• 제목/요약/키워드: Comminuted fracture

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Tibiotarsal and Ulnar Fracture Repair in a Great Horned Owl (Bubo virginianus)

  • Yoon, Hun-Young;Fox, Derek B.;Jeong, Soon-Wuk
    • 한국임상수의학회지
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    • 제25권3호
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    • pp.218-220
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    • 2008
  • A 1.4 kg adult great homed owl was presented to the University of Missouri-Columbia Veterinary Teaching Hospital after being found by the side of the highway. Physical examination revealed soft tissue injuries to the left wing and leg, and good body condition (body score 4/5). The radiographs revealed comminuted fracture of the diaphysis of the left tibiotarsus (severe) and ulna (mild). Closed reduction of the fracture was performed to the left tibiotarsus and ulna. System combining an intramedually (IM) Kirschner pin, IM Kirschner pin for external skeletal fixation, and polymethylmethacrylate was used for fracture repair. At 13 weeks, radiographs revealed that bridging callus was well formed over cortices of the fracture area. No physical, behavioral, or other assessable impairment was found during the rehabilitation period.

Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail

  • Kim, Beom-Soo;Cho, Jae-Woo;Yeo, Do-Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • 제31권2호
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    • pp.96-102
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    • 2018
  • Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

Single-Stage Reconstruction with Titanium Mesh for Compound Comminuted Depressed Skull Fracture

  • Eom, Ki Seong
    • Journal of Korean Neurosurgical Society
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    • 제63권5호
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    • pp.631-639
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    • 2020
  • Objective : Traditionally, staged surgery has been preferred in the treatment of compound comminuted depressed fracture (FCCD) after traumatic brain injury (TBI) and involves the removal of primarily damaged bone and subsequent cranioplasty. The main reason for delayed cranioplasty was to reduce the risk of infection-related complications. Here, the author performed immediate reconstruction using a titanium mesh in consecutive patients with FCCD after TBI, reported the surgical results, and reviewed previous studies. Methods : Nineteen consecutive patients who underwent single-stage reconstruction with titanium mesh for FCCD of the skull from April 2014 to June 2018 were retrospectively analyzed. The demographic and radiological characteristics of the patients with FCCD were investigated. The characteristics associated with surgery and outcome were also evaluated. Results : The frequency of TBI in men (94.7%) was significantly higher than that in women. Most FCCDs (73.7%) occurred during work, the rest were caused by traffic accidents. The mean interval between TBI and surgery was 7.0±3.9 hours. The median Glasgow coma scale score was 15 (range, 8-15) at admission and 15 (range, 10-15) at discharge. FCCD was frequently located in the frontal (57.9%) and parietal (31.6%) bones than in other regions. Of the patients with FCCDs in the frontal bone, 62.5% had paranasal sinus injury. There were five patients with fractures of orbital bone, and they were easily reconstructed using titanium mesh. These patients were cosmetically satisfied. Postoperatively, antibiotics were used for an average of 12.6 days. The mean hospital stay was 17.6±7.5 days (range, 8-33). There was no postoperative seizure or complications, such as infection. Conclusion : Immediate bony fragments replacement and reconstruction with reconstruction titanium mesh for FCCD did not increase infectious sequelae, even though FCCD involved sinus. This suggests that immediate single-stage reconstruction with titanium mesh for FCCD is a suitable surgical option with potential benefits in terms of cost-effectiveness, safety, and cosmetic and psychological outcomes.

폴라루스 골수정을 이용한 상완골 근위부 골절의 치료 (Treatment of Proximal Humerus Fracture by Polarus Nailing)

  • 최창혁;권굉우;정대의;장호진
    • Clinics in Shoulder and Elbow
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    • 제9권2호
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    • pp.169-175
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    • 2006
  • Purpose: The purpose of this study was to evaluate the usefullness of polarus nailing in the treatment of proximal humerus fractures including 2 part, 3 part and proximal comminuted fractures. Materials and methods: Fifteen cases of proximal humerus fracture treated with Polarus nailing from March, 2002 to March, 2004 were selected. Man was 3 cases, and woman was 11 cases. There were one case of follow up loss due to decease. Average age was 60 years old (range, 23 to 84), and there were 6 cases of 2 part fracture, 3 cases of proximal segmental fracture, 5 cases of 3 part fracture. We analyzed the outcom results between 2 part fracture and 3 part fracture. The average follow up period after the operation was 1.5(range, 1 to 2) years. Range of motion (ROM), pain and functional outcome were evaluated by visual analogue scale(VAS) and american shoulder and elbow surgery (ASES) activity of daily living (ADL) functional scoring system. Results: All cases showed union on radiologic evaluation, with 2.3 months follow up. In 5 cases of 3 part fracture, average union time was 1.9 months regardless of proximal screw loosening in 4 cases. In 2 part fracture union time was 2.2 months (P>0.05). VAS pain score was 1.3, ROM was $160^{\circ}$ in forward flexion, $40^{\circ}$ in external rotation, L3 level in internal rotation, and ASES, ADL functional score was 21 in 2 part fracture. VAS pain score was 1.25, ROM was $160^{\circ}$, $43^{\circ}$ and L1 level, and ASES, ADL functional score was 21 in 3 part fracture. There were no statistically significant difference between two groups (P>0.05) VAS pain score was 1.6, ROM was $170^{\circ}$, $47^{\circ}$ and L3 level, and ASES, ADL functional score was 23 in proximal comminuted fracture. Conclusion: Polarus nailing could be used as an effective modality in certain cases of proximal humeral fracture including 2 part, proximal segmental and in cases of 3 part fractures with large greater tuberosity fragment.

대구지방에서 발생한 개의 골절 (Fractures of the dog in Taegu area)

  • 김대영;장인호
    • 한국임상수의학회지
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    • 제15권1호
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    • pp.222-227
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    • 1998
  • This survey was based on the data of one hundred four dogs with 108 case,T of fracture admitted to the veterinary teaching hospital, College of Veterinary Medicine, Kyungpook National University and 24 private small animal hospitals from January, 1995 to Decemberi 1996. The results were analyzed as following criteria; the distribution of fractures causes of fractured age and sexual distributions month of the most frequencel total body weights presence of communicating external wound, extent of damaged direction of fracture line, location of fracture liner fracture managements fixations methods, fixations methods according to location of fracture. The results of survey were as follow: 1. Main distribution of fracture; radius . ulna (23.1%).2. Causes of fracture; road toraffic accident (39.4 T,). 3. Age; over 24 months (27.9%). 4. Sex; male (53.89)), female (46.2%). 5. Month of the most frequence; July (14.4%) 6. Total body weight: 2-5 kg (45.27)). 7. Presence of communicating external wound; closed fracture (94.2%). 8. Extent of damage; complete fracture (92.6%). 9. Direction of fracture line: comminuted fracture (27.8 To). 10. Location of fracture line; diaphysis (62.0%). 11. Fracture management; open reduction (58.3% ). 12. Fixation methods; not treat (22.2%). 13. Fixation methods according to location of fracture; radius ulna-Kirschner wire fixation (45.5%), femur. shaft-intramedullary pinning (71.4%), pelvis-bone plate (53.3%), metacarpus-not treat, Kirschner wire fixation (each 30.8%).

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외상 후 파괴된 주관절 또는 진구성 탈구에서의 주관절 전치환술 (Total elbow arthroplasty for posttraumatic destroyed or unreduced elbow joint)

  • 김영규;정이혁
    • Clinics in Shoulder and Elbow
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    • 제6권1호
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    • pp.37-43
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    • 2003
  • Purpose: To evaluate the results in patients who received total elbow replacement for posttraumatic destroyed or unreduced elbow joint. Materials and Methods: Six patients with posttraumatic destroyed, or unreduced elbow joint, who were nearly impossible to move actively and had pain and grossly unstable joint, were followed up average 42 months. 3 cases were soft tissue injuries and bone defects which were caused by severe comminuted fracture, 1 was a nonunion with comminuted fracture, and 2 were unreduced elbow joint. Total elbow replacement was performed average 10 months after the injury. All the cases were used by semiconstrained prosthesis, and the results were estimated by Mayo elbow perfomance score. Results: Pain was decreased in all the cases postoperatively. Average ranges of motion were improved with active extension 20° and flexion 120°. Mayo elbow performance scores were pain 42.5 points, range of motion 17.5 points, stability 8.3 points, function 19.2 points and totally 87.5 points, and final results were 3 excellent and 3 good. Loosening of prosthesis was not found in all the cases by final follow-up radiograph. Conclusicon: Semiconstrained TER can be used as a effective treatment improving pain and active ranges of motion caused by posttraumatic destroyed or unreduced elbow joint, however, long term follow-up is needed because early loosening of TER can be occurred due to severe bone defects.

Application of Plate and Circumferential Wiring with Resin to Bilateral Mandibular Fractures in a Calf: Case Report

  • Yu, Yong;Kim, Namsoo;Heo, Suyoung
    • 한국임상수의학회지
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    • 제37권6호
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    • pp.363-366
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    • 2020
  • A 2-month-old, 50 kg male Korean native calf was referred with bilateral mandibular fractures. The bilateral mandible was hanging loose, with inability to use the jaw, indicated by excessive salivation. Radiography revealed a long oblique fracture in the right mandible, and a short oblique fracture in the left mandible. Computerized Tomography, a different form of radiography, revealed the fracture in the left mandible to be a comminuted fracture. In order to stabilize the bilateral mandible fractures, a combination of bone plate and wiring was applied; in addition, resin was applied to enhance stabilization of the mandible. Six weeks after surgery, the calf was able to masticate and ruminate well. In this case, application of the plate and wiring with resin to bilateral mandibular fractures presented a successful functional recovery. Accordingly, the combination of bone plate and wiring with resin can be an effective technique for treating mandibular fractures.

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

  • Lee, Chul-Hyung;Choi, Hyun;Kim, Tae-In;Kim, Jun Beom;Shin, Sang Yeop;Rhee, Seung-Koo
    • Clinics in Shoulder and Elbow
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    • 제19권4호
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    • pp.223-228
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    • 2016
  • Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

관골상악골 복합체 골절 환자에서의 안면 비대칭에 대한 임상경험 (Clinical Experiences of Facial Asymmetries in Zygomaticomaxillary Complex Bone Fracture Patients)

  • 강낙헌;최상문;김주학;송승한;오상하
    • Archives of Plastic Surgery
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    • 제38권2호
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    • pp.161-165
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    • 2011
  • Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

Bone Fractures in Raptors in the Daegu-Gyeongbuk Region: A Retrospective Study

  • Kim, Taeil;Kwon, Youngsam
    • 한국임상수의학회지
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    • 제33권5호
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    • pp.261-265
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    • 2016
  • The purpose of this study was to perform retrospective data collection of the sites and types of fracture in raptors in order to enable wildlife veterinarians to manage cases of fracture more effectively. This study included raptors with fracture, rescued between January 2013 and August 2015 in the Daegu-Gyeongbuk region in Republic of Korea. The data were collected from the medical reports and radiographic findings acquired from designated animal hospitals for wild animals, the Dongin Animal Hospital and the Kyungpook wildlife rescue center. The distribution, sites, and types of fracture, and outcomes of rescue and fracture management of the raptors included in this study were analyzed. Among the 31 birds included in this study, Falco tinnunculus was the most common species. Of the 42 sites of fracture, the diaphysis of the humerus was the most common site of fracture, and comminuted fracture was the most common type. Of the 31 birds, 13 were treated surgically. Intramedullary pinning with bandaging was the most common method of surgical treatment. While 7 of the 13 birds died, 2 were reintroduced into the wild, and 4 were kept captive. This study presents the evaluation of the data on the species, sites, and types of fracture, and treatment procedures and outcomes in raptors with fractures, rescued in the Daegu-Gyeongbuk region. The findings of this study could serve as a basic database for the treatment of fracture in raptors.