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        New Classification of Polydactyly of the Foot on the Basis of Syndactylism, Axis Deviation, and Metatarsal Extent of Extra Digit

        석효현,박지웅,권성택 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.3

        Background Polydactyly of the foot is one of the most frequent anomalies of the limbs. However, most classification systems are based solely on morphology and tend to be inaccurate and less relevant to surgical methods and results. The purpose of this study is to present our new classification of polydactyly of the foot, which can serve as a predictor of treatment and prognosis. Methods To find a correlation between the various morphologic traits of polydactyly of the foot and the treatment plan and outcomes, we reviewed 532 cases of polydactyly of the foot in 431 patients treated in our hospital, expanding on our previous study that described polydactyly based on the importance of metatarsal bone status and varus deformity. The records of patients were evaluated and compared with previous studies at other centers. Results Unsatisfactory results were seen in 36 cases, which included 5 cases of incomplete separation due to syndactylism, 23 cases of axis deviation, and 8 cases of remnants of extradigit metatarsal bones. The locus of the polydactyly, or the digit which was involved, did not seem to affect the final postoperative outcomes in our study. Three factors-syndactylism, axis deviation, and metatarsal extension-are the major factors related to treatment strategy and prognosis. Therefore, we developed a new classification system using three characters (S, A, M)followed by three groups (0, 1, 2), to describe the complexity of polydactyly of the foot, such as S1A2M2. Conclusions Our new classification could provide a communicable description to help determine the surgical plan and predict outcomes.

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      • KCI등재후보

        Comparison of the 3D Digital Photogrammetry and Direct Anthropometry in Unilateral Cleft Lip Patients

        석효현,권근용,백승학,최태현,김석화,Seok, Hyo Hyun,Kwon, Geun-Yong,Baek, Seung-Hak,Choi, Tae Hyun,Kim, Sukwha Korean Cleft Palate-Craniofacial Association 2013 Archives of Craniofacial Surgery Vol.14 No.1

        Background: In cleft lip patients, the necessity of a thorough preoperative analysis of facial deformities before reconstruction is unquestioned. The surgical plan of cleft lip patient is based on the information gained from our preoperative anthropometric evaluation. A variety of commercially available three-dimensional (3D) surface imaging systems are currently introduced to us in plastic surgery for these use. However, few studies have been published on the soft tissue morphology of unrepaired cleft infants described by these 3D surface imaging systems. Methods: The purpose of this study is to determine the accuracy of facial anthropometric measurements obtained through digital 3D photogrammetry and to compare with direct anthropometry for measurement in unilateral cleft lip patients. We compared our patients with three measurements of dimension made on both sides: heminasal width, labial height, and transverse lip length. Results: The preoperative measurements were not significantly different in both side of labial height and left side of heminasal width. Statistically significant differences were found on both side of transverse lip length and right side of heminasal width. Although the half of preoperative measurements were significantly different, trends of results showed average results were comparable. Conclusion: This is the first study in Korea to simultaneously compare digital 3D photogrammetry with traditional direct anthropometry in unilateral cleft lip patients. We desire this study could contribute the methodological choice of the many researchers for proper surgical planning in cleft lip reconstruction field.

      • KCI등재후보

        Aspiration Pneumonia caused by Povidone-iodine (Betadine) in Cleft Palate Patient

        김석화,석효현,정의철,박지웅,최태현,Kim, Sukwha,Seok, Hyo Hyun,Jeong, Eui Cheol,Park, Ji Ung,Choi, Tae Hyun Korean Cleft Palate-Craniofacial Association 2013 Archives of Craniofacial Surgery Vol.14 No.1

        Povidone-iodine (PVP-I, Betadine) has many advantages as a disinfectant solution for preoperative preparations, especially for oral surgery. It is widely used because of its low toxicity and excellent bactericidal effect. The authors report a case of pneumonia secondary due to the aspiration of PVP-I, which was used as an oral disinfectant. We present a case of aspiration pneumonia that resulted from the careless use of PVP-I during preoperative preparation. The patient was a 10-month-old female scheduled for elective surgery to correct a complete cleft of secondary palate. During the preparation of the oral cavity for that cleft palate patient, PVP-I was incidentally aspirated to the airway. The lung resistance was noted with positive pressure and pneumonic infiltration on chest radiograph was seen. The operation was postponed and the patient underwent respiratory care. Three months later, elective palatoplasty under general anesthesia was performed without complication. Based on the experiences of this case, the authors advise that throat-packing should be placed before oral preparation to prevent serious pulmonary complications.

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