• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.168-173
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• 2008

Purpose: To evaluate the results of treatments by percutaneous Acutrak screw fixation for intra-articular joint depression type fracture of calcaneus. Materials and Methods: Thirteen cases with intra-articular joint depression type fracture of calcaneus, from September 2004 to March 2006, were reviewed. There were 9 males and 4 females with 52.5 years old mean age (range: $31{\sim}74$ years old). The average follow-up period was 18 months (range: $8{\sim}32$ months). Steinmann pins and Freers were used for closed reduction. After closed reduction, Acutrak screws and K-wires were inserted. The patients were evaluated with Creighton-Nebraska health foundation assessment sheet for calcaneal fracture, the extent of recovery of Bohler angle, fragment size, and state of subtalar joint. Results: Clinical results according to Creighton-Nebraska health foundation assessment sheet for calcaneal fracture were excellent in 6 cases (46%), good in 4 cases (30%), fair in 2 cases (15%), and poor in 1 case (7%). Average preoperative Bohler angle was $7.6^{\circ}$ (range: $2^{\circ}{\sim}13^{\circ}$). Average postoperative Bohler angle was $24.4^{\circ}$ (range: $4^{\circ}{\sim}33^{\circ}$). There were no soft tissue complications. There were one mild subtalar arthritis and one moderate subtalar arthritis. Conclusion: We think that closed reduction and percutaneous Acutrak screw fixation with or without K-wire is a good option for joint depression type fracture of calcaneus.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.15-19
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• 2020

Background Pain caused by nasal pack removal after closed reduction of nasal bone fractures is a common problem. This study investigated the effect of infiltrating lidocaine into nasal packs on the pain caused by pack removal after closed reduction of nasal bone fractures. Methods Seventy-five patients who underwent closed reduction of nasal bone fractures between March 2016 and March 2018 were enrolled in this prospective, randomized, single-blind study. Merocel (hydroxylated polyvinyl acetate) packs were applied bilaterally and retained for 5 days. Twenty minutes before removal, both packs were rehydrated with 6 mL of 2% lidocaine in 26 patients and with 6 mL of saline in 24 patients; the packs were not rehydrated in 25 patients. Visual analog scale (VAS) scores for pain on removal were recorded. Results The mean VAS score was 5.3±2.0 in all patients, 3.8±1.5 in the lidocaine group, 5.8±1.4 in the saline group, and 6.3±2.1 in the non-rehydrated group. There was a significant difference in the pain score between the lidocaine and saline groups (P<0.001) but not between the saline and non-rehydrated groups (P=0.186). Conclusions Infiltration of lidocaine into Merocel packs reduced the pain caused by pack removal after closed reduction of nasal bone fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.6
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• pp.266-272
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• 2014

Purpose: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. Methods: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. Results: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. Conclusion: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.

• Journal of the Korean Institute of Telematics and Electronics S
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• v.34S no.3
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• pp.24-32
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• 1997

This paper is on a discrete controller order reduction with the closed-loop stability and performance guaranteed. to achieve this, after finding the solutionsof two lyapunov inequalities and balancing the full order controller system, we find the reudced order controlers using the balanced truncation (BT) and the balanced singular perturbation approximation (BSPA). When the solutions of the two lyapunov inequalities exist, it is shown that the resulting controllers guarantee the closed-loop stability, and .inf.-norm error bounds are derived for the closed-loop performance region for the BT and in low frequency region for the BSPA. Finally, a numerical example is given to illustrate the validity of the proposed method.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.24-30
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• 2019

Background: Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction. Methods: Patients who visited the plastic and reconstructive surgery department between November 2016 and November 2017 with nasal bone fractures and treated by a single surgeon were prospectively followed up. Patients with simple unilateral or bilateral nasal bone fractures were treated with bedside finger reduction under local anesthesia and patients with comminuted nasal bone or septal fractures were scheduled for closed reduction under general anesthesia. Results: Of 84 patients, 28 met the inclusion criterion and underwent bedside finger reduction under local anesthesia. Twenty-seven patients (96.4%) were successfully contacted via telephone for survey. Twenty-three (85.2%) showed good and three (11.1%) showed fair results. All 27 patients (100%) were satisfied with their postoperative function and 25 (92.6%) were satisfied with their postoperative aesthetic result. Twenty-five patients (92.6%) preferred the finger reduction method under local anesthesia over closed reduction under general anesthesia. Conclusion: Finger reduction under local anesthesia in patients with mild unilateral or bilateral nasal bone fractures is an easy and efficient procedure with high patient satisfaction and favorable postoperative functional and aesthetic outcomes.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.254-259
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• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.49-54
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• 2005

Evaluations and treatments of nasal bone fracture have been mainly focused on aesthetic aspect, but nose has an important role as an airway. The purpose of this study was evaluation of nasal bone fractures in the view of nasal obstruction and its improvement after reduction. Acoustic rhinometry was applied to the 77 nasal bone fractured patients who received closed reduction from August 2002 to July 2003 and received closed reduction. This was tested twice, before and 6 days after reduction, for all 77 patients and additional acoustic rhinometry was also possible in 26 patients after 6 months. The analysis of acoustic rhinometry were based on data of minimal cross-sectional area(MCA) according to fracture sites(one side, both side and tip) and septal displacement. Mean MCA for all cases before reduction was $0.43{\pm}0.21cm^2$, which was 19% decrease compared to normal adult data($0.53{\pm}0.12cm^2$). Depending on fracture sites the MCA were $0.45{\pm}0.16cm^2$ for one side fracture, $0.35{\pm}0.18cm^2$ for both side fracture, and $0.42{\pm}0.25cm^2$ for tip fracture. The patients with septal displacement showed more severe obstruction than ones without septal displacement, $0.26{\pm}0.26cm^2$ and $0.46{\pm}0.10cm^2$, respectively. The MCA was improved up to $0.50{\pm}0.22cm^2$ after reduction and showed slight decrease after 6 month($0.48{\pm}0.23cm^2$). Based on the results of this study, nasal bone fracture really caused airway obstruction(19% decrease). Both side fracture showed more profound decrease than one side fracture and septal displacement was an important parameter which causes nasal obstruction. Closed reduction improved MCA by 14% right after reduction, and 11% after 6 month follow up.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.6
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• pp.432-437
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• 2021

Objectives: The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods: This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results: A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion: Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.43-48
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• 2010

The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.

• 제어로봇시스템학회:학술대회논문집
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• 1994.10a
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• pp.289-292
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• 1994

In this paper, the equations of motion are constructed systematically for multibody systems containing closed kinematic loops. For the displacement analysis of the closed loops, we introduce a new mixed coordinates by adding to the reference coordinates, relative coordinates corresponding to the degrees of freedom of the system. The mixed coordinates makes easy derive the explicit closed form solution. The explicit functional relationship expressed in closed form is of great advantages in system dimension reduction and no need of an iterative scheme for the displacement analysis. This forms of equation are built up in the general purpose computer program for the kinematic and dynamic analysis of multiboty systems.