• 제목/요약/키워드: Fracture, Cartilage

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전위를 동반한 갑상연골 골절의 자연 치유 치험 1례 (Spontaneously Healed Thyroid Cartilage Fracture with Displacement: Report of a Case)

  • 류현호;이병국;정경운
    • Journal of Trauma and Injury
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    • 제23권1호
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    • pp.53-55
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    • 2010
  • A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

갑상연골 골절로 인한 성대마비의 치험례 (A Case of Thyroid Cartilage Fracture with Vocal Cord Paralysis)

  • 조진규;차창일;안회영;조중생;홍남표
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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    • pp.14.2-14
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    • 1983
  • 후두외상의 손상은 그 정도나 범위에 따라 차이는 인지만 주요 후유증으로는 기도폐쇄, 부종, 주위조직의 봉와직염 및 농양, 누공, 후두연골 및 연골지막염, 만성 후두협착, 성대마비, 기관발거곤란증, 성음장애 등을 들 수 있고, 일반적인 후두외상의 치료방법은 일차적으로 신속한 기도유지를 위한 처치를 한 다음 상기각 후유증에 따르는 이차 시술을 시행하는 것이 보통이다. 최근 저자들은 교통사고로 인한 후두부 및 경부의 폐쇄적 외상으로 갑상연골 골절과 좌측 성대마비, 연하장애 및 우측 쇄골 골절을 보인 환자에게서 갑상연골 정복술을 시행 후 술후 2개월에 상기 증세의 호전을 보인 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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TIME-DEPENDENT FRACTURE OF ARTICULAR CARTILAGE: PART 1 - THEORY & VALIDATION

  • 문무성
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1995년도 춘계학술대회
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    • pp.27-33
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    • 1995
  • A time-dependent large deformation fracture theory is developed for application to soft biological tissues. The theory uses the quasilinear viscoelastic theory of Fung, and particularizes it to constitutive assumptions on polyvinyl-chloride (PVC) (Part I) and cartilage (Part II). This constitutive theory is used in a general viscoelastic theory by Christensen and Naghdi and an energy balance to develop an expression for the fracture toughness of the materials. Experimental methods are developed for measuring the required constitutive parameters and fracture data for the materials. Elastic stress and reduced relaxation functions were determined using tensile and shear tests at high loading rates with rise times of 25-30 msec, and test times of 150 sec. The developed method was validated, using an engineering material, PVC to separate the error in the testing method from the inherent variation of the biological tissues. It was found that the the proposed constitutive modeling can predict the nonlinear stress-strain and the time-dependent behavior of the material. As an approximation method, a pseudo-elastic theory using the J-integral concept, assuming that the material is a time-independent large deformation elastic material, was also developed and compared with the time-dependent fracture theory. For PVC. the predicted fracture toughness is $1.2{\pm}0.41$ and $1.5{\pm}0.23\;kN/m$ for the time-dependent theory and the pseudo-elastic theory, respectively. The methods should be of value in quantifying fracture properties of soft biological tissues. In Part II, an application of the developed method to a biological soft tissue was made by using bovine humeral articular cartilage.

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청소년기에서 발생한 슬개골 상단부 소매형 골절 (Sleeve Fracture of the Superior Pole of Patella in an Adolescent)

  • 유문집;유재성;류지원
    • Journal of Trauma and Injury
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    • 제26권3호
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    • pp.218-221
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    • 2013
  • A patella sleeve fracture is a type of avulsion fracture in which a small osseous fragment gets, along with a sleeve of periosteum and cartilage, is pulled off from the patella. The avulsed sleeve of cartilage and periosteum is not apparent on plain radiographs, which can result in a missed diagnosis or an underestimate of the extent of injury. An avulsion or sleeve fracture of the patella in a child can occur at the superior or the inferior pole of the patella. However, most reported cases of sleeve fractures involve the inferior patellar pole, with fractures involving the superior patellar pole being very rare. The authors report a case of a sleeve fracture of the superior pole of the patella in an adolescent; the fracture was diagnosed with magnetic resonance imaging (MRI) and was treated with surgery after early diagnosis. The course was uneventful, and the outcome was excellent.

관절 연골 손상의 병태 생리 (Pathophysiology of Articular Cartilage Injury)

  • 박정호
    • 대한정형외과스포츠의학회지
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    • 제4권1호
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    • pp.6-11
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    • 2005
  • 관절 연골 손상은 급성 손상과 만성 손상인 퇴행성 관절염으로 구분되며, 급성 손상은 연골 손상의 깊이에 따라서 미세 손상, 연골 골절, 골연골 골절의 세 종류로 구분할 수 있고 각 손상의 종류별로 서로 다른 양상의 치유 반응과 예후를 보인다. 만성 관절 연골 손상은 다양한 원인으로 인해서 발생하며 관절 연골의 전반적인 퇴행성 관절염의 형태를 보인다. 관절 연골 손상 시 초기 손상의 정도가 예후를 결정짓는데 가장 중요하고 이외에도 손상의 크기, 부위, 나이, 활동성, 비만 정도, 하지 정렬 상태등도 예후를 결정하는 중요한 요소들이다. 본 논문에서는 관절 연골 손상 시 발생하는 관절 연골 내의 병태 생리적 변화에 대하여 기술하고 비수술적인 치료 방법을 생역학적인 측면과 생물학적인 측면으로 구분하여 그 효과를 알아보고자 한다.

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양측 족관절에 발생한 외측 거골원개 골연골의 골절에 대한 골편제거 후 다발성 천공술 및 생흡수성 핀을 이용한 골편고정: 증례 보고 (Bony Fragment Excision Followed by Multiple Drilling and Fragment Fixation Using Bio-absorbable Pins for Bilateral Osteochondral Fracture of the Lateral Talar Dome: A Case Report)

  • 이용재;서진수;최준영
    • 대한족부족관절학회지
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    • 제23권4호
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    • pp.201-207
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    • 2019
  • An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favorable clinical outcome was obtained at 18 months follow-up.

경미한 둔상에 의하여 야기되는 늑연골 골절 진단에 있어서 흉벽 초음파 검사의 임상적 유용성 (Clinical Usefulness of Chest Wall Ultrasonography for Detecting Fractures of Costal Cartilage due to Minor Blunt Chest Trauma)

  • 이우성;김요한;지현근;황재준;이송암;정호성;신현준;최영칠
    • Journal of Chest Surgery
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    • 제42권4호
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    • pp.502-508
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    • 2009
  • 배경: 늑골 골절은 흥부 외상 중에 둔상으로 인한 손상 중 가장 흔한 질환이다. 하지만 늑연골 골절은 연골 부위의 석회화가 동반되지 않는 한 고전적인 흉부 방사선 검사에서 잘 관찰되지 않으며, 이러한 이유로 고전적인 흉부 방사선 검사로는 늑연골 골절의 진단에 한계가 있다 이에 저자들은 고전적인 흉부 방사선 검사에서 간과 되었던 늑연골 늑골 골절의 진단을 위하여 경미한 흉부 둔상 환자에게 흉벽 초음파 검사를 시행하였다. 대상 및 방법: 2008년 4월부터 2009년 3월까지 본원을 내원한 환자를 대상으로 하였고, 고전적 방사선 검사에서 이상 소견이 없었으며 중증 손상을 의심할 만한 병변이 없는 총 45명의 환자를 대상으로 하였다. 이들 중 여성은 24명, 남성은 21명이었으며, 평균 연령은 50.4$\pm$15.91세(17$\sim$76)였다. 상기 대상자들은 7.5-MHz 직선 탐촉자를 지닌 초음파 기기를 이용하여 흉벽 초음파 검사를 시행하였다 결과: 대상이 된 45명의 환자들 중 30예(67%)에서 늑연골 골절을 관찰할 수 있었고, 15예(33%)에서는 특별한 이상 소견이 관찰되지 않았다. 골절을 지닌 30명의 평균적인 골절 개수는 1.6$\pm$0.81 부위(1$\sim$4)였다. 늑연골 골절의 가장 흔한 동반 소견은 골막 주위 혈종으로 7예(17%)에서는 골절 소견과 동반되어 관찰되었고 1예(2%)에서는 골절 소견 없이 관찰되었다. 두 번째 흔한 동반 소견은 흉골 골절이었고, 5예(12%)에서는 연골 부위 늑골 골절과 동반되어 관찰되었고, 1예(2%)에서는 흉골 골절만 관찰되었다. 결론: 흉벽 초음파 검사는 경미한 흉부 외상 환자에게서 간과되었던 늑연골 골절의 진단에 유용한 방법으로 사료된다.

이개연골과 측두근막의 자가복합이식술에 의한 외상성 복시현상과 안구함몰의 치험례 (CORRECTION OF POSTTRAUMATIC DIPLOPIA AND ENOPHTHALMOS USING AUTOGENOUS COMPOSITE CONCHAL CARTILAGE AND TEMPORAL FASCIAL;A CASE REPORT)

  • 김일규;이성준;하수용
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.114-120
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    • 1990
  • This is a case report of correction of posttraumatic diplopia and enophthalmos using autogenous composite conchal cartilage and temporal fascia. The results are as follows. 1. Diplopia and enophthalmos may be persistent complications in zygomatic complex fracture. 2. The concha is a reservior of autogenous cartilage which leaves no cosmetic and functional deformity in reconstruction of orbital floor. 3. Warpping the cartilage in temporal fascia may serve to increase implant stability and get graft with smooth edge. 4. Donor incision lines are well hidden within the scalp and in auriculocephalic fold.

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Rib Fixation for a Patient with Severely Displaced and Overlapped Costal Cartilage Fractures

  • Han, Sung Ho;Chon, Soon-Ho;Lee, Jong Hyun;Lee, Min Koo;Kwon, Oh Sang;Kim, Kyoung Hwan;Kim, Jung Suk;Lee, Ho hyoung
    • Journal of Trauma and Injury
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    • 제31권1호
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    • pp.12-15
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    • 2018
  • Rib fixations for flail chest or displaced rib fractures are not a new technique. However, reports on rib fixations involving costal cartilage fractures are very few and surprisingly there are no reports of internal fixations involving only the costal cartilage in the English literature. The diagnosis is difficult and the necessity of the procedure may be quite controversial. Placing plates in screws into the costal cartilage alone may seem unstable and easily dislodged or stripped through the cartilage. We report a 31-year-old male scuba diver instructor who underwent rib fixations over his 7th and 8th costal cartilage ribs for severe pain. The procedure was done with conventional plates and screws. He had the plates and screws removed 2 months later due to lingering pain, but with them removed he is now quite happy with the results without pain. The procedure for fixation of painful overlapped costal cartilage is quite simple and can be done with the usual conventional methods, fixating plate and screws directly over the cartilage alone without fixation over the bony rib.

복잡계를 응용한 인체 골절치료 모델링과 해석에 관한 연구 (Simulation of Bone Fracture Healing by the Complex System Rule)

  • 문병영;박정홍
    • 한국정밀공학회지
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    • 제20권12호
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    • pp.198-204
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    • 2003
  • The bone fracture healing is simulated by using one of the complex system rules, named cellular automata method. It is assumed that each cell has property of Bone, Cartilage or Fibrous connective tissue. Nine local rules are adopted to change the property of each cell against the mechanical stimulus, which consists of the strain energy density, and the existence of bone in the surroundings. Two dimensional sheep metatarsal model is considered and the bone fracture healing is simulated. The simulation results agree well with those obtained by using fuzzy logic model and experimental data. The cellular automata method found to be one of the simulation methods to express the bone fracture healing. The cellular automata method is expected to be effective in representing biological phenomenon.