scope, we confirmed subluxation of medial meniscus. Transection of menisci including radial and root tear were excluded. We released the anterior horn of medial meniscus through anteromedial and burred the future insertion site of suture anchor. After inserting suture anchor through medial midpatellar portal, we used 90 degree suture hook and no.2 Nylon to retrieve the suture of inserted anchor. We tied the suture by sliding knot-tying method. Weight bearing was limited for 6 weeks postoperatively. Conclusion: Arthroscopic retightening of medial meniscus is less invasive, conserving and progressed method for subluxed meniscus.

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Functional Evaluation after Modified Brostrom Procedure with Suture Bridge Technique for Chronic Ankle Instability in Athletes (운동선수의 만성 발목관절 불안정성에서 교량형 봉합술을 이용한 변형 Brostrom 술식 후의 기능평가)

  • Park, Ji-Kang;Park, Kyoung-Jin;Cho, Byung-Ki;Im, Chae-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.108-114
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    • 2014
  • Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.

Reconstruction of a Traumatic Cleft Earlobe Using a Combination of the Inverted V-Shaped Excision Technique and Vertical Mattress Suture Method

  • Park, June Kyu;Kim, Kyung Sik;Kim, Seung Hong;Choi, Jun;Yang, Jeong Yeol
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.277-281
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    • 2017
  • Traumatic cleft earlobes are a common problem encountered by plastic and reconstructive surgeons. Various techniques have been reported for the repair of traumatic cleft earlobes. Usually, the techniques of split earlobe repair are divided into two categories, namely straight- and broken-line repairs. Straight-line repair is simple and easy, but scar contracture frequently results in notching of the inferior border of the lobule. It can be avoided by the broken-line repair such as Z-plasty, L-plasty, or a V-shaped flap. Between April 2016 and February 2017, six patients who presented with traumatic cleft earlobe underwent surgical correction using a combination of the inverted V-shaped excision technique and vertical mattress suture method. All the patients were female and had a unilateral complete cleft earlobe. No postoperative notching of the inferior border the lobule occurred during 6-16 months of follow-up. Without the use of a broken-line repair, both the patients and the operators attained aesthetically satisfactory results. Therefore, the combination of the inverted V-shaped excision technique and vertical mattress suture method is considered useful in the treatment of traumatic cleft earlobes.

Successful Surgical Treatment of Severe Lower Lip Avulsion in Two Cats

  • Jang, Kwangsik;Chae, Yangwon;Yang, Euisin;Jo, Hyun Min;Shim, Kyung Mi;Bae, Chunsik;Kang, Seong Soo;Kim, Se Eun
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.264-271
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    • 2022
  • Two Korean short-haired cats were admitted to the Veterinary Medical Teaching Hospital, Chonnam National University, with severe lower lip avulsion. In the first case, the treatment was performed using the tension-free suture technique with rubber tube stents. The second case was treated using the tension-free suture technique with rubber tube stents for lip avulsion and using the cerclage wiring technique for alveolar fracture. The teeth around the alveolar fracture were extracted and bone graft and collagen membrane were applied at the alveolar fracture site to stabilize the mandibular alveolar fracture. Thereafter, the cerclage wire was placed circumferentially around the mandible. In both cases, normal function of the oral cavity was successfully recovered by repairing the anatomic abnormality. In conclusion, tension-free suture technique can be a treatment option for bilateral lower lip avulsion in cats.

Alternative Technique of Aortic Valve Replacement -Implantation of Mechanical Aortic Valve at a Supra-Annular Level- (기계판막을 판륜상연에 위치시킨 대동맥판 치환술)

  • 최종범;이삼윤
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.504-509
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    • 1996
  • When a valve prosthesis is to be implanted in the aortic position, simple interrupted suture, figure-of- eight suture, or horizontal mattress suture technique is used as a suture method. However, the suture techniques may be unacceptable for aortic valve replacement in patients with friable annulus caused by some lesions, such as endocarditis and degenerative change. We used an alternative technique for the aortic vlave replacement in 4 patients with valve endocarditis, ) patients with degenerative valvular lesion, and 1 with rheumatic valvular disease. Mattress sutures through the annulus were placed with pledgets on the ventricular side of the annulus, whi h resulted in implantation of the prosthesis at a supra-annular level. Mechanical valves of 21 mm or larger were implanted in the supra-annular position in all patients and there was no impeded motion of leaflets during the follow-up period of mean 13.3 mouths. The transvalvular pressure gradient was less than 6 mm Hg in 3 patients and 20 to 40 mm Hg in 5 patients. The supra-annular implantation of mechanical aortic valve using a vertical mattress suture technique may be a useful alternative method of aortic valve replacement for the selected patients with friable or destroyed aortic annulus.

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Medial Horizontal Suture Fixation of the Akin Osteotomy: A Technical Report (Akin 절골술의 내측 횡 봉합사 고정: 술기 보고)

  • Yune, Young-Phil;Kim, Sanghwan
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.197-200
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    • 2015
  • The Akin osteotomy is a complimentary procedure in hallux valgus surgery. Surgical techniques may vary depending on the operators or fixation devices. Suture fixation, for which a removal procedure is not necessary, can often be recommended. However, there is a risk of failure due to the thin cortex of the phalanx. We describe a new technique using Ethibond suture fixation in Akin osteotomy, which can lower the risk of phalangeal cortical failure and articular cartilage irritation. First, the Akin osteotomy was performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. Then bone holes were drilled from dorsum to plantar parallel to osteotomy with the Kirschner wire. The final procedure involved passing the Ethibond sutures connected to a straight needle through the holes and tying it. This fixation method offers an effective and easy technique for performance of Akin osteotomy.

Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis

  • Colak, Ozlem;Kankaya, Yuksel;Sungur, Nezih;Ozer, Kadri;Gursoy, Koray;Serbetci, Kemal;Kocer, Ugur
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.228-234
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    • 2019
  • Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was $44.6{\pm}4.3N$ in group 1, $35.7{\pm}5.2N$ in group 2, and $56.7{\pm}17.3N$ in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.

Arthroscopic All-Inside Repair of Medial Meniscus Root Tear Using 18 Gauge Spinal Needle and Suture Anchor -A Report of Surgical Technique- (18 Gauge 척수 주사 바늘과 Suture Anchor를 이용한 내측 반월상 연골 경골 후방 부착부 파열의 관절경적 All-Inside 봉합술 - 수술 술기 보고 -)

  • Kim, Jong-Min;Jung, Sung-Hoon;Lee, Sang-Ho;Park, Byeong-Mun;Lee, Kil-Hyeong;Jeon, Ho-Seung
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.66-71
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    • 2012
  • The posterior root of medial meniscus maintains normal meniscal function by circumferential hoop tension and prevents extrusion of meniscus and progression of osteoarthritis. A complete tear of posterior root of medial meniscus leads to loss of hoop tension, it is important to repair it and preserve the function of the medial meniscus. Recently, a variety of arthroscopic assisted reduction and repair techniques have been used. We create an arthroscopic all-inside suture technique using a 18 gauge spinal needle and suture anchor that is easier and more convenient compared with the previous techniques. So we report this technique with a review of current literatures.

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