• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.55-60
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• 2009

Purpose: For blowout fracture of the medial orbital wall, the goals of treatment are complete reduction of the herniated soft tissue and anatomic reconstruction of the wall without surgical complications. Surgeons frequently worry about damage to the optic nerve from the dissection, when the part over the posterior ethmoidal foramen was fractured. The authors performed small incision and inlay grafting for reconstruction of medial orbital wall fracture. Methods: Between January 2007 and April 2008, 15 out of 32 patients were included in an analysing the outcome of corrected medial orbital wall fracture. In 15 patients of posterior comminuted fracture of medial orbital wall, insertion of porous polyethylene($Medpor^{(R)}$ channel implant, Porex, USA) to ethmoidal sinus was performed in multiple layer, through the transconjunctival approach (inlay grafting). Results: In all cases, the orbital bone volume was reconstructed in its normal anatomical position. The associated ocular problems disappeared except for mild enophthalmos in 2 patients and there were no surgical complications associated with inlay grafting. Conclusion: The advantage of inlay grafting include anatomical reconstruction of the orbital wall; the avoidance of optic nerve injury; the simplicity of the procedure; and consequently, the absence of surgery-related complications. This technique is presented as one of the preferred treatments for posterior comminuted fracture of medial orbital wall.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.238-241
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• 2017

A 52-year-old man experienced blunt trauma upon falling from a height of 40 m while trying to repair the elevator. The patient's systolic blood pressure and hemoglobin levels were 60 mmHg and 7.0 g/dL, respectively, upon admission. A large volume of bloody discharge was observed in the open wound of the perianal area and sacrum. A computed tomography scan revealed an open comminuted sacral fracture with multiple contrast blushes. He underwent emergency laparotomy. Both internal iliac artery ligations were performed to control bleeding from the pelvis. Protective sigmoid loop colostomy was performed because of massive injury to the anal sphincters and pelvis. Pad packing was performed for a sacral open wound and perineal wound at the prone position. After resuscitation of massive transfusion, he underwent the second operation 2 days after the first operation. The pad was removed and the perineal and sacral open wounds were closed. After the damage-control surgery, he recovered safely. In this case, the hemodynamically unstable, open comminuted sacral fracture was treated safely by internal iliac artery ligation with pad packing.

• Archives of Craniofacial Surgery
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• v.16 no.3
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• pp.119-124
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• 2015

Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.205-211
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• 1998

The comminuted fracture and dislocation of the proximal humerus occur more frequently in older patient group and operative treatment is difficult due to poor bone quality. Based on Neer's work, hemiarthroplasty has now become widly accepted for the management of the three-part fracture and four-part fracture-dislocation of the proximal humerus in old age group. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after hemiarthroplasty for proximal humerus fractures and dislocations. Authors reviewed and analyzed 14 prosthetic replacement in comminuted proximal humeral fracture and dislocation at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine from March, 1988 to May, 1997. The results were as follows the average age was 58.9years and the ratio of males and females was 5:9. The most common cause of injury was traffic accident(43%). According to the classification of Neer, three part fracture were three(21%), four-part fracture and four-part fracture-dislocation were eleven(79%). The prosthetic replacement was performed within two weeks in eight patient and six were performed after two weeks. The results were analysed according to Neer's criteria and five cases showed satisfactory results. We concluded that hemiarthroplasty for fracture and dislocation of the proximal humerus facilitated the restoration of humerus length and pain relief, thereby allowing earlier motion to prevent the development of painful shoulder: stiffness.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.94-98
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• 2011

Purpose: We present a case of anterior glenoid rim comminuted fracture that was treated with arthroscopic reduction and an AO headless compression screw (HCS) fixation. Materials and Methods: A 31-year old man complained of left shoulder pain after falling down on stairs. The anterior glenoid comminuted fragments were arthroscopically reduced. Fixation with an AO HCS was done after placement of 1.1 mm Kirschner wire as a guide pin through a standard cannulated anterosuperior portal. Results: Twelve months after the operation, union of the fracture was achieved and the range of motion was fully recovered. He did not complain of any discomfort during his activities of daily living. Conclusion: An AO HCS had various screw sizes and this was good for fixation of a small glenoid fracture and a long drill bit and screw driver were useful for fixation of deep seated glenoid fracture. A short guide wire could be replaced by a 1.1 mm K-wire. An AO HCS was useful for fixation of an anterior glenoid rim comminuted fracture.

• Proceedings of the Korean Society for Food Science of Animal Resources Conference
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• 2002.11a
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• pp.163-163
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• 2002

• Proceedings of the Korean Society for Food Science of Animal Resources Conference
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• 2003.06a
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• pp.146-146
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• 2003

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.52-52
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• 2008

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.51-57
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• 1998

Comminuted fracture of the distal end of the humerus in adults is very rare and difficult to treat. In operative treatment, an implant which can achieve accurate anatoraical reduction and rigid fixation is needed. But the pre­existing Y -shaped plate had wide and thick limbs and some problems in fixation for most distal humeral fractures. So we devised a modified plate which is more narrow and th1n and has a different hole distance and wing length (long lateral wing). The aim of the study was to evaluate the clinical result of this modified anatomical Y -plate. From 1991 to 1997, we treated 23 cases of distal humeral fractures using modified anatomical plate and the results were as follows. 1. Fracture type in 18 patients(78%) was C-type(C1,C2,C3) which were intraarticular and mostly displaced or comminuted. 2. Bony union was obtained in 22 patients(96%) through rigid fixation and observed radiologically at 3.5 months(2-6months) on the average. 3. In 23 patients, 19 patients(82%) showed satisfactory results after 34 months(6-73months) follow-up. So if the modified anatomical Y-plate is used in the treatment of distal humeral fracture, a satisfactory result can be obtained through a more accurate, easy, and rigid fixation than preexisting plate.

• Journal of the Korean Ceramic Society
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• v.29 no.6
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• pp.419-430
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• 1992

Fabrication possibility of low-shrinkage alumina without oxidation and wetting agent was presented on the basis of observation about oxidation behavior, microstructure and physical characteristics of such reaction agents free Al2O3-Al system. The composition less than Al 10w/o where Al can act as a sintering agent for Al2O3 was excluded. Under the condition of present experiments oxidation of Al2O3-Al system was dependent not on holding time but mainly on oxidation temperature. In thes case of Al powder not comminuted effectively during powder mixing of Al2O3-Al, columnar structure which would act as a hindrance to the densification during sintering developed more during oxidation with higher Al contents, and which made the fabrication of low-shrinkage Al2O3 ceramics impossible. If Al powder was comminuted effectively due to co-mixed Al2O3 characteristics, densification was improved because of no columnar structure and made the fabrication of sintered body with -2.7% dimensional change and 81% relative density possible. As a result, it is possible to fabricate dense low-shrinkage Al2O3 ceramics without oxidation and wetting agent under conditions such as smaller particle size of Al, Al contents below 50v/o, higher green density of Al2O3-Al compact and the use of Al2O3 powder used for high-density ceramics.