• Title/Summary/Keyword: Fracture, closed

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A RETROSPECTIVE CLINICAL STUDY OF CONDYLAR FRACTURES OF THE MANDIBLE IN A 4-YEAR PERIOD (하악 과두 골절에 대한 4년간의 후향적 임상연구)

  • Ryu, Jae-Young;Kim, Hyun-Syeob;Park, Chung-Youl;Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.388-397
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    • 2008
  • The present study was performed to evaluate the function of the mandible according to the pattern of fracture and treatment methods of condylar fractures of the mandible and help operators in making a treatment plan. Sixty patients (average follow-up period was $7.8{\pm}9.4$ months) who were treated for condylar fracture from June, 2002 to May, 2006 at the Department of Oral and Maxillofacial surgery, Chonnam National University Hospital were reviewed. The common causes of the condylar fracture were traffic accident and fall-down (35.0%). In concomitant injuries, laceration was 46.7% and the fracture of the mandibular symphysis was highest incidence (60.0%). The common site of the fracture was the condylar head (47.8%), followed by subcondyle (36.2%) and condylar neck (15.9%). Under 15 years old patients, the closed reduction was performed in 87.5% out of the patients. All of the condylar fragments were fixed to the mandible with titanium miniplates in cases of open reduction. The mean period of intermaxillary fixation (IMF) was $14.2{\pm}6.5$ days in closed reduction and $10.0{\pm}4.2$ days in open reduction. The old patient with bilateral condylar head fractures, who were treated by closed reduction with IMF for 3 weeks, showed the limitation of mandibular movements. But, there was no significant different results between open reduction and closed reduction with the respect of the Helkimo's mandibular mobility index and clinical dysfunction index (DI). Complications, such as fibrous ankylosis and resorption of the mandibular condyle, were not observed in all patients. These results suggest that the good results can be obtained by closed reduction with proper IMF periods and functional exercise in most condylar fractures of the mandible except severely displaced extracapsular fractures.

Correlation Between Mandibular Condylar Process Fracture and Temporomandibular Joint (하악 과두 골절과 측두하악관절과의 관계)

  • Moon, Chul-Woong;Kim, Su-Gwan;Oh, Ji-Su
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.488-492
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    • 2010
  • This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

A study on working limit of cold forging of carbon steel (냉간단조에 있어서 탄소강의 가공한계에 관한 연구)

  • Jae, Jin-Soo;Kang, Jong-Hun;Kang, Seong-Soo
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.21 no.7
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    • pp.1081-1088
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    • 1997
  • The purpose of this work is to investigate the working limit of carbon steel and forging condition of cold forging. The fracture criteria which was proposed by Oyane and Osakada was used. Compression test, hardness study and tension test by Oyane's creteria, microstructure study by Osakada's were carried out. The results were compared with each other. It was found that working limit on compressive hydrostatic stress is increased in comparison with that of tensile stress field and can be forecasted the fracture limit of closed cold forging.

Comparison Study of Open Reduction and Closed Reduction in Treatment of Mandibular Subcondylar Fractures (하악골 과두하부골절 정복술에서 관혈적 정복술과 비관혈적 정복술의 비교 연구)

  • Jang, Ju Yun;Kang, Dong Hee
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.51-54
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    • 2008
  • Purpose: The choice of open versus closed reduction for mandibular subcondylar fracture is a debatable issue. To evaluate the advantage of open approach to closed method with IMF(intermaxillary fixation), we conducted a retrospective study to compare the outcomes of each method. Methods: From 2002 to 2006, 29 patients with mandibular subcondylar fractures were treated by open or closed reduction. 17 patients were treated by open reduction and 12 patients by closed reduction and IMF. Each group was assessed for duration of mandibular immobilization, incidences of buccal palsy, malocclusion, TMJ(temporomandibular joint) pain, and deviation of the mandible on mouth opening. Results: All cases showed accurate reduction in anatomical position, no significant displacement and no deviation on mouth opening during the follow-up period. IMF period is statistically shorter in open reduction (p<0.05). Differences in incidence of other complications were not significant statistically. Conclusion: As there are significant independent morbidities associated with IMF which requires postoperative rehabilitation, prolonged temporomandibular immobilization should not be overlooked. Some patients with poor compliances will not tolerate IMF in nonsurgical treatment. In the aspect of patient's convenience and early recovery by short IMF period, open reduction would be recommended as a better treatment method.

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption and condyle fracture using gothic arch tracing and closed mouth impression technique: A case report (하악 과두 골절과 심한 잔존치조제 흡수를 보이는 완전 무치악 환자에서 폐구 인상법과 고딕아치 묘기법을 이용한 총의치 수복 증례)

  • Choi, In-Ho;Kim, Seong-A;Kim, Na-Hong;Lee, Yong-Sang
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.2
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    • pp.145-152
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    • 2020
  • It is essential to record maxillomandibular relationship accurately for the harmony of esthetic and function in complete denture. Gothic arch tracing visually demonstrates the movement of the mandible, and is useful to establish accurate and reproducible centric relation. Proper retention and stability of complete denture in patients with severe alveolar bone resorption is difficult to attain. In such case, the closed mouth impression technique might be recommended. The denture border and impression are determined by patient's physiologic movement in the closed mouth impression technique. And, denture peripheral border is entirely closed with oral mucous membrane. This report presents satisfactory complete denture restoration using closed mouth impression technique and gothic arch tracing in patients with mandibular condyle fracture and severe absorption of mandibular alveolar ridge.

Treatment of Radius Fracture Using a Shuttle Pin in a Cinereous Vulture (Aegypius monachus): A Case Study

  • Jinho Jang;Hee-Jong Kim;Young-Seok Park;YoungMin Yun
    • Journal of Veterinary Clinics
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    • v.41 no.3
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    • pp.189-194
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    • 2024
  • Cinereous vulture (Aegypius monachus) is a large raptor that belongs to the family Accipitridae in the order Falconiformes. It is a migratory bird that returns to Mongolia after wintering in the Korean Peninsula. In February 2015, a cinereous vulture was rescued from Asan-si, Chungcheongnam-do Province as it could not fly. It was transferred to the Chungnam Wild Animal Rescue Center in Korea. It was found to have a closed fracture on the right radius through radiographic examination, a basic procedure. Surgery was performed at the fracture site using a shuttle pin and wire. After successful physical therapy and rehabilitation, the cinereous vulture was released in October 2015. A metal ring (150-00713) and wing tags (G/BL 3) were attached to the bird before its release for subsequent identification. Two years and 4 months later, in March 2018, the cinereous vulture was rescued and brought back to the center. It was diagnosed with secondary pesticide poisoning. After receiving treatment, a radiography test revealed no specific findings related to the previous fracture surgery. Considering that migratory birds travel long distances, it was confirmed that the treatment for reducing the fracture in the radius using a shuttle pin and a cerclage wire was suitable.

Arthroscope-guided Closed Reduction and Internal Fixation of the Lateral Malleolar Fracture (관절경을 이용한 족관절 외과 골절의 비관혈적 정복술 및 내고정술)

  • Shin, Sung-Il;Kim, Gab-Lae;Hyun, Yoon-Suk;Ban, Tae-Seo;Kim, Tae-Hwa
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.74-79
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    • 2008
  • Purpose: In this study, we introduced an newly developed technique of operation for fracture of lateral malleolus of the ankle. We treated the fracture by close reduction and internal fixation using arthroscopy. Materials and Methods: From July 2006 to June 2007, we had treated 23 cases of lateral malleolar fracture (SER type) by closed reduction and internal fixation with arthroscopy and followed them up more six month. Operation time, union time, clinical and functional result were evaluated. Results: After the final follow-up, all the fractures were healed with satisfactory bony union. The subjective result was excellent in 15 cases (65%), good in 8 cases (35%), the objective result was excellent in 13 cases (57%), good in 10 cases (43%), and the roentgenographic result was excellent in 17 cases (74%), good in 6 cases (26%). Conclusion: Closed reduction and internal fixation with arthroscopy technique is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including corrective anatomical reduction and minimizing complication associated with injury of soft tissue.

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Ultrasound-Guided Closed Reduction of Nasal Bone Fracture (초음파를 이용한 비골 골절의 비관혈적 정복술)

  • Yang, Hyung Eun;Park, Eun Soo;Cha, Jang Gyu;Kim, Cheol Han;Kim, Jun Hyuk;Kim, Yong Bae
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.461-465
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    • 2007
  • Purpose: Nasal bone fracture may be the most common fracture among facial trauma. However, diagnosis and treatment tend to be overlooked while the reduction and maintenance of fragments remain complicated. Thus, the results are plagued with high rate of nasal deformity which leads cosmetic and functional discomfort. We took advantage of the fact that the nasal bone is one of the thinnest facial bone while at the same time being located close to the skin and utilized ultrasound in performing reduction of nasal bone. Methods:This method was performed on 25 patients with nasal bone fracture. The CL 15-7 linear array transducer (10-15MHz) ultrasound which provides a total of 7 views (3 axial views and 4 transverse views) of the elevator under the bony fragments was enough for the surgeon to accurately perform the reduction. Results: In our class, an accurate and precise reduction has been made possible by real time images before, during, and after the procedure with the help of ultrasound while reducing the exposure to radiation. Conclusion: Compared to previous methods, satisfaction of patients has increased in the nasal tip, minimal fracture of the side wall and secondary reduction cases. Therefore, the incorporation of ultrasound in the closed reduction of nasal bone may prove to be a useful method.

Application of Lateral Osteotomy in Nasal Bone Fracture (비골 골절에서 외측 비골 절골술의 적용)

  • Lim, Kwang Ryeol;Song, Jennifer K.;Hwang, So Min;Jung, Yong Hui;Cho, Ka Hyung
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.104-110
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    • 2012
  • Purpose: Who may dare to state that optimal choice of treating nasal bone fracture is closed reduction? Few decades of authors' experience in nasal bone fracture has lead to believe that more active and assertive approach in nasal bone fracture by performing simultaneous lateral osteotomy may be applied in proper indications to acquire more accurate reduction and cosmetically satisfying result. Methods: From May 2008 to October 2009, among 241 nasal bone fracture patients, 20 patients underwent simultaneous lateral osteotomy with nasal bone fracture reduction. Followed by rigid septal correction, nasal cavity is packed to stabilize the fracture segment for safer osteotomy. Through intranasal incision, in selected cases of difficult reduction or for cosmetic purposes, various types of lateral osteotomy was performed corresponding to the fracture anatomy, conditions of the nasal cavity. Postoperative nasal packing was retained for one week and nasal dorsum splint for 3 weeks. Results: Lateral osteotomy was utilized for difficult cases of closed reduction, for correction of wide nose, hump and deviation in 9, 5, 2, and 4 cases, respectively. Patient satisfaction was scaled 90% in satisfaction and moderate in 10% (2 cases), complaining of mild nasal tip deviation. Physicians detected 2 cases of apparent deformity with patient recognition; one patient with mild step deformity at the osteotomy site and the other patient with minimal implant mobility. Conclusion: By accompanying profound understanding of the fracture anatomy, more active and assertive approach in nasal fracture reduction can be coincide with simultaneous lateral osteotomy to reduce the rate of secondary deformity and to obtain more cosmetically satisfying result.

Incidence and management of mandibular fractures in a low-resource health facility in Ghana

  • Frimpong, Paul;Nguyen, Truc Thi Hoang;Sodnom-Ish, Buyanbileg;Nimatu, Edinam Salia;Dampare, Nana Yaa Asantewaa;Rockson, Roberta;Awuah, Samuel Baffour;Amponsah, Emmanuel Kofi;Newton, Cardinal;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.6
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    • pp.432-437
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    • 2021
  • Objectives: The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods: This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results: A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion: Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.