• 대한두개안면성형외과학회지
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• 제18권1호
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• pp.30-36
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• 2017

Background: Nasal fractures have a tendency of resulting in structural or functional complications, and the results can vary according to the type of nasal bone fracture. The aim of this study was to evaluate the objective postoperative results according to the type of nasal bone fractures. Methods: We reviewed 313 patients who had a closed reduction of nasal bone fracture. The classification of nasal bone fracture by Stranc and Robertson was used to characterize the fracture type: frontal impact group type I (FI), frontal impact group type II (FII), lateral impact group type I (LI), lateral impact group type II (LII), and comminuted fracture group (C). For each patient, we tried to use the same axial image section of computed tomographic (CT) scans before and immediately after operation. Postoperative outcomes were classified into 4 grades: excellent (E), good (G), fair (F), and poor (P). We also analyzed postoperative complications by fracture type. Results: Regarding the postoperative CT images, 189 subjects showed E results, 99 subjects showed G, 18 subjects showed F, and 7 subjects showed P reduction. The rate of operation results graded as E by each fracture type was 66.67% in FI, 52.0% in FII, 64.21% in LI, 62.79% in LII, and 21.74% in C. Complications of FI (7.14%), LII (13.95%), and C (13.04%) groups occurred more than in the FII (4.00%) and LI (4.21%) groups. Conclusion: It seems that the operation result by fracture type was better in the FI, LI, and LII type than the FII and C type; after one month, however, LII type showed more complications than other types. The septal fracture can be thought to affect early reduction results in nasal bone fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.224-227
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• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

• 대한정형외과스포츠의학회지
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• 제5권2호
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• pp.123-128
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• 2006

목적: 제 II형 원위부 쇄골 골절은 불유합과 지연 유합의 비율이 높아 수술적 치료의 대상이 된다. 저자들은 제 II형 원위부 쇄골 골절에 대해 Mersilene tape과 K-강선을 이용한 수술적 치료를 하여 좋은 결과를 얻었기에 보고하는 바이다. 대상 및 방법: 1999년부터 2003년까지 시행한 제 II형 원위부 쇄골 골절 환자 11예를 대상으로 Mersliene tape을 이용한 골절의 정복과 오구 쇄골 인대 봉합 그리고, 골절 부위에 K-강선을 이용한 고정을 시행하였다. 모든 환자에서 최소 12개월 이상의 추시관찰을 하였으며 최종 추시 상 기능적, 방사선적 평가를 시행하였다. 방사선적 평가는 최종 추시 상 전후면 사진에서 골유합 유무로, 기능적 평가는 UCLA scoring system과 Constant scoring system을 사용하였다. 결과: 전례의 환자에서 수술 후 11 $(10\sim13)$주에 골유합을 얻을 수 있었다. 11예에서 UCLA scoring system상 평균 33 $(31\sim35)$점, Constant soring system에서 평균 96 $(91\sim100)$점으로 만족할만한 결과를 얻었다. 결론: 이 술기는 비교적 간단하며, 견고한 고정을 할 수 있고, 조기 재활을 통하여 환자의 만족도를 높일 수 있는 술식이라 생각되며 이의 임상적 적용을 추천하는 바이다.

• Hip & pelvis
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• 제35권3호
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• pp.206-215
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• 2023

Purpose: Delay in performance of hip fracture surgery can be caused by medical and/or administrative reasons. Although early surgery is recommended, it is unclear what constitutes a delayed surgery and whether the impact of delayed surgery can differ depending on the reason for the delay. Materials and Methods: A total of 269 consecutive hip fracture patients over 50 years of age who underwent surgery were prospectively enrolled. They were divided into two groups: early and delayed (time from reaching the hospital to surgery less than or more than 48 hours). Patients were also categorized as fit or unfit based on anesthetic fitness. One-year mortality was recorded, and regression analyses were performed to assess the impact of delay on mortality. Results: A total of 153 patients (56.9%) had delayed surgery with a mean time to surgery of 87±70 hours. A total of 115 patients (42.8%) were considered medically fit to undergo surgery. No difference in one-year mortality was observed between patients with early surgery and those with delayed surgery (P=0.854). However, when assessment of the time to surgery was performed in a continuous manner, mortality increased with prolonged time to surgery, particularly in unfit patients, and higher mortality was observed when the delay exceeded six days (fit: P=0.117; unfit: P=0.035). Conclusion: The effect of delay on mortality was predominantly observed in patients who were not considered medically fit, suggesting that surgical delays might have a greater impact on patients with medical reasons for delay.

• 대한족부족관절학회지
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• 제8권1호
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• pp.86-91
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• 2004

Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.18-22
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• 2001

Purpose : The purpose of this study was to evaluate stress fracture of vascularized fibular grafts(VFG) by analyzing factors associated with stress fracture and the treatment results. Materials and Methods : From June 1985 to May 1998, 7 patients with stress fractures in the 38 patients with long bone defect who had vascularized fibular graft were evaluated with clinical and radiologic methods including grafted fibular length and hypertrophic index of de Boer. The average age of the patients was 35 years(range, $14{\sim}60$ years). The mean follow-up period was 20 months(range, $16{\sim}32$ months). Results: 7(18.4%) stress fractures occurred in 38 patients. Characteristics of the fractures were (1) all occurred at lower extremity of male patients treated with VFG for long bone defected caused by infected nonunion; (2) all occurred 10 months at the average(range, $4{\sim}17$ months) after VFG; and (3) the length and hypertrophic index of grafted fibula had no influence on the incidence of stress fracture. Union was obtained in 3 patients by conservative treatment. 4 patients obtained union by internal fixation; one at immediately onset of fracture; and three after failure of conservative treatment who had fracture around the knee joint. Conclusion : Stress fracture may occur during the first one year after vascularized fibular graft and more attention must be paid for prevention of it, especially in the cases of infected nonunion. Stress fracture around the knee joint was expected to lead to a good result of early union by operative treatment.

• 한국공작기계학회논문집
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• 제16권2호
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• pp.14-22
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• 2007

In this paper, the acoustic emission(AE) behaviors were investigated with single-and 2-spot resistance spot welded SPCC specimens. Test specimens were welded horizontally and/or vertically according to the rolling direction of base netal in 2-spot welding. In the case of 2-spot welding, when tensile-shear test has below amplitudes: crack initiation $50{\sim}60dB;$ tear fracture $40{\sim}50dB$. And when cross tensile test has below amplitudes: early stage $75{\sim}85dB;$ yielding point $65{\sim}75dB;$ post yielding $40{\sim}60dB;$ plug fracture $70{\sim}80dB\;or\;90{\sim}100dB$. Also, from the b-value that is slope of AE amplitude, we knew that there are lots of low amplitudes if b-value is big(i.e., tensile-shear $specimen{\rightarrow}tear$ fracture or shear fracture), and there are lots of high amplitudes if b-value is small(i.e.. cross tensile $specimen{\rightarrow}plug$ fracture). As the results of fiacture mechanism analyses through AE amplitude distributions, change of the b-value represented fracture patterns of materials. Correspondingly, low amplitude signals appeared in crack initiation, and high amplitude signals appeared in base metal fracture. We confirmed that these amplitude distributions represented the change or degradation of materials.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.553-559
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• 2008

Purpose: The lateral orbital wall fractures have been previously classified by some authors. As there are some limitations in applying in their own classifications, we hope to present a refined classification system of the lateral orbital wall fracture and to identify the correlation between the specific type of the fracture and clinical diagnosis. Methods: The facial bone CT scans and medical records of 78 patients with the lateral orbital wall fractures were reviewed in a retrospective manner. The classification is based on the CT scan. In type I, the fracture and its segments are away from the lateral rectus muscle and in type II, they are next to or slightly pushing the muscle in axial CT scan. In type III, the fracture segments compress and displace the longitudinal axis of the muscle or the optic nerve in axial view of CT scan. Type IV fracture includes multiple fractures found around the orbital apex or optic canal in coronal view of CT scans of the type I and type II fractures. Results: The most common fracture pattern was type I(43.6%), followed by type IV(29.5%), type II(20.5%), and type III(6.4%). As diplopia and restriction of extraocular muscles were found in type I and II fractures, severe ophthalmic complications such as superior orbital fissure syndrome, orbital apex syndrome, and traumatic optic neuropathy were found in type III and IV fractures almost exclusively. Conclusion: We propose an easy classification system of the lateral orbital wall fracture which correlates closely with ophthalmic complications and may help to make further treatment plan. In Type III and IV fractures, severe ophthalmic complications may ensue in higher rates, so early diagnosis and treatment should be performed.

• Restorative Dentistry and Endodontics
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• 제29권3호
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• pp.267-272
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• 2004

The purpose of this in vitro study was to evaluate the effect of surface defects and cross-sectional configuration of NiTi rotary files on the fatigue life under cyclic loading. Three NiTi rotary files ($K3^{TM},{\;}ProFile^{\circledR},{\;}and{\;}HERO{\;}642^{\circledR}$) with ＃30/.04 taper were evaluated. Each rotary file was divided into 2 subgroups : control (no surface defects) and experimental group (artificial surface defects), A total of six groups of each 10 were tested. The NiTi rotary files were rotated at 300rpm using the apparatus which simulated curved canal (40 degree of curvature) until they fracture. The number of cycles to fracture was calculated and the fractured surfaces were observed with a scanning electron microscope. The data were analyzed statistically. The results showed that experimental groups with surface defects had lower number of cycles to fracture than control group but there was only a statistical significance between control and experimental group in the $K3^{TM}$ (p<0.05), There was no strong correlation between the cross-sectional configuration area and fracture resistance under experimental conditions. Several of fractured files demonstrated characteristic patterns of brittle fracture consistent with the propagation of pre-existing cracks. This data indicate that surface defects of NiTi rotary files may significantly decrease fatigue life and it may be one possible factor for early fracture of NiTi rotary files in clinical practice.

• 한방재활의학과학회지
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• 제34권2호
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• pp.1-14
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• 2024

Objectives The purpose of this study is to evaluate the fracture healing effect of extracts from Cnidium officinale and Angelica sinensis (CO/AS) in mice with femoral fracture. Methods C57BL/6 mice were randomly divided into normal, control (phospate-bufferd saline), positive control (tramadol), CO/AS extract 40 mg/kg and 80 mg/kg. By using Collier's method, all groups except normal group went through femoral fracture. Aspartate aminotransferase (AST), alanine transferase (ALT), lactate dehydrogenase (LDH), blood urea nitrogen (BUN) and creatinine were measured to evaluate the safety of CO/AS. Hematoxylin & eosin, Safranin O staining, x-ray, tensile and compressive force were conducted to assess the effect of CO/AS on fracture. Results The liver function test showed AST, ALT and LDH in CO/AS at 14th and 28th days were not significantly different compared with control group. The renal function test showed BUN in CO/AS at 14th days and BUN and creatinine in CO/AS at 28th days were significantly decreased compared with control group. The morphological & histological analysis and x-ray showed that CO/AS promoted cartilage and callus formation process compared with control group. The tensile and compressive forces test showed tensile in CO/AS 40 mg/kg and tensile & compressive forces in CO/AS 80 mg/kg were significantly increased compared with control group. Conclusions CO/AS extract showed the possibility that it promotes early fracture union and increases bone tensile and compressive strength, while does not have hepatotoxicity. In conclusion, CO/AS has a potential to promote healing of bone fracture and this study warranted the clinical usage of CO/AS at bone fracture.