• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.543-547
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• 2007

The lips and corners of the mouth are not only important for appearance but are also essential for facial expression, speech, and nutrition. Defects in these areas can be caused by congenital clefts of the lip and face, trauma, infection, cysts, and excision of benign or malignant tumors. Numerous techniques have been introduced for reconstruction of the lips and corners of the mouth, and in particular, techniques such as the Kazanjian Roopenian I and II, Converse method, Zisser method, Platz and Wepner method. Gillies and Millard method are commonly utilized for elongation and reconstruction of the mouth corner. Few reports exist in the oral and maxillofacial surgery literature regarding correction of microsomia and reconstruction of the corners of the mouth. As such, the authors report a case of the corners of the mouth elongation in a patient with burn-induced microstomia using the Converse flap which yielded a satisfactory outcome.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.124-128
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• 2014

Purpose: The purpose of this study was to assess the treatment outcomes and prognosis of Lisfranc joint fracture and dislocation according to the mechanism of injury and treatment method. Materials and Methods: Twenty six patients with Lisfranc fracture-dislocation who had been treated surgically were included in this retrospective study. The patients were divided into two groups according to mechanism of injury: direct crushing injury (16 patients) and indirect rotational or compressive injury (10 patients). The patients were also divided into three groups according to the surgical methods. The parameters used were radiographic evaluation, patients' subjective satisfaction levels, length of hospital stay, and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Statistical analysis was performed. Results: The mean postoperative AOFAS midfoot score was 78.7. The mean length of stay was 39.6 days. Statistically significant differences in subjective satisfaction, AOFAS midfoot score, and length of hospital stay were observed between the two groups (p<0.05). However, no significance differences were observed between the three groups who were divided according to the different surgical methods (p>0.05). Conclusion: Mechanism of trauma and the severity of soft-tissue injury were significant prognostic factors affecting the surgical outcomes of Lisfranc joint fracture and dislocation.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.264-271
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• 2013

Purpose: We aimed to analyze the effect of fixation tightness of the syndesmotic screw and its indwelling period on the recurrence of the syndesmosis widening after screw removal and the clinical outcomes. Materials and Methods: Forty consecutive patients with acute syndesmotic injury were retrospectively reviewed. The tibiofibular clear space is measured by digitalized measurement tool on serial radiographs. We analyzed the effect of time from trauma to fixation, syndesmotic screw indwelling duration, and fixation methods. Residual symptoms at the last follow up were evaluated. The student t-test, correlation test, and chi-square test were used for statistical analysis. Results: Eighteen ankles (45%) had recurrent syndesmosis widening (greater than 5% compared to the contralateral side). Seven patients had pain and five had limitation of motion in the ankle joint. Fixation tightness had significant effect on reducing the recurrence while the severity of the initial widening, time to fixation, and duration of fixation did not affect the outcome. Conclusion: Tight fixation of syndesmotic screw is essential for achieving final syndesmotic stability and reducing recurrence.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.53-57
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• 2013

Myositis ossificans is a condition characterized by ossification within a muscle. It is a rare and unusual pathologic entity that has defied medical efforts to establish a definite etiology, pathogenesis, and satisfactory treatment of the disease. The condition predominantly affects the flexor muscles of the upper limbs and thighs, but rarely the head and neck area. A 53-year-old male patient visited our medical institution complaining of trismus, defined as limited mouth opening. The patient had a history of trauma to the facial bones and the computed tomography scans revealed calcification in the left temporalis muscle. The patient underwent surgical removal of the calcified mass with bilateral coronoidectomy under general anesthesia. Mouth opening at the end of post-operative 2 months was 28 mm. His oral intake of food was satisfactory. Myositis ossificans of the temporalis muscle is a very rare case. Satisfactory outcome was obtained by combining surgical excision of the affected muscle, coronoidectomy, and detachment of the insertion site of the ossified muscle.

• Annals of Coloproctology
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• v.34 no.6
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• pp.280-285
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• 2018

For many years, developmental and physiological differences have been known to exist between anatomic segments of the colorectum. Because of different outcomes, prognoses, and clinical responses to chemotherapy, the distinction between right colon cancer (RCC) and left colon cancer (LCC) has gained attention. Furthermore, variations in the molecular features and gut microbiota between right and LCCs have recently been a hot research topic. CpG island methylator phenotype-high, microsatellite instability-high colorectal cancers are more likely to occur on the right side whereas tumors with chromosomal instability have been detected in approximately 75% of LCC patients and 30% of RCC patients. The mutation rates of oncogenes and tumor suppressor genes also differ between RCC and LCC patients. Biofilm is more abundant in RCC patients than LLC patients, as are Prevotella, Selenomonas, and Peptostreptococcus. Conversely, Fusobacterium, Escherichia/Shigella, and Leptotrichia are more abundant in LCC patients compared to RCC patients. Distinctive characteristics are apparent in terms of molecular features and gut microbiota between right and LCC. However, how or to what extent these differences influence diverging oncologic outcomes remains unclear. Further clinical and translational studies are needed to elucidate the causative relationship between primary tumor location and prognosis.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.6
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• pp.547-556
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• 2021

Background: This study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions. Methods: This was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale). Results: A significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group. Conclusion: Physics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.

• Journal of Korean Foot and Ankle Society
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• v.26 no.3
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• pp.143-147
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• 2022

Past research has reported that the common causes of ankle arthritis include trauma, congenital deformity, and degeneration. Among them, fracture-induced post-traumatic arthritis is most common. For patients with ankle fractures, an anatomical reduction is performed through surgical treatment. However, insufficient reduction or malunion of the fracture site may change the alignment of the ankle joint, resulting in valgus or varus deformities. Currently, most operative options for valgus arthritis aim to either restore joint alignment and/or reduce the uneven load on the cartilage. In this report, we would like to share our clinical experience of a patient with posttraumatic valgus ankle arthritis caused by severely comminuted fracture and dislocation. A satisfactory outcome could be obtained with combined fibular lengthening osteotomy and medial displacement calcaneal osteotomy.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.440-443
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• 2022

Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6 months postoperative, she had full active range of motion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.151-157
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• 2024

Electrical burn injuries can cause more damage than clinical evaluations initially suggest. The energy waves penetrate from the surface to the deepest layers of tissue, causing extensive harm at every level. The neck is a critical area, both functionally and aesthetically. We present a case involving a young male patient with a severe fourth-degree electrical burn on the neck, who underwent a single-stage debridement and reconstructive surgery. The pectoralis major myocutaneous flap is a versatile option for various head and neck reconstructions. However, if the donor site cannot be closed primarily and requires split-thickness skin grafting, it can result in unsightly scars and deformities. For large flap paddles, it is ideal to reconstruct the secondary defect with locoregional flaps. In this case, we successfully reconstructed the donor site's secondary defect using a contralateral internal mammary artery perforator flap, without resorting to any skin grafts. The early postoperative results demonstrated satisfactory cosmesis, patient satisfaction, and functional outcomes.

• Clinics in Shoulder and Elbow
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• v.27 no.2
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• pp.219-228
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• 2024

Background: Standard open acromioclavicular (AC) stabilization is associated with increased postoperative complications including deltoid injury, infection, tunnel complications, loss of reduction, and wound/cosmetic concerns. Arthroscopy may offer superior visualization and advantages that limit these risks. The aim of this prospective non-randomized study is to evaluate advantages and long-term reliability of arthroscopic AC stabilization. Methods: Thirty-two patients with acute grade III, IV and V AC dislocations underwent arthroscopic AC reconstruction with long-term assessment by clinical AC examination, Simple Shoulder Test, American Shoulder and Elbow Surgeons scores, visual analog scale, Specific AC Score and Quick Disabilities of the Arm, Shoulder and Hand scores. Radiographs verified conservation of initial reduction and presence of coracoclavicular (CC) ossifications. Complications, revision rate, and satisfaction were assessed and compared to the literature. Results: Mean follow-up time was 67.6 months. All clinical outcome scores improved and differences were statistically significant (P<0.001). Initial postoperative radiographs consistently showed complete reduction. Two patients experienced relapse to grade II AC dislocation without clinical implications. In total, 71.8% showed CC ossifications without functional impairment, and in 31.3% concomitant injuries were observed. Reintervention rate was 9.4%, and 96.9% of patients were satisfied with procedure outcomes. Conclusions: Arthroscopic stabilization for acute AC joint dislocations offers satisfactory clinical and radiographic outcomes, and our results show that the arthroscopic technique is reliable in the long run. We report better reduction in maintenance, fewer complications, and similar reoperation rates compared to other techniques.