ABSTRACT
PURPOSE: To evaluate a symptomatic bunionette managed by a distal chevron osteotomy. MATERIALS AND METHODS: From 1997, among eighty-three patients who had been treated for a bunionette deformity with a distal chevron osteotomy, 17 patients, who had no other associated diseases, were reviewed retrospectively. The VAS pain score and AOFAS score, the patient satisfaction level, shoe selectability and disappearance of the callus on the foot were examined. The 5th metatarso-phalangeal angle and 4th and 5th intermetatarsal angle were measured using AP plain radiography. The bunionette was classified as types 1, 2, and 3 and the treatment results were analyzed. RESULTS: 8 male and 9 female patients were enrolled in this study. The mean age of the patients was 33.6 years (21-49 years). The mean follow-up period was 37.6 months (20-62 months). The pain VAS scores were 7.9 preoperatively and 1.2 postoperatively. The last follow-up AOFAS score was 94.7, and all patients were ranked at the very satisfied or satisfied level. All patients had also good shoe selectability and the callus on the lateral sole had disappeared. The preoperative 4th and 5th intermetatarsal angle (mean 10.2 degrees) and the 5th metatarso-phalangeal angle (mean 21.4 degrees) improved to 2.7 degrees and 7.2 degrees after surgery, respectively. There was a type 1, 2 and 3 deformity in 2 (12%), 1 (6%) and 14 patients (82%), respectively. The results among the types were satisfactory. CONCLUSION: A distal chevron osteotomy for the treatment of a symptomatic bunionette is safe, easy and can reduce the signs and symptoms. Regardless of the types of deformity, a distal chevron osteotomy can obtain satisfactory results.
Subject(s)
Female , Humans , Male , Bony Callus , Bunion, Tailor's , Congenital Abnormalities , Follow-Up Studies , Foot , Osteotomy , Patient Satisfaction , Radiography , Retrospective Studies , ShoesABSTRACT
In diabetic foot with arterial occlusive disease, skin defect on heel was tried to treat with free flap or local flap, but couldn't be treated well. Therefore below knee amputation was perfomed mostly. But we treated a patient of large heel defect with using of artificial bypass graft and antero-lateral thigh perforator flap.
Subject(s)
Humans , Amputation, Surgical , Arterial Occlusive Diseases , Diabetic Foot , Free Tissue Flaps , Heel , Knee , Perforator Flap , Skin , Thigh , TransplantsABSTRACT
Although Achilles tendinitis is a relatively common disease, tuberculous involvement of Achilles tendon is rare. We report a case of tuberculous Achilles tendinitis, which was successfully treated with chemotherapy and a combined surgical procedure (Achilles tendon parital excision and FHL tendon transfer).
Subject(s)
Achilles Tendon , Drug Therapy , Tendinopathy , TendonsABSTRACT
Although Achilles tendinitis is a relatively common disease, tuberculous involvement of Achilles tendon is rare. We report a case of tuberculous Achilles tendinitis, which was successfully treated with chemotherapy and a combined surgical procedure (Achilles tendon parital excision and FHL tendon transfer).
Subject(s)
Achilles Tendon , Drug Therapy , Tendinopathy , TendonsABSTRACT
BACKGROUND: Many recent studies based on non-linearity have been performed to quantify the complex behavior of the brain in order to understand the pathophysiology of Parkinson's disease (PD). METHODS: We calculated the Fractal dimension (FD) and Lyapunov exponent (L1), the non-linear biologic signals, by digital EEG using 'CHASIM' program, non-linear times series signal simulator and then compared the UPDRS score with the degree of atrophy in the substantia nigra upon brain MRI and EEG data respectively. All subjects (N=20) showed definite hemiparkinsonism. RESULTS: Upon EEG analysis, a strong positive correlation was noted between FD of the left hemispheric electrodes (FP1,F3,T3,T5) and the UPDRS scores in left-sided symptomatic patients. Additionally, positive correlations were noted between the ipsilateral MRI index ratio in the right and left-sided symptomatic patients and respective UPDRS scores. CONCLUSIONS: These results suggested that thalamocortical drive is reduced in the contralateral hemisphere to parkinsonian symptoms and thalamocortical or corticothalamic glutaminergic projection in the ipsilateral hemisphere is increased in the early stage of Parkinson's disease. Additionally, hemiparkinsonim may primarilly cause anatomic and functional changes in the contralateral hemisphere and a compensatory effect in the ipsilateral hemisphere at the same time. We suggest that disease duration may be a compensating factor and of which require further investigation. We hope that our results will aid the understanding of the specific patterns of dysfunction and treatment effects by non-linear EEG measures and anatomic changes of the substantia nigra through continuous follow up of the patients. (J Korean Neurol Assoc 19(3):232~238, 2001)
Subject(s)
Humans , Atrophy , Brain , Electrodes , Electroencephalography , Fractals , Hope , Magnetic Resonance Imaging , Parkinson Disease , Substantia NigraABSTRACT
BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.