• 제목/요약/키워드: Fracture Site

검색결과 528건 처리시간 0.027초

하악골 과두하 골절의 이하선 경유 접근법을 통한 관혈적 정복술 증례보고 (Case Report of Transparotid Approach of Mandibular Subcondylar Fracture)

  • 문민철;오석준;고성훈
    • 대한두개안면성형외과학회지
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    • 제10권1호
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    • pp.33-36
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    • 2009
  • Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

경골에 시행한 유리 생 비골 및 피부편 이식 (Free Vascularized Osteocutaneous Fibular Graft to the Tibia)

  • 이광석;박종웅;하경환;한상석
    • Archives of Reconstructive Microsurgery
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    • 제6권1호
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    • pp.63-72
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    • 1997
  • We have evaluated the clinical results following the 46 cases of free vascularized osteocutaneous fibular flap transfer to the tibial defect combined with skin and soft tissue defect, which were performed from May 1982 to January 1997. Regarding to the operation, flap size, length of the grafted fibula, anastomosed vessels, ischemic time of the flap and total operation time were measured. After the operation, time to union of grafted fibula and the amount of hypertrophy of grafted fibula were periodically measured through the serial X-ray follow-up and also the complications and results of treatment were evaluated. In the 46 consecutive procedures of free vascularized osteocutaneous fibular flap transfer, initial bony union were obtained in the 43 grafted fibulas at average 3.75 months after the operation. There were 2 cases in delayed unions and 1 in nonunion. 44 cutaneous flaps among the 46 cases were survived but 2 cases were necrotized due to deep infection and venous insufficiency. One necrotized flap was treated with latissimus dorsi free flap transfer and the other was treated with soleus muscle rotational flap. Grafted fibulas have been hypertrophied during the follow-up periods. The fracture of grafted fibula(15 cases) was the most common complication and occurred at average 9.7 months after the operation. The fractured fibulas were treated with the cast immobilization or internal fixation with conventional cancellous bone graft. In the cases of tibia and fibula fracture at recipient site, the initial rigid fixation for the fibula fracture at recipient site could prevent the fracture of grafted fibula to the tibia.

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Late-onset Brachial Artery Occlusion caused by Subclavian Artery Stenosis after Clavicular Fracture: A Case Report

  • 조철현;송광순;민병우;배기채
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2008년도 제16차 학술대회
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    • pp.175-175
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    • 2008
  • We report a rare case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture. When he referred to us, the right hand were pale and the radial and ulnar pulses at the wrist were absent. CT-angiogram showed compression of subclavian artery by excessive scar tissue beneath the fracture site and angiography revealed stenosis of subclavian artery with thrombus and complete obstruction of blood flow in the brachial artery with emboli. Therefore, we performed embolectomy. 2 years after operation, patient was essentially asymptomatic except mild pain after long standing elevation of arm. We recommend that minimal soft tissue dissection should be needed in the operative treatment of clavicular fracture, especially soft tissue beneath the clavicle should be protected maximally.

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Judet's strut를 사용한 늑골 고정술의 임상적 고찰 (Clinical Ewperiences of Rib Fixation Using Judet's Strut)

  • 김재련;임진수
    • Journal of Chest Surgery
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    • 제28권9호
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    • pp.847-850
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    • 1995
  • For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.

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내시경을 이용한 비강내 접근법과 속눈썹밑 절개를 동시에 이용한 안와내벽 재건술 (Two Portal Approach(Endoscopic Transnasal and Subciliary) in Medial Orbital Wall Fracture)

  • 장현;동은상;원창훈;윤을식
    • Archives of Plastic Surgery
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    • 제33권5호
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    • pp.552-556
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    • 2006
  • Purpose: As the use of computed tomographic scanning spread, the diagnosis of blow-out fractures of the medial orbital wall increased. Conventionally, the surgery of blow-out fractures in medial orbital wall was performed by various approaches with external incision or endoscopic approach. Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of the fracture site, blind dissection of the orbital wall, and difficulty in insertion of implant. In order to overcome these shortcomings, we explored the use of endoscopic transnasal approach together with subciliary approach. Methods: The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically, and the bone defect of medial orbital wall was reconstructed with $Medpor^{(R)}$ insertion via subciliary approach. This technique was applied to 13 patients who had medial orbital wall fracture. Results: The patients were followed-up for 3 to 24 months with an average of 9 months. The postoperative courses were satisfactory in all cases. Conclusion: The conjunction of endoscopic transnasal and subciliary approach technique seems to produce good results in medial orbital wall fracture.

춘천지역의 하악골 골절 양상 (A CLINICAL STUDY OF MANDIBLE FRACTURE FOR 10 YEARS AT CHUNCHEON CITY)

  • 김경수;강희인;길용갑;김재성;이영;서현수;홍순민;박준우
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권6호
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    • pp.519-525
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    • 2009
  • The population were increased by industrialization and urbanization of the modern society and social activities of the person were rapid increased too. Subsequently the number of motor vehicle accident, sports accident and industrial accident were increased, resulting in the number of oral and maxillofacial trauma were increased. Because of the mandible relatively protruded among the facial bone, the most frequent associated oral and maxillofacial injuries was mandible fracture in the trauma center setting. A clinical study on 411 patients with mandibular fracture who visited in Department of Oral and Maxillofacial Surgery, Chun-chon Sacred Heart Hospital during 10 years(1997-2006) was done by analysing sex, age, mode, fracture site and treatment method

연성파괴모델의 유한요소법을 이용한 하이드로포밍공정에의 성형한계 예측 (Prediction of Forming Limit in Hydroforming Processes by Using Finite Element Method and Ductile Fracture Criterion)

  • 김대환;뇌여평;강범수
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2000년도 춘계학술대회논문집A
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    • pp.230-235
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    • 2000
  • By using the finite element method, the Oyane's ductile fracture integral I was calculated from the histories of stress and strain according to every element and then the forming limit of hydroforming process could be evaluated. The fracture initiation site and the forming limit fer two typical hydroforming processes, tee extrusion and bumper rail under different forming conditions are predicted in this study. For tee extrusion hydroforming process, the pressure level has significant influence on the forming limit. When the expansion area is backed by a supporter and bulged, the process would be more stable and the possibility of bursting failure is reduced. For bumper rail, the ductile fracture integral I is not only affected by the process parameters, but also by the shape of preforming blank. Due to no axial feeding on the end side of the blank, the possibility of cracking in hydroforming of the bumper rail is influenced by the friction condition more strongly than that of the tee extrusion. All the simulation results show reasonable plastic deformation, and the applications of the method could be extended to a wide range of hydroforming processes.

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Minimally Invasive Plate Osteosynthesis of Radius-Ulna Fracture using Circular External Fixator in a Dog

  • Kwon, Yong-hwan;Kang, Jin-su;Kim, Young-ung;Cho, Hyoung-sun;Lee, Ki-chang;Kim, Nam-soo;Kim, Min-su
    • 한국임상수의학회지
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    • 제34권1호
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    • pp.47-49
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    • 2017
  • Fracture stabilization techniques continue to evolve and provide approaches that minimize the iatrogenic trauma associated with surgical procedures. Minimally invasive plate osteosynthesis (MIPO) is a recently described method of biological internal fixation performed by introducing a bone plate via small insertional incisions that are remote to the fracture site. Indirect reduction techniques can generally be utilized when performing MIPO. In this case report, we describe MIPO of a radius-ulna fracture by indirect reduction using circular external fixation for alignment and distraction in a dog.

PDMS 몰드 기반의 선택적 파단 위치 제어가 가능한 캡슐 제작 공정 개발 (Development of capsule fabrication process that can control selective fracture location based on PDMS mold)

  • 임태욱;성호;왕수러;호걸;정원석
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2022년도 봄 학술논문 발표대회
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    • pp.245-246
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    • 2022
  • Recently, research on the self-healing of concrete using bacteria has been actively conducted. The self-healing method using bacteria has a low self-healing rate and the surrounding environment of the fracture site is very important. A previous study to solve this problem involves the manufacture of capsules using 3D printing. Fracture position control was an important topic in 3D printing-based capsules. In this study, to compensate for the shortcomings of existing studies, a capsule capable of selective destruction location control was produced using PDMS-based molds that are not restricted by the environment. Resin capsules were prepared for each part using several molds and a bonding surface was arranged. In order to verify this on the bonding surface, fracture strength and wave unit values were analyzed through a three-way compression experiment. It can be seen that as the curing time increases, the deviation between samples decreases. In addition, through experiments, it was confirmed that the junction surface and wave unit values coincide in all three directions. It can be used for self-healing research using various solutions.

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사각 격자를 이용한 단열-다공암반내 분리 단열망 구축기법에 대한 연구 (A Study on the Constructing Discrete Fracture Network in Fractured-Porous Medium with Rectangular Grid)

  • 한지웅;황용수;강철형
    • 방사성폐기물학회지
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    • 제4권1호
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    • pp.9-15
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    • 2006
  • 결정질 암반에 위치한 가상의 방사성폐기물처분장에 대한 정확한 안전성 평가를 수행하기 위해서는 다공암반으로 대표되는 공학방벽 및 결정질 암반으로 대표되는 자연방벽을 모두 고려한 매질에서의 물질 거동 특성을 정확하게 모사하는 것이 중요하다. 본 논문에서는 단열-다공암반내 유동 및 물질전달의 정확한 해석을 위한 연결망 구축방법에 대하여 서술하였다. 실제 단열암반을 사실적으로 모사하기 위하여 단열 물성자료는 확률밀도함수를 이용하여 생성하였다. 2차원의 사각격자로 모사된 단열암반과 육면체로 모사된 다공암반간 교차선의 원활한 검색을 위하여 단열암반과 연결전 다공암반의 교차면에 가상의 단열암반을 추가적으로 도입하였다. 전체유동경로를 구성하기 저하여 생성된 단열들 간의 교차선을 효율적으로 검색할 수 있는 방법 및 단열암반 및 단열-다공암반간의 연결도를 신속히 확인하는 알고리즘을 제안하였다. 이러한 방법들은 추후 방사성폐기물처분장에서의 단열-다공 암반을 통한 핵종 이동 특성을 모사할 수 있는 수치코드 개발에 많은 도움을 줄 것으로 사료된다.

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