• Journal of Korean Foot and Ankle Society
• /
• v.7 no.2
• /
• pp.238-249
• /
• 2003

Purpose: To report the clinical result of the intraarticular calcaneus fracture after open reduction and internal fixation with plate by lateral approach. Materials and Methods: Thirty-six calcaneal fractures of 33 patients(29 men and 4 women) were treated by open reduction and internal fixation using an lateral approach from March, 1997 to May, 2002 and were followed more than one year. The autogenous iliac bone graft was done in 2 cases but the others didn't. Radiographically B?hler angle and Gissane angle on simple lateral radiograph were measured and in the 15 cases, the step-off(gap) of posterior facet joint on post-operative CT images were followed. The Salama method was used for evaluation of clinical results. Results: According to Sanders classification, 19 cases of the 36 cases were classified as type II. Type III fracture were found in 12 cases and type IV in 5 cases. The following results were obtained: twenty-two cases(61.1%) out of 36 cases were estimated as good or excellent. The good results or more were obtained in 15 cases(78.9%) in type II and 7 cases(58.3%) in type ill, but no case in type IV. B?hler angles were improved from preoperative average 1.6?to postoperative average 23.4?, Gissane angle was improved from preoperative 107.2?to postoperative 122.8?, respectively. Among 36 cases, Computed tomography was carried out in 15 cases. The postoperative step-off (gap) of posterior facet joint on computed tomography was filled with cancellous bone. Satifactory results was obtained in 7 cases with 2mm gap or less and in 6 cases of 2-5mm. There were no satifactory results in 2 cases with 5mm gap or more. Conclusion: Open reduction and internal fixation for intra-articular fracture of calcaneus was thought to be a good treatment modality. It is thought that the lateral approach is one of the good one for surgical treatment, and that accurate reduction of the posterior facet, acceptable recovery of B?hler angle are more important to obtain best results.

• Journal of Korean Foot and Ankle Society
• /
• v.6 no.2
• /
• pp.201-207
• /
• 2002

Purpose: To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach. Materials and Methods: From March 2000 to February 2002, thirty-eight displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type IV of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative care, all fractures healed without secondary displacement except 1 case on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed. Conclusion: Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.

• Archives of Craniofacial Surgery
• /
• v.14 no.1
• /
• pp.69-72
• /
• 2013

Lateral eyebrow mass with primary skull lesion are rare in pediatric population. Although epidermoid cyst and dermoid cyst are the most commonly encountered skull lesions in pediatric population, Langerhans cell histiocytosis (LCH) is rarely reported. We report a case of LCH arising from the lateral eyebrow with osteolytic lesion involving the frontal bone. A 5-year-old boy was presented with a hard, fixed mass in his lateral eyebrow. Contrast magnetic resonance imaging revealed inhomogeneous enhancement of the mass with direct invasion of the frontal bone and adjacent dura mater. Under general anesthesia, linear incision at the lateral eyebrow region was made. Intraoperative evaluation revealed hard, fixed and well-defined soft tissue mass. The final extirpated mass was $2.5{\times}2.4cm$ in size, and was accompanied by a $1{\times}1cm$ sized defect on the frontal bone with intact dura mater. The surgical wound was closed primarily by a layer-by-layer fashion. Histologic examination was later performed for definite diagnosis. The histologic examination revealed abnormal proliferation of Langerhans cell with granuloma formation. Radionuclide bone scan and positron emission tomography was taken and revealed free of multi-organ involvement. At 3 months after surgery, natural looking contour at the lateral eyebrow region was observed with no tumor recurrence. Differential diagnosis of the hard and fixed mass at the lateral eyebrow region affecting the primary skull lesion from pediatric population includes epidermoid cyst, dermoid cyst and LCH. Generally, brief physical examination with plain X-ray view can be performed for clinical evaluation, but for a definite diagnosis, contrast MRI may be helpful.

• The korean journal of orthodontics
• /
• v.43 no.4
• /
• pp.178-185
• /
• 2013

Objective: To standardize the facial soft-tissue characteristics of South Korean adults according to gender by measuring the soft-tissue thickness of young men and women with normal facial profiles by using three-dimensional (3D) reconstructed models. Methods: Computed tomographic images of 22 men aged 20 - 27 years and 18 women aged 20 - 26 years with normal facial profiles were obtained. The hard and soft tissues were three-dimensionally reconstructed by using Mimics software. The soft-tissue thickness was measured from the underlying bony surface at bilateral (frontal eminence, supraorbital, suborbital, inferior malar, lateral orbit, zygomatic arch, supraglenoid, gonion, supraM2, occlusal line, and subM2) and midline (supraglabella, glabella, nasion, rhinion, mid-philtrum, supradentale, infradentale, supramentale, mental eminence, and menton) landmarks. Results: The men showed significantly thicker soft tissue at the supraglabella, nasion, rhinion, mid-philtrum, supradentale, and supraglenoid points. In the women, the soft tissue was significantly thicker at the lateral orbit, inferior malar, and gonion points. Conclusions: The soft-tissue thickness in different facial areas varies according to gender. Orthodontists should use a different therapeutic approach for each gender.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.4
• /
• pp.310-312
• /
• 2005

We report a case of endodermal cyst of the posterior fossa. A 44-year-old man presented with headache for three months. Computed tomography and magnetic resonance imaging revealed a $6{\times}2.5{\times}2cm$ sized extra-axial non-enhancing cystic lesion on the ventral aspect to brain stem. To avoid retraction injury to brain stem, far lateral transcondylar approach was selected. Right suboccipital craniotomy and partial removal of occipital condyle with resection of C-1 and C-2 hemilaminae exposed the extra-axial cyst well. The cyst has a whitish thick membrane. It was not adherent to brain stem and lower cranial nerves. Total removal of the cyst was done without difficulty. Histological analysis disclosed a layer of pseudostratified columnar epithelium with basement membrane. The result of immunohistochemical study was consistent with endodermal cyst.

• Korean Journal of Head & Neck Oncology
• /
• v.21 no.1
• /
• pp.53-56
• /
• 2005

The branchial anomaly is a lateral neck mass commonly seen by otolaryngologists. Depending on its anatomic location, branchial anomaly can be classified into first, second, third and fourth. The fourth branchial cleft anomaly is very rare entity and until now, only 35cases have been reported worldwide. It may present as neck cyst, recurrent neck abscess, thyroiditis. Combined with barium swallow esophagogram and computed tomography scan can aid in diagnosis of this rare disease entity. Complete excision of the entire epithelial tract combined with ipsilateral thyroid lobectomy remains the mainstay of treatment. Authors experienced a case of lateral neck mass which was anatomically presumed to be the fourth branchial cleft cyst. We report this case with the related literature.

• Journal of Korean Neurosurgical Society
• /
• v.39 no.4
• /
• pp.292-295
• /
• 2006

Isolated fourth ventricle[IFV] is a rare entity producing symptoms of a progressive posterior fossa mass lesion. It is mainly reported in a patient who undergo shunt placement as its late complication. However, its surgical management has been difficult and its optional treatment remains controversial. We had an occasion to admit 19-year-old female to our hospital due to hydrocephalus : she had a history of meningitis when she was 2 years old. Ten years later she was diagnosed as hydrocephalus and managed by lateral ventriculo-peritoneal shunting procedure. Seven years after the procedure, the patient presented with headache, nausea, truncal ataxia and nystagmus. Computed tomography and magnetic resonance image scan demonstrated markedly enlarged fourth ventricle : and thus, neuroendoscopic aqueductoplasty and aqueductal stent insertion was performed. The authors present a case of an IFV after lateral ventriculo-peritoneal shunting for hydrocephalus, which was treated successfully with a neuroendoscopic surgery. The technique of this procedure is described below.

• Journal of Korean Foot and Ankle Society
• /
• v.22 no.4
• /
• pp.177-180
• /
• 2018

This paper reports a rare case of the symptomatic third metatarsal (MT3) - lateral cuneiform (LC) in a 55-year-old male who presented with complaints of severe intermittent pain in his right foot. Plain radiographs and computed tomography scans revealed sclerosis and irregularity at this joint. The intraoperative findings demonstrated a fibrocartilaginous coalition. The pain had improved one year after removing the MT3-LC joint by en bloc and arthrodesis.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.21 no.3
• /
• pp.253-260
• /
• 2021

Therapeutic injections into the craniofacial region can be a complex procedure because of the nature of its anatomical structure. This technical note demonstrates a process for creating an extra-oral template to inject therapeutic substances into the temporomandibular joint and the lateral pterygoid muscle. The described process involves merging cone-beam computed tomography data and extra-oral facial scans obtained using a mobile device to establish a correlated data set for virtual planning. Virtual injection points were simulated using existing dental implant planning software to assist clinicians in precisely targeting specific anatomical structures. A template was designed and then 3D printed. The printed template showed adequate surface fit. This innovative process demonstrates a potential new clinical technique. However, further validation and in vivo trials are necessary to assess its full potential.

• Journal of Chest Surgery
• /
• v.26 no.7
• /
• pp.548-551
• /
• 1993

Calcified right ventricular thrombi are very rare.One case of large clacified thrombus in right ventricle being seen in a 65-year old man, is presented. He had dyspnea and generalized edema.The chest film showed a large calcified mass in cardiac shadow especially in lateral view.On echocardiography and chest computed tomography, large calcified mass density occupied nearly entire right ventricular outflow tract.The mass removal was performed through right ventriculotomny.The mass was whitish, stony hard, measured 4 cm x 4.5 cm x 8 cm, tightly attached to right ventricular infundibular septum and ventriculoinfundibular fold.