High tibial osteotomy is a useful procedure in the treatment of early stage osteoarthritis of the knee which is confined to the medial compartment. But long term follow-up study of high tibial osteotomy has not been provided yet and its prerequisite for a successful result still remains unrevealed. Since the osteoarthritis can progress after the osteotomy, it may result in the loss of correction and recurrence of pain and require conversion to total knee replacement arthroplasty. We studied clinically and radiologically the long term result of high tibial osteotomy in 11 patients(16 knees) who had been treated at the Department of Orthopaedic surgery of Seoul Paik Hospital during the period from January, 1978 to May, 1989, and follow-up for longer than 4 years. Preoperative mean varus angle was 6.4 degrees and immediate postoperative mean valgus angle was 8.6 degrees and final mean valgus angle was 4.7 degrees. The average loss of correction angle was 3.9 degrees. At 2-year follow-up, the results of 16 knees were as follows; excellent in six knees, good in seven knees. The final results at average 7.2-year follow-up were excellent in four knees, good in six knees and one knee was converted to total knee replacement arthroplasty. The results showed deterioration of clinical results and loss of correction with time after osteotomy. However, in more than half of the cases the results were good or excellent at the final follow-up, We, therefore, conclude that high tibial osteotomy is still a useful procedure in osteoarthritis of the knee if performed with a precise surgical technique and an adequate overcorrection more than 10 degrees.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy ; Recurrence ; Seoul

PURPOSE: To evaluate changes in the degree of pseudomyopia and prognosis in patients with convergence spasm and acquired pseudomyopia. METHODS: The medical records of patients with convergence spasm and acquired pseudomyopia at the Korea University Medical Center from 2011 to 2014 were identified. We reviewed the patients' gender, age, onset time, visual acuity, refractive error, angle of strabismic deviation and the selected management (cycloplegics, patching, cycloplegics + patching, prism glasses). RESULTS: At the first medical examination, the mean age was 20.08 years. The mean spherical equivalent was -3.75 diopter (D) in the right eye and -4.03 D in the left eye based on manifest refraction and -2.59 D in right eye and -2.85 D in left eye using cycloplegic refraction. Eleven of 12 patients had esodeviation with a mean esodeviation of 10.42 D. The pupil size was 3.63 mm in the right eye and 3.63 mm in the left eye. No patient experienced severe miosis (pupil size <2 mm). Observation (5), patching (3), cycloplegics (2), patching + cycloplegics (1) and prism (1) management were performed in 12 patients. Outcomes included completely cured (3), improvement (7) and no change or recurrence (2). CONCLUSIONS: Active management is necessary for patients with convergence spasm and acquired pseudomyopia.
Academic Medical Centers ; Esotropia ; Humans ; Korea ; Medical Records ; Methods* ; Miosis ; Mydriatics ; Prognosis ; Pupil ; Recurrence ; Refractive Errors ; Spasm* ; Visual Acuity

PURPOSE: To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. MATERIALS AND METHODS: Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or prosthodontic treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. RESULTS: In the sagittal views, mandibular condyle within articular fossa was posteriorly located at medial and central sections. In the coronal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial,central, and lateral sections. CONCLUSION: Mandibular condyle within articular fossa in an asymptomatic population was observed nonconcentric position in the sagittal and coronal views.
Cone-Beam Computed Tomography* ; Female ; Humans ; Male ; Mandibular Condyle* ; Prosthodontics ; Temporomandibular Joint ; Temporomandibular Joint Disorders

Living-Related-Liver-Transplantation(LRLT) has been established as a reliable method of treatment for patients with end-stage liver disease when the scarcity of cadaveric organ donor was considered. But the hepatic artery is high at risk in thrombosis(HAT) following LRLT. So microsurgical technique was introduced in anastomosis of hepatic artery. This study was aimed at using microsurgical technique in LRLT and presenting some technical details of the procedures. From December 1994 to November 1997, a sereis of 41 LRLTs on patients with end-stage liver disease was performed with follow-up period of 5 to 40 months(mean,15.6 months). Organs were donated by living-related donors(n=36) and living-nonrelated ones(n=5). Hepatic artery was reconstructed with microsurgical technique by plastic surgeon. All hepatic arteries were patent intraoperatively and postoperatively except one case, which had leakage at anastomosed site on the postoperative fourth day.Hepatic artery is high at risk in thrombosis(HAT) following LRLT due to the caliber discrepancy and technical difficulties. To overcome these risks, microsurgical technique was introduced. The technique has greatly reduced arterial complication. However, there are some difficulties in microsurgery of LRLT, which are somewhat different from those in other microsurgery fields: the first difficulty is to obtain a good operative field and a sufficient view through the microscope. The second one is to overcome arterial caliber discrepancy. And the last is to achieve a stable posture in narrow and deep operating field against the respiratory movement and heartbeat.With the persistent team approach of plastic and general surgeons in the field of LRLT, we could have reduced the HAT and have had better outcome after LRLT.
Arteries ; Cadaver ; Follow-Up Studies ; Hepatic Artery ; Humans ; Liver Diseases ; Liver Transplantation* ; Liver* ; Microsurgery ; Posture ; Tissue Donors*

PURPOSE: The purpose of this study was to analyze the clinical effectiveness of open reduction in the treatment of distal humeral fracture using a newly designed combined approach of anterolateral and lateral approaches to protect the radial nerve. MATERIALS AND METHODS: We investigated 24 consecutive cases of distal humeral fracture who received open reduction and internal fixation with a plate and screws with a minimum follow-up period of 1 year. We analyzed the patients' age, sex, fracture pattern, timing of the union, range of motion of the elbow joint, and complications. The Mayo elbow performance index (MEPI) was employed for the assessment of elbow joint function. RESULTS: Clinical union was observed at 10.8 weeks (6~20 weeks) on average. Pre-operatively, there were 3 cases of incomplete radial nerve palsy. All of the cases recovered, and there was no additional radial nerve palsy due to surgery. According to the MEPI, 13 cases were "excellent" and 10 cases were "good" or better, comprising 95.83% of the cases. The range of motion at the elbow was 5.5 degrees (0~15 degrees) of extension, and 131.5 degrees (120~145 degrees) of flexion, suggesting no functional disability. The duration of return to work was 11.2 weeks (5~32 weeks) on average. There were no nonunion, malunion, or infection complications. CONCLUSION: The combined anterolateral and lateral approach we designed is a clinically effective approach due to facilitation of protection of the radial nerve and attainment of adequate fixation space.
Elbow ; Elbow Joint ; Follow-Up Studies ; Humeral Fractures ; Humerus ; Paralysis ; Radial Nerve ; Range of Motion, Articular ; Return to Work

No abstract available.
Tendinopathy

BACKGROUND: Due to the anatomical nature of the radial nerve, dissection and attainment of an adequate operative field in mid to distal humerus fracture is dangerous and limited. We devised a combined anterolateral and lateral approach that ensures protection of the radial nerve. This is achieved by performing bimodal dissection of the proximal humerus anteriorly and the distal humerus laterally. METHODS: Thirty-five consecutive patients were treated using a combined anterolateral and lateral approach for a minimum follow-up period of 24 months. We analyzed time to bony union, time to return to daily work, range of motion, elbow joint function as assessed by the Mayo elbow performance index and complications. RESULTS: Radiologic bony union was observed at 11.2 weeks (range, 8 to 20 weeks) on average. Four cases of incomplete radial nerve palsy before surgery all recovered. Time to return to work was 10.2 weeks (range, 2 to 32 weeks) on average. The average range of motion of the elbow was 3.3degrees (range, 0degrees to 10degrees) of extension and 135.9degrees (range, 125degrees to 145degrees) of flexion. There were 21 cases of excellent and 13 cases of good or better recovery, comprising over 97.1% on the Mayo elbow performance index. There were no complications of radial nerve palsy, non-union, mal-union, or infection. CONCLUSIONS: Our a modified combined anterolateral and lateral approach is a clinically effective surgical method of achieving protection of the radial nerve and securing easy and firm internal fixation.
Adolescent ; Adult ; Aged ; Female ; Humans ; Humeral Fractures/radiography/*surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Orthopedic Procedures/adverse effects/instrumentation/*methods ; Pain, Postoperative ; Prospective Studies ; Range of Motion, Articular ; Return to Work ; Treatment Outcome

Purpose: Diastasis recti abdominis (DRA) is a common issue among postpartum women, resulting in abdominal muscle weakness and associated problems such as back pain and urinary incontinence. However, compliance with exercise programs is often poor due to childcare demands. This study aims to assess changes in ultrasound parameters (inter-recti distance [IRD], shear wave elastography [SWE]) and patient-reported outcomes (PROs) related to DRA following an online exercise program. Methods: Sixty-seven women aged 25–35 years, who had undergone single vaginal delivery, participated in an8-week exercise program delivered via a mobile app. Pre- and post-intervention ultrasound parameters and clinical scores for low back pain (LBP) and urinary incontinence were compared. Results: After the 8-week program, IRD decreased and SWE increased significantly. PROs, including scores for LBP and urinary incontinence, showed significant improvement. Subgroup analysis based on initial IRD diagnostic criteria for DRA revealed significant improvements in ultrasound parameters and PROs in both groups, with greater improvements observed in those initially diagnosed with clinical DRA. Conclusion The 8-week online exercise program through mobile application reduced IRD, SWE, and LBP-related disability and stress urinary incontinence. In particular, IRD showed a larger decrease than the decrease reported in a recent meta-analysis. These results suggest that an online exercise program

Purpose: Diastasis recti abdominis (DRA) is a common issue among postpartum women, resulting in abdominal muscle weakness and associated problems such as back pain and urinary incontinence. However, compliance with exercise programs is often poor due to childcare demands. This study aims to assess changes in ultrasound parameters (inter-recti distance [IRD], shear wave elastography [SWE]) and patient-reported outcomes (PROs) related to DRA following an online exercise program. Methods: Sixty-seven women aged 25–35 years, who had undergone single vaginal delivery, participated in an8-week exercise program delivered via a mobile app. Pre- and post-intervention ultrasound parameters and clinical scores for low back pain (LBP) and urinary incontinence were compared. Results: After the 8-week program, IRD decreased and SWE increased significantly. PROs, including scores for LBP and urinary incontinence, showed significant improvement. Subgroup analysis based on initial IRD diagnostic criteria for DRA revealed significant improvements in ultrasound parameters and PROs in both groups, with greater improvements observed in those initially diagnosed with clinical DRA. Conclusion The 8-week online exercise program through mobile application reduced IRD, SWE, and LBP-related disability and stress urinary incontinence. In particular, IRD showed a larger decrease than the decrease reported in a recent meta-analysis. These results suggest that an online exercise program

Purpose: Diastasis recti abdominis (DRA) is a common issue among postpartum women, resulting in abdominal muscle weakness and associated problems such as back pain and urinary incontinence. However, compliance with exercise programs is often poor due to childcare demands. This study aims to assess changes in ultrasound parameters (inter-recti distance [IRD], shear wave elastography [SWE]) and patient-reported outcomes (PROs) related to DRA following an online exercise program. Methods: Sixty-seven women aged 25–35 years, who had undergone single vaginal delivery, participated in an8-week exercise program delivered via a mobile app. Pre- and post-intervention ultrasound parameters and clinical scores for low back pain (LBP) and urinary incontinence were compared. Results: After the 8-week program, IRD decreased and SWE increased significantly. PROs, including scores for LBP and urinary incontinence, showed significant improvement. Subgroup analysis based on initial IRD diagnostic criteria for DRA revealed significant improvements in ultrasound parameters and PROs in both groups, with greater improvements observed in those initially diagnosed with clinical DRA. Conclusion The 8-week online exercise program through mobile application reduced IRD, SWE, and LBP-related disability and stress urinary incontinence. In particular, IRD showed a larger decrease than the decrease reported in a recent meta-analysis. These results suggest that an online exercise program