• Title/Summary/Keyword: 관혈적

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Arthroscopic and open reduction for ankle fractures (족관절 골절에 대한 관절경적 정복술과 관혈적 정복술)

  • Kim, Dong-Heon;Chang, Byeong-Chun;Lee, Jae-Sung
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.2
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    • pp.82-87
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    • 1998
  • The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. And so the goals of operative treatment for ankle fractures are to obtain an anatomical reduction that is maintained by stable fixation, resulting in a healed fracture and recovery of normal function. The 64 patients who had ankle fractures were treated by arthroscopic reduction(20 cases) and open reduction (43 cases) in Konkuk university hospital from February 1991 to October 1997 and the results were analyzed in clinical and radiological aspects. The following results were obtained. According to the criteria of Meyer, arthroscopic assisted reduction group had good or excellent results in 18 cases (90%) and open reduction group good or excellent in 35 cases (83%). The difference of the results was not significant statistically, but arthroscopic assisted reduction technique has several advantages over open technique; the best assessment of articular surface, lower wound problem, postoperatively faster rate of rehabilitation and minor discomfort.

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Outcome of Open Reduction Via Retromandibular Approach for Mandibular Subcondyle Fracture (하악골 과두경부 골절에 있어서 후하악부 절개법을 이용한 관혈적 정복술의 유용성)

  • Lee, Hyung Chul;Kang, Dong Hee;Koo, Sang Hwan;Park, Seung Ha
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.739-743
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    • 2005
  • Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.

Clinical Applications of Endoscopic-Assisted Open Reduction and Internal Fixation of Subcondylar Fractures (아래턱뼈 관절돌기밑 골절에서 내시경을 이용한 관혈적 정복술 및 내부고정술의 임상적 적용)

  • Han, Seung Youl;Kang, Seok Joo;Park, Jin Hyung
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.735-742
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    • 2009
  • Purpose: The management of fractures of mandibular subcondyle continues to be controversial between open and closed treatment. The purpose of this article is to explain the endoscopic assisted open reduction and internal fixation and minimize the controversy. Methods: Nine patients of mandibular subcondylar fracture were reduced and fixed by using intraoral endoscopic - assisted open reduction and internal fixation and were followed up for 14 ~ 24 months after surgery. Results: Eight patients of mandibular subcondylar fracture had been treated without significant complications. One patient, whose malocclusion had been remained, was recovered normal occlusion by maxillomandibular fixation using intermaxillary screws for 3 weeks. Conclusion: The advantages of endoscopic - assisted open reduction and internal fixation are direct visualization, accurate fracture repair, minimized scar, decreased morbidity. And maxillomandibular fixation is not needed when it is done by accurate reduction and rigid fixation with one miniplate in the region of subcondylar fracture. With the above consideration, endoscopic - assisted open reduction and internal fixation can be considered as one of the best treament for subcondylar fracture of the mandible.

COMPLICATIONS ASSOCIATED WITH OPEN REDUCTION OF MANDIBULAR FRACTURES (관혈적 정복술로 치료한 하악골 골절에서의 합병증)

  • Park, Young-Ah;Sohn, Woo-Ill;Chang, Ic-Jun;Song, Jae-Chul;Chin, Byung-Rho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.474-480
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    • 2001
  • Purpose: The aim of this study was to evaluate the complications of open reduction and internal fixation of mandibular fracture with miniplates. Patients and Methods: A total of 134 patients who presented with 196 fractures were analyzed retrospectively. Complications were evaluated for factors such as age, the site of fracture, the severity of fracture, delayed operation, preoperative wound contamination, the site and disposition of teeth in the fracture line and midfacial fractures. Statistical analysis was used to compare complications to risk factors. Results: Of the 134 patients, 20 patients had some form of postoperative complications and complication rate was 14.9%. These complications included infection, plate fracture, malocclusion, wound dehiscence, nerve injury and nonunion. There was a significant correlation between complication rate and the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth(p<0.05). Conclusion: The occurrence of postoperative complications in the treatment of mandibular fractures was related to the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth.

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CLINICAL STUDIES OF LAG -SCREW OSTEOSYNTHESIS IN CONDYLAR FRACTURES OF THE MANDIBLE (하악 과두 골절 환자에서 Lag-screw를 이용한 관혈적 정복 후 임상적 연구)

  • Jeong, Jong-Cheol;Song, Min-Seok;Choi, Jae-Uk;Kim, Seong-Beom;Seo, Ji-Hun;Lee, Gye-Hyeok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.442-446
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    • 2001
  • Purpose : This study evaluated clinical and radiographic results after open reduction and lag-screw fixation of mandibular condyle fractures. Patients and Methods : 26 patients had been treated by lag-screw fixation for madibular condyle fracures via submandibular approach and follow up for over 6 months. The lag-screw used in this study was designed by Eckelt. Results : Radiographically, resorption of the condyle head found in 4 cases (15%) and minimal displacement of the condyle head was found in 3 cases (12%). Post-operative infection were not found in all cases. Clinically, All patiens had a stable occlusion and normal mouth opening (over 40mm). TMD problems with crepitus or some discomfort encountered in 4 patients but tolerable to the patients. Conclusion : Lag screw fixation can be a good option especially high level condylar fractures, however this procedure must be used in cautiously because of slipping of the fragments and possible to resorption of the fragments.

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The treatment of an impacted canine related with a miniplate inserted for mandibular fracture (하악골 골절 치료를 위한 miniplate와 관련된 매복견치의 치험례)

  • Hwang, Sang-Hee;Park, Hyo-Sang;Kwon, Tae-Geon;Nam, Ki-Young;Kim, Jong-Bae
    • The korean journal of orthodontics
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    • v.35 no.2 s.109
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    • pp.148-152
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    • 2005
  • This case report describes the treatment of an impacted tooth in relation to pediatric mandibular fracture. A 10-rear-old girl presented with au impacted mandibular canine related with a miniplate in the left mandibular body area. An ordinary surgical traction ended in failure. Good occlusion was established by removal of the miniplate. It would be considered important to make an exact diagnosis of the cause and remove the mechanical obstruction instantly for successful orthodontic treatment of an impacted tooth.

A Comparative Study of Surgical Treatment in the Ruptured Achilles Tendon: Minimal incision and Open repair (아킬레스건 파열의 수술적 치료 비교: 최소 절개 봉합술과 관혈적 봉합술)

  • Kong, Gyu-Min;Gwak, Heui-Chul;Kim, Jeon-Gyo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.3
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    • pp.181-189
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    • 2012
  • Purpose: The purpose of this study was to compare and analyse the clinical outcomes of minimal incision repair and open repair in ruptured Achilles tendon. Materials and Methods: We retrospectively analyzed the outcomes of 10 patients with minimal incision repair (group 1) and 19 patients with open repair (group 2) from February 2007 to June 2011. The postoperative clinical evaluations were done by Arner-Lindholm scale, AOFAS score, overall patient's satisfaction and cosmetic satisfaction of scar. Results: There was no statistical difference between two groups in Arner-Lindholm scale, AOFAS score, overall patient's satisfaction (p=1.21, 0.87, 1.07). There was statistically high rate of cosmetic satisfaction in group 1(p<0.001). There were no complications in group 1. Complications occurred in three patients (deep infection, rerupture, deep vein thrombosis) of group 2. Conclusion: Treatment of minimal incision repair in Achilles's tendon ruptures showed high rate of cosmetic satisfaction and low rate of complication's, but there were no significant differences with open repair in other clinical outcomes. The minimal incision repair could be recommended as one of the effective treatment for the Achilles's tendon ruptures.

Bilateral Traumatic Locked Posterior Dislocation of the Shoulder - A Case Report - (외상 후 발생한 양측성의 견관절 잠긴 후방 탈구 - 증례 보고 -)

  • Lim, Jong-Min;Suh, Jeung-Tak;Ahn, Jae-Min
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.226-231
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    • 2009
  • Purpose: Bilateral traumatic locked posterior dislocations of the shoulder are very rare and there has been no report on the operative treatment for this injury in the Korean medical literature. Materials and Methods: We present here a case of bilateral locked posterior dislocations of the shoulders after trauma and this was successfully treated with open reduction and lesser tuberosity transfer on the right shoulder and subscapularis tendon transfer on the left shoulder. Results and Conclusion: Twenty-four months later, the clinical and radiologic results were excellent.

Arthroscopic Reduction of Irreducible Knee Dislocation - A Case Report - (정복 불가능한 슬관절 탈구의 관절경적 치료)

  • Jeong, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.161-164
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    • 2009
  • Irreducible knee dislocation is a rare injury and often need an open procedure with ligaments reconstruction. This report describes a case of arthroscopic treatment of a patient with traumatic knee dislocation unable to reduce in a closed method. MRI revealed incarceration of the medial collateral ligament and capsule in the medial compartment. And arthroscopic examination confirmed incarcerated medial capsuloligamentous structures which prevented the knee from reduction. Arthroscopic procedure without ligaments reconstruction was complete when the medial condyle was well visualized and the knee reduced. After 4 weeks of immobilization in extension, range of motion exercise and gradual increases in weight bearing was allowed. At the 3- year follow-up, mild laxity was remained but the patient did not have any discomfort of doing ADL activity and showed full range of motion of the knee.

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Dual Plate Fixation for Displaced Transverse Fracture of the Lower Sacrum (전위된 하부 천골 횡골절에 대한 이중 금속판을 이용한 내고정술)

  • Choi, Dong-Hyuk;Park, Ji-Hun;Shim, Seong-Woo;Choi, Yong-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.178-182
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    • 2020
  • Isolated fractures of lower sacrum are commonly treated conservatively in most cases because of low energy damage and stable fracture. However, surgical treatment is required in displaced unstable fracture. But the surgical technique is not established and even case reports are not common. We reported a case of displaced transverse fracture of the lower sacrum that was treated with an open reduction and dual plate fixation.