• Title/Summary/Keyword: proximal

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Modified Proximal Scarf Osteotomy for Hallux Valgus

  • Young, Ki Won;Lee, Hong Seop;Park, Seong Cheol
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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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.

Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study

  • Palukuri Lakshmi;Sreedharala Srinivas;Dharmapuri Madhulika;Sanujit Pawde;Ajo Sebastian;Swathi Sankar;Sandeep Reddy Chintha
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.369-375
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    • 2023
  • Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm2, and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm2, and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.

Effect to Testosterone on the Growth of Primary Rabbit Proximal Tubule Cells in Serum-Free Medium (Testosterone이 토끼 근위 세뇨관 상피세포의 성장에 미치는 영향)

  • Chu Min-Ho;Park Seung-Joon;Chang Joo-Ho;Jung Jee-Chang
    • The Korean Journal of Pharmacology
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    • v.31 no.1 s.57
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    • pp.85-93
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    • 1995
  • In order to examine the effect of testosterone of the cell growth, using a primary rabbit kidney proximal tubule cell culture system, we observed the effect of 3 growth factors and testosterone supplementation on the growth of primary rabbit kidney proximal tubule cells in the serum-free medium. 1 nM of testosterone showed a potentiation of the effect on the growth of the proximal tubule cell in serum-free medium, but higher concentration (>10 nM) of testosterone indeed inhibited the growth. In the absence of hydrocortisone as a growth supplement in serum-free medium, testosterone caused to potentiate the growth of the cell. In the presence of hydrocortisone, testosterone also potentiated the grwoth of the proximal tubule cells. According to the Northern analysis, testosterone increased significantly the level of ${\beta}-actin$ mRNA in proximal tubular cells of rabbit kidney. Consequently we may suggest that growth stimulatory effect of testosterone on the primary rabbit kidney proximal tubule cell in serum-free and hormonally defined media ascribed to increase the synthesis of ${\beta}-actin$, which is an important protein consisting of cellular microfilament.

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CLASS II COMPOSITE RESIN RESTORATION USING ORTHODONTIC BANDS (교정용 밴드를 이용한 구치부 2급 와동의 복합레진 수복)

  • Park, Sung-Dong;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.13-17
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    • 2005
  • Children and teenagers have a higher frequency of proximal surface caries in the posterior teeth than adults. For proximal restoration, class II amalgam or stainless steel crown has been widely used in the past, however composite resin restoration is getting ore popular due to it's superior cosmetic appearance. When applying composite resin on proximal area, various types of matrix bands can be utilized according to the operator's reference or skill. Such bands have several clinical effects including suitability for proximal margin, reduction of micro-leakage, moisture-control against saliva and ease finishing and polishing. In this case report, orthodontic bands were utilized instead of matrix bands as a remedy for proximal restorations in both primary and permanent teeth and their clinical advantages are as follows. 1. Orthodontic bands showed superior marginal adaptation compared to conventional matrix bands and moisture-control against saliva was excellent. 2. While applying composite resin, deformation of restoration material was estimated to be insignificant due to he rigidity of the orthodontic bands. 3. Natural tooth contour of the orthodontic bands facilitates to reproduce proximal tooth contour of the restoration. 4. In general, pediatric dentists are accustomed to applying orthodontic bands and this may allow pediatric dentists to make proximal composite restorations more efficiently than other dental specialists.

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Comparison of symptomatic and asymptomatic pulmonary embolism in proximal deep vein thrombosis (근위부 심부정맥 혈전증에서 유증상 폐색전증과 무증상 폐색전증의 비교)

  • Kim, Dong Hun;Seo, Young Woo;Kim, Gyun Moo;Ko, Seung Hyun;Jang, Jae Seok;Jang, Tae Chang
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.231-237
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    • 2017
  • Background: Deep vein thrombosis (DVT) and pulmonary embolism (PE) are conditions with significant morbidity and mortality. Proximal DVT has a significant association with PE and possible fatal outcomes. Traditionally, PE is subdivided into symptomatic PE and asymptomatic PE, which have different treatments, preventions and prognoses. The growing utilization of computed tomography pulmonary angiography has led to increased detection of PE in DVT patients. This study examined the clinical characteristics and compared symptomatic PE and asymptomatic PE following proximal DVT. Methods: The medical records of 258 DVT inpatients from July, 2012 to June, 2015 were reviewed retrospectively. After excluding the patients who did not performed PE evaluation and were not diagnosed with PE, 95 patients diagnosed with PE following proximal DVT were enrolled in this study. They were divided into the symptomatic PE group and asymptomatic PE group. Results: The body weight, body mass index, thrombus size, thrombus length and location were similar in the two groups. The symptomatic PE following proximal DVT group showed an older age, higher incidence of emergency department access (85.0% vs. 38.7%, p<0.001) and preceding infection (25.0% vs. 1.3%, p<0.001) as well as a higher incidence of immobilization (45.0% vs 13.3%, p=0.016). In the multivariate logistic regression study, preceding infection and emergency department access showed significant association with symptomatic PE. Conclusion: In proximal DVT inpatients, symptomatic PE was associated with emergency department access and preceding infection. The possibility of a symptomatic PE event should be considered in proximal DVT patients, especially those who were admitted through the emergency department and had preceding infection.