• 제목/요약/키워드: Fracture reduction

검색결과 1,064건 처리시간 0.039초

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

  • Son, Kyung-Min;Yang, Jeong-Yeol;Kim, Gyu-Bo;Han, Yun-Ju;Cheon, Ji-Seon
    • Archives of Plastic Surgery
    • /
    • 제38권5호
    • /
    • pp.602-608
    • /
    • 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.

Evaluation of postoperative complications according to treatment of third molars in mandibular angle fracture

  • Lim, Hye-Youn;Jung, Tae-Young;Park, Sang-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제43권1호
    • /
    • pp.37-41
    • /
    • 2017
  • Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

Fractures of the dog in Taegu area (대구지방에서 발생한 개의 골절)

  • 김대영;장인호
    • Journal of Veterinary Clinics
    • /
    • 제15권1호
    • /
    • pp.222-227
    • /
    • 1998
  • This survey was based on the data of one hundred four dogs with 108 case,T of fracture admitted to the veterinary teaching hospital, College of Veterinary Medicine, Kyungpook National University and 24 private small animal hospitals from January, 1995 to Decemberi 1996. The results were analyzed as following criteria; the distribution of fractures causes of fractured age and sexual distributions month of the most frequencel total body weights presence of communicating external wound, extent of damaged direction of fracture line, location of fracture liner fracture managements fixations methods, fixations methods according to location of fracture. The results of survey were as follow: 1. Main distribution of fracture; radius . ulna (23.1%).2. Causes of fracture; road toraffic accident (39.4 T,). 3. Age; over 24 months (27.9%). 4. Sex; male (53.89)), female (46.2%). 5. Month of the most frequence; July (14.4%) 6. Total body weight: 2-5 kg (45.27)). 7. Presence of communicating external wound; closed fracture (94.2%). 8. Extent of damage; complete fracture (92.6%). 9. Direction of fracture line: comminuted fracture (27.8 To). 10. Location of fracture line; diaphysis (62.0%). 11. Fracture management; open reduction (58.3% ). 12. Fixation methods; not treat (22.2%). 13. Fixation methods according to location of fracture; radius ulna-Kirschner wire fixation (45.5%), femur. shaft-intramedullary pinning (71.4%), pelvis-bone plate (53.3%), metacarpus-not treat, Kirschner wire fixation (each 30.8%).

  • PDF

Botulinum toxin as adjunct therapy in surgical management of a periprosthetic scapular spine fracture: a case report

  • Alex E. White;Christopher M. Brusalis;David S. Wellman;Samuel A. Taylor
    • Clinics in Shoulder and Elbow
    • /
    • 제26권1호
    • /
    • pp.87-92
    • /
    • 2023
  • Six months after undergoing reverse shoulder arthroplasty (RSA) a 73-year-old woman sustained a periprosthetic scapular spine fracture following a fall. She was treated with open reduction and internal fixation (ORIF), followed by botulinum toxin injection into the deltoid muscle to temporarily minimize strain at the fracture. Fracture union was achieved by 3 months, with excellent clinical function more than 1 year following fracture fixation and full resolution of deltoid function. Scapular spine fracture following RSA can be treated with ORIF and temporary deltoid paralysis using botulinum toxin in the immediate postoperative period to safely support fracture healing.

Subbrow Approach as a Minimally Invasive Reduction Technique in the Management of Frontal Sinus Fractures

  • Lee, Yewon;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Plastic Surgery
    • /
    • 제41권6호
    • /
    • pp.679-685
    • /
    • 2014
  • Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

Parameter calibrations and application of micromechanical fracture models of structural steels

  • Liao, Fangfang;Wang, Wei;Chen, Yiyi
    • Structural Engineering and Mechanics
    • /
    • 제42권2호
    • /
    • pp.153-174
    • /
    • 2012
  • Micromechanical facture models can be used to predict ductile fracture in steel structures. In order to calibrate the parameters in the micromechanical models for the largely used Q345 steel in China, uniaxial tensile tests, smooth notched tensile tests, cyclic notched bar tests, scanning electron microscope tests and finite element analyses were conducted in this paper. The test specimens were made from base metal, deposit metal and heat affected zone of Q345 steel to investigate crack initiation in welded steel connections. The calibrated parameters for the three different locations of Q345 steel were compared with that of the other seven varieties of structural steels. It indicates that the toughness index parameters in the stress modified critical strain (SMCS) model and the void growth model (VGM) are connected with ductility of the material but have no correlation with the yield strength, ultimate strength or the ratio of ultimate strength to yield strength. While the damage degraded parameters in the degraded significant plastic strain (DSPS) model and the cyclic void growth model (CVGM) and the characteristic length parameter are irrelevant with any properties of the material. The results of this paper can be applied to predict ductile fracture in welded steel connections.

Surgical Treatment of Using Acutrak Screw for Ankle Medial Malleolar Fracture (Acutrak 나사를 이용한 족관절 내과 골절의 치료)

  • Kim, Kwang-Yeol;Kim, Hyoung-Cheon;Ahn, Su-Han;Yun, Hyoung-Jo;Cho, Sung-Jun
    • Journal of Korean Foot and Ankle Society
    • /
    • 제14권1호
    • /
    • pp.84-89
    • /
    • 2010
  • Purpose: The purpose of this study is to evaluate the clinical and radiologic results of using Acutrak screws for treating ankle medial malleolar fracture. Materials and Methods: We reviewed 38 cases of ankle medial malleolar fracture treated with Acutrak screws from February 2005 to May 2008. Results: In clinical result, there were 30 exellent cases, 7 good cases, 1 fair case. In radiologic result, there is no case with reduction loss. Average union time is 10.5 weeks. Conclusion: We conclude that Acutrak screw fixation is a useful method for ankle medial malleolar fracture, there are many advantages in accurate anatomical reduction, small incision, short operative time.

Modified Extracorporeal Reduction of the Mandibular Condylar Neck Fracture

  • Kim, Min-Keun;Kwon, Kwang-Jun;Kim, Seong-Gon;Park, Young-Wook;Kim, Jwa-Young;Kweon, Hae-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제36권1호
    • /
    • pp.30-36
    • /
    • 2014
  • There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.

Arthroscopic-assisted Reduction and Percutaneous Screw Fixation for Glenoid Fracture with Scapular Extension

  • Kim, Se Jin;Lee, Sung Hyun;Jung, Dae Woong;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
    • /
    • 제20권3호
    • /
    • pp.147-152
    • /
    • 2017
  • Background: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. Methods: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. Results: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. Conclusions: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.

Risk Factors in Stability after Immobilization of the Distal Radius in Unstable Fractures in Children (소아 요골 원위부 불안정 골절의 캐스트 후 안정성에 영향을 미치는 요소)

  • Shin, Yong-Woon;Sohn, Jong Min;Park, Sang-Yoon
    • Journal of the Korean Orthopaedic Association
    • /
    • 제56권3호
    • /
    • pp.215-223
    • /
    • 2021
  • Purpose: Distal radius fractures in youth are treated conservatively in most cases, but there are some cases of redisplacement in the follow-up period after cast immobilization, even after complete reduction. This study examined the risk factors of redisplacement in reduced unstable distal radius fractures. Materials and Methods: From February 2011 to June 2018, 44 unstable distal radius fractures were managed with a closed reduction and cast immobilization. The patients were aged between 6 and 14 years. The cases of redisplacement were analyzed with the fracture characteristics (fracture obliquity, fracture level ratio, ulnar fracture combined), cast qualities (gap index, cast index, 3 point index, and radius-2nd metacarpal angle) and host factors (age, sex). Results: The mean angulation in the union was 9.2° (0°-32.8°). In the categorical grouping 29 cases were within 10° angulation, and 15 cases were more than 10°. No significant differences in the factors of the cast indices or host factors were noted. The meaningful factor was the fracture level calculated by the relative width of the fracture site divided by the sum of width of diaphysis and epiphysis (p=0.001) and combined ulnar fracture (p=0.019). Conclusion: Unstable distal radius fractures should be treated with more stubborn guidelines lest the fracture loses its anatomical alignment. In particular, in patients with less remodeling power, operative treatment would secure a better result if the fracture occurs in a more proximal location.