• Archives of Plastic Surgery
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• 제36권6호
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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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권5호
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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.

• 대한치과교정학회지
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• 제35권2호
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• pp.148-152
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• 2005

하악 좌측 견치의 미맹출을 주소로 내원한 10세 여환의 과거 병력 조사 중 3년 전 교통사고로 하악 좌측 골체부에 골절이 생겨 miniplate로 관혈적 정복술을 시행받은 것을 발견하였다. 통상적인 외과적 노출과 교정적 견인치료로는 견치 맹출에 실패하였고, miniplate를 제거함으로써 정상적인 매복 견치 맹출에 성공하였기에 보고하는 바이다.

• 대한정형외과학회지
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• 제55권2호
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• pp.178-182
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• 2020

하부 천골의 단독 골절은 일반적으로 저에너지 손상으로 안정된 골절이 많아 대부분의 경우에서 보존적 치료가 이루이지고 있고 그 결과도 좋은 것으로 보고되고 있다. 하지만 전위된 불안정 골절에서는 수술적 치료의 필요성이 요구되나 치료 방법이 정립되어 있지 않으며 증례보고마저 매우 드물다. 이에 저자들은 하부 천골의 전위된 횡골절에 대해 관혈적 정복 및 이중 금속판을 이용한 내고정술을 치험한 증례를 보고하고자 한다.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.211-215
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• 2006

Reported in this article is a case report of a patients who developed limb threatening ischemia as a consequence of a subclavian artery thrombosis resulting from screws. The subclavian artery thrombosis after open reduction and internal fixation of clavicle fracture, when it occurs, should be treated promptly by plate removal and claviculectomy. It can be prevented by placing screws in locations away from the underlying neurovascular structures.

• 대한정형외과스포츠의학회지
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• 제1권2호
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• pp.143-148
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• 2002

목적: 임상적으로드물며, 발생시도수정복이잘안되는무지중수지관절복합탈구의임상적결과를알아보고자하였다.대상및방법: 무지중수지관절의외상성탈구11예(10예후방탈구, 1예전방탈구)를대상으로초기에탈구의정복가능성,도수정복을방해하는해부학적요인, 수술적접근법에관하여조사하였다.결과: 모든증례에서초기에도수정복을시도하였으나, 2예에서만이정복이되었다. 8 례는전방도달법으로관혈정복을하였고, 1예는만성적인소견을보여관절고정술을시행하였다. 정복방해요인은파열된수장판내로근위부에서단무지굴건과요측종자골이감입되어있었고, 중수골두는파열된인대와단무지굴건사이에형성된간격사이로빠져나와있었다.결론: 과신전에의한중수지관절의후방복합탈구는드물지만, 정복이쉽지않아서주로관혈정복이요구되며, 이때정복방해요인인파열된수장판과관절막, 단무지굴건과종자골등에관심을갖고치료에임하여야한다.

• 대한두개안면성형외과학회지
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• 제14권2호
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• pp.81-88
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• 2013

Background: To suggest the need of more aggressive reduction techniques than closed reduction (CR) technique in nasal fracture treatment, we identified the usefulness of algorithm oriented treatment of nasal fracture that includes indirect open reduction (IOR) and external fixation (EF) as well as the CR. Methods: We compared the clinical course of the group A (n=128) where only the CR was performed regardless of the pattern of the nasal fracture and the group B (n=127) where algorithm oriented treatment including IOR and EF as well as CR was performed depending on the pattern of nasal fracture. And the degree of postoperative pain after CR and IOR technique was compared through the dose of analgesics and pain scores. Results: More than 80% of patients were satisfied the result of reduction in both group A and B. Good contour of nasal bone after reduction was showed 71% of group A and 81% of group B without significant difference. Minor (p>0.05) and major (p<0.05) deformity after reduction were less occurred in the group B than group A. Postoperatively, the dose of analgesics was significantly lower after IOR technique than CR technique (53 mg vs. 142 mg) (p<0.05). Conclusion: Algorithm oriented treatment of nasal fracture including IOR and EF as well as CR reduce major deformity after reduction than treatment of CR alone. It is useful to perform the more aggressive reduction techniques such as IOR and EF according to the pattern of fracture in treatment of nasal fracture.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.619-625
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• 2010

Purpose: Trapdoor orbital blowout fracture is most common in orbital blowout fracture. Various materials have been used to reconstruct orbital floor blowout fracture. Absorbable alloplastic implants are needed because of disadvantages of nonabsorbable alloplastic materials and donor morbidity of autogenous tissue. The aim of the study is to evaluate usefulness of absorbable mesh plate as a reconstructive material for orbital blowout fractures. Methods: From December 2008 to October 2009, 18 trapdoor orbital floor blowout fracture patients were treated using elevator fixation, depressor fixation, or elevatordepressor fixation techniques with absorbable mesh plates and screw, depending on degree of orbital floor reduction, because absorbable mesh plates are less rigid than titanium plates and other artificial substitutes. Results: Among 18 patients, 5 elevator fixation, 4 depressor fixation, and 9 elevator and depressor fixation technique were performed. In all patients, postoperative computed tomographic (CT) scan showed complete reduction of orbital contents and orbital floor, and no displacement of bony fragment and mesh plate. Mean follow-up was 10 months. There were no significant intraoperative or postoperative complications. Conclusion: Three different techniques depending on the degree of orbital floor reduction are useful for open reduction and internal fixation of trapdoor orbital floor blowout fracture with absorbable mesh plates.

• 대한족부족관절학회지
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• 제8권2호
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• pp.182-190
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• 2004

Purpose: To evaluate the clinical feature and the results of the treatment of Lisfranc joint fracture/dislocation with limited open reduction, pin fixation and Ilizarov external fixation. Materials and Methods: From June 2001 to May 2003, six patients with Lisfranc fracture/dislocation were treated. The average periods of follow-up was 23 months. After limited open reduction on the second tarso-metatarsal joint, we performed pin fixation of the above joint. On the other Lisfranc joint fracture/dislocation, closed reduction and the application of Ilizarov external fixator was done. This rigid system produced the early partial weight bearing and joint motion of the injured foot and ankle joint. The parameters used were radiographic evaluation, patient's clinical assesment and the AOFAS midfoot score. Results: We used the Myerson's criterier to evaluate the radiographic result. All cases could be achieved more than nearly anatomical reduction. Three cases of excellent and 3 cases of good result could be obtained in the evaluation of the patient's clinical assesment. The average AOFAS midfoot score was 87.2 ($76{\sim}95$) points. Conclusion: The treatment using Ilizarov external fixation on Lisfranc joint fracture/dislocation can be another useful method.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.168-175
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• 2003

근위 상완골 골절은 골절의 형태에 따라 크게 관절편 또는 해부학적 경부, 대 결절, 소 결절, 상완골 간부 또는 외과적 경부의 4개의 골절편으로 나눌 수 있다. 현재 널리 사용되고 있는 Neer의 근위 상완골 골절의 분류는 골절선에 의해 골절편을 나누는 분류가 아니며, 1 cm이상전이나 45$^{\circ}$ 이상의 각형성 이 있는 경 우를 전 이 골절편으로 생각하였다. 골절에 대한 관혈적 정 복 및 내고정술의 일차적 적응증은 골다공증이 없는 젊은 환자에서 발생된 튼튼한 내고정물을 시행할 수 있는 삼분 골절로 만족할 만한 결과를 위해 술후 오랜 기간동안 시행할 재활치료에 잘견딜수 있는 활동력 이 좋은 환자여야 한다. 수술적 치료의 절대적 적응증은 개방성 골절 ,혈관이 나 신경 손상이 동반될 때 , 정복이 불가능한 골절 탈구등이다. 반대로 환자가 골다공증이 심하거나, 근위 상완 골절편의 분쇄정도가 심하며 , 튼튼한 내고정을 시행할 가능성 이 희박한 나이가 많은 경 우에는 관혈적 정복 및 내고정술보다 일차적 인공삽입물을 이 용한 관절성형 술을 시행한 후 조기 재활 치료를 시행하는 것을 고려할 수 있다. 상완골 근위부 골절의 수술적 요법에는 다양한 수술 기법과 이에 따른 여러 합병증이 발생할 수 있으며 지속적 이고 체계적 인 재활 치 료가 꼭 필요하다. 여러 수술 기 법 중 관혈적 정복 및 장력 대 강선 기법을 시행할 때 만족할 만한 결과를 얻 을 수 있다. 이 방법 은 수술적 기법이 어렵지 않고, 골에 대한 고정과 함께 회전근 개의 건부착 부위에 대한 봉합을 추가할 수 있으나 역시 여러 가지 합병증이 있으므로 골절의 양상이 나 환자의 상태 ,환자의 활동력 등을 고려하여 치료 방법을 결정하여야 할것으로 사료된다.EX>46N으로, 슬개건-티타늄 간섭나사군이평균 1067.4$\pm$145N에서평균 601.8$\pm$134N으로, 슬개건-생체흡수성간섭나사군이평균 987.1$\pm$168N에서588.7$\pm$124N으로각각40$\%$, 39$\%$, 50$\%$, 24$\%$, 44$\%$, 40$\%$가감소하였다. 결론: 수술후초기고정력은슬괵건을LA나사(R) 또는Semifix(R)로고정하는방법과슬개건을티타늄및생체흡수성간섭나사로고정하는방법등이우수하였으며, 슬괵건을생체흡수성간섭나사나Endobutton(R)으로 고정하는 방법 등은고정력이 상대적으로매우약함을 알수있었다. 최대인장력은단순인장검사로는이상의대퇴골측고정방법의고정력이초기부하를견뎌내는데충분하다고생각되었으나주기성부하실험후현저히감소되어충분한초기안정성을제공하지못함을알수있었다.를 나타내었다. 또한 3m깊이에서의 측방 선량분포에서 Spoiler의 거리변화(6, 10cm)는 심부선량의 변화에 영향을 주지 않는 것으로 확인할 수 있었다. 그리고 위의 실험측정치를 치료계획 시스템에 입력하여 선량분포를 확인한 결과 Spoiler를 사용하는 경우 OPEN에 비해 선량분포 영역을 표면으로 끌어 올릴 수 있으며 Bolus 보다 피부 보호효과는 어느 정도 유지가 되는 것을 보여주었다. 4.결론 이와 같이 Spoiler는 Bolus와 비교하여 6MV 광자선의 build up 영역을 표면으로 증가시키는 동시에 Skin Sparing(피부보호)효과를 유지할 수 있으며 두경부암의 치료에서 Spoiler의 사용이 가능한 조건으로는 조사면이