• Title/Summary/Keyword: Z-osteotomy

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THE CORRECTION OF Z-SHAPED SLIDING OSTEOTOMY FOR ADVANCING MANDIBLE IN MICROGNATHIA (왜소악 환자의 Z-형 골절단술에 의한 성형술 증예보고)

  • Min, Byong-Il;Lee, Jum-Sik;Chung, Ho-Kyoon;Ha, Woong-Chieul
    • The Journal of the Korean dental association
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    • v.10 no.6
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    • pp.379-383
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    • 1972
  • Patient, S.B. moon, an 20-years old female was first seen S.N.U. Dental Hospital in January 1971 because of masticatory dysfunction, cosmetic unfiguration due to mandibular micrognathia. Her Complaint was 'bird face' due to under development of the jaw. A bilateral Z-shape sliding osteotomy was performed with the patient under the general Anesthesia.

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Surgical correction of septal deviation after Le Fort I osteotomy

  • Shin, Young-Min;Lee, Sung-Tak;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.21.1-21.6
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    • 2016
  • Background: The Le Fort I osteotomy is one of the most widely used and useful procedure to correct the dentofacial deformities of the midface. The changes of the maxilla position affect to overlying soft tissue including the nasal structure. Postoperative nasal septum deviation is a rare and unpredicted outcome after the surgery. There are only a few reports reporting the management of this complication. Case Presentation: In our department, three cases of the postoperative nasal septum deviation after the Le Fort I osteotomy had been experienced. Via limited intraoral circumvestibular incision, anterior maxilla, the nasal floor, and the anterior aspect of the septum were exposed. The cartilaginous part of the nasal septum was resected and repositioned to the midline and the anterior nasal spine was recontoured. Alar cinch suture performed again to prevent the sides of nostrils from flaring outwards. After the procedure, nasal septum deviation was corrected and the esthetic outcomes were favorable. Conclusion: Careful extubation, intraoperative management of nasal septum, and meticulous examination of preexisting nasal septum deviation is important to avoid postoperative nasal septum deviation. If it existed after the maxillary osteotomy, septum repositioning technique of the current report can successfully correct the postoperative septal deviation.

Scarf(Z) osteotomy of the First metatarsal shaft in the Treatment of Hallux Valgus (무지 외반증 환자에서 스카프 절골술을 이용한 치료)

  • Young, Ki-Won;Lee, Kyung-Tai;Kim, Jae-Young;Lee, Hui-Dong
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.157-165
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    • 2003
  • Purpose: The purpose of this study was to the evaluate the clinical and radiographic results and complication of the Scarf osteotomy which is one of the surgical treatment of Hallux valgus. Material and Method: Fifty feet (30 patients) of moderate to severe hallux valgus deformity were operated by Scarf osteotomy procedure from January 2002 to July 2002. Patients were asked about their satisfaction in terms of pain, appearance and motion. The AOFAS clinical ratio scales and radiographic results for hallux valgus were evaluated. Result: The mean Hallux valgus angle improved from an average of 30.6 degrees to 9.0 degrees and the first intermetatarsal angle improved from an average 13.3 degrees to 5.2 degrees respectively. The preoperative mean AOFAS score was 58 points and on last follow up AOFAS score improved to 88 points. Complication which including troughing, nonunion, malunion was not developed. Conclusion: We found that Scarf osteotomy is a reliable operation for mild to moderate Hallux valgus deformity as regards firm fixation and early postoperative ambulation and large contact area for union.

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Sagittal split ramus osteotomy, intraoral vertical ramus osteotomy, and lateral corticectomy for asymmetric mandibular prognathism

  • Lee, Joo Young;Han, Se Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.249-256
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    • 2021
  • Objectives: The purpose of this study was to evaluate the postoperative anteroposterior stability and improvements in facial asymmetry after performing LeFort I osteotomy in the maxilla, sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) in the mandible, and lateral corticectomy on the IVRO side. Materials and Methods: From July 2009 to October 2018, a retrospective analysis was performed on 11 subjects. Lateral cephalometric radiograph was performed preoperatively (T0), postoperatively (T1), and at 12 months of follow-up (T2), and the B point distance was measured. Posteroanterior cephalometric radiograph was performed preoperatively (S0) and at 12 months of follow-up (S1) and was used to measure five indicators (Ag angle, M-Ag, Co-Ag, Co-Me, and Ag-Me) of facial asymmetry. Results: The B point distances for T0 and T1 were significantly different (P=0.007), whereas those for T1 and T2 were not significantly different (P=0.1). In addition, there was a significant difference between the B point distances of T2 and T0 (P=0.026). Comparison of the facial asymmetry indicators before and after surgery showed a significant difference for all indicators between S0 and S1: the P-values of Ag angle, M-Ag, Co-Ag, Co-Me, and Ag-Me were 0.003, 0.003, 0.008, 0.006, and 0.004, respectively. The Z value was based on negative ranks. Conclusion: There was no significant difference in the B point distances from postoperation to the 12-month follow-up. However, there were significant differences in all five indicators related to facial asymmetry before and after surgery. The values for the five indicators of facial asymmetry all increased postoperatively.

Operative Treatment for Fibular Shortening after Trauma: A Case Report (외상 후 발생한 비골 단축증의 수술적 치료: 증례 보고)

  • Kim, Jiyoun;Kim, Gab-Lae;Lee, Chae-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.177-180
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    • 2021
  • Pediatric ankle fractures can cause physeal injuries which can lead to the shortening of the fibula. This induces a lateral shift of the talus, valgus tilt, and instability of the ankle joint, which can result in an arthritic change in this joint. Patients with a shortening of the fibula may complain of constant pain and restricted movements in their daily lives and during sports activities. Ankle reconstruction with fibula lengthening Z-osteotomy can provide excellent results if arthritis is absent or minimal, especially in young and active patients. To the best of the authors' knowledge, this is the first report in South Korea regarding the treatment of fibula shortening following a growth arrest due to injury.

Reconstruction of Large Skull Defect Using Right-Angled Zigzag Osteotomy (직각 Z-절골술을 이용한 거대 두개골 결손의 재건)

  • Lee, Kiyoung;Paik, Hye Won;Byeon, Jun Hee
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.667-670
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    • 2007
  • Purpose: Among the materials for cranioplasty, autogenous bone is ideal because it is less susceptible to infection and has lower rates of subsequent exposure. However, the procedure is technically demanding to perform and requires a donor site. Disadvantages further exist when the defect is large and there are attendant limitations in donor site. The authors present their experience with reconstruction of large skull defect using right-angled zigzag osteotomized outer table of autogenous calvarial bone, overcoming the limitation in donor site. Methods: From 2000 to 2006, 9 patients were retrospectively reviewed, who had undergone reconstruction with right angled zigzag osteotomized outer table of autogenous calvarial bone. Results: Aesthetically satisfactory skull shape was achieved. Major complications of infection, hematoma, plate exposure, and donor site complications of dural tear with bleeding, cerebrospinal fluid leak, and meningitis were not seen. One patient had delayed wound healing and was successfully managed conservatively. Conclusion: Autogenous bone is the material of choice for cranioplasty, especially in complicated cases. Right angled zigzag osteotomy is a useful method in reconstruction of large skull defects with less donor site morbidity.

The Differences of Fixation Method in Proximal Chevron Osteotomy for Hallux Valgus: K-Wire, Cannulated Screw, Plate (무지외반증에서 근위 갈매기형 절골술 후 고정 방법에 따른 차이: K-강선, 유관나사, 금속판)

  • Kim, Taik-Seon;Kim, Hak-Jun;Park, Young-Hwan;Lim, Hyung-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.62-67
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    • 2011
  • Purpose: The authors evaluated the differences between K-wires and Cannulated screw, plate for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus. Materials and Methods: There were 62 patients (79 feetz) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. We divided the patients into 4 groups, Two K-wire fixed group as A, one cannulated screw fixed group as B. Two cannulated screw fixed group as C, Plate fixed group as D, Group A were patients (26 feet) and Group B were patients z(9 feet), Group C were patients (31 feet) and Group D were patients (13 feet). Preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patient. ANOVA test and Student t-test were done for statistical analysis. Results: Mean follow up period was 43.8 months (range: 12~82 months). Preoperative mean IMA was $16.4{\pm}3.5$, $17.7{\pm}11.3$, $17.3{\pm}5.9$ and $16.6{\pm}2.3$ degrees in respectively group A, B, C, D. Immediate postoperative mean IMA was $5.6{\pm}3.4$, $7.3{\pm}4.4$, $7.6{\pm}4.4$ and $6.7{\pm}2.8$ degrees in respectively group A, B, C, D. The final mean IMA was $8.9{\pm}4.5$, $15.2{\pm}7.5$, $10.3{\pm}4.4$ and D $7.7{\pm}3.5$ degrees in respectively group A, B, C, D. There were significant statistical increase in final mean IMA of group B and C (p<0.05). Conclusion: The IMA was significantly increased in the group which used one or two cannulated screw for fixation on follow up, therefore more caution should be needed when using one or two cannulated screw fixation technique after proximal chevron osteotomy.

The Correction of Clinodactyly on Thumb by Bone Graft from Deformed Metacarpal Region-Previous Correction of Polydactyly: Case Report (무지에 합지증이 동반된 사지증의 치험례)

  • Choi, Chi Won;Nam, Su Bong;Bae, Yong Chan
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.379-382
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    • 2006
  • Clinodactyly is defined as an angulation of a digit in the radio-ulnar plane. This anomaly can be congenital, dominantly inherited, or acquired due to trauma or inflammation. Although the deformity usually causes little functional impairment, correction is made because of cosmetic problems. Male subject, with polydactyly on thumb(Wassel's type VII) received first surgery at the age of one. And at the age of six, abnormal growth on the radial side of the first metacarpal bone and ulnar deviation of the distal phalanx of the thumb at the interphalangeal joint had developed. The authors used the growing bony segment from the first metacarpal bone as a bone graft for the correction of clinodactyly on thumb. Z-plasty incision was made on the concave(ulnar) side of thumb and a wedge osteotomy was made on the distal phalanx. The bone graft was inserted into the gap of the distal phalanx of the thumb and fixed it with K-wires. Deformity of the metacarpal bone and clinodactyly on thumb was corrected effectively without donor site morbidity with noticible growth of the grafted metacarpal bone 12 months after surgery.

Bilateral Checkrein Deformities of the Hallux Following Intramuscular Sarcoidosis: A Case Report (근육 내 사르코이드증 후 발생한 양측 무지의 체크레인 변형: 증례 보고)

  • Min Gyu Kyung;Sangyun Yun;Dong Yeon Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.71-74
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    • 2024
  • This report presents a unique case of checkrein deformities in both halluces following isolated intramuscular sarcoidosis, a rare occurrence given the infrequent musculoskeletal involvement in sarcoidosis. Typically resulting from flexor hallucis longus tendon entrapment by scar tissue post-trauma, the checkrein deformity reported in this paper presented with unusual metatarsophalangeal joint flexion and interphalangeal joint extension during ankle dorsiflexion. A 49-year-old woman with a history of intramuscular sarcoidosis presented with a great toe deformity and discomfort while wearing shoes, leading to a diagnosis of dynamic deformity, possibly attributed to tendon tethering by sarcoidosis. Surgical treatments, including abductor hallucis muscle intratendinous tenotomy, flexor hallucis longus Z-plasty lengthening, Weil osteotomy, and Kirschner wire fixation, significantly improved the functional scores and patient discomfort. This report underscores the importance of recognizing dynamic deformities and the potential for rare diseases, such as sarcoidosis, to cause such conditions, highlighting the need for careful diagnosis and tailored surgical intervention for atypical checkrein deformities.

Analysis of the Deformities of the Foot after Tibial Fracture and Outcome of the Surgical Treatment (경골 골절후 발생한 족부 변형들의 분석 및 치료 결과에 대한 분석)

  • Kim, Jung-Ryul;Kim, Young-Sin;Shin, Sung-Jin;Kim, Sang-Rim;Seo, Kyu-Bum
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.118-123
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    • 2009
  • Purpose: We wanted to evaluate the relating factors for deformities of the foot after tibial fracture and the outcome of respective surgical treatment. Materials and Methods: We studied thirty-two patients (thirty-five feet) who had foot deformities after tibia fracture. The age, gender, shape, location, concurrent soft tissue injury and operative treatment of tibial fracture were analysed and outcome of the surgical treatment was investigated. Results: Deformities of the foot mostly occurred in open fractures of Gustilo type 3 or closed fracture with severe soft tissue injury. Variable surgical treatments such as simple release, lengthening, Z-plasty and osteotomy were performed. The AOFAS ankle-hind foot scale was improved from average of 37.3 points preoperatively to an average of 77.2 points at the last follow up. The Maryland foot score was from 42.9 to 90.2 and AOFAS Lesser Toe Metatarso-phalangeal interphalangeal scale was from 42.9 to 90.5. Radiological correction was also improved from 21.9 degrees to 7.9 degrees (Meary angle), from 112.2 to 138.5 (Hibb's angle) and from 33.8 to 25.9 (Calcaneal pitch). Conclusion: We proposed that great care should be taken of treatment for the tibial fracture and early detection and proper management of the foot deformities are crucial.

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