• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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• pp.474-480
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• 2001

Purpose: The aim of this study was to evaluate the complications of open reduction and internal fixation of mandibular fracture with miniplates. Patients and Methods: A total of 134 patients who presented with 196 fractures were analyzed retrospectively. Complications were evaluated for factors such as age, the site of fracture, the severity of fracture, delayed operation, preoperative wound contamination, the site and disposition of teeth in the fracture line and midfacial fractures. Statistical analysis was used to compare complications to risk factors. Results: Of the 134 patients, 20 patients had some form of postoperative complications and complication rate was 14.9%. These complications included infection, plate fracture, malocclusion, wound dehiscence, nerve injury and nonunion. There was a significant correlation between complication rate and the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth(p<0.05). Conclusion: The occurrence of postoperative complications in the treatment of mandibular fractures was related to the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.32-36
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• 2014

Preoperative surgical simulation in orthognathic surgery has progressed in recent years; the movement of the mandible can be anticipated through three-dimensional (3D) simulation surgery before the actual procedure. In this case report, the mandible was moved to the intended postoperative occlusion through preoperative surgical 3D simulation. Right-side condylar movement change was very slight in the surgical simulation, suggesting the possibility of mandibular surgery that included only left-side ramal osteotomy. This case report describes a patient with a mild asymmetric facial profile in which the mandibular menton had been deviated to the right and the lips canted down to the left. Before surgery, three-dimensional surgical simulation was used to evaluate and confirm a position for the condyle as well as the symmetrical postoperative state of the face. Facial asymmetry was resolved with minimal surgical treatment through unilateral intraoral vertical ramus osteotomy on the left side of the mandible. It would be a valuable complement for the reduction of the surgical treatment if one could decide with good predictability when an isolated intraoral vertical ramus osteotomy can be done without a compensatory osteotomy on the contralateral side.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.179-186
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• 2003

Purpose: The purpose of this study was to evaluate the result of modified Lapidusprocedure for Hallux valgus associated with first ray hypermobility Materials and Methods: A retrospective study was conducted between Aug. 1999 and Oct. 2003. We evaluated 20 cases (12patients)of hallux valgus that performed modified Lapidus procedure. We asked to patient about postoperative satisfaction in terms of overall, pain, and appearance. preoperative and postoperative AOFAS score for the forefoot was calculated, also preoperative and postoperative radiologic evaluation was done. Results: In terms of satifaction, overall rate was 70%, pain relief and appearance were 70% and 70%. preoperative mean Hallux valgus angle and mean intermetatarsal angle were 42.6degree and 19.4degree. after procedure, at last follow up, mean hallux valgus angle and mean intermetatarsal angle were 16degree and 8.7degree. In terms of complication, nonunion was seen in 3 cases and recurrence of hallux valgus deformity was 2 cases. Conclusion: In consideration of high complication rate, modified Lapidus prociduremust be improved in terms of more rigid fixation technique, etc.

• Journal of International Society for Simulation Surgery
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• v.3 no.1
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• pp.22-27
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• 2016

Background Craniosynostosis management using distraction osteogensis represent a challenge for surgeons due to the great variability of the skull deformity even within the same etiology. The ability to apply the simulation surgery for improving the preoperative planning for distraction osteogensis could improve the results.Planning and Simulation 14 patients presented with craniosynostosis had been subjected to simulation surgery prior to real surgery. 3D CT scans was obtained upon patient admission. Adjustment of all skull position to Frankfort horizontal plane was done. 3 different distraction osteogensis plans were done for each patient according to the skull morphology. For each plane, movement for each bone segment was done according to the pre-planned distraction vectors. Also the distances of distractions were pre-determined according to the cephalic index as well as brain volume. Intraoperatively, we choose the most appropriate plan for the patient by the surgeon. At the end of distraction, 3D CT scan was obtained, and was compared to the simulation plan. Also the distance and the direction of distraction was compared to that of the plan. Accordingly, the distance was almost matching that of the simulation surgery, however the vector of distraction was not matched.Conclusion Preoperative stimulation planning for craniosynostosis patient is very valuable tool in the surgical management of craniosynostosis patients.

• Journal of Gastric Cancer
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• v.16 no.1
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• pp.43-50
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• 2016

Purpose: It is well known that old age is a risk factor for postoperative complications. Therefore, this study aimed to explore the risk factors for poor postoperative surgical outcomes in elderly gastric cancer patients. Materials and Methods: Between January 2006 and December 2015, 247 elderly gastric cancer patients who underwent curative gastrectomy were reviewed. In this study, an elderly patient was defined as a patient aged ${\geq}65$ years. All possible variables were used to explore the risk factors for poor early surgical outcomes in elderly gastric cancer patients. Results: Based on multivariate analyses of preoperative risk factors, preoperative low serum albumin level (<3.5 g/dl) and male sex showed statistical significance in predicting severe postoperative complications. Additionally, in an analysis of surgery-related risk factors, total gastrectomy was a risk factor for severe postoperative complications. Conclusions: Our study findings suggest that low serum albumin level, male sex, and total gastrectomy could be risk factors of severe postoperative complications in elderly gastric cancer patients. Therefore, surgeons should work carefully in cases of elderly gastric cancer patients with low preoperative serum albumin level and male sex. We believe that efforts should be made to avoid total gastrectomy in elderly gastric cancer patients.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.779-782
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• 2010

Purpose: As the evaluation of the preoperative sensibility in the orbitozygomatic complex fracture, used by most surgeons, depends on the patient's subjective judgements, it is difficult to make generalization and to use it as an objective evaluation method. We used the blink reflex study to objectively evaluate injury to the infraorbital nerve. Methods: From December 2008 to November 2009, a total of 16 patients underwent the patient's subjective report on sensory symptoms and the blink reflex study preoperatively. Among patients having orbitozygomatic complex fracture of type III or more according to Henderson's classification and simultaneously suspected as being injured along the infraorbital nerve pathway, patients who had difficulty in checking preoperative sensibility and said 'normal sensibility' were selected as candidates. Results: Fifteen patients showed abnormal R1 on the fracture side. These results suggested that most of patients had injury to the infraorbital nerve. Conclusion: Contrary to the existing tests, the blink reflex study is a useful diagnostic tool in reflecting injury to the infraorbital nerve objectively.

• Journal of Korean Clinical Nursing Research
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• v.17 no.3
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• pp.443-454
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• 2011

Purpose: The purpose of this study was to investigate the predictors of delirium in patients after orthopedic surgery. Methods: Participants were 121 orthopedic surgery patients from one university affiliated hospital located in Seoul. The instrument of Delirium Observation Screening Scale (DOS) developed by Schuurmans et al. (2003) was utilized. Data were collected from September 1st, 2010 to March 31st, 2011 and analyzed using SPSS 12.0 with descriptive statistics, t-test, chi-square test and logistic regression. Results: The delirium in patients after orthopedic surgery was occurred in 9 (7.4%) out of 121 patients. Several factors were associated with the delirium occurrence age, admission route, preadmission Activity of Daily Living (ADL), preadmission hearing aid use, preadmission walking degree, diagnosis, type of surgery, Intensive Care Unit (ICU) stay after surgery, restraint, drainage tube, time of admission to surgery, preoperative albumin and preoperative sodium. Preadmission ADL, preoperative sodium and time of admission to surgery were the significant predictors of the delirium occurrence. Conclusion: Study results may help nurses predicting and detecting delirium early and providing preventive measures to the patients with high risk of delirium after orthopedic surgery.

• Imaging Science in Dentistry
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• v.51 no.3
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• pp.313-321
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• 2021

Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

• Hip & pelvis
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• v.30 no.4
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• pp.226-232
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• 2018

Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA. Results: The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA. Conclusion: THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

• Archives of Craniofacial Surgery
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• v.21 no.6
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• pp.345-350
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• 2020

Background: This study evaluated the efficacy of the endoscopic medial orbital wall repair by comparing it with the conventional transcaruncular method. This surgical approach differs from the established endoscopic technique in that we push the mesh inside the orbit rather than placing it over the defect. Methods: We retrospectively reviewed 40 patients with isolated medial orbital blowout fractures who underwent medial orbital wall reconstruction. Twenty-six patients underwent endoscopic repair, and 14 patients underwent external repair. All patients had preoperative computed tomography scans taken to determine the defect size. Pre- and postoperative exophthalmometry, operation time, the existence of diplopia, and pain were evaluated and compared between the two methods. We present a case showing our procedure. Results: The operation time was significantly shorter in the endoscopic group (44.7 minutes vs. 73.9 minutes, p= 0.035). The preoperative defect size, enophthalmos correction rate, and pain did not significantly differ between the two groups. All patients with preoperative diplopia, eyeball movement limitation, or enophthalmos had their symptoms resolved, except for one patient who had preexisting strabismus. Conclusion: This study demonstrates that endoscopic medial orbital wall repair is not inferior to the transcaruncular method. The endoscopic approach seems to reduce the operation time, probably because the dissection process is shorter, and no wound repair is needed. Compared to the previous endoscopic method, our method is not complicated, and is more physiological. Larger scale studies should be performed for validation.