• 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.

• 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.

• 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.

• 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.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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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.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.143-148
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• 2002

Purpose: We examined patients to evaluate the clinical results of traumatic metacarpophalangeal(M-P) dislocations of the thumb, uncommon and irreducible. Materials and Methods: In 11 traumatic M-P dislocations of the thumb, the types of dislocations were 10 dorsal and 1 volar dislocations resulted from the impacted and hyperextended forces on thumb. Authors evaluated the possibility of closed reduction, the anatomical structures interfering with closed reduction, and the surgical approaches. Results: Eight cases were treated with open reduction through volar approach and two cases were treated with closed reduction. Joint fusion was done with a plate in a chronic case. Initial closed reduction was attempted in all cases, but succeeded in only 2 cases because the interposed ruptured volar plate, the flexor pollicis brevis tendon and ulnar sesamoid bone at the volar side of the M-Pjoint were the obstacles to reduce. The metacarpal head was caught in button-hole slit between theflexor pollicis brevis and the ruptured volar joint capsule in all cases. Conclusion: Similar with the M-P joint dislocations of other fingers, the dorsal complex M-P dislocations of the thumb due to hyper extension are unusual and can't easily be reduced by closed manipulation. It is necessary to pay attention to the ruptured volar plate, capsule, the subluxated portion ofthe sesamoid and flexor pollicis brevis as interfering structures.

• Archives of Craniofacial Surgery
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• v.14 no.2
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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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• v.37 no.5
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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.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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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.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.168-175
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• 2003

Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.