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At least 19 recordsLinked to original sources

The metatarsal osteotomy: a 10-year follow-up on the second, third and fourth metatarsal osteotomies and a new approach to the fifth metatarsal osteotomy.

The metatarsal osteotomy, a relatively simple procedure, provides a great amount of correction and relief with a limited amount of bone resection. Postoperative pain and edema are minimal, and disability and loss of time from employment are eliminated as patients are able to walk immediately in a surgical shoe. If biomechanical management is not adequate in relieving discomfort, then a 10-year study of more than 1000 cases indicates that the osteotomy is the procedure of choice.

Follow-Up Studies

A new osteotomy for the correction of mandibular prognathism: techniques and rationale of the intraoral vertico-sagittal ramus osteotomy.

The sagittal split ramus osteotomy (SSRO) and the intraoral vertical ramus osteotomy (IVRO) are long established methods for correcting mandibular prognathism, each having its own advantages. However, both procedures have the same disadvantage: the potential for postoperative condylar displacement. The displacement of the condyle is mainly due to the fact that the osteotomy plane is not parallel to the original sagittal plane in which the mandible is repositioned. The author has developed a new ramus osteotomy since 1985 in which the osteotomy plane is theoretically parallel to the original sagittal plane and thereby attempting to decrease the incidence of condylar displacement. This osteotomy was designed additionally to decrease neurosensory disturbances and has the advantages of both methods, and therefore has been named 'intraoral vertico-sagittal ramus osteotomy (IVSRO)'. Initial experience with the 24 prognathic patients operated on by means of the IVSRO indicated excellent clinical results. It has been noted clinically that the IVSRO is very effective in reducing postoperative iatrogenic TMJ symptoms and in treating preoperative TMJ symptoms. It has the additional effect of reducing neurosensory disturbances. This osteotomy seems to be more applicable in mandibular prognathism with excessive flaring of the ramus, particularly that associated with TMJ dysfunction, because the IVSRO has a 'condylotomy effect' and its splitting plane diverges less from the original sagittal plane than that of the SSRO and the IVRO.

Bone Screws

The pivotal metatarsal osteotomy: a modification of the metatarsal metaphyseal osteotomy.

The presence of cancellous bone determines the choice of location for osteotomies in the metatarsals. The head and base have good cancellous bone, whereas the shaft has cortical bone and a medullary canal which make it a poor choice of osteotomy site. Many practitioners are now using a transverse metaphyseal osteotomy; however, the authors choose the pivotal metaphyseal osteotomy as the procedure of choice using a 10- or 12-mm Pivotal Osteotomy Blade attached to an oscillating power source.

Humans

Surgical-orthodontic approach to skeletal class III malocclusion. Analysis of 45 cases with evaluation of curved oblique osteotomy and sliding osteotomy.

A curved oblique osteotomy in which the ascending ramus was cut obliquely on a curved line from its anterior border to the angle was used for the treatment of 29 patients with skeletal Class III malocclusion, and 16 other patients were corrected by either an ordinary body ostectomy or a sliding osteotomy in the first premolar region. Both curved oblique osteotomy and sliding osteotomy could easily be performed with a Stryker's reciprocating saw, and osseous healing at the sites of surgery was rapid as a large area of intimate bony contact between the segments was obtained. The resulting profile and skeletal changes studied by cephalograms were excellent, with no significant relapse, and recovery of a stable occlusion was attained. The combined approach with orthodontists which included thorough analysis of each patient, preoperative alignment of the dental arches and postoperative care was essential for obtaining the best results.

Adolescent

Tibial rotational osteotomy for idiopathic torsion. A comparison of the proximal and distal osteotomy levels.

A retrospective analysis was done of 52 rotational tibial osteotomies (RTOs) performed on 35 patients with severe idiopathic tibial torsion. Thirty-nine osteotomies were performed at the proximal or midtibial level. Thirteen were performed at the distal tibial level with a technique previously described by one of the authors. Serious complications occurred in five (13%) of the proximal and in none of the distal RTOs. For severe and persisting idiopathic tibial torsion, the authors recommend correction by RTO at the distal level. Proximal level osteotomy is indicated only when a varus or valgus deformity required concurrent correction.

Bone Diseases

Transtrochanteric anterior rotational osteotomy of the femoral head in the treatment of osteonecrosis affecting the hip: a new osteotomy operation.

"Transtrochanteric anterior rotational osteotomy of the femoral head" is a new approach to the treatment of idiopathic avascular necrosis of the femoral head. The results of 41 hips with a follow-up suggest that the procedure prevents the progression of the collapse of the femoral head and preserves joint surfaces. Cases with extensive lesions and with bilateral involvement require long-term follow-up investigations in a large series of cases. This method does not preclude prosthetic replacement at a later date. The method is also applicable to the treatment of slipped capital femoral epiphysis, partial defects of the femoral head in weight-bearing area due to trauma and tumor and osteoarthritis of the hip with localized changes in weight-bearing area.

Adult

The osteotomy in rhinoplasty.

The purpose is to assist the surgeon in the selection of modifications for nasal osteotomies. Details of the technique include: 1. Incision for osteotomy made perpendicular to the pyriform rim and modified incisions, intraoral or through the Weir incision. 2. Rasping of the lateral nasal vault prior to any osteotomies. 3. Removal of a modified beveled wedge of bone prior to the medial osteotomy, unroofing the bony dorsum to a higher level. 4. The medial osteotomy done prior to either the lateral or the intermediate osteotomy. The intermediate osteotomy is performed prior to the lateral. 5. "Complete" and "fading" medial osteotomies are utilized as indicated. 6. The lateral osteotomy may be relatively straight and low depending then on a transverse fracture or may be high and curved meeting the fading medial osteotomy. 7. A sub-periosteal tunnel with the osteotome guard external to the bone is preferred to a submucosal tunnel.

Humans