BACKGROUND: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. METHODS: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was 36.50 ± 10.22 years. The mean follow-up duration was 54.80 ± 32.50 months. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. RESULTS: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were 9.72°± 3.95°, 27.67°± 10.75°, and 6.92% ± 3.40%, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were 14.73°± 2.97°, 11.55°± 3.26°, and 11.33% ± 6.39%, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. CONCLUSIONS: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.
Adult* ; Child ; Congenital Abnormalities* ; Elbow ; Follow-Up Studies ; Humans ; Humeral Fractures ; Osteotomy* ; Ulnar Nerve

IVRO is a popular procedure to setback prognathic mandible. But guided functional physiotherapy after IVRO is the most important factor to get successful result, because there have been some concerns over an openbite tendency following this procedure. The purpose of this study is to evaluate the early adaptability to fuctional phsiotherapy and early openbite tendency associated with the kinds of surgery performed. The study was performed in fifty patients who had received bilateral IVRO from 1993 to 1994. After two weeks of maxillomandibular fixation(MMF), active physiotherapy was carried out according to Park's protocol and detail of openbite tendency was checked. We recorded the number of days for physiotherapy to analzye the adaptability in early physiotherapy until there was no more openbite tendency. The following results were obtained. 1. The adaptability in early physiotherapy to prevent openbite tendency following IVRO was more favorable in two-jaw surgery group than one-jaw surgery group.(p<0.005) 2. The adaptability in early physiotherapy was more favorable in lesser mandibular setback group than larger setback group, but there was no statistical significance. (p<0.05). 3. The adaptability in early physiotherapy was more favorable in posterior impaction group than non-posterior impaction group, but there was no statistical significance.(p<0.05). 4. The cases which MMF was applied again because of the strong openbite tendency were more plentiful in one-jaw surgery group than in two-jaw surgery group. 5. First two or three days after releasing of maxillomandibular fixation might be the critical period to prevent anterior openbite tendency, and if the partient shows strong openbite tendency during this period, 4-5 days of reapplication of MMF was enough to prevent openbite tendency .
Critical Period (Psychology) ; Humans ; Jaw Fixation Techniques ; Mandible ; Open Bite* ; Prognathism*

No abstract available.

No abstract available.
Orthognathic Surgery*

Septic arthritis in neonates is a rare condition. A failure to make an early diagnosis of septic arthritis in neonates may leave a permanent disability as a result of a delayed treatment. Thus, septic arthritis, requires a prompt diagnosis and a timely treatment especially in this subset of patients. In this case report, we describe our treatment protocol for septic arthritis and concurrent osteomyelitis in the right shoulder of a 28-day-old newborn. Using 2.4 mm wrist arthroscopy, we performed an arthroscopic irrigation and drainage, to remove intra-articular debris and inflammatory tissue, and multiple drilling. We report a satisfactory clinical outcome without any postoperative complications or side effects.
Arthritis, Infectious* ; Arthroscopy ; Clinical Protocols ; Diagnosis ; Drainage ; Early Diagnosis ; Humans ; Infant, Newborn* ; Osteomyelitis ; Postoperative Complications ; Shoulder Joint ; Shoulder* ; Wrist

No abstract available.
Fibrin Tissue Adhesive ; Fibrin ; Surgery, Oral

We designed this study to analyze the causes of repeat surgery in the low back disorder after primary procedure, to evaluate the risk factors and to suggest the rational approachs can prevent and solve the problems related with repeat surgery. We retrospectively reviewed the medical record and radiographs of 24 patients who had sustained persistent or recurrent pain, failed to extended conservative therapy, showing abnormal myelogram and/or CT scan with nerve root compression, and with segmental instability consistent with patients symptom and sign after the primary procedures. We evaluated the functional outcome according to Kims(1986) criteria. The causes of remained or recurrent pain with neurologic symptom were persistent or aggravated lumbar spinal stenosis in 10 cases(42%), recurrent disc herniation in 4 cases(17%), infection in 3 cases(12%), instability in 2 cases(8%) and others in 5 cases(20%). Satisfactory outcome was recorded in 79%(19/24) of patients. The characteristics of the patients associated with satisfactory outcome were those who operated by recurrent disc herniation, instability, retained disc, metal malposition, and nerve root compression by bone chip. But the characteristics of the patients associated with unsatisfactory outcome were those who operated by infection, lumbar spinal stenosis aggravated by degenerative spondylosis and multiple herniated disc, inadequate decompression of lateral and/or foraminal stenosis in aged patients. The most common lesion site was on L4-5 disc, and unsatisfactory result was expected at the upper lumbar spine involvement. Favorable outcome could be expected in the presence of a pain-free interval more than 1 year from the date of the previous operation or persistent symptoms immediately after the initial operaion. We were expected the risk factors leading to repeat surgery were old aged(more than 60) patients, upper lumbar spine involvement and multiple lumbar disc herniation. Postoperative diskitis or osteomyelitis, pain free interval more than 1 month or less than 1 year, and those who had a revision on the lumbar spine previously could be considered as a poor prognostic indicators. When surgery is indicated for degenerative lumbar spinal disorders, adequate diagnostic tests and the execution of appropriate procedures based upon this information should be carried out to prevent the repeat surgery in the low back disorders. Adequate postoperative management can reduce the occurrence of failed back surgery syndrome and in cases necessitating repeat surgery, thorough analysis of causes following proper surgical stabilization can reduce the operative morbidity with early return to daily life.
Constriction, Pathologic ; Decompression ; Diagnostic Tests, Routine ; Discitis ; Failed Back Surgery Syndrome ; Humans ; Intervertebral Disc Displacement ; Medical Records ; Neurologic Manifestations ; Osteomyelitis ; Radiculopathy ; Reoperation* ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine ; Spondylosis ; Tomography, X-Ray Computed

No abstract available.
Humans ; Religion*

No abstract available.
Facial Asymmetry* ; Prognathism*

The superior volume maintenance of membranous over endochondral bone grafts, which was shown in several studies has provided the basis for its preferred clinical use as an onlay grafting material on the craniofacial skeleton. The scientific rationale for this seeming embryological advantage, however, has never been proven, Since the cortical component of membranous bone is proportionally greater than that of endochondral bone, it follows that membranous grafts would show greater volume maintenance over time. Our hypothesis is that the pattern of onlay bone graft resorption is primarily determined by a graft's micro-architecture (relative cortical and cancellous composition) rather than its embryololgical origin(membranous versus endochondral). Fourty adult New Zealand white rabbits were used for this study. There were 8 animals in each of 4 groups. The rabbits of each group were sacrificed at 3, 8, and 16 weeks. Four types of grafts were placed subperosteally, onto each rabbit's cranium: a hydroxyapatite, a cortical bone graft of membranous origin, a cortical bone graft of endochondral origin and a cancellous bone graft of endochondral origin. Membranous bone grafts were obtained from the lateral mandible and endochondral bone grafts were obtained from the ileum. In order to determine post-sacrifice volume and density of the bone grafts, a caliper technique and bone densitometry(bone densitometer: LUNAR, DPX-L, U.S.A.) were performed on all of the bone grafts. Bone graft specimens were histologically examined at 3, 8, and 16 weeks.The measurement of volume and density show that there is a statistically greater resumption in the cancellous endochondral bone grafts for all parameter, compared to either the endochondral or membranous cortical bone grafts or hydroxyapatite at all time points(p< 0.05). In addition, there is no significant difference in the resorption rates between the endochondral and membranous cortical bone grafts for all parameters at all time points. By placing cortical bone grafts and cancellous bone grafts on the recipient sites separately, we have shown that the former grafts maintain their volumes, widths and projections significantly better than the latter grafts. Futhermore, we found no statistical difference in resorption rates between the two cortical bone grafts of different embryologic origins, a finding which has never been previously shown. Bone volume fraction, measured with bone densitometry, was shown to be higher in cortical bone than in cancellous bone at all time points, further illustrating the differences between cortical and cancellous bone.From our results, we believe cortical bone to be a superior onlay-graftiong material, independent of its embryololgic origin.
Adult ; Animals ; Biological Factors* ; Densitometry ; Durapatite ; Humans ; Ileum ; Inlays* ; Mandible ; Rabbits ; Skeleton* ; Skull ; Transplants*