• Title/Summary/Keyword: Closed Reduction

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An Irreducible Hip Dislocation with Femoral Head Fracture

  • Kim, Tae-Seong;Oh, Chang-Wug;Kim, Joon-Woo;Park, Kyeong-Hyeon
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.181-188
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    • 2018
  • Urgent reduction is required in cases of traumatic hip dislocation to reduce the risk of avascular necrosis of the femoral head. However, in cases of femoral head fractures, the dislocated hip cannot be reduced easily, and in some cases, it can even be irreducible. This irreducibility may provoke further incidental iatrogenic fractures of the femoral neck. In an irreducible hip dislocation, without further attempting for closed reduction, an immediate open reduction is recommended. This can prevent iatrogenic femoral neck fracture or avascular necrosis of the femoral head, and save the natural hip joint.

Clinical Results after Closed Reduction and Internal Fixation for Unstable Subtle Injuries of Lisfranc Joint (초기 진단에 어려움이 있는 불안정성 족근 중족 관절 미세 손상에 대한 도수 정복 및 내고정술 후 임상적 결과)

  • Yu, Sun-O;Park, Yong-Wook;Kim, Joo-Sung;Lee, Gi-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.71-75
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    • 2004
  • Purpose: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. Materials and Methods: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Results: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs. Conclusion: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.

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A retrospective clinical investigation for the effectiveness of closed reduction on nasal bone fracture

  • Kang, Byung-Hun;Kang, Hyo-Sun;Han, Jeong Joon;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Kook, Min-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.53.1-53.6
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    • 2019
  • Background: The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture. Patients and methods: A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient's records, and radiographic images of nasal bone fractures were evaluated. Results: Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture. Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications. Conclusion: Closed reduction could be performed successfully within 2 weeks after injury.

Comparison Study of the Use of Absorbable and Nonabsorbable Materials as Internal Splints after Closed Reduction for Nasal Bone Fracture

  • Yi, Chang Ryul;Kim, Young Joon;Kim, Hoon;Nam, Sang Hyun;Choi, Young Woong
    • Archives of Plastic Surgery
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    • v.41 no.4
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    • pp.350-354
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    • 2014
  • Background The authors sought to compare the use of the nonabsorbable polyvinyl alcohol sponge (PVA, Merocel) and absorbable synthetic polyurethane foam (SPF, Nasopore Forte plus) as intranasal splints after closed reduction of fractured nasal bones during the hospitalization period. Methods The medical records of 111 patients who underwent closed reduction for nasal bone fracture at Sanggye Paik Hospital, Inje University College of Medicine, from 2012 to 2013 were reviewed retrospectively. PVA (group A) or SPF (group B) was packed as an internal splint after closed reduction. The efficacy of the materials was compared and statistically analyzed. Results PVA was used in 82 patients, and SPF was used in 29 patients. The patients in group B complained significantly more of nasal pain on the first day after operation than the patients in group A. Headaches on the operation day were significantly more painful in group B than in group A. Bleeding on the fourth postoperative day was significantly reduced in group B as compared to group A. The patients in group B exhibited significantly more intensive nasal obstruction on the operation day and the following day than the patients in group A. However, on the third and fourth postoperative days, the nasal obstruction in group B was less than that in group A. The pain and bleeding related to the packing material was significantly reduced in group B as compared to group A. Conclusions The use of SPF as an absorbable packing material is a reasonable substitute for the traditional nonabsorbable material.

Are postoperative prophylactic antibiotics in closed reduction of nasal bone fracture valuable?: prospective study of 30 cases

  • Jang, Nam;Shin, Hyun Woo
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.89-93
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    • 2019
  • Background: Prophylactic antibiotic administration after surgery for a nasal bone fracture is performed due to concerns about infection-related complications, such as, toxic shock syndrome. To evaluate the validity and efficacy of antibiotic use, we compared the results obtained and the bacterial profiles of nasal packing materials in patients that underwent closed reduction for a nasal bone fracture with or without prophylactic antibiotic administration. Methods: Thirty consecutive patients with a nasal bone fracture, but without an open wound, that underwent closed reduction during March to August 2017 were included in the present study. Fifteen of these 30 patients were randomly assigned to a control group, members of were administered postoperative intravenous antibiotics once at the day of surgery and then oral antibiotics for 4 days. The other 15 patients were assigned to an experimental group and not administered any antibiotic postoperatively. Antibiotic ointment was not applied to nasal packing in either group. Nasal packing was removed on postoperative day 4 in all cases. Removed nasal gauze packings were culture tested and strains identified in the two groups were compared. Results: Bacterial strain types cultured from packings were similar in the experimental and control groups and no patient showed signs of clinically significant infection. Conclusion: The findings of this study suggest postoperative prophylactic antibiotic use is not clinically required after closed reduction of a nasal bone fracture. Furthermore, the non-use of postoperative antibiotics is biologically beneficial, as it reduces the occurrence of resistant strains and medical costs, and is more convenient for patients.

Antibiotic use in nasal bone fracture: a single-center retrospective study

  • Jung, Ji Hyuk;Jeon, Yeo Reum;Song, Joon Ho;Chung, Seum
    • Archives of Craniofacial Surgery
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    • v.22 no.6
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    • pp.319-323
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    • 2021
  • Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures. Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon's specialty, and operation time. Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of "surgical site infection." Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon's specialty did not show any difference in infection-related complication rates. Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

Die Stress Reduction Design and Mechanical Properties Analysis of Warm Forging Process for the Application of Warm-Closed Forging of Automative Steering Unit Yoke (자동차 조향장치 부품 요크의 온간 밀폐 단조 적용을 위한 금형 응력 저감 설계 및 온간 단조품의 기계적 특성 분석)

  • Seong, S.G.;Kim, K.H.;Lee, Y.S.;Lee, S.Y.;Yoon, E.Y.
    • Transactions of Materials Processing
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    • v.31 no.2
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    • pp.51-56
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    • 2022
  • In this study, finite element analyses were performed by applying a stress ring and split die design to relieve the tensile stress acting on the die due to high surface pressure during warm-closed forging. The applied material was a yield-ratio-control-steel (YRCS). It was used without quenching or tempering after forging. In the case of stress rings design, the number of stress rings and the tolerance for shrink fit were different. Vertical and horizontal splits were applied for insert die split design. Case 5 die with three stress rings, 0.2 % shrink fit tolerance, and vertical split was selected as an effective die design for tensile stress reduction. Based on die stress reduction analyses, Case 5 die for warm-closed forging was produced and smooth forgeability was secured, making it possible to manufacture forging product of yoke with the required geometry. In addition, controlled cooling using warm forging heat was applied to secure mechanical properties of yokes. When oil cooling was used for direct controlled cooling after warm-closed forging, a relatively uniform Rockwell hardness distribution and high mechanical properties could be obtained.

Speciation of Phosphorus Dependent upon pH and Oxidation Reduction Potential in Overlying Water and Sediment (pH와 산화환원전위에 따른 상등수-퇴적물에서의 인 형태 변화)

  • Jung, Woo-Hyeok;Kim, Geon-Ha
    • Journal of Korean Society of Environmental Engineers
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    • v.28 no.5
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    • pp.472-479
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    • 2006
  • In this research, speciation of phosphorus in sediment and overlying water dependent upon pH and ORP(Oxidation Reduction Potential) was studied. Three possible conditions were simulated: open system with circulation, closed system with stratification and closed system with sand capping on the sediment. Phosphorus release rate from sediment was increased for both open system and closed system if pH was less than 6.0. Phosphorus concentration for closed system was increased from 0.9 mg/L to 0.51 mg/L, and stabilized at 0.34 mg/L if anaerobic conditions were maintained in the overlying water. When sand capping was implemented, phosphorus concentrations of overlying water were maintained less than those of closed system.

Analysis of Methane from Screened Soil of Closed Landfill and Application of Landfarming for the Reduction of the Methane (사용종료 매립지 선별토양의 메탄 발생 분석 및 토양경작기술 적용 효과 연구)

  • Kim, Kyung;Yang, Jae-Kyu;Chang, Yoon-Young
    • Journal of Soil and Groundwater Environment
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    • v.15 no.5
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    • pp.40-45
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    • 2010
  • In this study, methane production by reuse of screened soil of landfill was estimated and the effect of application of landfarming for the reduction of methane was investigated. The study soil sampled from S closed landfill contains VS 9.8~12.8% and its BOD/COD is 0.31~0.33 which is more than three times over 0.1, the BOD/COD stabilization criteria of Ministry of Environment. The effective remediation technology for the reduction of organics of soil, landfarming was applied to the screened soil for 60 days. VS and TPH removal showed 5.2~8.3% and 67~74% respectively, and the reduction of VS until 30 day charged 70% of the total reduction. BMP test showed 27.77~30.46 mL $CH_4$/g VS and total methane production from total screened soil for remediation is expected about 260.4 $CH_4$ ton. Expected amount of methane production of the screened soil by landfarming application is 12.9 $CH_4$ ton, which shows 95% gas reduction effect and landfarming is effective for the reduction of methane production from screened soil of landfill.

Torque ripple reduction of a closed-loop driven permanent magnet stepping motor by lead angle control (Lead angle 제어에 의한 폐루프 운전 영구자석형 스테핑 전동기의 토오크 리플 저감)

  • Lee, Hyun-Chang;Jun, Ho-Ik;Woo, Kwang-Joon
    • Journal of Institute of Control, Robotics and Systems
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    • v.3 no.3
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    • pp.280-288
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    • 1997
  • In this paper, we will show that the torque ripple in closed-loop drives of permanent magnet stepping motors is reduced as properly selected lead angle control method. We propose an instantaneous torque equation, which is the function of lead angle, to estimate the influence on torque ripple. We design a closed-loop lead angle control system based on the proposed instantaneous torque equation and measure the instantaneous torque in various excitation modes. It is shown that torque ripple is greatly reduced, as seen from the experimental results as well as from the computer simulation results. For example, torque ripple reduced from 78.25% to 46.82% in the case of 50 PPS single-phase excitation mode operation.

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