• Title/Summary/Keyword: 골절단

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Short Segment Pedicle Screw Fixation with Augmented Intra-Operative Vertebroplasty in Unstable Thoraco-Lumbar Fracture - Preliminary Report - (불안정성 흉·요추부 골절에 대한 단 분절 척추경 나사못 고정술 및 추체 보강 성형술 - 예 비 보 고 -)

  • Kim, Young Woo;Oh, Sung Han;Yoon, Do Heum;Chin, Dong Kyu;Cho, Yong Eun;Kim, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1271-1277
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    • 2001
  • Objectives : Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. Material and Methods : The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography. Results : Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. Conclusions : In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.

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QUANTITATIVE ASSESSMENT OF NASAL AND UPPER LIP CHANGES AFTER LE FORT I OSTEOTOMY SURGERY USING A 3-DIMENSIONAL COMPUTED TOMOGRAPHY (르포씨 1형 골절단술후 코와 상순의 연조직 변화의 삼차원 컴퓨터 단층촬영을 이용한 정량적 측정에 관한 연구)

  • Lee, Won-Deok;Yoo, Chung-Kyu;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.1
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    • pp.49-56
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    • 2010
  • Objective: To evaluate nasal and upper lip changes after Le Fort I surgery by means of images taken with a three-dimensional computed tomography (3D-CT). Methods: Fifteen patients (9 female and 6 male, mean age 21.9 years) with preoperative and postoperative 3D-CT were studied. The patients underwent maxillary movement with impaction or elongation, and advancement or setback. With the 3D-CT which presents reconstructive soft tissue images, preoperative and postoperative measurement and analysis were performed for nasal tip projection angle, columellar angle, supratip break angle, nasolabial angle, interalar width, internostril width, columella length and nasal tip projection. Results: Postoperative interalar and internostril widening was significant for all categories of maxillary movement. However, there was little significant relation in all parameters between the amount and direction of maxillary movement. Interestingly, movement of the maxilla with upward did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. Also movement of the maxilla with forward did show a little advancement in the upper lip position. Conclusion: Changes to the nose clearly occur after orthognathic surgery. There was a significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary impaction did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. In addition, we used 3D-CT for more precise analysis as a useful tool.

Managements of ankylosed incisor occurred during adolescence using alveolar bone distraction osteogenesis and decoronation: case report (성장기에 발생한 유착치의 치조골 신장술과 치관 절제술을 이용한 심미적 개선 치험례)

  • Kwon, Eun-young;Son, Woo-Sung;Park, Soo-Byung;Kim, Seong-sik;Kim, Yong-il;Choi, Youn-kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.2
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    • pp.143-153
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    • 2017
  • One of the common complications of dental injury is tooth ankylosis. Unlike adults, when tooth ankylosis occurs in the adolescents, ankylosis interfered the growth of the adjacent alveolar bone, resulting in the developmental failure of the alveolar bone and subsequent open bite. The most common treatment option for ankylosed tooth is extraction. However, when prognosis of ankylosed tooth after extraction is expected to be poor due to severity of infrapositioning or prosthetic replacement cannot be performed immediately, various treatment options should be considered. This report suggests multidisciplinary treatment that might bring functionally and esthetically favorable result included alveolar bone distraction osteogenesis and decoronation of ankylosed maxillary anterior tooth with orthodontic and prosthetic treatments.

Treatment for the Rockwood type Ⅱ Fractures of Lateral End of Clavicle (쇄골 외측단 Rockwood 제2형 골절의 치료)

  • Oh Chang-Wug;Kyung Hee-Soo;Park Gun-Wook
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.66-71
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    • 1998
  • The fractures of lateral end of clavicle can be treated by conservative or operative treatment, but many authors report the higher rate of non-union with conservative treatment and that the operative treatment is more effective for the type II fractures. The authors reviewed and analysed 15 cases of lateral end fracture of clavicle which had been treated at Department of Orthopedic Surgery, Kyungpook National University Hospital from 1991 to 1996. The results were as follows; 1. Among the 15 patients, male was 6,female 9 and the average age was 46.2 years ranged from 21 to 72 years. 2. According to the classification by Rockwood, type II a was 8 cases and II b was 7 cases. 3. We treated operatively 12 cases, 9 cases with tension band wiring and 3 cases with intramedul-Iary K-wire fixation. And we treated conservatively 3 cases with Velpeau cast, but I case of nonunion was treated with tension band wiring. 4. The average follow-up was 3.2 years ranged from 2.1 to 4.7 years. 5. The functional results were evaluated with Weitzman's classification. 6. In the operatively treated cases, there were 4 cases(30.7%) in excellent, 7 cases(53.8%) in good and 2 cases(15.3%) in fair result. But, in the conservatively treated cases, there were 2 cases in good and I case in poor result, and the poor case did not united and had open reduction and internal fixation. 7. In conclusion, the operative treatment revealed good functional results in most cases (10/12) and early open reduction and internal fixation was better method than conservative treatment.

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Treatment of Distal Tibial Metaphyseal Fracture Using MIPPO Technique (MIPPO 수기를 이용한 원위 경골 골간단 골절의 치료)

  • Lee, Ho-Seung;Kim, Jung-Jae;Oh, Se-Kwan;Ahn, Hyung-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.166-170
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    • 2004
  • Purpose: To evaluate the results of MIPPO (minimal invasive percutaneous plate osteosynthesis) technique for distal tibial metaphyseal fractures. Materials and Methods: It is a retrospective study of 13 patients who were treated by MIPPO technique for distal tibial metaphyseal fractures from Jan. 2001 to Jan. 2003. The average age was 46.7 years and mean follow-up period was 13.3 months. According to AO classification, there were 8 cases of A1, 3 cases of A2, 1 case of B1 and 1 case of C2. One case of A1 was a Gustilo-Anderson type I open fracture and fibular fractures were combined in 12 cases. We applied anatomical reduction and internal fixation for the fibular fractures and internal fixation on the medial side of the tibia by MIPPO technique for distal tibial metaphyseal fractures. Clinical results were evaluated using radiographic results, Neer score, the starting time of postoperative exercise and clinical complications. Results: According to the Neer score, all cases showed satisfactory results. Active ankle ROM was started at average 2.4 weeks ($2{\sim}4$ weeks) and full weight bearing ambulation at average 5.2 weeks ($4{\sim}8$ weeks) postoperatively. Union of fractures was obtained by average 14.4 weeks ($8{\sim}18$ weeks) postoperatively. Two cases showed $5^{\circ}$ limitation of motion without functional deficits and other cases showed satisfactory ROM results. One case had $6^{\circ}$ valgus deformity without functional deficits. There were not any other complications like soft tissue problems and delayed-or non-union. Conclusion: MIPPO technique for the treatment of distal tibial metaphyseal fractures is a feasible technique with a good clinical outcomes.

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SURGICAL REPOSITIONING OF THE EXTRUDED DENTO-ALVEOLAR SEGMENTS BY THE SINGLE-STAGE POSTERIOR MAXILLARY SEGMENTAL OSTEOTOMY (하악구치부 보철공간을 위한 상악구치부의 분절골절단 및 상방 정위)

  • Kim, Myung-Rae;Kim, Choong;Kim, Hyung-Sub
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.4
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    • pp.338-347
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    • 2001
  • Purpose: This is to review the cases of posterior maxillary segmental osteotomies to regain the interarch spaces for dental implants in the posterior mandible. Materials & Methods: Seven patients who presented with alveolar extrusion of upper posterior molars underwent segmental osteotomies by single-stage Kufner's buccal approach under the intravenous sedation and local anesthesia. The posterior maxillary cento-alveolar segments were repositioned upward using pre-fabricated palato-occlusal resin splints and immobilized with osteosynthesis microplates and screws. Dental implants were installated simultaneously. The regained spaces, tooth vitality, periodontal healing, relapse, tenderness on function, and complications including maxillary sinus involvements were evaluated periodically for over one year after the surgeries. Results: The single-tage procedures were completed within 80 minutes without any surgical complications. The posterior maxillary segments were repositioned upward to regain the interarch spaces ranging from 2.5 to 5.5mm. All teeth involved in the procedures keep their vitalities. The repositioned segments were maintained showing neither evidence of periodontal break-down nor tenderness to function. One patient whose segments had not been immobilized by osteosynthesis plate resulted in 2mm down-ward relapse in post-operative 8 months. A case of postoperative nasal bleeding from the posterior-lateral wall resulted in oroantral fistula and chronic maxillary sinusitis later. Conclusion: The extruded dento-alveolar segments of the posterior maxilla were repositioned properly by Kufner's one-stage segmental osteotomies. One microplate can be of help to keep the position until the osseous healing enough to support the masticatory force.

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OBLIQUE TRANSCRANIAL RADIOGRAPHIC ANALYSIS OF CHANGES IN CONDYLE POSITION FOLLOWING SAGITTAL SPLIT RAMUS OSTEOTOMY IN MANDIBULAR PROGNATHISM (측사위경두개방사선사진(Oblique Transcranial Radiograph)을 이용한 하악전돌증환자의 하악지 시상골절단술후 하악과두위치변화 분석)

  • Kwon, Tae-Geon;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.32-45
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    • 1995
  • This study was intended to evaluate condyle position and the relationship of condyle position change and post surgical relapse following the sagittal split ramus osteotomy for mandible setback in 25 patients by paired t-test and multiple regression analysis. We used oblique transcranial and cephalometric radiographs taken before operation, immediate after operation, and at least 6 months post operatively. 1. In oblique transcranial view, posterior joint space was decreased immediate after operation and increased 6 months after operation. To compare the measurement before and 6 months after operation, there was no statistically significant change in over all joint spaces(P>0.05). 2. The joint spaces changed under the 0.2mm were 30%, 0.2mm to 1.0mm were 60.7%, above 1.0mm were 9.3%. This result reveals that condyle position was relatively reproduced to pre-operative state. 3. Statistically, the amount of mandible set back didn't influence the post operative relapse(P>0.05). 4. Statistically, the amount of mandible set back didn't influence the condylar displacement(P>0.05), and the amount of joint space change didn't influence the post operative relapse.(P>0.05) The changes in joint space is in the standard tracing error or within the adaptive capacity of the individual, it was too small to influence the stability of surgery.

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Evaluation of Sensory Nerve Function Before and after Intraoral Vertico-Sagittal Ramus Osteotomy Using Current Perception Threshold(CPT) Test (구강내하악지수직시상골절단수술 전후 전류역치검사(CPT)를 이용한 지각신경의 변화에 대한 연구)

  • Choung Pill-Hoon;Kim Sao-Geol;Seo Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.4 no.1
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    • pp.39-43
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    • 2001
  • The design of osteotomy plane in orthognathic surgery has been developed to diminish the nerve injury. Intraoral Vertico-Sagittal Ramus Osteotomy (IVSRO) is the one of the best way to minimize untoward results, which is designed not to expose the lingula. We evaluated the nerve damage before and after with current perception threshold (CPT) test which is modem and numerically expressible way of nerve damages. Sixty patients underwent IVSRO since 1998 were evaluated. They were divided into 2 groups; one group underwent IVSRO only, and the other underwent IVSRO plus genioplasty. The both groups were evaluated with CPT test 1 week before surgery, and 1, 3 and 6 months after surgery. The CPT test was performed on A-beta, A-delta and C fiber respectively. 111e result showed that the recovery of sensory function of damaged nerve fibers was observed at the period of three to six months after surgery. There was no impairment of nerve function after only the IVSRO . But there were sensory disturbances in cases of additional genioplasty group. We thought that one of major factors on nerve damages were exposure of nerve and traction injury during genioplasty.

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Early Stage Legg-Calve-Perthes Disease in a Dog: Clinical, Surgical, Radiological, Computed Tomography and Histological Findings (초기 허혈성 대퇴골두 괴사증을 보이는 개에서 임상학적, 수술적, 방사선학적, 컴퓨터단층촬영, 조직학적 소견)

  • Thak, Min-Ae;Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.366-370
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    • 2013
  • A 7-month-old Pomeranian presented with non-weight bearing lameness on the right pelvic limb. Physical examination revealed pain on extension of the right hip joint, and serum chemistry results showed an increased concentration of creatine kinase. Radiographic findings at admission included a weak radiolucent line on the right femoral head and widening of the right hip joint space, and mild displacement of the right capital femoral epiphysis was additionally identified on day 14. Computed tomography (CT) showed a decreased Hounsfield Unit measurement and a fracture line on the right femoral head. Early stage Legg-Calve-Perthes disease (LCPD) was diagnosed and femoral head and neck ostectomy was performed on the right femur. A fracture fissure and osteophytes at the epiphyseal plate of the femoral head were identified surgically. Necrosis in the femoral metaphysis and epiphysis was observed histologically. This case report describes the radiography, CT images, and surgical and histological findings in a dog with early stage LCPD.

THE EFFECT OF EARLY REMOVAL OF THE FIXATION PLATES AND ACTIVE MOUTH OPENING EXERCISE ON THE TEMPOROMANDIBULAR DYSFUNCTION AFTER MANDIBULAR SETBACK SURGERY (하악골 전돌증 환자에서 하악지 시상분할골절단술후 금속고정판의 조기제거 및 기능운동이 턱관절장애에 미치는 영향)

  • Jeon, Joon-Hyuk;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Oh, Jung-Hwan;Kwon, Yong-Dae;Yoon, Byung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.6
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    • pp.545-551
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    • 2005
  • Purpose: The effect of orthognathic surgery on the temporomandibular dysfunction has been controversial. The purpose of this study is to prove statistically that early removal of fixation plate at postoperative 2 weeks with active exercise of mouth opening could relieve preoperative temporomandibular dysfunction and reposition of temporomandibular joint. Patients and Methods: All 28 subject patients underwent mandibular setback with BSSRO in Kyunghee medical center by one surgeon. The fixation plates used for rigid fixation were removed at postoperative 2 weeks and we had the patients excercise active mouth opening with intermaxillary rubber rings for the guiding proper postoperative occlusion. Temporomandibular symptoms were checked and radiographs were taken before surgery, within a month after surgery, six to twelve months after surgery respectively. Results: The temporomandibular dysfunction symptoms were relieved after the surgery and the condyle was displaced inferior-posteriorly immediate after surgery and repositioned toward its original position during follow-up periods. Conculusion: Orthognathic surgery may benefit temporomandibular joint dysfunction by obtaining a postoperative stable occlusion and more physiologic neuromuscular function. The early removal of fixation plates after BSSRO could reposition the temporomandibular joint to physiologic position and relieve the symptoms of temporomandibular dysfunction by permitting movement of proximal segment.