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장규선,김태완,김학준,Jang, Kyu-Sun,Kim, Tae Wan,Kim, Hak Jun 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.2
Hallux valgus is a lateral deviation of the first phalanx and medial deviation of the first metatarsal at the first metatarsophalangeal (MP) joint. Its incidence has increased due to developing footwear. The etiologies include fashion footwear, genetic causes, anatomical abnormality around the foot, rheumatoid arthritis, and neuromuscular disorders. Physiologic alignment of the first MP joint is maintained by congruent and symmetric alignment of the articular surface of the first proximal phalanx and first metatarsal head, physiologic relationship of the distal first metatarsal articular surface and the first metatarsal shaft axis, and stable balance of soft tissue around the first MP joint and stable tarsometatarsal joint. Several factors have been associated with hallux valgus, including pes planus, hypermobility of the first tarsometatarsal joint, flattened shape of the first metatarsal head, increased distal metatarsal articular angle, and deformation of the medial capsular integrity. History and physical examination are very important to diagnosis of hallux valgus. Simple radiography provides information on deformity, particularly in weight-bearing anteroposterior and lateral radiographs. Understanding the etiologies and pathophysiology is very important for success in treatment of patients with hallux valgus.
안면신경 전방전위를 이용한 경정맥공 종양 제거 수술에서 술 후 안면신경 기능의 예후인자 분석
장영수(Young-Soo Chang),조양선(Yang-Sun Cho),장규선(Kyu-Sun Jang),최나연(Nayeon Choi),박준오(Jun Oh Park) 대한두개저학회 2011 대한두개저학회지 Vol.6 No.1
Objectives : Resection of jugular foramen tumors is limited by the intratemporal course of the facial nerve. Facial nerve rerouting techniques were developed to facilitate resection of extensive tumors occupying the skull base. Although facial nerve rerouting technique can maximize the surgical view, it may result in some degree of facial nerve paresis. We have therefore analyzed factors associated with post-operative facial nerve outcome in patients with jugular foramen tumor who were undergone surgical management including anterior facial nerve rerouting. Study design : Retrospective study Methods : We retrospectively enrolled 21 patients with jugular foramen tumor who underwent anterior rerouting of the facial nerve. Rerouting technique, type of mastoidectomy, operation time, completeness of tumor resection and change of facial expression were obtained from the medical records. Facial nerve function was evaluated using House-Brackmann grading system. Results : Shorter rerouting resulted in a better outcome without statistical significance. Operation time lesser then 12 hours had a better facial nerve outcome at immediately postoperative evaluation. However, facial nerve outcome within 6-12 months did not show the difference. Conclusion : The facial nerve function at 12 months after operation could be preserved in 90.5 % of patients who underwent surgical management of the jugular foramen tumor including anterior rerouting of the facial nerve. We can expect better facial nerve outcome with short rerouting and after operation with short duration. The facial nerve should be minimally manipulated during even in the rerouting procedure.