• Title/Summary/Keyword: Fracture Recovery

검색결과 200건 처리시간 0.029초

견갑골 골절 환자의 기능회복에 대한 추나 요법을 포함한 한방재활치료: 증례 보고 (The Clinical Effects of Korean Medicine Rehabilitation Including Chuna Manual Therapy on Scapular Fracture Patient's Functional Recovery: A Case Report)

  • 배준형;고준혁;김세윤;이한솔;장호경;안종현;김형석;정원석
    • 한방재활의학과학회지
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    • 제29권4호
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    • pp.117-126
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    • 2019
  • To evaluate the effects of Korean medicine and Chuna treatment on patient with pain and limited range of motion (ROM) after scapular fracture. Patient was treated with Chuna manual therapy, acupuncture, herbal medicine, pharmacoacpuncture, cupping therapy and measured by ROM, visual analog scale (VAS), shoulder pain and disability index (SPADI), American shoulder elbow surgery scale (ASES), Korean shoulder score for instability (KSS). After the 3 weeks treatment, the patient's ROM, VAS, SPADI, ASES, KSS scores were improved. Rehabilitation program including Chuna manual therapy can be effectively used to improve scapular fracture patient's pain and symptom during rehabilitation period. Therefore it is recommended to use Chuna manual therapy for the improvement of movement and pain from fracture.

두부외상후 심리사회적 예후 (Psychosocial Outcome after Head Injury)

  • 박기창;김헌주
    • Journal of Korean Neurosurgical Society
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    • 제29권2호
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    • pp.196-202
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    • 2000
  • Objective : This study was designed to evaluate the relationship between the initial neurosurgical or psychosocial factors and the psychosocial outcome. Patients and Methods : We analyzed 123 head-injured patients who were referred to the department of psychiatry for the evaluation of psychosocial function. We analyzed initial neurosurgical variables such as Glasgow Coma scale(GCS) score, skull fracture, CT finding, and psychosocial outcomes with regards to psychosis, personality change, depression, anxiety and IQ on Intelligence Scale. Results : Patients with mild head injury(GCS score 13-15, N=94, 76.4%) had better recovery rate on Glasgow Outcome Scale(GOS), less personality change than those with moderate or severe head injury. However, depression, anxiety and intelligence were not significantly different between two groups. The skull fracture(N=37, 30.1%) did not influence on the psychosocial outcome with reference to personality change, depression, anxiety and intelligence. The patients with abnormal CT findings(N=64, 52%) had lower recovery rate on GOS, more frequent tendency in psychosis, personality change and severe depression, less frequent in anxiety and mild depression, than patients with normal CT finding. However, levels of intelligence were not different between two groups. The patients with industrial accidents(IA) had lower educational level, milder head injury, more delay for the psychiatric evaluation (longer treatment period) than those with motor vehicular accidents(MVA). The psychosocial outcome with reference to personality change, depression, anxiety, intelligence were not different between two groups. Conclusion : These findings indicate that the more severe initial trauma, the poorer psychosocial outcome. However, it was frequently observed that patients with mild head injury suffered from mild anxiety and depression. Therefore mild head injury appeared to be more complicated by psychosocial stressors. The patients with IA, despite the fact that initial head injury was mild, required longer treatment period than MVA.

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Comparing the Use of Single and Double Interlocking Distal Screws on a Polarus Intramedullary Nail for Humeral Shaft Fractures

  • Yang, Hee Seok;Kim, Jeong Woo;Kang, Hong Je;Park, Jung Hyun;Lee, Yong Chan;Kim, Kwang Mee
    • Clinics in Shoulder and Elbow
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    • 제18권2호
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    • pp.91-95
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    • 2015
  • Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

생체용 Ti-18Nb-6Zr-XO (X = 0~1.5at%) 합금의 형상기억특성에 미치는 산소 농도의 영향 (Effect of Oxygen Content on Shape Memory Characteristics of Ti-18Nb-6Zr-XO (X = 0~1.5at%) Alloys)

  • 박영철;옥지면;오정화;박수호;이준희;김재일
    • 한국재료학회지
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    • 제21권11호
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    • pp.617-622
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    • 2011
  • The effect of oxygen on the shape memory characteristics in Ti-18Nb-6Zr-XO (X = 0-1.5 at%) biomedical alloys was investigated by tensile tests. The alloys were fabricated by an arc melting method at Ar atmosphere. The ingots were cold-rolled to 0.45 mm with a reduction up to 95% in thickness. After severe cold-rolling, the plate was solution-treated at 1173 K for 1.8 ks. The fracture stress of the solution-treated specimens increased from 450 Mpa to 880 MPa with an increasing oxygen content up to 1.5%. The fracture stress increased by 287MPa with 1 at% increase of oxygen content. The critical stress for slip increased from 430 MPa to 695 MPa with an increasing oxygen content up to 1.5 at%. The maximum recovery strain of 4.1% was obtained in the Ti-18Nb-6Zr-0.5O (at%) alloy. The martensitic transformation temperature decreased by 140 K with a 1.0 at% increase in O content, which is lower than that of Ti-22Nb-(0-2.0)O (at%) by 20 K. This may have been caused by the effect of the addition of Zr. This study confirmed that addition of oxygen to the Ti-Nb-Zr alloy increases the critical stress for slip due to solid solution hardening without being detrimental to the maximum recovery strain.

Middle superior and anterior superior alveolar nerve injury following trauma to the maxillary sinus: a prospective clinico-radiographic evaluation

  • Sathish Radhakrishna;Eashwari Narayanan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제49권5호
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    • pp.262-269
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    • 2023
  • Objectives: Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. Materials and Methods: This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. Results: More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. Conclusion: NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.

54두 개에서 발생한 골반 골절의 임상적 분석 (Clinical Analysis of Pelvic Fracture in 54 Dogs)

  • 김경희;이종훈;윤헌영;정순욱
    • 한국임상수의학회지
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    • 제28권5호
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    • pp.467-472
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    • 2011
  • 본 연구의 목적은 골반 골절을 지닌 54두의 환축의 임상적 결과를 분석하고 체중 지지까지의 기간, 입원 기 간, 수술 후 파행 등급 등을 평가하는데 있다. 54두의 환축에서 총 195 부위의 골절을 확인하였으며, 이중 47두에서는 2 부위 이상 골절이 확인되었다. 수술을 실시한 31마리에서 수술 이후 체중 지지까지 걸린 평균 기간은 7.04일이었으며, 평균 입원 기간은 16.39일이었다. 또한 수술 이후 평균 최종 파행 등급은 1.25 이었다. 천장골 탈구, 장골 골절, 관 골구 골절 간의 체중 지지 기간, 입원 기간, 최종 파행 등급에서 유의적 차이는 없었다. 수술을 2 부위 이상 실시한 경우와 양측 골반을 동시에 수술한 경우에서 입원 기간과 최종 파행 등급은 유의적인 증가를 보였다. 결론적으로 골 절의 위치보다 골절의 개수가 골절의 회복에 더 큰 영향을 주는 것으로 생각된다.

Sensory change and recovery of infraorbital area after zygomaticomaxillary and orbital floor fractures

  • Sang Woo, Han;Jeong Ho, Kim;Sug Won, Kim;Sung Hwa, Kim;Dae Ryong, Kang;Jiye, Kim
    • 대한두개안면성형외과학회지
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    • 제23권6호
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    • pp.262-268
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    • 2022
  • Background: To compare the sensory change and recovery of infraorbital area associated with zygomaticomaxillary and orbital floor fractures and their recoveries and investigate the factors that affect them. Methods: We retrospectively reviewed 652 patients diagnosed with zygomaticomaxillary (n= 430) or orbital floor (n= 222) fractures in a single center between January 2016 and January 2021. Patient data, including age, sex, medical history, injury mechanism, Knight and North classification (in zygomaticomaxillary fracture cases), injury indication for surgery (in orbital floor cases), combined injury, sensory change, and recovery period, were reviewed. The chi-square test was used for statistical analysis. Results: Orbital floor fractures occurred more frequently in younger patients than zygomaticomaxillary fractures (p< 0.001). High-energy injuries were more likely to be associated with zygomaticomaxillary fractures (p< 0.001), whereas low-energy injuries were more likely to be associated with orbital floor fractures (p< 0.001). The sensory changes associated with orbital floor and zygomaticomaxillary fractures were not significantly different (p= 0.773). Sensory recovery was more rapid and better after orbital floor than after zygomaticomaxillary fractures; however, the difference was not significantly different. Additionally, the low-energy group showed a higher incidence of sensory changes than the high-energy group, but the difference was not statistically significant (p= 0.512). Permanent sensory changes were more frequent in the high-energy group, the difference was statistically significant (p= 0.043). Conclusion: The study found no significant difference in the incidence of sensory changes associated with orbital floor and zygomaticomaxillary fractures. In case of orbital floor fractures and high-energy injuries, the risk of permanent sensory impairment should be considered.

외상으로 동시에 발생한 양측 쇄골 골절 - 증례 보고 - (Simultaneous Bilateral Clavicle Fractures - A Case Report -)

  • 장기영;노권재;윤건웅;신상진
    • 대한정형외과스포츠의학회지
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    • 제8권2호
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    • pp.125-128
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    • 2009
  • 양측 쇄골 골절은 양측 견관절 부위에 강한 외력이 동시에 작용하여 발생하는 드문 골절이다. 편측 쇄골 골절은 보존적 치료로 대부분 만족할 만한 임상 경과를 보이나 동시에 양측이 골절 되는 경우 극심한 통증과 재활 운동의 어려움을 겪게 되며, 호흡운동 장애를 초래할 수도 있다. 저자들은 다발성 늑골 골절 및 혈흉과 흉추 가시돌기 골절을 동반한 양측 쇄골 골절 환자에 대해 수술적 치료를 통해 견관절 기능 회복을 얻었으며, 호흡운동 장애 문제를 해결하였기에 문헌 고찰과 함께 보고하고자 한다.

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

  • 장주윤;강동희
    • 대한두개안면성형외과학회지
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    • 제9권2호
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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.

족관절 골절에 대한 관절경적 정복술과 관혈적 정복술 (Arthroscopic and open reduction for ankle fractures)

  • 김동헌;장병춘;이재성
    • 대한족부족관절학회지
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    • 제2권2호
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    • pp.82-87
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    • 1998
  • The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. And so the goals of operative treatment for ankle fractures are to obtain an anatomical reduction that is maintained by stable fixation, resulting in a healed fracture and recovery of normal function. The 64 patients who had ankle fractures were treated by arthroscopic reduction(20 cases) and open reduction (43 cases) in Konkuk university hospital from February 1991 to October 1997 and the results were analyzed in clinical and radiological aspects. The following results were obtained. According to the criteria of Meyer, arthroscopic assisted reduction group had good or excellent results in 18 cases (90%) and open reduction group good or excellent in 35 cases (83%). The difference of the results was not significant statistically, but arthroscopic assisted reduction technique has several advantages over open technique; the best assessment of articular surface, lower wound problem, postoperatively faster rate of rehabilitation and minor discomfort.

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