• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.280-285
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• 2000

Posterior transarticular screw fixation for atlantoaxial instability due to trauma or rheumatoid arthritis provides immediate rigid fixation of the C1-2 vertebral segment while preserving motion between the occiput and C1. This technique provides more resistance to translational and rotational forces than wiring technique. However, the technique of transarticular screw fixation is inherently demanding because of the complex anatomy of the occipitocervical region and vertebral artery(VA) at risk for arterial damage. VA injury may lead to serious subsequent neurological deficits and possibly death from bilateral VA injury. We report a case of a vertebral artery-to-epidural venous plexus fistula after posterior transarticular screw fixation which was treated with balloon occlusion.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.27-30
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• 2020

Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.272-275
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• 2015

Pelvic bone fracture with unstable vital signs is a life-threatening condition demanding proper diagnosis and immediate treatment. Unlike long bones, the pelvic bone is a three dimensional structure with complex holes and grooves for vessels and nerves. Because of this complexity, a pelvic bone fracture can lead to complicated and serious bleeding. We report a case of a fifty-year-old male suffering from a pelvic bone fracture due to a fall. An imaging study showed fractures of both the superior and the inferior ramus of the pubic bone, with contrast extravasation underneath them, resulting in a large preperitoneal hematoma. He was sent for angiography, which revealed a hemorrhage from a branch of the left obturator artery. Embolization was done with a glue and lipiodol mixture. The patient recovered without complication, and was discharged at four weeks after admission.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.28-34
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• 2006

Purpose: In maxillofacial surgery, proper preoperative diagnosis is very important in achieving good postoperative results. Although conventional CT scans are useful for visual representations of fractures, they cannot provide direct guidance for reconstructing facial bone fractures. However, the recent technology of multislice scanning has brought many clinical benefits to CT images. Direct correlations can be made between preoperative imaging data and operative planning. The aim of the current study is to evaluate the differences between conventional CT and multidetective three-dimensional CT(3D MDCT) measurements in craniofacial deformities. Methods: From January 2005 to November 2005, MDCT scans of 41 patients were evaluated by comparing them with conventional CT scans. The 3D MDCT images were assessed and reviewed by using a simple scoring system. Results: The 3D MDCT scans offered easy interpretation, facilitated surgical planning, and clarified postoperative results in malar complex fractures, mandibular fractures, and extensive maxillofacial fractures and cranioplasty. However, 3D MDCT images were not superior to conventional CT scans in the diagnosis of blowout fractures. Conclusion: In spite of its limitations, the 3D MDCT provided additional and more comprehensive information than the conventional CT for preoperative assessment of craniofacial deformities. Therefore, the 3D MDCT can be a useful tool for diagnosis and systematic treatment planning in craniofacial skeletal deformities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.6
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• pp.302-308
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• 2019

Fractures of the styloid process of the temporal bone may occur with or without an obvious relation to trauma. The incidence of either isolated styloid process fracture or in combination with mandibular fractures is rare, and such occurrences are often misdiagnosed or neglected. A fractured styloid when displaced may impinge on adjacent vital structures, leading to neurological or vascular symptoms that vary according to the anatomical structure compressed. Styloid process fractures associated with atlas/C1 fractures have also been rarely reported in the literature. In this review of literature, the majority of patients was treated conservatively, as few demonstrated the necessity of surgical intervention. There is a definitive need for a protocol to recognize and classify styloid fractures to plan for further treatment. The aim of this review was to achieve a comprehensive understanding of all types of styloid fractures, determine the clinical severity of symptoms, and to consider management and prognosis. In addition, a new classification of cervico-stylo-mandibular fractures is proposed based on important evidence in the literature regarding clinical and radiographic factors that might influence the treatment and prognosis of such fractures.

• Safety and Health at Work
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• v.9 no.1
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• pp.30-41
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• 2018

Background: The purpose of the work is to develop a system that allows processing of information for analysis and industrial risk management, to monitor the level of industrial safety and to perform necessary measures aimed at the prevention of accidents, casualties, and development of professional diseases for effective management of industrial safety at hazardous industrial sites. Methods: Risk assessment of accidents and incidents is based on expert evaluations. Based on the lists of criteria parameters and their possible values, provided by the experts, a unified information and analytical database is compiled, which is included in the final interrogation questionnaires. Risk assessment of industrial injuries and occupational diseases is based on statistical methods. Results: The result of the research is the creation of Guidelines for risk management on hazardous industrial sites of the Republic of Kazakhstan. The Guidelines determine the directions and methods of complex assessment of the state of industrial safety and labor protection and they could be applied as methodological basis at the development of preventive measures for emergencies, casualties, and incidents at hazardous industrial sites. Conclusion: Implementation of the information-analytical system of risk level assessment allows to analyze the state of risk of a possible accident at industrial sites, make valid management decisions aimed at the prevention of emergencies, and monitor the effectiveness of accident prevention measures.

• Archives of Craniofacial Surgery
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• v.22 no.3
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• pp.168-172
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• 2021

Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.457-471
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• 2020

Fingers are body parts with a complex structure and essential functions that are the most prone to trauma. The principle of treatment for finger fractures is to determine the balance between obtaining stable fracture fixation and early joint movement. Despite proper treatment, there are many cases of functional and cosmetic problems caused by stiffness or deformation as complications. This review article introduces the latest knowledge in the treatment of finger fractures focusing on fractures and dislocations around the interphalangeal joints, including joint surface damage, which is difficult to treat and leads to poor results. This article consists of fracture cases and describes the methods and solutions to address these complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.651-657
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• 2007

Odontomas are the common type of odontogenic tumors and generally are asymptomatic and frequently lead to impaction or delayed eruption of permanent teeth. They are composed of enamel, dentin, cementum and pulp tissue and are divided into compound and complex according to the morphology of the hard tissues. Compound odontomas consist of varying numbers of small toothlike structure and have a predilection for the maxillary anterior regions. Complex odontomas consist of an unorganized mass of odontogenic tissues and comprise approximately 25 percent of all odontomas and have a predilection for the mandibular posterior regions. The etiology of odontomas is uncertain but hypothesized to involve local trauma, infection and genetic factors. Treatment of odontoma is conservative surgical removal and are little probability of recurrence. These two cases were about the patients with delayed eruption of mandibular first molar and mandibular lateral incisor. We surgically removed odontoma, exposed impacted tooth and guided impacted tooth into normal position by orthodontic traction. At the completion of traction, the mandibular first molar and mandibular lateral incisor was positioned fairly within the arch and complications such as root resorption were not observed.

• Archives of Plastic Surgery
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• v.38 no.2
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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.