• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권3호
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• pp.144-150
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• 2016

Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P -value less than 0.05 was considered significant. Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권2호
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• pp.177-182
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• 2005

Malocclusion can be often found after improper reduction of facial bone fractures, especially by the plastic surgeon or other medical doctor. This causes lots of problem in esthetics, mastication, or facial symmetry. We present four cases which are related above problems. These were well treated by orthognathic surgery or orthodontic treatment.

• 대한족부족관절학회지
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• 제13권1호
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• pp.91-94
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• 2009

Metatarsal head and neck fractures are injuries that often result from a direct blow of a heavy objects to the metatarsal head. The head is often impacted or displaced to the plantar aspect that if not treated may cause malunion which later induces painful plantar calluses. If the fracture fragment is large enough, closed reduction may be successfully performed, but when the fragment is small or closed reduction is unsuccessful, open reduction is needed. We present our reduction and fixation technique for the metatarsal head and neck fractures using antegrade intramedullary Kirschner wire (K-wire) without opening the fracture site or infringing the metatarsophalangeal (MTP) joint which allows immediate motion of the joint and partial weight bearing in a stiff soled shoe.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.264-270
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• 2009

목적: 주관절은 인체에서 가장 안정적인 관절 중 하나지만, 견관절 다음으로 탈구와 골절이 흔히 발생한다. 이러한 손상은 발생 당시 기전과 환자의 나이 그리고 충격에 따라 다양하게 나타나는데 적절한 치료에도 불구하고 여러 가지 합병증들이 발생 가능하다. 이에 저자들은 외상후 합병증을 고찰하고자 한다. 대상 및 방법: 저자들은 일반적인 주관절 탈구의 합병증인 관절 운동제한, 불안정성, 그리고 관절 주위 이소성 골형성의 원인과 치료 등에 대해 기술하였다. 결과 및 결론: 주관절 주위 골절 이후 발생 가능한 합병증 중 부정유합, 불유합, 외상성 관절염 등에 대한 그 기전과 치료에 대해 기술하고자 한다.

• 대한족부족관절학회지
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• 제26권3호
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• pp.143-147
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• 2022

Past research has reported that the common causes of ankle arthritis include trauma, congenital deformity, and degeneration. Among them, fracture-induced post-traumatic arthritis is most common. For patients with ankle fractures, an anatomical reduction is performed through surgical treatment. However, insufficient reduction or malunion of the fracture site may change the alignment of the ankle joint, resulting in valgus or varus deformities. Currently, most operative options for valgus arthritis aim to either restore joint alignment and/or reduce the uneven load on the cartilage. In this report, we would like to share our clinical experience of a patient with posttraumatic valgus ankle arthritis caused by severely comminuted fracture and dislocation. A satisfactory outcome could be obtained with combined fibular lengthening osteotomy and medial displacement calcaneal osteotomy.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.67-71
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• 2024

Clavicle fractures are frequent injuries accounting for approximately 4% of all fractures in adults with about 35% occurring in the shoulder region among which midshaft fractures are the most common (>66%). Nonsurgical management is the treatment of choice for most clavicle fractures; however, poor functional and aesthetic outcomes may result from nonunion, symptomatic malunion, and aesthetic impairment which are the most common complications. A young woman was referred to our clinic for a "Step Deformity" resulting after primary, nonsurgical treatment of a midshaft clavicle fracture. Residual deformity was corrected with a novel simple and little invasive approach. Midshaft clavicle fractures typically only require conservative nonsurgical treatment, nevertheless suboptimal outcomes may occur. Selective osteotomies and fixation are deemed too invasive when only cosmetic impairment of the clavicle contour is present without any functional or sensitive damage and most patients are discouraged from undergoing surgery. Thus far, no specific focus on this topic, nor exploration of possible correction can be found in the published literature. These residual deformities may be very noticeable sometimes and cause psychological distress and social life impairment. Despite no related functional impairment, this deformity should still be addressed, to improve patients' quality of life.

• 대한족부족관절학회지
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• 제13권2호
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• pp.162-168
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• 2009

Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권6호
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• pp.559-564
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• 2006

According to the development of operation technique and biologic materials, oromaxillofacial surgery department have used many kinds of metal and biologic materials in ORIF and plastic surgery. In maxillofacial fracture, ORIF with metal plate and screw have short healing period and good prognosis. But ORIF with metal materials have many complications as maxillofacial abnormal growth, screw loosening, bone malunion. And metal materials have not used in infection site. The purpose of this study is to evaluate the clinical value of 10 condylar fracture patients operated with absorbable screw at Wonkwang university. Ten patients(8 males, 2 female, mean aged 28) who had mandibular condyle process fracture treated with PLLA implants(poly-l-lactide) was recalled for follow-up clinical and radiologic examination for 10 years. Mouth opening recorvered to more than 35mm and occlusion was stable in all patients. All fractured mandibular condyles showed anatomic good reduction and long-term stability with the use of resorbable miniplates and screw. Bone healing was satisfactory in all patients, and there was no evidence of abnormal resorption of condylar process.

• Clinics in Shoulder and Elbow
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• 제15권1호
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• pp.43-51
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• 2012

목적: 쇄골 골절의 치료에 관한 광범위한 자료 검토를 통해 현 시점에서의 적절한 쇄골 골절 치료방법을 찾고자 한다. 대상 및 방법: 성인에서 발생한 쇄골 골절과 관련된 전반적인 내용, 즉 쇄골 골절의 역학, 분류, 수술 적응증, 최근 도입된 치료 방법의 현황 및 결과를 문헌 고찰을 통해 정리하였다. 또한, 쇄골 중간 부위 골절의 수술 적응증의 확대와, 새로운 치료법의 하나로 주목받고 있는 anatomically precontoured plate의 도입을 비롯한 최신 지견에 대해 살펴보았다. 결과 및 결론: 지금까지 쇄골 골절은 비수술적 방법으로 대부분 치료되어 왔다. 하지만 최근 들어 기존에 추산되었던 것 보다 많은 수의 불유합, 부정유합 발생이 보고되면서 수술적 치료의 적응증이 점점 확대되는 추세이다. 하지만 아직까지는 쇄골 골절에 대한 이상적인 치료 방침이 확립되지 않았음을 고려할 때, 환자 개개인의 임상 정보와 선호도를 세심히 고려한 맞춤형 치료가 이루어져야 하겠다.

• 대한족부족관절학회지
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• 제5권1호
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• pp.23-27
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• 2001

It has been known that the ankle arthrodesis is a common surgical procedure for treating the ankle arthrosis and deformity that do not respond to the non-operative treatment. To date, various surgical techniques for the ankle arthrodesis have been reported. Clinical and biomechanical trials have shown that the rigid internal fixation leads the increased rate of the union. The ankle arthrodesis may be complicated with the nonunion, delayed union, malunion, and infection. In cases of the Charcot joint of the ankle in diabetic patients, however, arthrodesis could reduce the disadvantage of the nonoperative treatment, such as the loss of the reduction, progressive collapse, multiple ulcerations and infection. The object of this case report is to report our experience of a successful ankle arthrodesis using an anterior T plate in treating the unstable ankle of a diabetic patient, associated with the ankle fracture and the neuropathy. The surgical approach of this technique is simple so that it would allow less soft tissue injury, and this procedure would be regarded as one alternative to provide the rigid internal fixation in the ankle arthrodesis.