• 제목/요약/키워드: proximal

검색결과 2,599건 처리시간 0.025초

무지외반증 치료에서 근위 중족골 절골술과 원위 연부조직 교정술 후 종자골의 교정정도 (Correction of Sesamoid after Proximal Metatarsal Osteotomy and Distal Soft Tissue Procedure in Hallux Valgus)

  • 정화재;신헌규;장일성;이종근
    • 대한족부족관절학회지
    • /
    • 제9권1호
    • /
    • pp.74-80
    • /
    • 2005
  • Purpose: A retrospective review of the radiographs of the proximal metatarsal osteotomy and distal soft tissue procedure for hallux valgus, evaluating the correction of the tibial sesamoid, was undertaken. We evaluated the correlation between the reduction of the tibial sesamoid and the clinical outcomes. Materials and Methods: 17 patients (23 cases) with moderate to severe hallux valgus deformity underwent the proximal metatarsal osteotomy and distal soft tissue procedure. The preoperative and last follow-up radiographs were reviewed according to the tibial sesamoid grade classification recommended by the Research Committee of the American Orthopedic Foot and Ankle Society (AOFAS). We divided them into two groups according to the reduction of the tibial sesamoid. We anaylyzed the clinical outcomes in each group according to Mayo Clinic Forefoot Scoring System (FFSS). Results: In all of the patients, the preoperative tibial sesamoid position were grade 2 or greater. At the last follow-up, 52% (n=12) were grade 1 or less (Group I) and 48% (n=11) were grade 2 or greater (Group II). In group I, the forefoot score was improved from preoperative mean value of 32.0 points to final follow-up value of 66.3 points. In group II, the forefoot score was improved from preoperative mean value of 31.7 points to final follow-up value of 65.9 points. There was no statistical significance between postoperative, average scores in group I and II (p>0.05). Conclusion: The position of the tibial sesamoid was corrected insufficiently in almost half of all cases. In view of clinical outcomes, there was no significant difference between the corrected group and the other group.

  • PDF

McBride씨 변형 술식과 근위 중족골 반월형 절골술을 이용한 무지 외반증의 치료 (Treatment of Hallux Valgus with Modified McBride Procedure and Proximal Metatarsal Crescentic Osteotomy)

  • 이주홍;박종혁
    • 대한족부족관절학회지
    • /
    • 제9권1호
    • /
    • pp.81-86
    • /
    • 2005
  • 중등도 이상의 변형을 보인 무지 외반증 치료에서 McBride씨 변형 술식과 근위 중족골 반월형 절골술은 만족스러운 결과를 보이는 치료 수단이나 신중한 환자 선택과 세심한 술기가 요구된다.

  • PDF

무지 외반증의 치료에서 단일 나사못을 이용한 근위 중족골 쐐기 절골술 (Proximal Metatarsal Wedge Osteotomy with Single Screw Fixation in Treatment of Hallux Valgus)

  • 최재열;신헌규;장일성;강동호
    • 대한족부족관절학회지
    • /
    • 제9권1호
    • /
    • pp.87-93
    • /
    • 2005
  • Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

  • PDF

근위 족저 근막염의 비수술적 치료 결과 : 족저 근막 두께에 따른 비교 분석 (Outcome of Nonoperative Treatment for Proximal Plantar Fasciitis: Comparative Analysis According to Plantar Fascia Thickness)

  • 윤광섭;정홍근;배의정;김태훈
    • 대한족부족관절학회지
    • /
    • 제12권2호
    • /
    • pp.122-127
    • /
    • 2008
  • Purpose: To evaluate the clinical outcome of proximal plantar fasciitis after nonoperative treatment, and also to find the correlation of the heel pain with the plantar fascia thickness measured by ultrasonography. Materials and Methods: The study is based on 41 patients, 46 feet of the proximal plantar fasciitis that were treated conservatively with at least 12 months follow-up. All were treated with heel pad, Achilles and plantar fascia stretching and pain medications for at least 3 months. Heel ultrasonography was performed at the beginning of the treatment to measure the plantar fascia (PF) thickness and the echogenicity. PF thickness over 4 mm and less were grouped in to group A and B respectively to compare the clinical outcome. Results: Average thickness of the PF at the calcaneal attach was 5.2 mm. Symptom duration before the treatment was average 13.2 month; group A being 14.6 months and group B being 9.0 months with no significant difference (p=0.09). As functional evaluation, Roles-Maudsley score improved from 3.4 initially to 2.3 at final follow-up, while morning heel pain also improved from average VAS pain score of 7.2 to 4.0. However Maudsley and VAS score both didn't show statistical difference between the 2 groups (p>0.05). Conclusion: Plantar fasciitis improved substantially with the nonoperative treatments. However, the 2 groups, divided according to 4 mm thickness by ultrasonography, didn't show significant difference in either symptom duration or in the clinical outcomes.

  • PDF

EVALUATION OF TIGHTNESS OF PROXIMAL TOOTH CONTACT IN PERMANENT DENTITION

  • Kim, Kyoung-Hwa;Jung, Jae-Hyun;Kim, Hee-Jung;Chung, Chae-Heon;Oh, Sang-Ho
    • 대한치과보철학회지
    • /
    • 제46권6호
    • /
    • pp.553-560
    • /
    • 2008
  • STATEMENT OF PROBLEM: Proximal contact plays an important role in the stability and maintenance of the integrity of the dental arches. However, it is difficult to evaluate quantitatively the tightness of proximal tooth contact (TPTC). PURPOSE: The aim of this study was to measure the TPTC in permanent dentition. MATERIAL AND METHODS: Ten young adult volunteers with healthy dentition participated in this experiment. The TPTC between the teeth of both the maxilla and the mandible was measured at rest state by a novel device which records the TPTC by pulling of a stainless steel strip (0.03 mm thick) using the electric motor. One-way ANOVA test was used to compare the values in all measured area. When a statistically significant difference was calculated, Bonferroni correction was applied. Independent samples t-test was used to compare the values in male and female. RESULTS: The lowest TPTC and the highest TPTC was measured between the lower central incisors (0.87 ${\pm}$ 0.20 N), and between the lower left first molar and second molar (1.99 ${\pm}$ 0.68 N), respectively. All TPTC per quadrant demonstrated a similar pattern of a continuous increased gradient in an anterior-posterior direction. There are no significant difference between the maxilla and mandible. CONCLUSION: The TPTC was measured quantitatively by a novel device and decreased progressively in a posterior-anterior direction.

사과 자엽의 기내 식물체 재분화와 배양 광조건 및 절편체 극성과의 관계 (Correlation between in vitro Plant Regeneration of Apple Cotyledon and Light Condition, Polarity of Explant)

  • 안현주;예병우;임용표;신용억
    • 식물조직배양학회지
    • /
    • 제27권1호
    • /
    • pp.19-23
    • /
    • 2000
  • 사과 자엽조직으로부터 기내에서 식물체를 재분화시키는 데에 있어서 배양 광조건 및 절편체 극성과의 관계를 살펴보고자 사과‘Fuji’품종의 자엽을 재료로하여 광조건 및 광질을 달리하여 배양하였고, 또한 여러 가지 형태의 절편체를 사용하여 시험을 수행하였다. 배양환경조건 중 광조성에 따른 신초 재분화율을 본 결과 배양 초기 10일간 암배양한 후 명 배양한 처리구에서 가장 높은 재분화율을 나타내었으며, 배양중기의 암처리는 효과가 없었다. 광질별로 비교할 때 전처리로 4일간 암배양한 후 청색광을 조사한 처리구에서 높은 신초 재분화율을 나타내었다. 신초 재분화 유기와 절편체 극성과의 관계를 보면 모든 신초의 형성은 절제된 자엽의 기부 끝쪽에서만 이루어졌다. 즉, 기부쪽 절편체의 말단부 절단면에서보다는 기부쪽 절편체와 말단 절편체의 기부쪽 절단면에서 식물체의 재분화가 이루어짐을 알 수 있었다. 신초 유기는 배축의 기부쪽 자엽 절편체 에서 매우 높게 나타난 반면 자엽의 말단부위에 가까운 곳에서는 현저히 감소하였다.

  • PDF

경골 근위부에 발생한 Brodie 농양에서 내시경을 이용한 소파술 - 증례 보고 - (Endoscopic-Assisted Curettage of Brodie Abscess in Proximal Tibia - A Case Report -)

  • 구정회;조형래;박만준;최승현
    • 대한관절경학회지
    • /
    • 제11권2호
    • /
    • pp.134-138
    • /
    • 2007
  • Brodie 농양은 빈도가 흔하지 않고, 독성이 적은 원인균에 의해 발생하는 아급성 혹은 만성 골수염의 국소형으로 소아나 청소년의 하지 장골 특히 경골의 골간단과 골단 부위에 호발하나 성인에서도 발생할 수 있다. 수술적 치료시 병변의 위치가 근위 경골 골간단 후방에 위치한 경우 개방적 소파술로는 병소 접근이 어렵고 신경 혈관 손상 및 주위 조직 오염의 위험성이 있다. 본원 정형외과에서 48세 남자에서 발생한 경골 근위부 골간단 후방부의 Brodie 농양을 전방 십자 인대 재건술시 사용하는 표적 기구(Rigid fix system, Mitek, Johnson & Johnson, Norwood, MA)를 이용하여 병소에 손쉽고 정확하게 삽입구를 만들어 내시경 시야 하에서 염증 및 육아 조직을 제거하여 치료한 경험이 있어 이를 문헌 고찰과 함께 보고하고자 한다.

  • PDF

The Outcomes of Proximal Humerus Fractures with Medial Metaphyseal Disruption Treated with Fibular Allograft Augmentation and Locking Plate

  • Kim, Doo Sup;Yoon, Yeo Seung;Kang, Sang Kyu;Jin, Han Bin;Lee, Dong Woo
    • Clinics in Shoulder and Elbow
    • /
    • 제20권2호
    • /
    • pp.90-94
    • /
    • 2017
  • Background: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. Methods: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. Results: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was $127.5^{\circ}$. Conclusions: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

Operative Treatment with Intramedullary Fibular Strut Allograft for Osteoporotic Proximal Humerus Fracture

  • Chun, Yong-Min;Lee, Wonyong
    • Clinics in Shoulder and Elbow
    • /
    • 제20권2호
    • /
    • pp.95-99
    • /
    • 2017
  • Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

나선빗인대 재건을 이용한 원위지관절 신전장애의 교정 (Correction of Distal Interphalangeal Joint Extension Lag Using Spiral Oblique Retinacular Ligament Reconstruction)

  • 문경환;김진수;이동철;기세휘;노시영;양재원
    • Archives of Plastic Surgery
    • /
    • 제33권4호
    • /
    • pp.480-484
    • /
    • 2006
  • Purpose: A lot of surgical techniques were tried to correct extension lag of distal interphalangeal joint. Spiral oblique retinacular ligament reconstruction is the one of correction techniques. Methods: From January 2004 to January 2005, a total of 13 extension lag of distal interphalangeal joint corrections were performed using spiral oblique retinacular ligament reconstruction for 11 patients. After dorsal incision exposing from base of distal phalanx to proximal phalanx, the new ligament(half of lateral band or graft tendon) lies distally at the dorsum of the distal phalanx and passes volarly and proximally along the side of the middle phalanx and anterior and obliquely across the front of the proximal interphalangeal joint to the opposite side of the digit at the proximal phalanx. Results: 5 of 6 mallet finger deformities and 7 swan neck deformities were corrected, which were both extension lag of distal interphalangeal joint and hyperextension of proximal interphalangeal joint. Conclusion: As a result, spiral oblique retinacular ligament reconstruction is an effective and recommendable method for correction of mallet finger deformity and swan neck deformity.