• 제목/요약/키워드: osteotomy

검색결과 903건 처리시간 0.024초

비골 골절에서 외측 비골 절골술의 적용 (Application of Lateral Osteotomy in Nasal Bone Fracture)

  • 임광열;송제니퍼김;황소민;정용휘;조가형
    • 대한두개안면성형외과학회지
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    • 제13권2호
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    • pp.104-110
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    • 2012
  • Purpose: Who may dare to state that optimal choice of treating nasal bone fracture is closed reduction? Few decades of authors' experience in nasal bone fracture has lead to believe that more active and assertive approach in nasal bone fracture by performing simultaneous lateral osteotomy may be applied in proper indications to acquire more accurate reduction and cosmetically satisfying result. Methods: From May 2008 to October 2009, among 241 nasal bone fracture patients, 20 patients underwent simultaneous lateral osteotomy with nasal bone fracture reduction. Followed by rigid septal correction, nasal cavity is packed to stabilize the fracture segment for safer osteotomy. Through intranasal incision, in selected cases of difficult reduction or for cosmetic purposes, various types of lateral osteotomy was performed corresponding to the fracture anatomy, conditions of the nasal cavity. Postoperative nasal packing was retained for one week and nasal dorsum splint for 3 weeks. Results: Lateral osteotomy was utilized for difficult cases of closed reduction, for correction of wide nose, hump and deviation in 9, 5, 2, and 4 cases, respectively. Patient satisfaction was scaled 90% in satisfaction and moderate in 10% (2 cases), complaining of mild nasal tip deviation. Physicians detected 2 cases of apparent deformity with patient recognition; one patient with mild step deformity at the osteotomy site and the other patient with minimal implant mobility. Conclusion: By accompanying profound understanding of the fracture anatomy, more active and assertive approach in nasal fracture reduction can be coincide with simultaneous lateral osteotomy to reduce the rate of secondary deformity and to obtain more cosmetically satisfying result.

무지 외반증 환자의 원위 갈매기형 절골술 시 무지 내전건 절단술 병행의 유무에 따른 치료결과 비교 (Comparison of Distal Chevron Osteotomy between with and without Adductor Tenotomy in the Treatment of Hallux Valgus)

  • 주인탁;박현우;김찬규
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.234-237
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    • 2006
  • Purpose: Authors analyzed and compared the treatment result of distal chevron osteotomy between with and without adductor tenotomy. Materials and Methods: 36 patients (60 feet) with a minimum follow-up of one year were involved in this retrospective study. The chevron osteotomy without adductor tenotomy was performed for 20 patients (30 feet) and chevron osteotomy with adductor tenotomy was done for 16 patients (30 feet). The first metatarsophalangeal (MTP) angle and angle between first and second metatarsal longitudinal axis (IM) was measured. The difference of these angles were measured pre-and postoperatively and compared using Student's T-test. Results: In the group of chevron osteotomy with adductor tenotomy, the mean first MTP angle corrected $29^{\circ}$ pre-operatively to $9^{\circ}$ and the mean first IM angle corrected $16^{\circ}$ pre-operatively to $12^{\circ}$. In the group of chevron osteotomy without adductor tenotomy the mean first MTP angle corrected $31^{\circ}$ pre-operatively to $11^{\circ}$ (P>0.05) and the mean first IM angle corrected $13^{\circ}$ pre-operatively to $11^{\circ}$ (P>0.05). Deep peroneal neuroma were found in 3 cases of chevron osteotomy with adductor tenotomy. Conclusions: Adductor tenotomy should be performed in selected patient with chevron osteotomy to prevent deep peroneal neuroma.

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고도의 무지 외반증에서 역갈매기형 중족골 절골술 및 Akin 절골술의 치료 (Treatment of Severe Hallux Valgus Deformity with Proximal Reverse Chevron Metatarsal Osteotomy and Akin Osteotomy)

  • 정홍근;오정환;김태훈;박재용;강민석
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.16-20
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    • 2010
  • Purpose: This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy. Materials and Methods: The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle ${\geq}40^{\circ}$ or intermetatarsal angle ${\geq}18^{\circ}$) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal-interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed. Results: AOFAS Hallux Metatarsophalangeal-interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from $43.3^{\circ}(31-58^{\circ})$ preoperatively to $6.8^{\circ}(-8-27^{\circ})$ postoperatively. The intermetatarsal angle was decreased from $18.4^{\circ}(11-24)^{\circ}$ preoperatively to $5.3^{\circ}(1-12^{\circ})$postoperatively. The sesamoid subluxation was improved from $2.8{\pm}0.4$ preoperatively to $0.4{\pm}0.6$ postoperatively. Conclusion: Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.

Modified Proximal Scarf Osteotomy for Hallux Valgus

  • Young, Ki Won;Lee, Hong Seop;Park, Seong Cheol
    • Clinics in Orthopedic Surgery
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    • 제10권4호
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    • pp.479-483
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    • 2018
  • Background: We developed a modified proximal scarf osteotomy technique for moderate to severe hallux valgus in an attempt to obtain better correction of the deformity. In addition, we compared the clinical and radiographic results of this modified technique with those of the classic scarf osteotomy reported in other studies. Methods: Between December 2004 and July 2009, 44 cases of modified proximal scarf osteotomy was performed in 35 patients with moderate hallux valgus. The American Orthopedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, range of motion of the first metatarsophalangeal joint, and radiographic results were evaluated. Results: The mean hallux valgus angle and the mean first intermetatarsal angle improved from an average of $32.2^{\circ}$ and $14.3^{\circ}$, respectively, to an average of $12.5^{\circ}$ and $8.6^{\circ}$, respectively. The distal metatarsal articular angle improved from an average of $18.7^{\circ}$ to $12.4^{\circ}$. The preoperative mean AOFAS and VAS scores were 47 points and 7 points, respectively, which improved to 86 points and 1 point, respectively, at the final follow-up. Limited range of motion occurred in two cases postoperatively. The height of the first metatarsal-cuneiform joint, which was an average of 15.9 mm preoperatively, did not change. The first metatarsal-talus angle increased from an average of $4.1^{\circ}$ to $7.1^{\circ}$. Conclusions: The modified proximal scarf osteotomy for the treatment of moderate hallux valgus showed similar results with the classic scarf osteotomy with regard to changes in the first intermetatarsal angle and postoperative satisfaction. Therefore, we suggest the modified proximal scarf osteotomy be considered as well as other proximal osteotomy in the treatment of moderate to severe hallux valgus.

제 1열 전족부 절골술을 통한 평발 교정에 있어 골이식 없이 사용한 소형 쐐기형 금속판의 치료 결과 (The Results of the First Ray Forefoot Osteotomy Using Low Profile Wedge Plate without a Bone Grafting for Pes Planus Correction)

  • 최준영;신명진;서진수
    • 대한족부족관절학회지
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    • 제21권1호
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    • pp.7-11
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    • 2017
  • Purpose: We retrospectively analyzed the radiographic and clinical results after the first ray of forefoot osteotomy using low profile wedge plate without additional cancellous bone grafting for pes planus correction. Materials and Methods: Twenty-four patients were enrolled in this study. Medial cuneiform opening wedge osteotomy was performed in 12 patients (Cotton osteotomy, group C) and first metatarsal base osteotomy was performed in 12 patients (group MT). Results: On average, the wedge size was 5.61 mm (5~6 mm). The mean time to radiographic union was 3.18 and 3.27 months in groups C and MT, respectively. Postoperative talonavicular coverage angle, talo-first metatarsal angle (anteroposterior), talo-first metatarsal angle (lateral), talo-calcaneal angle (lateral), medial cuneiform height, and American orthopaedic foot, as well as ankle society midfoot scale were significantly improved in both groups. Nonunion, delayed union or fixation failure was not presented in our series. Conclusion: We have shown that low profile wedge plate was effective in the case of first ray forefoot osteotomy for pes planus correction without any additional cancellous bone grafting.

전방 분절골 절단술과 임프란트 식립을 이용한 구강악기능의 재건 : 증례보고 (ORAL REHABILITATION WITH MANDIBULAR ANTERIOR SEGMENTAL OSTEOTOMY AND IMPLANTATION: A CASE REPORT)

  • 문철웅;김수관;김학균;문성용;유재식
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권4호
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    • pp.319-324
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    • 2009
  • Kole's Anterior segmental osteotomy of the mandible is commonly used to close an anterior open bite, to depress an elevated anterior dentoalveolar segment, or to retrude or advance a dentoalveolar segment. The procedure is often combined with an anterior maxillary segmental osteotomy to correct bimaxillary protrusion. We report 53-year-old woman who the extruded state of mandibular anterior alveolar segment was corrected using an mandibular anterior alveolar segmental osteotomy and dental implantation of the anterior maxilla. We planned to remove the old prosthesis, and then perform an anterior mandibular segmental osteotomy and implant restoration of the anterior maxilla. We suggest that anterior segmental osteotomy is very useful for rehabilitating edentulous patients with malaligned alveolar segment.

New Fixation Method Using Two Crossing Screws and Locking Plate for Cubitus Varus Deformity in Young Adult Elbow: Case Report

  • Kim, Byoung Jin;Seol, Jong Hwan;Kim, Myung Sun
    • Clinics in Shoulder and Elbow
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    • 제19권1호
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    • pp.43-47
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    • 2016
  • Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

고도의 원위 중족골 관절면 각을 동반한 성인 무지 외반증 환자에서의 삼중 절골술의 결과 (The Results of Triple Osteotomy in Adult Hallux Valgus Patients with Highly Increased Distal Metatarsal Articular Angle)

  • 이경태;차승도;양기원;김재영;조주원
    • 대한족부족관절학회지
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    • 제11권1호
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    • pp.28-34
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    • 2007
  • Purpose: To evaluate the clinical and radiographical results of triple osteotomy as a treatment for adult hallux valgus with highly increased distal metatarsal articular ankle (DMAA). Materials and Methods: From October 2003 to April 2005, we retrospectively reviewed 7 hallux valgus patients (3 cases: moderate, 4 cases: severe) treated with triple osteotomy and followed-up for more than 1 year after operation. The mean follow up was 15.1 months. The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA) and the length of 1 : 2 metatarsal bone were measured. Proximal chevron osteotomy and distal biplanar chevron osteotomy were done in 1st metatarsal bone. Akin osteotomy was added to the base of the proximal phalanx. The clinical result was assessed using the AOFAS Hallux score, tenderness on the medial eminence, ROM of 1st metatarsophalangeal joint, calluses and patient satisfaction. Results: The mean HVA and IMA was improved from $37.5^{\circ}$ and $13.4^{\circ}$ to $10.5^{\circ}$ and $6.2^{\circ}$ respectively. The mean DMAA was corrected from $34.2^{\circ}$ to $11.2^{\circ}$ and mean shortening of 1st metatarsal was 2.4 mm (0.9-5.8 mm). The mean AOFAS hallux score was improved from 66.4 to 92.5 and VAS score (pain on the medial eminence) from 4.3 points to 0.4 points. Metatarsalgia disappeared in all cases and there was no complications such as necrosis of the metatarsal head. Conclusion: Triple osteotomy for adult hallux valgus with a highly increased DMAA is effective and should be considered as a part of the treatment armamentarium.

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무지 외반증 환자에서 근위지골 기저부의 내측 돌출부 절제술 후 관절면을 통한 AKIN 절골술 (Transarticular Fixation of Akin Osteotomy on Patients with Hallux Valgus after Resection of Medial Protrusion of Base of Proximal Phalanx)

  • 안성준;김부환;송무호;강석웅;오관택;유성호
    • 대한족부족관절학회지
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    • 제17권3호
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    • pp.220-224
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    • 2013
  • Purpose: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. Materials and Methods: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. Results: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. Conclusion: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.

봉합사 고정을 이용한 Akin 절골술 (Fixation with Suture Material in Akin Osteotomy)

  • 양기원;이경태;김재영;차승도;김응수
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.138-141
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    • 2004
  • Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

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