• 제목/요약/키워드: Fracture, closed

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Objective Outcomes of Closed Reduction According to the Type of Nasal Bone Fracture

  • Kang, Chang Min;Han, Dong Gil
    • 대한두개안면성형외과학회지
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    • 제18권1호
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    • pp.30-36
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    • 2017
  • Background: Nasal fractures have a tendency of resulting in structural or functional complications, and the results can vary according to the type of nasal bone fracture. The aim of this study was to evaluate the objective postoperative results according to the type of nasal bone fractures. Methods: We reviewed 313 patients who had a closed reduction of nasal bone fracture. The classification of nasal bone fracture by Stranc and Robertson was used to characterize the fracture type: frontal impact group type I (FI), frontal impact group type II (FII), lateral impact group type I (LI), lateral impact group type II (LII), and comminuted fracture group (C). For each patient, we tried to use the same axial image section of computed tomographic (CT) scans before and immediately after operation. Postoperative outcomes were classified into 4 grades: excellent (E), good (G), fair (F), and poor (P). We also analyzed postoperative complications by fracture type. Results: Regarding the postoperative CT images, 189 subjects showed E results, 99 subjects showed G, 18 subjects showed F, and 7 subjects showed P reduction. The rate of operation results graded as E by each fracture type was 66.67% in FI, 52.0% in FII, 64.21% in LI, 62.79% in LII, and 21.74% in C. Complications of FI (7.14%), LII (13.95%), and C (13.04%) groups occurred more than in the FII (4.00%) and LI (4.21%) groups. Conclusion: It seems that the operation result by fracture type was better in the FI, LI, and LII type than the FII and C type; after one month, however, LII type showed more complications than other types. The septal fracture can be thought to affect early reduction results in nasal bone fractures.

코뼈 골절 수술결과 평가에 있어서 Bird's Eye View의 유용성 (Clinical Usefulness of a Newly Standardized Bird's Eye View Clinical Photography in Nasal Bone Fracture)

  • 박동권;최재훈;이진효
    • 대한두개안면성형외과학회지
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    • 제12권2호
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    • pp.97-101
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    • 2011
  • Purpose: Nasal bone fracture is the most common type of facial bone fracture. The standard 6-view photography was not adequate to support the evaluation of nasal deformity and the results of closed reduction. The authors have standardized a bird's eye view photography to more effectively evaluate this nasal deformity. Methods: We reviewed the medical records and radiologic studies of 63 nasal bone fracture patients. We had taken clinical photography including bird's eye view that was standardized as nasal tip was aligned to Cupid's bow of upper lip and light was focused on the nasion of all 63 patients. Results: Nasal deviations and reductions were more noticeable on the newly standardized bird's eye view. This clinical photography was very useful to explain the results of reduction. Conclusion: It was concluded that this photography can be more reliable for evaluation of severity of nasal deformity and the result of closed reduction.

Outcome of open reduction and Kirschner wire fixation in pediatric radial neck fracture

  • Rouhani, Alireza;Chavoshi, Mohammadreza;Sadeghpour, Alireza;Aslani, Hossein;Mardani-Kivi, Mohsen
    • Clinics in Shoulder and Elbow
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    • 제24권4호
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    • pp.239-244
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    • 2021
  • Background: Radial neck fracture in children is rare. This study attempted to evaluate the outcome of surgically treated patients and any associated complications. Methods: This study evaluated 23 children under 15 years of age with radial neck fracture who were treated with open reduction between 2006 and 2016 to determine their range of motion, postoperative complications, and radiographic outcomes. The results were assessed clinically using the Mayo clinic elbow performance score. Results: The mean follow-up duration for patients was 34.6 months. The average postoperative angulation was 3.6°. Hypoesthesia was reported in only 9% of patients, and none of the patients complained of postoperative pain. The postoperative X-ray results were excellent in 60% and good in 40%. No radiographic complications were identified. The elbow score was excellent in 87% and good in 13% (mean score, 96.74). There was a statistical relationship between range of motion limitations and age, degree of fracture, initial displacement, and surgical pin removal time. Conclusions: Although most patients accept the closed reduction method as a primary treatment, the present study suggests that an open-reduction approach has been associated with optimal therapeutic outcomes for patients in whom closed reduction was not satisfactory or indicated.

비골 골절 교정 후 Rolled Silastic Sheet를 이용한 비강 충진의 효과 (The Effect of Nasal Packing with Rolled Silastic Sheet after Closed Reduction of Nasal Bone Fracture)

  • 손경민;양정열;김규보;한윤주;천지선
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.602-608
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    • 2011
  • Purpose: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. Methods: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I (n=92), $Merocel^{(R)}$ was used for nasal packing, for Group II (n=152) vaseline gauze was used, and Rolled silastic sheet (RSS) with vaseline gauze packing (VGP) was used for Group III (n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. Results: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased ($p$ <0.05) and the postoperative complication (deviation) were decreased comparing to vaseline gauze packing and $Merocel^{(R)}$ packing, however, these differences were not statistically significant ($p$ >0.05). Conclusion: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.

하악과두골절시 Arthrocentesis와 Lavage를 이용한 치험에 관한 연구 (TREATMENT OUTCOME OF MANDIBULAR CONDYLAR FRACTURE WITH ARTHROCENTESIS AND LAVAGE)

  • 윤옥병
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권4호
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    • pp.286-289
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    • 2002
  • In the treatment of mandibular condylar fractures, arthrocentesis, lavage and selective intermaxillary fixation were performed after closed reduction. In this lavage group, the physiotherapy performed for 3-6 months after injury. in control group, continuous intermaxillary fixation was done for 1-3 weeks, and physiotherapy followed in the same method of the lavage group. In the comparative study of the both groups, the following results are shown. 1. Compared to control group, the lavage group had a slightly superior result at range of motion, joint pain and occlusal deviation, from I day after arthrocentesis to 6 months after injury. 2. The significant differences between both groups were seen at range of motion and joint pain in 1 month after injury. 3. At 6 months after injury, the differences between both groups were not significant at range of motion, joint pain and occlusal deviation. From this study, in the mandibular condylar fracture, the arthrosentesis, lavage and selective intermaxillary fixation after closed reduction can improve symptoms such as joint pain and occlusal deviation, also increase range of motion. in this therapeutic way, intracapsular hemarthrosis which can cause TMJ ankylosis or dysfunction can be removed effectively. in addition, patient's discomfort such as swallowing disturbance, speech disturbance and emotional stress can be reduced signuficantly.

악골 골절후 발생된 골수염의 처치의 치험례 (TREATMENT OF THE OSTEOMYELITIS OCCURRED BY THE FRACTURE OF THE MANDIBLE)

  • 김성국;손동석;고말식;서정식;이철희
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권3호
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    • pp.277-282
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    • 1995
  • With the use of antibiotics and improved dental care, osteomyelitis of the jaw is less common these days, But sometimes the management of osteomyelitis is more difficult because of appearance of resistant organisms to antibiotics. Treatment of the steomyelitis are incision and drainage, closed catheter irrigations, sequestrectomy, saucerization, hyperbaric ocygen therapy, and resection with or without bone graft. We experienced advanced osteomyelitis due to delayed treatment of left mandibular angle fracture. He have medical history of pschysoprenia. We decided to treat the patient with open reduction and closed cather irrigation. We achived reconsolidation of mandibular fracture accompanied by osteomyelitis by complete removal of inflammatory tissues, rigid fixation with miniplate and closed catheter irrigation.

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압분공정의 유한요소 해석을 위한 AZO 분말의 Closed-die Compaction 실험 (Closed-die Compaction of AZO Powder for FE Simulation of Powder Compaction)

  • 김용배;이종섭;이상목;박훈재;이근안
    • 소성∙가공
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    • 제21권4호
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    • pp.228-233
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    • 2012
  • In this study, powder compaction of AZO (alumina doped zinc oxide) powder was performed with a MTS 810 test system using a cylindrical die having a diameter of 10mm. Pressure-density curves were measured based on the load cell and displacement of the punch. The AZO powder compacts with various densities were formed to investigate the mechanical properties such as fracture stress of the AZO powder as a function of the compact density. Two types of compression tests were conducted in order to estimate the fracture stress using different loading paths: a diameteral compression test and a uniaxial compression test. The pressure-density curves of the AZO powder were obtained and the fracture stress of the compacted powders with various densities was estimated. The results show that the compact pressure dramatically increases as the density increases. Based on the experimental results, calibration of the modified Drucker-Prager/Cap model of the AZO powder for use in FE simulations was developed.

기도유지기 마스크 환기마취를 이용한 비관혈적 비골골절 정복술 (Closed Reduction of Nasal Bone Fracture Under the Mask Ventilation Anesthesia Using Oral Airway)

  • 박병찬;남현재;이준호;김용하;허민정;서일숙
    • 대한두개안면성형외과학회지
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    • 제9권2호
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    • pp.77-80
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    • 2008
  • Purpose: The majority of nasal fractures have been treated by closed reduction. And they were manipulated under local anesthesia or general anesthesia. Under the local anesthesia, patients can feel the pain and fear, so general anesthesia through the endotracheal intubation became popularized recently to treat the nasal fracture. But it has still the drawbacks of postanesthetic complication. Therefore, under the mask ventilation anesthesia using oral airway, we tried to manipulate the nasal fracture. Methods: From July 2007 to November 2007, we worked with fifty patients that were manipulated the nasal fracture. Fifty patients were divided into two groups, general anesthesia with the endotracheal intubation group(n=25) and the mask ventilation using oral airway group(n=25). We checked up the anesthesia time, postanesthetic complication, postoperative aesthetic & functional problem of nose in two groups. Results: In total operation time and sore throat frequency among the postoperative anesthetic complications, there was statistically significant difference between the mask ventilation group and the endotracheal intubation group(p<0.05). But there was no difference statistically in nausea frequency(p>0.05). And no patients complained of postoperative nasal complication such as septal deviation, septal perforation, nasal obstruction and hump nose in two groups. Conclusion: Through the mask ventilation using oral airway, we could reach satisfactory results in the anesthetic time and postanesthetic complication.

소아 상완골 과상부 골절의 경피적 K-강선 고정술 (Percutaneous K-wire Fixation of Supracondylar Fracture of Humerus in Children)

  • 신덕섭;안종철;김세동;이동우
    • Journal of Yeungnam Medical Science
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    • 제10권2호
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    • pp.400-408
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    • 1993
  • 1990년 3월에서 1993년 9월까지 영남대학병원 정형외과에서 22례의 소아 상완골 골절의 치료에서 도수정복 후 K-강선 고정술을 시행 하였다. 환자의 연령은 대부분 3세에서 11세 사이였으며, 신전형의 Gartland 2, 3형 전위 골절이 많았다. 22례의 환자중 일년 이상 추시가 가능 하였던 10례에서 미관상의 결과는 모두 만족 스러웠고, 기능상의 결과는 한 례를 제외하고는 모두 만족 스러웠다. 일부 단기 추기 가능하였던 7례의 환자 중에서도 5례가 만족스러운 결과를 보였다. 척골신경 손상이나, 연부조직 손상의 합병증은 없었다. 입원 기간도 11.4일로 다른 치료법에 비하여 단축되어, 도수 정복후 K-강선 고정술은 많은 장점을 가진 좋은 치료법으로 사료된다.

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