• Title/Summary/Keyword: 골절 정복

Search Result 222, Processing Time 0.03 seconds

Submental Intubation for Maxillofacial Surgery -A Case Report - (구강악안면수술을 위한 악하 기관 삽관 -증례보고-)

  • Kim, Soung-Min;Kwon, Kwang-Jun
    • Journal of The Korean Dental Society of Anesthesiology
    • /
    • v.4 no.2 s.7
    • /
    • pp.96-99
    • /
    • 2004
  • 구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

  • PDF

Conservative Management for a Highly Displaced Dens Fracture in a Two-Year-Old Child (2세 유아에서 발생한 고도 전위성 치상돌기 골절의 보존적 치료)

  • Lim, Sung Joon;Kim, Geon Jung;Kim, Yong Min
    • Journal of the Korean Orthopaedic Association
    • /
    • v.56 no.6
    • /
    • pp.530-534
    • /
    • 2021
  • Fractures of the dens (odontoid process) in children's cervical spine are rare, with very few case reports dealing with these injuries. In particular, a treatment modality has not been established for severe displaced fractures. Surgical fixation can theoretically afford early reduction and better maintenance, but it requires a very delicate and cautious procedure and results in permanent fusion of 1-2 cervical articulation. The authors chose conservative management for a displaced dens fracture in a two-year-old toddler and achieved a promising result. We report this case with a review of the relevant literature.

Digital workflow for prosthetic restoration in the pan facial fracture patient: A case report (다발성 안면 골절 환자의 보철 수복을 위한 디지털 워크플로우: 증례보고)

  • Kim, Seung-Wan;Park, Geun-Taek;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra;Ko, Kyung-Ho
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.60 no.4
    • /
    • pp.395-403
    • /
    • 2022
  • In the fracture operation of pan facial fracture, there are many cases where the shape and position of the occlusal and oral structures are abnormally changed because the index for repositioning to the original position is insufficient. And trismus and gag reflex in patients with pan facial fractures increase the difficulty of dental treatment, and the difference in the position of the jaw bone makes it difficult to restore aesthetically and functionally. In this case, digital workflows for minimal intraoral work could be selected to reduce patient discomfort and the difficulty of dental treatment. This case is using a digital workflow from implant planning to final prosthesis production in a patient with acquired skeletal grade III, trismus, and gag reflex due to pan facial fracture 15 years ago. In this case report, the use of digital workflow in a patient who has difficulty in dental treatment was able to minimize patient discomfort and obtain esthetic and functionally appropriate results.

Long Term Follow-up of Children with Facial Asymmetry: A Case Report (안면 비대칭을 보이는 아이의 장기 추적 관찰 : 증례보고)

  • Oh, Yoonjeong;Oh, Sohee
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.45 no.3
    • /
    • pp.378-385
    • /
    • 2018
  • Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.

Percutaneous K-wire Fixation of Supracondylar Fracture of Humerus in Children (소아 상완골 과상부 골절의 경피적 K-강선 고정술)

  • Shin, Duk-Seop;Ahn, Jong-Chul;Kim, Se-Dong;Lee, Dong-Woo
    • Journal of Yeungnam Medical Science
    • /
    • v.10 no.2
    • /
    • pp.400-408
    • /
    • 1993
  • During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safety, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an excellent reduction.

  • PDF

A Clinicostatistical Study of 677 Mandibular Fractures (하악골 골절 667 증례의 임상통계학적 분석)

  • Lee, Sang-Han;Lee, Seoung-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.11 no.1
    • /
    • pp.50-62
    • /
    • 1989
  • This is clinicostatistical study of mandibular fractures. This study was based on a series of 677 patients with mandibular fracture during the period of 1982 to 1987. This results obtained were as follows : 1. In respect of incidence, there were high frequency in May and September, and in large city(63%). 2. The age frequency was the highest in the 20s-year old group (38.7%), and the ratio of male to female was 4.64 : 1. 3. The most common etiologic factor was blow(31.5%), but in children that was traffic accident followed by fall down. 4. The most common site of bone fractures was symphysis, followed by angle, condyle. In comparison of right and left sides, left side was more frequently involved(364 cases) than right side(257 cases). 5. The patients arrived in hospital immediately within 24 hours after accident were 62.9% of all, and 42.4% was arrived via private medical and dental clinic. 6. In respect of treatment, open reduction was 55.5% of all, closed reduction was 37.2%. In children, closed reduction was done in 50.6%.

  • PDF

Treatment of Anterior Glenoid Rim Fracture with Comminuted Fragment Using Arthroscopic Reduction and AO Headless Compression Screw Fixation - A Case Report - (관절경하 AO 무두 압박 나사를 이용한 견갑골 전방 관절와 분쇄 골절의 치료 - 증례 보고 -)

  • Kim, Hyung-Sik;Koh, Il-Hyun;Kim, Sung-Guk;Chun, Yong-Min;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
    • /
    • v.14 no.1
    • /
    • pp.94-98
    • /
    • 2011
  • Purpose: We present a case of anterior glenoid rim comminuted fracture that was treated with arthroscopic reduction and an AO headless compression screw (HCS) fixation. Materials and Methods: A 31-year old man complained of left shoulder pain after falling down on stairs. The anterior glenoid comminuted fragments were arthroscopically reduced. Fixation with an AO HCS was done after placement of 1.1 mm Kirschner wire as a guide pin through a standard cannulated anterosuperior portal. Results: Twelve months after the operation, union of the fracture was achieved and the range of motion was fully recovered. He did not complain of any discomfort during his activities of daily living. Conclusion: An AO HCS had various screw sizes and this was good for fixation of a small glenoid fracture and a long drill bit and screw driver were useful for fixation of deep seated glenoid fracture. A short guide wire could be replaced by a 1.1 mm K-wire. An AO HCS was useful for fixation of an anterior glenoid rim comminuted fracture.

Coracoclavicular Ligament Augmentation Using Endobutton for Unstable Distal Clavicle Fractures - Preliminary Report - (불안정성 쇄골 원위부 골절에서의 Endobutton을 이용한 오구 쇄골 인대 보강술 - 예비 보고 -)

  • Cho, Chul-Hyun;Jung, Gu-Hee;Sin, Hong-Kwan;Lee, Young-Kuk;Park, Jin-Hyun
    • Clinics in Shoulder and Elbow
    • /
    • v.14 no.1
    • /
    • pp.1-5
    • /
    • 2011
  • Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after operative treatment using endobuttons for unstable distal clavicle fractures. Materials and Methods: Between October 2007 and September 2009, 9 consecutive patients who were followed up for at least more than 12 months after operative treatment using a TightRope$^{(R)}$ were studied. The radiologic results on the serial plain radiographs and the clinical results according to the American Shoulder Elbow Surgeons (ASES) score were analyzed. Result: Bony union was shown in 8 cases (88.9%) and the average time to union was 12.9 (range: 9~16) weeks. The average coracoclavicular distances at the postoperative and final follow-up were 5.6 mm and 6.2 mm, respectively, with no statistically significant difference (p>0.05). The average ASES score was 90.3 (range: 78~96) and the clinical outcomes were 6 excellent, 2 good and one fair. There were no complications such as implant failure or infection except for one case of nonunion due to loss of the initial reduction. Conclusion: A major advantage of TightRope$^{(R)}$ fixation for unstable distal clavicle fractures is that no further surgery is needed to remove the implant. We suggest that this technique provides an alternative for fracture with a distal fragment, which is difficult to fix.

Treatment of Type 2 Distal Clavicle Fracture using Wolter Plate (Wolter 금속판를 이용한 제 2형 원위부 쇄골 골절의 치료)

  • Shin, Sung-Il;Song, Kyung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Rae;Hyun, Yoon-Suk;Lee, Kwang-Nam;Lee, Eun-Soo
    • Clinics in Shoulder and Elbow
    • /
    • v.12 no.1
    • /
    • pp.14-20
    • /
    • 2009
  • Purpose: This study examined the clinical results of the treatment of type 2 distal clavicle fracture with using a Wolter plate. Materials and Methods: Between 2004 and 2007, 16 patient treated for type 2 distal clavicle fracture using a Wolter plate were included in this study. Their average age was 32.6 years and the postoperative mean follow-up period was 22.9 months. The reduction and union were qualified according to the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and the Constant score Results: By Kona's functional evaluation, there were 12 cases with excellent results, 3 cases with good results and 1 case of fair results and the average Constant score was 90. All 16 cases showed bony union. As complications, there was 1 case in which the protruded hook of the plate could be palpated at the skin, and 1 case showed an acromial fracture, but all the cases dispalyed successful bony union and there was no acromioclavicular joint arthritis, infection or any other complications. Conclusion: Wolter plate fixation for type 2 distal clavicle fracture is a reliable surgical method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result.

Surgical Repair of Rostral Hemimandibular Fractures with Canine Tooth Luxation in a Dog (개에서 견치 탈구를 동반한 앞쪽 하악골 골절의 수술적 정복 1례)

  • Yoon, Hun-Young;Kang, Myung-Gon;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
    • /
    • v.26 no.4
    • /
    • pp.359-361
    • /
    • 2009
  • A sexually intact female Alaskan Malamute, 5-year-old weighing 25.2 kg presented to the Hangang Animal Hospital, following hit-by-car. On initial presentation, the dog had severe salivation and the right canine tooth luxation. Radiographs revealed fractures of the right rostral hemimandible with the right canine tooth luxation and symphyseal separation. Surgical repair of fractures was performed by use of an interdental wiring technique and external fixation technique that included pins, an acrylic connecting bar, and polymethyl methacrylate bone cement. Post-operative radiographs revealed that bridging callus was well formed over cortices of the fracture area. Pins and an acrylic connecting bar were removed 7 weeks post-operatively. The dog exhibited evidence of normal mastication.