• Title/Summary/Keyword: Fracture, Bone

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The Results of Surgical Treatments in the Peripheral Nerve Injuries (말초신경 손상 후 수술적 치료에 대한 고찰)

  • Chung, Moon-Sang;Park, Jin-Soo;Seo, Joong-Bae;Park, Yong-Bum
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.121-127
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    • 1996
  • Peripheral nerve injury occurs mostly by trauma and is usually associated with fracture of bone and joint, muscular injury and tendon injury and it also evokes paralysis and anesthesia. When treatment of peripheral nerve injury is considered,, the modality of treatment is decided by the general condition of the patient, type of injury, associated injuries and the condition of wound. To get the maximum results, surgical treatment and reconstruction and rehabilitation should all go in hand-in-hand. From January 1985 to December 1994, we observed 61 patients that had operation without reconstruction due to peripheral nerve injury with a follow-up period of more than 1 year. Among the 61 patients, 44 were men(72%) and 17 were women(28%). Follow-up period was average 19 months. Age distribution was mostly in their twenties with a mean age of 28 years. Time interval of operation after injury was average 11 months. Trauma was the main cause of peripheral nerve injuries with a proportion of 87%. 31 patients had neurorrhaphy, in which case 14 patients had stay suture and 17 patients did not. 14 patients had nerve graft, and 16 patients had neurolysis. We used our scales to compare the results of surgery on the basis of British Research Council System. We gave scores to every sensory and motor scale to estimate functional improvement and emphasized on motor functional improvement. The total score = sensory score + ($2{\times}motor$ score). We considered 8-9 points as excellent, 6-7 points as good, 2-5 points as fair, 0-1 points as poor result. We considered excellent and good as much improved. Excellent and good results were obtained in 13 out of 14 neurorrhaphy with stay suture(93%), 12 out of 17 neurorrhaphy without stay suture(71%), 6 out of 14 nerve graft(43%), 12 out of 16 neurolysis(75%). Among the patients with neurorrhaphy done within 3 months, 11 out of 14(86%) showed improvement, but among the patients after 4 months 3 out of 17(76%) showed improvement. 84% of improvement was observed in the patients with time interval from injury to surgery within 3 months, and 64% in the patients with time interval after 4 months. In the aspect of age, 77% with the age below 20 years, 70% with the age between 21 and 30 years, 66% with the age above 31 years showed improvement. We conclude that considering degree of injury, time interval from injury and age with the adequate method of treatment, we can obtain good results from surgery.

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Treatment of Ossifying Fibroma (화골성 섬유종의 치료)

  • Jung, Sung-Taek;Chung, Jae-Yoon;Song, Eun-Kyoo;Park, Yong-Cheol
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.61-68
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    • 2003
  • Purpose: We reviewed the outcome of treatment of ossifying fibroma involving long bones. Materials and methods: Eight patients who enrolled at our hospital for ossifying fibroma from 1994 to 1999 were selected for this study. Mean age was 7.9 years old. Five were male and three female. Seven involved tibia and one fibula. All cases were diagnosed by biopsy. The initial treatment was conservative and the followings were operative indications; (1) repeated fracture, (2) suddenly growing mass, (3) severe bowing deformity, (4) pseudoarthrosis. We assessed the recurrence by x-ray follow-up. Results: As initial treatment, curettage was performed in 2 patients, observation in 2 subperiosteal resection in one and extraperiosteal resection in 3 patients. Two patients who were observed and 3 patients who received extraperiosteal resection did not suffer recurrence. Two patients who received curettage and one patient who received subperiosteal resection had recurrence. The second treatment was performed in 3 patients. The one case of curettage received extraperiosteal resection. The other was in observation. The case of subperiosteal resection was in observation, too. There were no recurrence and aggravation at follow-up. Conclusion: Ossiying fibroma should to be treated by conservative method. If operation is indicated, extraperiosteal resection could reduce the recurrence.

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A CASE REPORT OF CORRECTION OF MANDIBULAR PROGNATHISM BY INTRAORAL OBLIQUE SPLITTING OSTEOTOMY OF MANDIBULAR RAMI (구내 경사 분열 골절단술(Intraoral oblique splitting osteotomy)에 의한 하악 전돌증의 치험례)

  • Park, Hui-Dae;Doe, Kee-Yong;Bae, Yun-Ho;Byun, Sang-Kill;Chin, Byung-Rho;Lee, Hee-Keung
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.183-194
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    • 1989
  • This is a report of 2-cases of mandibular prognathism corrected by Intraoral oblique splitting osteotomy of mandibular ramus. The Intraoral oblique splitting osteotomy is a modification of sagittal split osteotomy of ramus and it is documented by Yoshida, on 1985. By this method. authors obtained the following results. 1. The patients' esthetic, psychological and functional problems were dissolved by setback of mandibular prognathism. 2. The postoperative infection, splitted bone segments fracture, paresthesia of the face and T.M.J. dysfunction were not appeared. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. The patients could open their mouths in normal range after a week of intermaxillary fixation removal. 4. The soft tissue changes of lower lip and chin were about 1:1 to the hard tissue changes. 5. During intermaxillary fixation period and postoperative orthodontic treatment, slight relapse was observed. Now, the patients are under postoperative orthodontic treatment.

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3-Year Survival Analysis of RBM and Acid-Etched Surface Implants (RBM 표면 임플란트와 산부식 표면 임플란트의 3년 생존율에 대한 비교 연구)

  • Yoon, Dae-Woong;Kim, Moon-Seob;Jang, Han-Seung;Jin, Soo-Young;Mah, Deuk-Hyun;Jeong, Gyeong-Dal;Park, Hyun-Chun;Kim, Hee-Jung;Kim, Hak-Kyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.4
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    • pp.393-403
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    • 2011
  • The purpose of this study was to analyze and compare survival rates of resorbable blast media(RBM) surface and acid-etched surface implants being usually used in clinics. RBM surface implants (USII, Osstem, Busan, Korea) or acid-etched surface implants ($Osseotite^{(R)}$, Biomet $3i^{[TM]}$, FL, USA) were placed in edentulous area of 140 patients between January of 2005 and March of 2007. The number of implants was 304, and 152 out of them were RBM surface implants while another 152 were acid-etched surface implants. According to the evaluation items, the survey was performed before and after the implants installations. The 3-year survival rates of both kind of implants were calculated. 1. Total of 152 RBM surface implants were placed. Among them, one implant was failed, which was implanted in the posterior mandible with D2 bone quality. The failure was resulted from fracture of the fixture. Others showed good results and survival rate of RBM surface implant was 99.34%. 2. Total of 152 acid-etched surface implants were placed. Seven implants of them were failed, thus, survival rate was 95.39%. The causes of the failures were considered as infection, overheat and the lack of initial stability. In this research, both implants showed good 3-year survival rate, although RMB surface implant represented a better result.

Ag Impregnated HAp Coatings on Alumina Substrate by IBAD and Its Biological Test (IBAD를 이용하여 알루미나 위에 HAp를 Coating하는 연구와 이의 항균력 시험)

  • Park, Eui-Seo;Kim, Taik-Nam;Yim, Hyuk-Jun;Kim, Yun-Jong;Hwang, Deuk-Soo;Kim, Jung-Woo;Kim, Sun-Ok
    • The Journal of Engineering Research
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    • v.3 no.1
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    • pp.181-187
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    • 1998
  • Hydroxyapatite was used as implant materials, because it has a good biocompatibility and is similar to human bone. However it is not expected to have a high strength as implant materials because of a low fracture strength after sintering of HAp. Alumina ($\alpha$-alumina) shows a stable chemical properties and high strength in physiological environments. Thus it was tried to use a HAp coatings on Alumina substrate as implant materials. In this study, HAp was coated on Alumina substrate by lon Beam Assisted Deposition(IBAD). Then Ag was impregnated on HAp coating layer, which showed antimicrobial effects. To carry out the ion exchange of $Ag^+$ with $Ca^{2+}$ in HAp on the surface, HAp coated alumina substrate was immersed in 20ppm, 100ppm $AgNO_3$ solution at room temperature for 48 hours. Antimicrobial test was studied by using bacteria, which normally caused periprosthetic infections. The follwing bacteria was used in antimicrobial test. Escherichia coli, Pseudomonas aeruginosa (gram negative) and staphylococcus epidermidis (gram positive). Ag impregnated HAp shows very good antimicrobial effects against these bacteria. The surface structure of sample, which was treated in $AgNO_3$ solution was studied by SEM, XRD. Ag release curve was studied in Simulated Body Fluid (SBF) solution.

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Surgical Management of Traumatic Liver Injury (외상성 간 손상 환자의 수술적 치료)

  • Han, Sun Wook;Lee, Hwa Soo;Bae, Sang Ho;Kang , Gil Ho;Kim, Sung Yong;Baek, Moo Jun;Lee, Moon Soo;Kim, Hyung Chul;Cho, Moo Sik;Kim, Chang Ho
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.21-27
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    • 2006
  • Purpose: The liver is one of the most commonly injured organs by blunt or penetrating abdominal trauma. Patients with liver injury can be treated by using nonoperative or operative management. The aim of this study was to study patients with traumatic liver injury who were treated by using operative management. Methods: Ninety-eight patients with traumatic liver injury underwent surgical treatment from January 1995 to December 2004 at Soonchunhyang University Cheonan hospital. Medical records were reviewed retrospectively, and demographic, clinical, operative, and postoperative datas were collected and analyzed. Results: Among the patients with operative management, the peak incidence was in the third and the fourth decades. The male-to-female ratio was 1.9:1. The most frequent injury mechanism was blunt trauma (85.7%). Abdominal computed tomography was the diagnostic modality used most frequently. Severe liver injury above Grade III was seen in 80.6% of all patients, and long bone fracture was the most common combined injury. Patients were managed by using various techniques, including simple closure, liver resection, and perihepatic packing. Pulmonary complications were the most common postoperative complications (35.7%). the overall mortality rate was 17.3%. Between the survival group and the expired group, the amount of transfusion for the expired group was statistically more than that for the survival group. Conclusion: Operative management is an effective treatment modality for hemodynamically unstable patients with severe traumatic liver injury. The amount of transfusion is a significant prognostic factor for survival.

Retreatment of fractured implant overdenture due to long-term maintenance failure (장기간의 유지관리 실패로 인해 파절된 임플란트 피개의치 재수복 증례)

  • Kim, Minjee;Hong, Seoungjin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.3
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    • pp.235-242
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    • 2018
  • Periodontal and prosthodontic maintenance of implant overdenture is a very important factor for the long term success of the prosthesis and implants. Failure of maintenance can lead to prosthetic failure due to peri-implant bone loss and fracture and wear of the prosthesis or components. In this case, the existing gold milled bars were reconstructed with cobalt chrome milled bar in a manner that does not interfere with the external shape for the retreatment of fractured implant overdenture by maintenance failure. Two implants of mandible were selected strategically and the CM LOC attachments were connected to the two implants, and implant overdentures were fabricated. As a result, prosthesis with a functional and esthetic design that facilitates good hygiene management of the patient was delivered, which is advantageous for long term maintenance, and regular check-ups were scheduled for proper maintenance.

Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction Using Achilles Allograft - Preliminary Report - (이중고리 동종 아킬레스건을 이용한 후방십자인대 재건 - 예비 보고 -)

  • Lim, Hong-Chul;Yoo, Jae-Chul;Han, Sang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.7-13
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    • 2002
  • Purpose : Preliminary report of the technique and trial of double bundle PCL reconstruction using Achilles allograft. Materials and Methods : From May 1999 to July 2000, 8 cases of PCL insufficient patients were treated with Achilles allograft reconstruction using the double bundle and double femoral tunnel technique. The tibial tunnel was prepared anteromedially. All other combined injuries within the knees were treated accordingly. Minimal follow-up period was 1 year. The results was assessed from the point of function and stability using Lysholm knee score and KT-2000 arthrometer. Results : Up to present follow up. 8 patients showed good sign of recovery with no instability (translation less than 2 mm) except olio that has been grafted-ligament rupture. In addition, none showed any sign of infection nor ROM limitation. Two complications were seen, which one had grafted-bone fracture and the other grafted-ligament rupture. The former occurred during operation and the latter occurred due to improper protection. Conclusion : Presently the follow up period is too short to draw any conclusive opinion but it is essential to select healthy and well sterilized allografts fur successful outcome. Double femoral tunnel technique seems to be more physiologic in PCL reconstruction. With these prerequisites, it seems to be a good alternative to use Achilles allografts fur the reconstruction of PCL. However, a longer follow-up is needed.

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THE STUDY BY USING THE COMPUTERIZED TOMOGRAPHY IMAGING IN ORDER TO ACCESS TO MANDIBULAR FORAMEN WHILE INFERIOR ALVEOLAR NERVE ANESTHESIA (하치조신경 마취시 하악공으로의 접근을 위한 전산화단층촬영을 통한 방사선적 연구)

  • Kim, Ji-Kwang;Gu, Hong;An, Jin-Suk;Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun;Cho, Jin-Hyoung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.566-574
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    • 2006
  • Purpose : This study was performed to provide an anatomical information of the mandibular ramus for the successful inferior alveolar nerve block. Three dimensional images were reconstructed from the computerized tomography (CT) and the anatomical evaluation of the mandibular ramus was done. Materials and methods : Sixty-four patients who had been taken the facial CT scans from 2000, Jan to 2003, June was selected. The patients who had the anterior or posterior teeth misssing, edentulous ridge, and jaw fracture were excepted. In the occulusal plane, the lingual surface angle (LSA) between the mid-sagittal plane and the mandibular molar lingual surface from the 2nd premolar to the 2nd molar, the inner ramal surface angle (IRSA), the maximum inner ramal surface angle (MxIRSA), and the outer ramal surface angle (ORSA) to the-mid sagittal plane were measured. The inner ramal surface angle in the ligular tip level (IRSA-L) and the outer ramal surface angle in the ligular tip level (ORSA-L), the ramal length (RL), and the anterior ramal length (ARL) were also measured in the lingular tip level. Results : In the lingular tip level, the mean IRSA-L and ORSA-L were $28.6{\pm}6.3^{\circ}$ and $17.9{\pm}4.9^{\circ}$ respectively. The larger was the IRSA, the larger was the ORSA. In the lingular tip level, the mean ramal length was 35.8${\pm}$3.4 mm. The larger was the IRSA-L, the shorter was the ramal length. On the lingular tip level, the mean anterior ramal length from anterior ramus to lingular tip was 19.6${\pm}$3.3 mm. when the ramal length was longer, the anterior ramal length was also longer. On the lingular tip level, there was positive correlation vetween the IRSA and the ORSA, negative correlation between the IRSA and the ramal length, and positive correlation between the ramal length and the lingular tip level to the anterior ramus. There was no statistical meaning of data between sex and age. Conclusion : In the clinical view of the results so far achieved, if the direction of needle is closer to posterior it is able to contact bone on lingular tip when the internal surface of ramus is wided outer.

APPLICATION OF 0.2% HYALURONIC ACID GEL IN ORAL SURGICAL WOUND : A RANDOMIZED DOUBLE-BLIND STUDY (구강내 외과적 창상 치유에서 0.2% hyaluronic acid gel의 유효성에 대한 이중 맹검 연구)

  • Kim, Jae-Yoon;Lee, Jin-Yong;Bae, Kwang-Hak;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.157-165
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    • 2008
  • The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.