• 대한족부족관절학회지
• /
• 제5권2호
• /
• pp.129-135
• /
• 2001

Purpose: To evaluate the radiographic results of the treatment for Danis-Weber type B lateral malleolar fracture with 2 cannulated screws. Materials and Methods: Thirty-four cases of Danis-Weber type B lateral malleolar fracture were available. Follow-up averaged 8 months (6-25 months). The medial clear space for lateral displacement of talus, talo-crural angle for lateral malleolar shortening, and malunion evidence of lateral malleolar fracture were observed. Results: Medial clear space was from 2mm to 4mm in 34 cases. Talo-crural angle was from $73^{\circ}$ to $82.5^{\circ}$ in 33 cases. One case was complicated with malunion of lateral malleolus. But, we found the same condition in the immediate post- operative radiographic film. Conclusion: We believe that the 2 cannulated screws fixation for Danis-Weber type B lateral malleolar simple fractures is an excellent treatment method.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제36권6호
• /
• pp.259-265
• /
• 2014

Purpose: The purpose of this study is to evaluate the influence of intracapsular fracture lines of the mandibular condyle on the anatomical and functional recovery after non-surgical closed treatment. Methods: Clinical and radiological follow-up of 124 patients with intracapsular fractures of the mandibular condyle was performed after closed treatment between 2005 and 2012. The intracapsular fractures were classified into three categories: type A (medial condylar pole fracture), type B (lateral condylar pole fracture with loss of vertical height) and type M (multiple fragments or comminuted fracture). Results: By radiological finding, fracture types B and M lost up to 24% vertical height of the mandibular condyle compared to the height on the opposite side. In Type M, moderate to severe dysfunction was observed in 33% of the cases. Bilateral fractures were significantly associated with the risk of temporomandibular joint (TMJ) dysfunction in fracture types A and B. Bilateral fracture and TMJ dysfunction were not statistically significantly associated in type M fractures. Conclusion: Most of the mandibular intracapsular condylar fractures recovered acceptably after conservative non-surgical treatment with functional rehabilitation, even with some anatomical shortening of the condylar height. The poor functional recovery encountered in type M fractures, especially in cases with additional fracture sites and bilateral fractures, points up the limitation of closed treatment in such cases.

• 대한족부족관절학회지
• /
• 제11권2호
• /
• pp.226-231
• /
• 2007

Purpose: To evaluate the clinical outcomes and radiographic results of open reduction and internal fixation for intraarticular calcaneal fractures. Materials and Methods: We reviewed 20 cases of calcaneal fractures managed with open reduction and internal fixation from March 2003 to January 2005. We used the computed tomographic classification system proposed by Sanders et al to classify these fractures. Preoperative and postoperative Bohler's angle, heel height (calcaneal facet height) and calcaneal length, calcaneal width were measured. The Creighton-Nebraska Health Foundation Assessment score was used for clinical evaluation. Results: There were 12 cases of type II fractures, 5 of type III fractures and 3 of type IV fractures. The mean clinical score was 84.3 for type II, 82.6 for type III and 56.1 for type IV. The mean preoperative $B{\ddot{o}}hler$ angle was $6.1^{\circ}$ and final was $22.8^{\circ}$. The mean preoperative calcaneal facet height was 76.6 mm and final was 80.3 mm (The mean calcaneal facet height was changed from preop 76.6 mm to postop 80.3 mm). The mean preoperative calcaneal length was 88.2 mm and final was 92.6 mm. The mean preoperative width was 38.1 mm and final was 35.6 mm. Conclusion: Open reduction and internal fixation showed good results for type II and III fractures, but for type IV fractures the clinical result was significantly worse than the other types. However, type IV fractures still had restoration of (should be restored in) $B{\ddot{o}}hler's$ angle, calcaneal facet height, calcaneal length and width which may be helpful in later subtalar fusion.

• Journal of Gastric Cancer
• /
• 제24권3호
• /
• pp.267-279
• /
• 2024

Purpose: The optimal treatment for gastroesophageal junction adenocarcinoma (GEJA) remains controversial. We evaluated the treatment patterns and outcomes of patients with locally advanced GEJA according to the histological type. Materials and Methods: We conducted a single-institution retrospective cohort study of patients with locally advanced GEJA who underwent curative-intent surgical resection between 2010 and 2020. Perioperative therapies as well as clinicopathologic, surgical, and survival data were collected. The results of endoscopy and histopathological examinations were assessed for Siewert and Lauren classifications. Results: Among the 58 patients included in this study, 44 (76%) were clinical stage III, and all received neoadjuvant therapy (72% chemoradiation, 41% chemotherapy, 14% both chemoradiation and chemotherapy). Tumor locations were evenly distributed by Siewert Classification (33% Siewert-I, 40% Siewert-II, and 28% Siewert-III). Esophagogastrectomy (EG) was performed for 47 (81%) patients and total gastrectomy (TG) for 11 (19%) patients. All TG patients received D2 lymphadenectomy compared to 10 (21%) EG patients. Histopathological examination showed the presence of 64% intestinal-type and 36% diffuse-type histology. The frequencies of diffuse-type histology were similar among Siewert groups (37% Siewert-I, 36% Siewert-II, and 33% Siewert-III). Regardless of Siewert type and compared to intestinal-type, diffuse histology was associated with increased intraabdominal recurrence rates (P=0.03) and decreased overall survival (hazard ratio, 2.33; P=0.02). With a median follow-up of 31.2 months, 29 (50%) patients had a recurrence, and the median overall survival was 50.5 months. Conclusions: Present in equal proportions among Siewert types of esophageal and gastric cancer, a diffuse-type histology was associated with high intraabdominal recurrence rates and poor survival. Histopathological evaluation should be considered in addition to anatomic location in the determination of multimodal GEJA treatment strategies.

• Archives of Plastic Surgery
• /
• 제39권6호
• /
• pp.601-605
• /
• 2012

Background Cryptotia is a congenital ear deformity in which the upper pole appears buried beneath the mastoid skin. Cryptotia is a common auricular malformation among Asians. The aim of this paper is to examine the surgical techniques for and complications of 34 cryptotic patients. Methods Surgery was performed for 34 cryptotic deformities (January 2005 to January 2012). Twenty-two patients (64.7%) were classified as having type I cryptotia, and 12 patients (37.5%) type II cryptotia. Among the type I cryptotia patients, 8 patients had mild deformity and 14 severe deformity. Among the type II cryptotia patients, 10 patients had mild deformity and 2 severe deformity. Results The mild deformities were corrected via Z-plasty, V-Y plasty, full-thickness skin graft, and transposition flap, while the severe deformities were corrected via cartilage graft or Medporfor the spread of cartilage adhesion of antihelix. There were two cases of reinvagination in the autologous cartilage graft group. Implant exposure occurred with Medpor (two cases). There were two cases of hypertrophic scar on the previous surgical wound with Medpor. There were no complications in the 18 patients who had mild deformities. Conclusions The type I cryptotia patients had more severe deformities than the type II cryptotia patients. As most of the type II cryptotia patients had only mild deformities, their deformities were corrected without using autologous conchal cartilage graft or Medpor, except for two patients. Through more case analyses, researchers should make an effort to identify methods for recurrence and prevention of complication.

• Clinics in Shoulder and Elbow
• /
• 제19권3호
• /
• pp.155-162
• /
• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제22권5호
• /
• pp.487-492
• /
• 2019

Waardenburg syndrome (WS) type IV is characterized by pigmentary abnormalities, deafness and Hirschsprung's disease. This syndrome can be triggered by dysregulation of the SOX10 gene, which belongs to the SOX (SRY-related high-mobility group-box) family of genes. We discuss the first known case of a SOX10 frameshift mutation variant defined as c.895delC causing WS type IV without Hirschsprung's disease. This female patient of unrelated Kuwaiti parents, who tested negative for cystic fibrosis and Hirschsprung's disease, was born with meconium ileus and malrotation and had multiple surgical complications likely due to chronic intestinal pseudo-obstruction. These complications included small intestinal necrosis requiring resection, development of a spontaneous fistula between the duodenum and jejunum after being left in discontinuity, and short gut syndrome. This case and previously reported cases demonstrate that SOX10 gene sequencing is a consideration in WS patients without aganglionosis but with intestinal dysfunction.

• 임상이비인후과
• /
• 제29권2호
• /
• pp.198-203
• /
• 2018

Background and Objectives : Pediatric orbital blowout fractures occur in discreet patterns, in reference to the characteristic developmental anatomy of the facial skeleton at the time of injury. The purpose of this study was to investigate the clinical characteristics, ocular symptom, fracture type and postoperative results of orbital blowout fractures in the pediatric population. Material and Methods : A retrospective study was conducted from January 2009 to June 2015 in 116 patients with orbital floor fractures ; all less than 18 years old. Patients were divided into 3 groups by age : 0 to 6, 7 to 12, and 13 to 18 years of age. The cause of fracture, fracture site and type, preoperative and postoperative ocular symptoms, timing of surgery were reviewed from their records. Results : Medial wall fractures were the most common site in the 0 to 6 years old group, and floor fractures were the most common site in other age groups. However, floor fracture was the most common site of the need for surgery in all age groups. Trapdoor type of fractures occurred more frequently than open door type of fractures in all age groups. Preoperative symptoms did not differ among the 3 age groups. In case of need surgery, frequency of preoperative ocular symptoms increased with age. However, as age group was young, rate of residual postoperative ocular symptoms were increased. Conclusions : The younger patients are more to have trapdoor type fracture and residual postoperative ocular symptom. Earlier surgical intervention more needed for children with entrapment results.

• 대한족부족관절학회지
• /
• 제13권2호
• /
• pp.211-213
• /
• 2009

Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder that affects synovium, tendon sheath and bursa. Although the condition can present in any joint, knee joint is the most commonly affected site and only 2.5% of cases occur in foot and ankle joint. PVNS occurs in two types: localized and diffuse. Localized type is characterized by focal involvement of the synovium with either nodular or pedunculated masses, Diffuse type affects virtually the entire synovium. Diffuse type has reported more recurrence rate. We have experienced a patient who has diffuse type PVNS of ankle joint and report an optimal method of surgical treatment.

• Journal of Chest Surgery
• /
• 제8권1호
• /
• pp.69-74
• /
• 1975

Twenty-nine cases of ventricular septal defect operated in this department during the period from 1969 to May 1975 were presented. Out of 29 cases, there were 20 cases of type II defects, 8 cases of type I, and one case of type III, and the last case was multiple defect. The anomalies associated with ventricular septal defect were eight in all; three patent ductus arteriosus, one atrial septal defect, one tricuspid insufficiency and an aortic insufficiency. Over all mortality was 17%. The causes of death were complete heart block in a case, respiratory distress due to excessive administration of morphine in one, low cardiac output in two and perforation of the aortic annulus after repair of the ventricular septal defect associated with aortic insufficiency.