• Archives of Plastic Surgery
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• v.43 no.2
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• pp.134-144
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• 2016

In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed. Tubiana's classification takes into account the size of the bony articular fragment and DIPJ subluxation. We propose to stage subluxated fractures as stage III if the subluxation is reducible with a splint and as stage IV if not. Left untreated, mallet finger becomes chronic and leads to a swan-neck deformity and DIPJ osteoarthritis. The goal of treatment is to restore active DIPJ extension. The results of a six- to eight-week conservative course of treatment with a DIPJ splint in slight hyperextension for tendon lesions or straight for bony avulsions depends on patient compliance. Surgical treatments vary in terms of the approach, the reduction technique, and the means of fixation. The risks involved are stiffness, septic arthritis, and osteoarthritis. Given the lack of consensus regarding indications for treatment, we propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which we treat with extra-articular pinning.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.17-22
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• 1988

Fractures of the femoral neck in children are rare and usually the result of severe trauma. The femoral necks in children, in contrast to those of adults, have many anatomic and physiologic differences. Among the late complications encountered are avascular necrosis, coxa vara, premature closure of the proximal capital femoral epiphysis and nonunion. In spite of careful management, significant complication rate often results. Nine cases of fractures of the femoral neck in children which were treated at Yeungnam University Hospital from June 1984 to August 1987 were reviewed. The results obtained are as follows: 1. The main causes of fractures were traffic accidents(5 cases). 2. Among 9 patients, 6 were girls and 3 were boys. 3. According to the classification of Delbet and Colonna, the transcervical fracture(6 cases) was the commonest type. 4. 4 cases were treated by closed reduction and internal fixation, 3 cases were treated by open reduction and internal fixation. 2 cases were treated by skin traction and cast. 5. The results were analyzed according to Ratliff's assessment. 6 cases showed good results, and 3 cases showed poor results. 6. Early diagnosis and good fixation method seemed to be vital to prognosis.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.295-300
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• 2007

Objective : Unilateral facet dislocation of the cervical spine occurs by flexion and rotation injuries and cannot be easily reduced by axial traction. We analyzed 14 consecutive patients with unilateral facet dislocation of the cervical spine to increase knowledge about anatomical reduction of locked facet and factors for successful reduction. Methods : Fourteen patients [10 men and 4 women] with unilateral facet dislocation of the cervical spine were retrospectively analyzed. Plain X-ray, computerized tomography scan, and magnetic resonance imaging were performed. All patients underwent manual reduction and surgery with anterior interbody fusion and plate fixation. The manual reduction was performed by neck flexion and rotation to the opposite side of dislocation, followed by rotation and flexion of the head toward the side of dislocation and extension with relaxation of traction. Mean follow-up period was 17 months. The level of spine, amount of subluxation, combined facet fracture, and time from injury to initial reduction were analyzed using the data obtained from medical records. Results : Thirteen [93%] patients were reduced successfully. Immediate reduction was achieved in 7 patients but failed in 7 patients. Seven patients underwent delayed closed reduction under general anesthesia, and successful reduction was achieved in 6 patients. Only one patient with bone chips between articular facets failed to achieve anatomical reduction. Conclusion : In order to reduce the locked facet more easily and safely, we recommend manipulative traction with anterior interbody fusion and plate fixation under general anesthesia after being aware of spinal cord injury with magnetic resonance imaging.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.270-276
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• 2001

The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.

• Imaging Science in Dentistry
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• v.34 no.4
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• pp.185-190
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• 2004

Purpose: To compare the diagnostic accuracy for the detection of root fractures in CMOS-based digital periapical images with conventional film-based periapical images. Materials and Methods: Sixty extracted single-root human teeth with closed apices were prepared endodontically and divided into two groups; artificially induced vertical root fracture group and control group. All radiographs were obtained using the paralleling technique. The radiographs were examined by 4 observers three times within a 4 week interval. Receiver operating characteristic (ROC) analysis was carried out using data obtained from four observers. Intra- and inter-examiner agreements were computed using kappa analysis. Results: The area under the ROC curve (Az) was used as an indicator of the diagnostic accuracy of the imaging system. Az values were as follows: direct-digital images; 0.93, film-based images; 0.92, and inverted digital images; 0.91. There was no significant difference between imaging modalities (P<0.05). The kappa value of inter-observer agreement was 0.42 (range: 0.28-0.60) and intra-observer agreement was 0.57 (range: 0.44-0.75). Conclusion : There is no statistical difference in diagnostic accuracy for the detection of vertical root fractures between digital periapical images and conventional periapical images. The results indicate that the CMOS sensor is a good image detector for the evaluation of vertical root fractures.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.77-82
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• 1997

Sixty children were admitted to he Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in )2% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45% ), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severi y Scale(MISS) score was measured in the multiple Injured group. MISS score correlated significantly with the length of stay In the intensive care unit. One child(1.7% ), involved in a traffic accident, died of sepsis.

• Journal of Chest Surgery
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• v.4 no.1
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• pp.11-24
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• 1971

Eighty-four cases of mitral commissurotomy were done in this department between October 1958 and September 1970. Therc wcre 54 males and 30 females. Six cases were under the age of 20 years. Prcoperativc embolization occurred in 9. 5% of the cases. consisting of 8. 3% cerebral and 1.2% peripheral embolization. Intraoperative and postoperative cmbolization occurred in 4.7% of the cases, with 1. 2% cerebral and 3.5% peripheral embolism. Two out of three postopeative embolism cases expired, one of which was caused by septic cerebral embolism due to valve vegetation nnd the other by mesenteric embolism. Atrial fibrillation was 1loted ill 43% of the case. Seventy closed mitral commissurotomy was done by left appendegeal approach with finger fracture method or Bailey's guillotine valvotome. Fourteen open mitral commissurotomy cases were done either by right side approach or median sternotomy, three of which were reoperation cases after blind mitral commissurotomy. One out of 14 cases were operated on with open mitral commissurotomy and concomitant open aortic valve bicuspidalization, This case expired due to severe serum hepatitis ten days after operation. Thirty-two per cent of valve calcification was noted during operation and one of which had marked vegetation on the valve cusps too. Operative mortality was 1.4% in blind mitral commissurotomy and 14% in open mitral commissurotomy. Over-all mortality in the entire series was 3.5%. One case among the blind commissurotomy cases expired during operation due to left inferior pulmonary vein laceration and death was caused in two open mitral commissurotomy cases by coronary artery airembolism. Three hospital death occurred in blind operation group, one due to coronary embolism, and two by hepatic failures. Three hospital death among open heart surgery cases were caused by hepatic failure in two and cerebral embolism in one cases. ln most of the survivors improved functional capacity and exercise lolerance were noted.

• Journal of the Korean Society for Nondestructive Testing
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• v.28 no.4
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• pp.352-357
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• 2008

The detection of micro cracks in materials at the early stage of fracture is important in many structural safety assurance problems. The nonlinear ultrasonic technique (NUT) has been considered as a positive method for this, since it is more sensitive to micro crack than conventional linear ultrasonic methods. The basic principle is that the waveform is distorted by nonlinear stress-displacement relationship on the crack interface when the ultrasonic wave transmits through, and resultantly higher order harmonics are generated. This phenomenon is called the contact acoustic nonlinearity (CAN). The purpose of this paper is to prove the applicability of CAN experimentally by detection of micro fatigue crack artificailly initiated in Aluminum specimen. For this, we prepared fatigue specimens of Al6061 material with V-notch to initiate the crack, and the amplitude of second order harmonic was measured by scanning along the crack direction. From the results, we could see that the harmonic amplitude had good correlation with COD and it can be used to detect the crack depth in more accurately than the common 6 dB drop echo method.

• Archives of Craniofacial Surgery
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• v.22 no.2
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• pp.93-98
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• 2021

Background: Pediatric nasal fractures, unlike adult nasal fractures, are treated surgically as early as 7 days after the initial trauma. However, in some cases, a week or more elapses before surgery, and few studies have investigated the consequences of delayed surgery for pediatric nasal fractures. The purpose of this study was to evaluate the postoperative outcomes of pediatric nasal fractures according to the time interval between the initial trauma and surgery. Methods: The records of pediatric patients under 12 years old who underwent closed reduction of nasal bone fracture from March 2012 to February 2020 were reviewed. The interval between trauma and surgery was divided into within 7 days (early reduction) and more than 7 days (delayed reduction). Postoperative results were classified into five grades (excellent, good, moderate, poor, and very poor) based on the degree of reduction shown on computed tomography. Results: Ninety-eight patients were analyzed, of whom 51 underwent early reduction and 47 underwent delayed reduction. Forty-two (82.4%) of the 51 patients in the early reduction group showed excellent results, and nine (17.6%) showed good results. Thirty-nine (83.0%) of the 47 patients in the delayed reduction group showed excellent results and eight (17.0%) showed good results. No statistically significant difference in outcomes was found between the two groups (chi-square test p= 0.937). However, patients without septal injury were significantly more likely to have excellent postoperative outcomes (chi-square test p< 0.01). Conclusion: No statistically significant difference was found in the outcomes of pediatric nasal fractures between the early and delayed reduction groups. Successful surgical results were found even in patients who received delayed reduction (more than 7 days after trauma).

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.112-123
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• 2007

Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.