• Archives of Plastic Surgery
• /
• v.36 no.1
• /
• pp.61-65
• /
• 2009

Purpose: Most nasal bone fractures involve the septum; either or both of the ethmoidal perpendicular plate(EPP) and quadrangular cartilage(QC). Unlocked tension from the underlying quadrangular cartilage and poorly reducted bony septum are obstacles to the successful reduction of nasal bone. So we compared the preliminary outcome of septoplasty as a primary treatment with the untreated septum in nasal bone fractures. Methods: We performed a retrospective study of 215 patients underwent reduction of nasal fracture between January 2002 and February 2008. We graded patients into four groups according to the amount of deviation and direction of force by CT. Our indication for septoplasty and combined procedures was the deviation of EPP or QC over 50% from the midline. We interviewed part of the patients by telephone regarding the subjective esthetic and functional outcomes. Results: Forty five of 215 patients (21 percent) underwent septoplasty and combined procedures (cartilage graft, etc) after the informed consent. Patients who underwent septoplasty significantly satisfied with the outcome of esthetic appearance and nasal patency compared with patients who underwent simple closed reduction despite of having septal deviation over 50 percent from the midline. (p < 0.05) Conclusion: Septal surgery and esthetic consideration shoud be made even in simple nasal reductions. And if CT scans reveal severe deviation of septum, septoplasty should be considered as a primary treatment.

• The Journal of Korean Physical Therapy
• /
• v.16 no.2
• /
• pp.1-16
• /
• 2004

The purpose of this paper is to review changes in articular cartilage properties from the joint immobilization. Joint immobilization is accompanied not only by many disorders including rheumatologic disorders, degenerative disorders, trauma and fracture but treatment for disorders. Articular cartilage are sensitive to mechanical events. Immobilization is associated with cartilage degradation that may cause joint pain and reduced range of motion. An understanding of the effects of immobilization on the articular cartilage will help to plan of physical therapy program

• Investigative Magnetic Resonance Imaging
• /
• v.22 no.2
• /
• pp.135-139
• /
• 2018

Most capitate fractures occur in association with additional carpal injuries, particularly scaphoid fractures. Isolated fractures of the capitate account for only 0.3% of carpal injuries, and stress fractures are one form of this fracture. We report the case of a 20-year-old male who had a stress fracture of the capitate after serving as an honor guard in the military. Conventional radiographs and computed tomography of the right wrist revealed a minimally displaced fracture line located at the midcarpal aspect of the right capitate. A magnetic resonance imaging scan demonstrates a subarticular capitate fracture with diffuse bone marrow edema, small osteophytes, and irregularity of the midcarpal articular cartilage. We also review the carpal kinematics which possibly caused the stress fracture. Although stress fractures of the capitate are rare, they should also be accounted for with patients who perform repetitive motions of the wrist to a considerable extent.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.5
• /
• pp.345-349
• /
• 2005

Objective: Anterior screw fixation provides the best anatomical and functional results for type II odontoid process fracture (type II-A, II-N, and II-P) with intact transverse ligament. The purpose of this study is to evaluate the usefulness of the 4.5mm diameter, cannulated Herbert screw in anterior screw fixation. Methods: From Jan. 2003 to Feb. 2004, consecutive 10cases of type II odontoid process fractures were treated with anterior screw fixation using a Herbert screw. The Herbert screw has double threads, with different pitches on the distal and proximal ends. It has no head, so it can be inserted through articular cartilage and buried below bone surface. It was originally developed for treating scaphoid fractures. Results: There were 8male and 2female patients whose ages ranged from 15 to 67years (mean 42.1years). The fracture type was type II-A in 4patients, II-N in 3 patients, and II-P in 3 patients. The fracture line was oblique downward and backward in 6cases, oblique downward and forward in 1 case, and horizontal in 3cases. The range of follow-up was 5 to 18months (mean 12months). Bone fusions were achieved in all cases without any instrumental failures or postoperative complications. Conclusion: The Herbert screw is very useful in anterior fixation for type II odontoid process fracture. This series showed successful results also in type II-A odontoid fracture when treated with the Herbert screw, but further more studies are required.

• Journal of Korean Foot and Ankle Society
• /
• v.10 no.2
• /
• pp.117-124
• /
• 2006

Purpose: This study was aimed at elucidating the pathogenesis of talar osteochondral lesion by analyzing the histopathological findings. Materials and Methods: Twenty specimens from 20 patients who underwent surgical treatment for talus osteochondral lesions were studied. Preoperative MRI images including T1, T2, and stir images were taken and cases were classified according to modification of the Anderson's classification. There were 5 cases of MRI group 1, 6 cases of group 2, 7 cases of group 3 and 2 cases of group 4. A full thickness osteochondral plug including the osteochondral lesion of the talus was harvested from each patient and reviewed histopathologic changes of osteochondral fragment using H-E staining. Mean diameter of specimens was 8.5 mm and mean depth was 10.3 mm. Pathologic changes of articular cartilage and subchondral bone were observed. Subchondral bone was divided into superficial, middle and deep zones according to depth. Cartilage formation, trabecular thickening and marrow fibrosis were observed in each zone. Results: There were detachment of the joint cartilage at the tidemark in 16 cases of 20 cases and the separated cartilages were almost necrotic on the histopathologic findings. Cartilage formation within subchondral bone was discovered beneath the tidemark in 12 cases. Trabeculae were increased and thickened in 17 cases. These pathologic changes were similar to fracture healing process and these findings were more conspicuous near the tidemark and showed transition to normal bone marrow tissue with depth. No correlation between the pathological progression and MRI stages was found. A large cyst shown on MRI's was microscopically turned out to be multiple micro-cysts accompanied by fibrovascular structure and newly formed cartilage tissue. Conclusion: The histopathologic findings of osteochondral lesions are detachment of overlying cartilage at the tidemark and subsequent changes of subchondral bone. Subchondral bone changes are summarized as cartilage formation, marrow fibrosis and trabecular thickening that mean healing process following repeated micro fractures of trabecular. These osteochondral lesions should have differed from osteochondral fractures.

• Archives of Craniofacial Surgery
• /
• v.21 no.1
• /
• pp.7-14
• /
• 2020

Background: It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type. Methods: The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded. Results: There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types. Conclusion: The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.

• Korean Journal of Bronchoesophagology
• /
• v.13 no.1
• /
• pp.51-54
• /
• 2007

Laryngeal trauma is an uncommon injury but can be life-threatening event. So, early diagnosis is important for appropriate surgical management and better outcome. Because there have been some controversies about Initial airway management, appropriate diagnostic evaluation, operative indication and timing, operative technique, it is difficult to make a common management pathway in laryngeal trauma. A case of laryngeal trauma with thyroid cartilage and hyoid bone fracture is presented with a brief review of literature.

• Journal of Korean Foot and Ankle Society
• /
• v.11 no.2
• /
• pp.130-134
• /
• 2007

Purpose: To investigate the relationship between classification based on simple radiographic findings and arthroscopic findings of the cartilage lesions in medial degenerative arthritis of the ankle joint. Materials and Methods: We studied 41 ankles of 36 patients with asymmetrical narrowing of the medial joint space. Degenerative arthritis following fracture and those with generalized arthritic disease were excluded, but those with a history of ankle sprain were included. Standing radiographs of all patients were graded according to the Takakura classification and the Kellgren-Lawrence (K/L) classification. Arthroscopic findings were classified according to the depth, width, and anteroposterior dimension of articular cartilage damage. Results: According to the Takakura classification, 29 ankles were classified as stage II, 7 cases as stage IIIA and 2 cases as stage IIIB. According to our classification of arthroscopic findings of 29 ankles in stage II, 1 ankle was graded as Grade I, 3 ankles as grade II, 10 ankles as grade III, and 15 ankles as grade IV. Spearman correlation coefficient between Takakura classification and arthroscopic classification was 0.342 (P=0.028), and coefficient between K/L classification and arthroscopic classification was 0.480 (P=0.001). Conclusion: Degenerative changes of the articular cartilage are more advanced than radiographic findings in many patients with ankle degenerative arthritis with asymmetrical narrowing of medial joint space. Therefore, we conclude that more aggressive effort should be made for correct diagnosis and treatment of degenerative arthritis.

• Journal of Korean Medicine Rehabilitation
• /
• v.34 no.2
• /
• pp.1-14
• /
• 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.

• Journal of Chest Surgery
• /
• v.20 no.3
• /
• pp.578-581
• /
• 1987

A very rare form of intrapulmonary cyst is an enterogenous cyst two examples of which were described by Ward and Krahl [1942]. Microscopically, the cyst wall is lined by gastric or intestinal type of mucous membrane which may include islets of pancreatic tissue; their walls contain muscle but no cartilage. We recently experienced a case of intrapulmonary enterogenous cyst. The patient was 30-year-old-male who showed chest pain and tightness after chest trauma. Chest X-ray revealed pneumothorax in both lung field with giant bullae in left upper lung field, right 6th and 7th rib fracture. Left lower lobectomy including cyst was done and the postoperative course was uneventful.