Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.
Purpose: This study examined patients with facial bone fracture visiting Pusan National University Dental Hospital to understand the trends, and to enhance appropriate care and treatment for patients with facial bone fracture. Methods: We investigated 531 patients presenting with facial bone fracture in Yangsan and 802 patients in Busan from January 2010 to December 2013. We divided the patients by year, month, gender, age, site, and cause to compare with historic data and other studies. Results: The gender ratio was 3.58:1 in Yangsan and 4.31:1 in Busan. Patients aged in their 20s had the highest number of facial bone fractures in both Yangsan and Busan. The most frequent fracture site was the mandible, and the most frequent cause was slip down in both Yangsan and Busan. Conclusion: The investigation and comparison of patients with facial bone fracture who visited Pusan National University Hospital located at Yangsan and Busan from 2010 to 2013 found a difference in the total number of patients at each hospital, but the trends were not significantly different.
Hwang, So-Min;Kim, Jang Hyuk;Kim, Hyung-Do;Jung, Yong-Hui;Kim, Hong-Il
Archives of Craniofacial Surgery
/
v.14
no.2
/
pp.96-101
/
2013
Background: Among facial fractures, nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture take a large portion. Among surgical operations for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture, closed reduction has been generally used but, unlike open reduction, there is a problem in evaluating its accuracy of reduction. Methods: An assessment was made from October 2011 until April 2013 prospectively on 37 patients. For all the operations, closed reductions were executed in a conventional way and simultaneously using C-Arm to verify the reduction of fractures. Two images of plain radiography, one taken before operation and another one taken one day after the operation, were compared. After obtaining images of plain radiography using C-Arm immediately after the correction upon operation, they were compared with the images of plain radiography taken one day after the operation. Results: The fracture reductions of 26 patients among 27 nasal fracture patients were satisfactory but one patient showed a marginal overcorrection of less than 1 mm. The fracture reductions of 7 patients among 8 zygomatic arch fracture patients were satisfactory but one patient showed a marginal undercorrection of less than 2 mm. All of two mandibular subcondyle fracture patients showed less than 2 mm undercorrection. Conclusion: Closed reduction guided by C-Arm for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture was clinically useful because it could make a real-time assessment on fractured areas and add immediate corrections during the operation.
Park, Ji-Suk;Oh, Hyun-Soo;Seo, Wha-Sook;Ham, Ok-Kyung
Korean Journal of Adult Nursing
/
v.20
no.3
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pp.461-469
/
2008
Purpose: This study was conducted to identify the personality type, problematic drinking pattern, and stress coping style of the nasal bone fracture patients by comparing those with general fracture patients. Methods: 50 nasal bone fracture patients due to violence and 50 general fracture patients due to simple trauma, such as fall and traffic accident were conveniently selected. Results: The study results showed that nasal bone fracture patients due to violence significantly presented higher level of A type personality and more problematic drinking pattern than general fracture patients due to simple trauma. Stress coping style, however, did not show significant difference between two groups. Conclusion: In order to prepare prevention strategies for basal bone fracture in the future, health education alter problematic drinking habit to sound drinking pattern may be offered and provided nursing interventions tailored to A type personality.
Evaluations and treatments of nasal bone fracture have been mainly focused on aesthetic aspect, but nose has an important role as an airway. The purpose of this study was evaluation of nasal bone fractures in the view of nasal obstruction and its improvement after reduction. Acoustic rhinometry was applied to the 77 nasal bone fractured patients who received closed reduction from August 2002 to July 2003 and received closed reduction. This was tested twice, before and 6 days after reduction, for all 77 patients and additional acoustic rhinometry was also possible in 26 patients after 6 months. The analysis of acoustic rhinometry were based on data of minimal cross-sectional area(MCA) according to fracture sites(one side, both side and tip) and septal displacement. Mean MCA for all cases before reduction was $0.43{\pm}0.21cm^2$, which was 19% decrease compared to normal adult data($0.53{\pm}0.12cm^2$). Depending on fracture sites the MCA were $0.45{\pm}0.16cm^2$ for one side fracture, $0.35{\pm}0.18cm^2$ for both side fracture, and $0.42{\pm}0.25cm^2$ for tip fracture. The patients with septal displacement showed more severe obstruction than ones without septal displacement, $0.26{\pm}0.26cm^2$ and $0.46{\pm}0.10cm^2$, respectively. The MCA was improved up to $0.50{\pm}0.22cm^2$ after reduction and showed slight decrease after 6 month($0.48{\pm}0.23cm^2$). Based on the results of this study, nasal bone fracture really caused airway obstruction(19% decrease). Both side fracture showed more profound decrease than one side fracture and septal displacement was an important parameter which causes nasal obstruction. Closed reduction improved MCA by 14% right after reduction, and 11% after 6 month follow up.
Purpose: Heterotopic ossification in pressure sore patients is reported to rarely develop, but once it occurs, it frequently causes joint stiffness and mobilization restriction. The aim of this article is to report our experience of atypical bone growing at femur neck fracture site with chronic, extensive pressure sore in patient with paraplegia secondary to spinal injury. Methods: A 28-year-old male patient presented with atypical bone growth at femur neck fracture site with pressure sore. He had undergone atypical growth bone removal and separation of united iliac bone and femur, and then pressure sore was covered by advanced rotation flap. Results: The patient mobilized hip joint and rode in a wheelchair. Complications such as dehiscence, infection, hematoma and flap necrosis did not occur. Conclusion: We experienced successful correction of atypical bone growth removal and recovery of pressure sore. We report our experience of atypical bone growth of fracture site and the related literature was reviewed.
Background: Nasal bone fractures are the most common type of facial bone fracture, but are under-studied in adults above 65 years of age. Therefore, we investigated the epidemiology and patterns of nasal bone fractures among older adults in comparison to different age groups. Methods: This retrospective study included 2,321 nasal bone fracture patients who underwent surgery at our hospital from January 2010 to December 2017. The patients were classified by age as preschoolers, school-age children, young and middle-aged adults, and the elderly. We performed pairwise comparisons between elderly patients and each other age group in terms of sex, cause of injury, and fracture type. Results: The 2,321 nasal bone fracture patients included 76 elderly patients (50 men [65.8%] and 26 women [34.2%]). In these patients, the two most common injury causes were falling or slipping down (n= 39; 51.3%) and road traffic accidents (n= 19; 25.0%). According to the Stranc and Robertson classification, the most common force vector was lateral, and plane 2 fractures with lateral forces predominated. Conclusion: The elderly showed similar patterns of nasal bone fractures to those observed in young and middle-aged adults, but significant differences from preschoolers (in the injury vector and plane of fracture) and from school-age children (in the sex ratio and plane of fracture). However, elderly patients presented significantly different epidemiological characteristics compared to the other three groups. Therefore, it is necessary to improve the quality of life of the elderly and prepare for the upcoming super-aged society by taking steps to reduce the incidence and severity of fractures. Possible options for doing so include strengthening individual-level safety factors and expanding the social safety net for the elderly.
Kim, Tae Ho;Kang, Seok Joo;Jeon, Seong Pin;Yun, Ji Young;Sun, Hook
Archives of Craniofacial Surgery
/
v.19
no.2
/
pp.102-107
/
2018
Background: Nasal fracture and orbital blowout fracture often occur concurrently in cases of midface blunt trauma. Generally, these multiple fractures treatment is surgery, and typically, the nasal bone and orbit are operated on separately. However, we have found that utilizing a transconjunctival approach in patients with concurrent nasal bone fracture and orbital blowout fracture is a useful method. Methods: The participants in the present study included 33 patients who visited the Plastic Surgery outpatient department between March 2014 and March 2017 and underwent surgery for nasal fracture and orbital blowout fracture. We assessed patients' and doctors' satisfaction with surgical outcomes after indirect open reduction via a transconjunctival approach for the treatment of nasal bone fracture with associated orbital blowout fracture. Results: According to the satisfaction scores, both patients and doctors were satisfied with transconjunctival approach. Conclusion: We presented here that our method enables simultaneous operation of nasal fracture accompanied by orbital blowout fracture, rather than treating the two fractures separately, and it allows precise reduction of the nasal fracture by direct visualization of the fracture site without any additional incisions or difficult surgical techniques. Also, by preventing the use of excessive force during reduction, this method can minimize damage to the nasal mucosa, thereby reducing the incidence of nasal bleeding.
This study was performed to investigate the effects of electrical stimulation on femoral fracture healing in dogs. Eight healthy dogs from 4 to 5 $\beta^3$ were used in this experiment. In the treatment group, anode and cathode were connected to proximal and distal site apart from the fracture line by 2 cm and electrical stimulation was applied to the fracture site for l5minutes by 2 V, 25 Hz and for a month. The control group was connected to electrostimulator as the treatment group, but no electrical stimulation was applied. Various parameters were evaluated including radiograph and serum levels of total-ALP(TALP), bone-ALP(BALP) and osteocalcin. The radiography revealed more rapid callus formation in the treatment group than in the control by about a week. The total-ALP levels of the treatment group were higher than those of the control group from the 2nd to the 24th day(p< 0.05). The bone-ALP levels of the treatment group were significantly higher than those of the control from the 2nd to the 24th day(p< 0.05). The bone-ALP/ total-ALP ratios of the treatment group were higher than those of control throughout this experiment but there were no significance. There were no significance in the osteocalcin levels between two groups. In conclusion, the electrical stimulation on femoral fracture site was effective for bone healing in dogs.
Estrangement hierarchical by bipolarization is deepened and time space that social welfare by graying corresponds great so. Specially, is real condition that indifference by patient's increase which is solitary life string is come to involve by social problem. Together, Jaetaek bone fracture patient's ratio is zooming. Domestic BT technology, medical treatment solution technology offer more important role than role assistance enemy of modern technology and utilize by creative technology can . Specially, if apply supersonic waves in bone fracture treatment, there is treatise data that can reduce bone fracture treatment period of bone that bone does not stick well about 40%. Supersonic waves operation frequency used on both end because do 1m Hz, 1.3mHz, supersonic waves origination that have 1.5mHz's Piezo-ceramic crystal tranducer material each 4 premature senilitys in this research, and outside diameter according to impedance and Phase d used Gakgak4mm, 5.4mm, Dukke0.5mm, transformer deuce of length 70mm. Manufactured, and investigated supersonic waves distribution chart by capacity 50m W. Supersonic waves used by diagnosis mainly but is seen to become convenient medical treatment mounting in bone fracture patient's treatment if supplement clinically. If supplement system furthermore, is going to apply to osteoporosis patient, and this research tried to design poetic theme width directly and study rain standardization special quality and approach basic form because do modelling.
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