• 제목/요약/키워드: Fractures, Bone

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Delayed Reduction of Nasal Bone Fractures

  • Yoon, Han Young;Han, Dong Gil
    • 대한두개안면성형외과학회지
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    • 제17권2호
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    • pp.51-55
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    • 2016
  • Background: Nasal bone fractures are managed by closed reduction within the 2-week period, and are managed by secondary correction after this time. There is little literature on the delayed reduction for nasal bone fractures beyond the 2-week duration. We report our experience with nasal fractures, which were reduced beyond this period. Methods: A retrospective review was performed for all patients who had undergone closed reduction of isolated nasal bone fracture. Patients were included for having undergone reduction of nasal bone fractures at or more than 2 weeks after the injury. Medical records were reviewed for demographic information, injury mechanism, fracture type, delay in treatment, and cause for delay. Postoperative outcomes were evaluated using computed tomography images. Results: The review identified 10 patients. The average reduction time was 22.1 days. Five of patients underwent reduction between days 15 and 20, and the remaining five patients underwent reduction between days 21 and 41. The postoperative outcomes were excellent in 8 patients and good in 2 patients. Conclusion: Outcomes were superior for nasal fractures with displaced end plates and multiple fracture segments. Our study results appears to support delayed reduction of isolated nasal fractures in the presence of factors that delay bony reunion.

Long Bone Fractures in Raptors: 28 cases (2004-2007)

  • Yoon, Hun-Young;Fox, Derek B.;Jeong, Soon-Wuk
    • 한국임상수의학회지
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    • 제25권3호
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    • pp.215-217
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    • 2008
  • Medical records from the Veterinary Medical Teaching Hospital of the University of Missouri-Columbia from 2004 to 2007 were available for 28 raptors that underwent long bone fracture repair. There were 14 owls, 10 hawks, 2 vultures, 1 eagle, and 1 falcon. Mean body weight was 780 g (ranged from 150 to 1400 g) for 14 owls; 650 g (ranged from 150 to 1270 g) for 10 hawks; 1760 g (ranged from 1520 to 2000 g) for 2 vultures; 5000 g for 1 eagle; and 130 g for 1 falcon. Of all 28 fracture cases, 11 cases (39%) and 1 case (3%) were related to hit-by-car and shooting respectively. Physical examination revealed dehydration in 18 raptors (64%) and lethargy in 12 raptors (42%). Forty one long bone fractures were included in 28 cases. The radiographs revealed 13 ulnar fractures (32%), 12 humeral fractures (30%), 10 radial fractures (25%), 4 tibiotarsal fractures (9%), 1 femoral fracture (2%), and 1 fibular fracture (2%). External skeletal fixation using polymethylmethacrylate (PMMA) combined with intramedullary fixation was used in 19 long bone fractures (46%). Intramedullary fixation using intramedullary Kirschner pin was used in 16 long bone fractures (39%). No surgical treatment was performed in 6 long bone fractures (15%). This study reported that many of raptors presented dehydration and lethargy when admitted for treatment. Therefore, proper hydration and nutrition are critical pre-surgical requirements. In addition, combination of internal fixation and external skeletal fixation using PMMA might be better option to treat raptors with comminuted fracture that results from mostly trauma of hit-by-car.

Clinical characteristics of adolescent nasal bone fractures

  • Kim, Se Hun;Han, Dong Gil;Shim, Jeong Su;Lee, Yong Jig;Kim, Sung-Eun
    • 대한두개안면성형외과학회지
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    • 제23권1호
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    • pp.29-33
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    • 2022
  • Background: There have been many reports of nasal bone fractures in adults, but there are few clinical reports of them in adolescents, although adolescence is the main growth period of the nasal bone. In addition, previous studies have tended to classify and describe child and adolescent nasal fractures in the same category. The aim of this study was to identify the clinical aspects of nasal fractures in adolescents, and to evaluate the characteristics of nasal fractures in the growth period. Methods: Our institution's database was reviewed to extract data on adolescent patients between the age of 13 to 18 who had isolated nasal bone fractures from March 2012 to February 2020. The study excluded patients with other facial fractures, previous facial fractures, or congenital deformities. Results: This study included 243 boys and 26 girls. Interpersonal violence and sports-related accidents accounted for 85 and 79 cases, respectively. There were 128 frontal impact injuries and 132 lateral impact injuries, and 97 patients had accompanying septal fractures. An accompanying septal fracture was present in 36.06% of all patients, but in 51.20% of those who underwent surgery. Conclusion: The prevalence of adolescent nasal fractures was significantly higher in boys, to a greater extent than observed for pediatric or adult fractures. The main causes of fractures were interpersonal violence and sports-related accidents. An explanation for these results is that adolescent boys are more prone to have violent accidents or companionship with active sports than other age or sex groups, leading to substantially more fractures.

소아 환자의 코뼈 골절 진단을 위한 실제적 접근 (Practical Approach to the Diagnosis of Pediatric Nasal Bone Fractures)

  • 이율곡;오성찬;조석진;김혜진;강태경;최승운;유한빈;류석용
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.95-100
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    • 2014
  • Purpose: Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT). Methods: Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups. Results: A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray. Conclusion: Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.

Study on the Treatment of Fractures in Korean Native Calves: 52 Cases (2017-2020)

  • Kim, Hoon;Kang, Jinsu;Heo, Suyoung;Kim, Namsoo
    • 한국임상수의학회지
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    • 제39권4호
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    • pp.156-161
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    • 2022
  • The objective of the present study was to assess the prevalence, occurrence pattern, and clinical outcomes of transfixation pinning and casting (TPC) for fractures in Korean native calves, and to identify the advantages of the procedure. The study investigated 52 cases of bone fractures documented from January 2017 to December 2020. Hindlimb fractures (72%) were the most common in bone fractures (n = 50). The distribution of fractures was highest in the tibia (n = 15), followed by the metatarsal (n = 12), femur (n = 9), radius/ulna (n = 8), metacarpal (n = 3), humerus (n = 3), mandible (n = 1), and caudal vertebrae (n = 1). All cases were diagnosed via radiographic evaluation. Closed fractures (86%) were the most common, followed by open fractures (14%). Surgery was performed on 34 calves using intramedullary pin (IM pin), TPC, cross pin, flexible wire (F-wire), and/or plate fixation. The rest of the calves were treated with external coaptation (n = 12) or were not treated (n = 6). Subsequently, 24 calves with follow-up records were evaluated in the bone fracture cases (n = 50). Bone union was observed in 15 (62%) calves; 3 (12%) calves showed non-union; 4 (16%) calves were dead after surgery; and 2 (8%) calves were euthanized at the owner's request. Among the 24 follow-up surgery cases, the most successful cases were tibia fractures (75%) surgically treated using TPC and/or IM pin. These findings suggest that TPC surgery is effective in the management of fractures in Korean native calves.

골신티그라피의 3시간과 24시간 방사능 섭취비를 이용한 골 전이와 골절의 감별 (Differentiation of Bone Metastases and Fractures using 24 hour/3 hour Radio-uptake Ratio in Bone Scintigraphy)

  • 한송이;천경아;정용안;김성훈;김영주;정수교;박석희
    • 대한핵의학회지
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    • 제33권6호
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    • pp.512-518
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    • 1999
  • 목적: 3시간과 24시간 골신티그라피 영상에서 골전이와 급성 및 치유기 골절을 감별하는데 병변/비병변 방사능 섭취비의 24시간/3시간 비율(24 hour/3 hour radio-uptake ratio: 24/3 RUR)이 유용한지 알아보고자 하였다. 대상 및 방법: 총 63명($26{\sim}81$세, 남자 32명, 여자 31명)외 90개 병변(골 전이 30예, 외상 2개월 이내의 급성 골절 30예, 외상 2개월 이상의 치유기 골절 30예)을 대상으로 하였으며 골신티그라피는 $^{99m}Tc$-MDP 740 MBq를 정맥 주사하고 시간과 24시간 후에 영상을 얻었다. 각각의 영상에서 병변과, 인접한 정상 부위의 방사능 섭취비를 측정하여 24시간/3시간 비율(24/3 RUR: [lesion/non-lesion RUR at 24 hour]/[lesion/nonlesion RUR at 3 hour])을 구하여 세 질환을 감별하는데 의의가 있는 지를 분석하였다. 결과: 24/3 RUR의 평균치는 골전이 $1.22{\pm}0.18$, 급성 골절 $1.25{\pm}0.14$, 치유기 골절 $0.99{\pm}0.15$였으며 골 전이와 급성 골절의 24/3 RUR은 유의한 차이가 없었고 골 전이와 치유기 골절, 그리고 급성 골절과 치유기 골절간에는 유의한 차이가 있었다(p<0.001). 24/3 RUR 기준점을 1.0 이상인 경우 골 전이로 진단할 때 민감도는 100% (30/30)였고, 골 전이를 급성 골절로부터 구분하는 소견으로서 특이도는 0% (0/30), 골 전이를 치유기 골절로부터 구분하는 소견으로서 특이도는 47% (14/30)였다. 또한 기준점을 1.2로 설정했을 때는 골전이로 진단하는 소견으로서 민감도 53% (16/30), 골 전이를 급성골절로부터 구분하는 소견으로서 특이도 37% (l1/30), 골 전이를 치유기 골절로부터 구분하는 소견으로서 특이도 100% (30/30)였다. 결론: 24/3 RUR은 골 전이와 치유기 골절을 감별하는데 유용했으나 골 전이와 급성 골절의 감별에는 도움이 되지 않았다. 24/3 RUR이 1.0 미만인 경우는 치유기 골절을, 1.2 이상인 경우는 골 전이나 급성 골절을 시사하는 소견으로 생각된다.

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응급실을 내원한 구강악안면외과 안면골 골절 환자의 변화에 대한 비교 연구 (A COMPARATIVE STUDY ON ALTERATIONS OF FACIAL BONE FRACTURE PATIENTS VISITING PUSAN UNIV.-HOSPITAL EMERGENCY CENTER)

  • 이정훈;김용덕;신상훈;김욱규;김종렬;정인교
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권2호
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    • pp.171-176
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    • 2005
  • Although there have been many clinical studies about the facial trauma in the recent as well as in the past, severity and frequency of facial trauma are reported multifarious. It seemed to be because of variety of social, cultural, and environmental factors, and the view point of investigators. In this study, we investigated about the patients visiting emergency room during recent 5 years(1999-2003), and compared with retrospective study during former 5 years(1992-1996) in Dept. OMS Pusan Univ-Hospital. We are assessed the cause, type, demographic ect. And analyzed alterations of facial bone fractures during past 2 periods. the results were as follows. The total number of patients was increased slightly. 429 patients treated for maxillofacial fractures between January 1992 and December 1996 and 466 patients treated between January 1992 and December 1996. The male-to-female ratio reduced in the second period by a factor of 0.7. Patients in the age groups of 10-19 years and 20-29 years increased by a factor of 4.2 and 7.9 in the second period. Assaults and falls in the second period decreased by a factor of 15.4 and 7.9. But, traffic accidents and slip downs in the second period increased by a factor of 6 and 6.6. The mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%), and nasal bone fractures(4.0%). In the second period, the mid-face fracture was increased slightly. So, the mandibular fractures(69.0%) followed by maxillary bone fractures(12.9%), zygomatic bone and arch fractures(8.0%), nasal bone fractures(7.0%). Ramus fractures and body fractures of mandible was increased slightly in the second period.

Osteoporosis and Osteoporotic Fractures in Gastrointestinal Disease

  • Oh, Hyun Jin;Ryu, Kum Hei;Park, Bum Joon;Yoon, Byung-Ho
    • 대한골대사학회지
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    • 제25권4호
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    • pp.213-217
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    • 2018
  • Patients with gastrointestinal disease (GI) are at risk for osteopenia or osteoporosis, which can lead to fractures. Although these patients may be at risk from a young age, gastroenterologists often overlook this fact in practice. There are well-known GI diseases associated with osteopenia and osteoporosis, such as the post-gastrectomy state, inflammatory bowel disease (IBD), and celiac disease. As there is an increase in the prevalence of IBD patients, newly diagnosed celiac disease in adulthood, and gastric cancer survivors following gastrectomy, bone disease in these patients becomes an important issue. Here, we have discussed osteoporosis and fractures in GI disease, especially in the postgastrectomy state, IBD, and celiac disease. Although the pathogenesis of bone loss in each disease has not been fully identified, we have confirmed that the prevalence of osteoporosis and fractures in each of these diseases is high. There are scarce studies comparing the prevalence of osteoporosis or osteoporotic fractures in GI disease patients with studies in postmenopausal women, and specific guidelines for their management in each disease have not been established. Intensive surveillance and management are needed to ensure that these patients attain peak bone mass for age and sex to prevent fractures.

골다공증성 족관절 골절 (Osteoporotic Ankle Fracture)

  • 이효범;김철현;김갑래
    • 대한족부족관절학회지
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    • 제27권2호
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    • pp.43-48
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    • 2023
  • The incidence of osteoporotic ankle fractures is increasing as the population ages. These fractures are becoming more common in clinical practice and require careful management because of the higher likelihood of developing complications than typical ankle fractures. The introduction of a method for measuring the ankle joint bone mineral density is a valuable tool for assessing the bone quality of the ankle joint. By evaluating the bone mineral density, healthcare professionals can better understand the extent of osteoporosis and the overall strength of the ankle joint. This information is crucial for determining the appropriate treatment for individual fractures. Several factors must be considered when deciding on the treatment for osteoporotic ankle fractures. These include the ankle joint bone mineral density, skin condition, any comorbidities the patient may have, and the patient's functional demands. Taking these factors into consideration allows healthcare providers to tailor the treatment plan to the specific needs and the circumstances of each patient. By applying the appropriate treatment, it is expected that the complications associated with osteoporotic ankle fractures can be minimized, and the prognosis for patients can be improved.

Zygomaticomaxillary buttress and its dilemma

  • Malaviya, Pallavi;Choudhary, Sandeep
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제44권4호
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    • pp.151-158
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    • 2018
  • Zygomatic fractures are the second most common fractures of the facial skeleton, after nasal bone fractures. Due to its uniqueness, the malar bone plays a very important role in maintaining appropriate facial contours. Zygomatic fractures can cause ocular and mandibular functional impairment, along with cosmetic defects. With the help of advanced imaging techniques and various treatment options, the management of zygomatic fractures has become more sophisticated and less invasive. This article discusses zygomatic fractures in detail: their clinical and radiographic features, and the various treatment options available.