• 제목/요약/키워드: osteotomy

검색결과 903건 처리시간 0.022초

요내반족 교정에 있어 드와이어씨 절골술 및 제 1중족골 절골술이 방사선학적 지표에 미치는 영향 (The Effect of Dwyer's Osteotomy and the 1st Metatarsal Osteotomy for Cavovarus Correction on Radiographic Parameters)

  • 최준영;차성무;염지웅;서진수
    • 대한족부족관절학회지
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    • 제20권1호
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    • pp.27-31
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    • 2016
  • Purpose: Several techniques have been introduced for correction of pes cavo-varus deformity. We retrospectively reviewed and compared the data of patients who underwent 1st metatarsal osteotomy alone, Dwyer's osteotomy alone, and 1st metatarsal osteotomy combined with Dwyer's osteotomy to determine the effect on radiographic parameters. Materials and Methods: Data on 28 cases in 27 consecutive patients recruited from 2006 to 2014 who underwent 1st metatarsal osteotomy alone (group F), Dwyer's osteotomy alone (group H), or 1st metatarsal osteotomy followed by Dwyer's osteotomy (group HF) with a minimum 1-year follow-up were reviewed retrospectively. Results: Calcaneal pitch angle on the standing foot lateral radiographs was significantly decreased after the operation in groups H and HF whereas Meary angle was decreased in groups F and HF. Hindfoot alignment angle and ratio on the hindfoot alignment view were improved in groups H and HF. Maximal medial cuneiform height reduction was observed in group HF. 1st ray was significantly shortened in groups F and HF. Conclusion: Combined forefoot and hindfoot operation took the largest correction power of all radiologic parameters.

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

  • 윤영필;김상환
    • 대한족부족관절학회지
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    • 제19권4호
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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.

무지 외반증의 새로운 변형 Chevron 절골술 (New Modified Chevron Osteotomy for Hallux Valgus)

  • 오인석;김명구;최성욱;반준호
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.126-130
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    • 2004
  • Purpose: In this study, we tried to develop the technique of osteotomy for hallux valgus. The new modified technique of osteotomy was accomplished with even more greater stability, accurate correction of the deformity and more effective than 'chevron' osteotomy in terms of correction of the deformity. Materials and Methods: Between March 1998 and December 2001, 55 cases of new modified osteotomy for hallux valgus were performed for 39 patients, 16 of whom underwent operation of both feet. Operations were made for 34 women and 5 men whose average age was 46 years old (range, $20{\sim}71$ years). Average follow up period was three years (range, $2{\sim}5$ years), and during the follow up, the patients underwent physical examination and assessment with use of the American Orthpaedic Foot and Ankle Society's hallux-metatarso-phalangealinterphalangeal scale and standard foot radiographic measurements. Results: 37 patients (53 cases) out of 39 patients (55 cases) had no pain, good cosmesis, and all of the patients were satisfied with the results of the operation. Two had occasional mild discomfort. The average score according to the hallux-metatarso-phallangeal-interphalangeal scale was 93.2 points (range, $78{\sim}100$ points). The average preoperative intermetatarsal angle was $14.4^{\circ}$, which was decreased to $7.9^{\circ}$ after the osteotomy with an average correction of $6.5^{\circ}$ and The average preoperative hallux valgus angle was $34.1^{\circ}$, which was decreased to $11.1^{\circ}$ after the osteotomy with an average correction of $23^{\circ}$. This new modified technique would prevent the angulation or shortening at the osteotomy site and it was also even more stable at osteotomy site, and could do even more effective and accurate correction of the deformity than conventional Chevron osteotomy. Conclusion: New modified chevron osteotomy for the treatment of symptomatic hallux valgus was done in 55 cases, and the results were satisfactory in all cases. This method was more stable at the osteotomy site than conventional Chevron osteotomy and was also possible to do more accurate and more effective correction of the deformity. It was also easy to control the distal fragment of first metatarsal bone.

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가상 수술 시뮬레이션과 3차원 프린팅 절골술 가이드를 이용한 교정 수술: 증례 보고 (Corrective Surgery Using Virtual Surgical Simulation and a Three-Dimensional Printed Osteotomy Guide: A Case Report)

  • 최기원;신기준
    • 대한족부족관절학회지
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    • 제27권3호
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    • pp.112-116
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    • 2023
  • A 74-year-old female patient, who underwent surgery for a left distal tibiofibular fracture 40 years earlier, visited the hospital with an ankle varus deformity due to malunion. The patient complained of discomfort while walking due to the ankle and hindfoot varus deformity but did not complain of ankle pain. Therefore, correction using supramalleolar osteotomy was planned, and through virtual surgical simulation, it was predicted that a correction angle of 24° and an osteotomy gap open of 12 mm would be necessary. An osteotomy guide and an osteotomy gap block were made using three-dimensional (3D) printing to perform the osteotomy and correct the deformity according to the predicted goal. One year after surgery, it was observed that the ankle varus was corrected according to the surgical simulation, and the patient was able to walk comfortably. Thus, for correction of deformity, virtual surgical simulation and a 3D-printed osteotomy guide can be used to predict the target value for correction. This is useful for increasing the accuracy of correction of the deformity.

중증 무지외반증에서 변형 Mau 절골술을 이용한 치료 (Modified Mau Osteotomy for the Treatment of Severe Hallux Valgus)

  • 배서영;김영은
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.117-120
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    • 2004
  • 저자에 의해 개선된 변형 Mau 절골술은 우수한 교정력과 견고한 고정이 가능하면서도 술기가 간단하고 중족골두의 상하 전위가 없고 조기 보행이 가능한 안전한 방법이라 할 수 있었다. 따라서 향후 장기 추시가 필요하긴 하지만 중족골간각이 큰 중증의 무지외반증에서 추천할만한 좋은 방법으로 사료된다.

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중등도 무지 외반증 환자에서 원위부 갈매기형 절골술과 중족골 근위부 폐쇄성 쐐기 절골술의 치료 결과 비교 (Comparison of the Results between Distal Chevron Osteotomy and Proximal Metatarsal Osteotomy for the Treatment of Moderate Hallux Valgus)

  • 정창훈;박일중;김윤수;이기행;문찬웅;이경훈;김형민
    • 대한족부족관절학회지
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    • 제12권2호
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    • pp.140-144
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    • 2008
  • Purpose: The purpose of this study is to compare the treatment outcomes of distal chevron osteotomy with those of proximal metatarsal closing wedge osteotomy in patients with moderate severity hallux valgus. Materials and Methods: Forty-two patients (51 feet) who were underwent either distal chevron osteotomy (Group I, 22 patients, 27 feet) or proximal metatarsal closing wedge osteotomy (Group II, 20 patients, 24 feet) for the correction of moderate hallux valgus deformity were evaluated retrospectively. We assessed the radiographic results with several parameters including hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). And clinical results with modified AOFAS score at last follow-up. Results: There were no significant differences in IMA, HVA and DMAA between two groups preoperatively. We can achieve the good results with both procedures, but mean HVA and IMA of group II was significantly lower than those of group I. There was some loss of correction in group I at the last follow-up. There was no significant difference in clinical results according to modified AOFAS scoring between two groups at the last follow-up. Conclusion: The proximal metatarsal closing wedge osteotomy for the hallux valgus with moderate severity is better treatment option to achieve better radiographic correction and to prevent loss of correction or recurrence than distal chevron osteotomy.

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A safe, stable, and convenient three-dimensional device for high Le Fort I osteotomy

  • Sugahara, Keisuke;Koyachi, Masahide;Odaka, Kento;Matsunaga, Satoru;Katakura, Akira
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.32.1-32.4
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    • 2020
  • Background: Le Fort I osteotomy is a highly effective treatment for skeletal jaw deformities and is commonly performed. High Le Fort I osteotomy is a modified surgical procedure performed for improving the depression of the cheeks by setting the osteotomy higher than the conventional Le Fort I osteotomy. Developments in three-dimensional (3D) technology have popularized the use of 3D printers in various institutions, especially in orthognathic surgeries. In this study, we report a safe and inexpensive method of performing a high Le Fort I osteotomy using a novel 3D device and piezosurgery, which prevent tooth root injury without disturbing the operation field for patients with a short midface and long tooth roots. Results: A 17-year-old woman presented with facial asymmetry, mandibular protrusion, a short midface, and long tooth roots. We planned high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. Prevention of damage to the roots of the teeth and the infraorbital nerve and accurate determination of the posterior osteotomy line were crucial for clinical success. Le Fort I osteotomy using 3D devices has been reported previously but were particularly large in size for this case. Additionally, setting the fixing screw of the device was difficult, because of the risk of damage to the roots of the teeth. Therefore, a different surgical technique, other than the conventional Le Fort I osteotomy and 3D device, was required. The left and right parts of the 3D device were fabricated separately, to prevent any interference in the surgical field. Further, the 3D device was designed to accurately cover the bone surface from the piriform aperture to the infra-zygomatic crest with two fixation points (the anterior nasal spine and the piriform aperture), which ensured stabilization of the 3D device. The device is thin and does not interfere with the surgical field. Safe and accurate surgical performance is possible using this device and piezosurgery. The roots of the teeth and the infraorbital nerve were unharmed during the surgery. Conclusions: This device is considerably smaller than conventional devices and is a simple, low-cost, and efficient method for performing accurate high Le Fort I osteotomy.

중등도 퇴행성 족관절염에 대한 과상부 경골 절골술의 술기 (Supramalleolar Osteotomy for Moderate Degenerative Ankle Osteoarthritis)

  • 강정모;이명진
    • 대한족부족관절학회지
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    • 제21권4호
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    • pp.122-127
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    • 2017
  • This paper reviews the indications and surgical technique of supramalleolar osteotomy as one of the treatments for moderate degenerative ankle osteoarthritis. Although it is technically demanding and requires extensive preoperative planning, supramalleolar osteotomy will be a good treatment option for moderate degenerative ankle osteoarthritis. The osteotomy is designed to shift the weight bearing axis to the lateral side of the ankle joint and unload the medial side of the joint. In our experience, a supramalleolar osteotomy is effective to the treatment of moderate ankle osteoarthritis with a small amount of preoperative talar tilt and varus or normal heel alignment.

무지 외반증 환자에서 평행 변형 스카프 절골술을 이용한 치료 결과 (Treatment Results of Hallux Valgus Deformity by Parallel-Shaped Modified Scarf Osteotomy)

  • 박현우;김성진
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.123-127
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    • 2012
  • Purpose: The purpose of this study was to evaluate the clinical and radiographic results of the parallel-shaped modified Scarf osteotomy which is performed the Scarf osteotomy parallel to the shaft of the 1st metatarsal bone for hallux valgus deformities. Materials and Methods: We retrospectively reviewed 43 patients who had been treated by the parallel-shaped modified Scarf osteotomy for hallux valgus deformities between January 2006 and March 2011. We evaluated the results after this Scarf osteotomy with respect American Orthopaedic Foot & Ankle Society (AOFAS) scores, radiologic results by comparing intermetatarsal angle between 1stand 2nd metatarsal bones and hallux valgus angle. Results: We checked out the pre-operational and post-operational radiologic evaluation of intermetatarsal angle and hallux valgus angle between 1st and 2nd metatarsal bones. The mean AOFAS scores improved from 63.5 to 88.5. At final follow up, The hallux valgus angle improved from $31.4^{\circ}$ (16-52) to $9.0^{\circ}$ (3-13) and the intermetatarsal angle improved from $18.6^{\circ}$ (12-30) to $9.3^{\circ}$ (6-12) postoperatively. There was no case of major complications included recurrence of valgus deformity, correction or fixation failure and stress fractures. Conclusion: Our results suggest the our parallel-shaped modified Scarf osteotomy produces improved AOFAS scores, and effective correction of hallux valgus deformities. Our Scarf technique of osteotomy which is performed in parallel to the metatarsal bone minimizes the need for skill while more reliable and obtaining good correction and avoids associated complications.

원위부 중족골 쉐브론 절골술을 이용한 무지 외반증의 치료 (Treatment of Hallux Valgus with Distal Chevron Metatarsal Osteotomy)

  • 안재훈;최원식;김하용;이도현;배경완
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.124-128
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    • 2009
  • Purpose: The authors intended to analyze the operative results of mild to moderate hallux valgus treated with distal chevron metatarsal osteotomy. Materials and Methods: Twenty six feet of twenty three patients were followed for more than 1 year after the distal chevron metatarsal osteotomy. Biplanar osteotomy with wedge resection was done when the distal metatarsal articular angle (DMAA) was increased. The mean age was 39 years, and the mean follow up period was 27 months. Clinically preoperative and postoperative AOFAS hallux MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, the 1st intermetatarsal angle, DMAA and sesamoid position before and after the operation were analyzed. Results: Distal chevron osteotomy was done in 15 cases and biplanar osteotomy was done in 11 cases. Clinically AOFAS scale was increased from 65.3 points preoperatively to 92.2 points postoperatively. Two patients were not satisfied with the results. Radiologically hallux valgus angle was decreased from $21.9^{\circ}$ preoperatively to $8.5^{\circ}$ postoperatively. The first intermetatarsal angle was decreased from $11.8^{\circ}$ preoperatively to $6.7^{\circ}$ postoperatively. DMAA was decreased from $11.8^{\circ}$ preoperatively to $5.5^{\circ}$ postoperatively. There was one case of minor wound infection. Conclusion: Distal chevron metatarsal osteotomy appears to be safe and satisfactory procedure for mild to moderate hallux valgus.

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