• Archives of Plastic Surgery
• /
• v.33 no.4
• /
• pp.440-444
• /
• 2006

Purpose: The nasal bone fracture is the most common type of facial bone fracture. In making a diagnosis, physical findings are much more important than the simple radiologic findings. Facial bone CAT scan can provide the accurate diagnosis and the correct location of nasal bone fractures, so it can be lessoned with proper intervention. The aim of this study was to evaluate the usefulness of facial bone CAT scan in the diagnosis of nasal bone fractures. Methods: The medical records and facial bone CAT scan of 45 patients clinically suspected nasal bone fracture but was not diagnosed on simple radiologic findings were analyzed. Results: All of the 45 patients were confirmed as nasal bone fractures in the facial bone CAT scan. The most common cause of fracture was assault. The mean age was 23.2 years. Physical findings were tenderness (100%), swelling(93.3%), epistaxis(66.6%), deviation (42.2 %), external wound(17.7%) and crepitus(4.4%) in order. Conclusions: It was concluded that the simple radiologic findings can not be conclusive, where the physical findings indicate a suspected nasal bone fracture. The facial bone CAT scan was more reliable for the correct diagnosis and follow-on treatment.

• Journal of Trauma and Injury
• /
• v.19 no.1
• /
• pp.28-34
• /
• 2006

Purpose: In maxillofacial surgery, proper preoperative diagnosis is very important in achieving good postoperative results. Although conventional CT scans are useful for visual representations of fractures, they cannot provide direct guidance for reconstructing facial bone fractures. However, the recent technology of multislice scanning has brought many clinical benefits to CT images. Direct correlations can be made between preoperative imaging data and operative planning. The aim of the current study is to evaluate the differences between conventional CT and multidetective three-dimensional CT(3D MDCT) measurements in craniofacial deformities. Methods: From January 2005 to November 2005, MDCT scans of 41 patients were evaluated by comparing them with conventional CT scans. The 3D MDCT images were assessed and reviewed by using a simple scoring system. Results: The 3D MDCT scans offered easy interpretation, facilitated surgical planning, and clarified postoperative results in malar complex fractures, mandibular fractures, and extensive maxillofacial fractures and cranioplasty. However, 3D MDCT images were not superior to conventional CT scans in the diagnosis of blowout fractures. Conclusion: In spite of its limitations, the 3D MDCT provided additional and more comprehensive information than the conventional CT for preoperative assessment of craniofacial deformities. Therefore, the 3D MDCT can be a useful tool for diagnosis and systematic treatment planning in craniofacial skeletal deformities.

• Archives of Plastic Surgery
• /
• v.38 no.3
• /
• pp.263-272
• /
• 2011

Purpose: The human face is the most exposed part of the body, and in patients with simple or complex trauma from traffic accidents, industrial calamities, sports injuries, human assaults, and daily accidents, facial trauma occupies an important portion. The etiology of facial trauma vary on a society's economic, cultural, and environmental status. Methods: Regarding patients who were admitted from between the years 2000 to 2009 at the Hanyang University hospital, the authors studied how the changes in the economic status in the past 10 years of our country influences the incidence of facial bone fractures. Results: In this study, 1) The unemployment rate showed a strong negative relationship with the total number of inpatients with facial bone fractures, the number of male patients, the number of female patients, the number of patients with facial bone fractures caused by fall down, the number of patients who were admitted for shorter than 7 days, and the number of the facial bone fracture patients with their age in the twenties. 2) The consumer price index showed a strong positive relationship with the number of female patients, the number of patients who were admitted for shorter than 7 days, and the number of the facial bone fracture patients with their age in the teens and fifties. Conclusion: Looking at the results of correlation analysis and multiple regression analysis with economic indicators, the unemployment rate showed negative influence to the total number of inpatients with facial bone fractures, and the number of inpatients with facial bone fractures caused by fall down, with statistical significance.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.11 no.2
• /
• pp.1-10
• /
• 1989

The major causes of the facial bone fractures are fractures are automobile collision or other accident, and fights. Of the facial bone fractures, the nasal bone fractures are monst common. According to Schroeder et al., 50% of facial bone fractures are isolated fractures of the nasal pyramid. But the fractured nasal bone is not immediately treated as other facial bone fractures. And it is necessary to delay the treatment of the combined nasal bone fractures with other jaw bone fractures because of the difficult anesthetic techniques. Therefore there are many residual nasal deformities following a fracture; nasal hump, saddle nose and alar rim defect. Many authors have suggested the methods to correct the post-traumatic nasal deformities. We have treated several patients with several methods and this paper presents the operating methods and results.

• Journal of Veterinary Clinics
• /
• v.20 no.1
• /
• pp.138-141
• /
• 2003

First case, a one-year-old female Shih Tzu weighing 3 kg with closed transverse fractures of bilateral mandibular body between 2nd and 3rd premolar teeth were treated surgically with bone plates and screws, and cranial luxation of temporomandibular joints were reduced to closed method. Second case, a 8.4 years old male Yorkshire terrier weighing 2.6 kg with closed transverse/oblique fractures of bilateral mandibular body between premolar and molar teeth were treated surgically with bone plates and screws. Radiographic examination revealed that the fractures in two cases fixed well and temporomandibular joint was stabilized. One month after operation, jaw activity was excellent and malocclusion wasn't observed.

• Journal of Trauma and Injury
• /
• v.18 no.2
• /
• pp.87-93
• /
• 2005

Background: The most frequent fracture seen at the emergency department (ED) in the elderly is a femur fracture whereas they do not know the degree of osteoporosis. We analyzed the degree of osteoporosis in patients with femur fractures and compared patients with only femur fractures (FX) to patients with femur and vertebral fractures (VX) by examining the clinical features, the bone mineral density (BMD), and biochemical markers. Methods: From January 2004 to December 2004, we enrolled prospectively 30 femur fracture patients who visited the ED. The bone mineral densities of the lumbar spine and the femur were examined. Total calcium, phosphate, alkaline phosphatase, osteocalcin, and serum C-terminal telopeptide (s-CTx) were measured. The patients with femur fractures were divided into two subgroups according to the presence of vertebral fracture. Results: All BMDs of the FX group showed osteoporosis. The s-CTx levels were higher than normal. The patients in the FX with VX were older than those in the FX only group, and had lower BMDs. There were no significant differences in markers between the subgroups, but the incidence of trochanteric fractures was higher in FX with VX group than in the FX only group. Conclusion: Femur fractures in the elderly were associated with osteoporosis. In our study, despite a considerable difference in BMD between patients with femur fractures and those with femur fractures combined with vertebral fractures, there was no difference in biochemical markers on bone formation nor in the those of bone resorption. We will further investigate the biochemical markers and BMD in the population of osteoporotic fractures. So those indicators should be helpful for planning treatment and for prevention of FX in the elderly.

• Advances in biomechanics and applications
• /
• v.1 no.3
• /
• pp.211-225
• /
• 2014

The usual assumption that the increase of fractures in aging bone is due entirely to lower bone density is taken back with respect to the possibility that aging bone fractures result from a loss of stability, or buckling, in the structure of the bone lattice. Buckling is an instability mode that becomes likely in end-loaded structures when they become too slender and lose lateral support. The relative importance of bone density and architecture in etiology bone fractures are poorly understood and the need for improved mechanistic understanding of bone failure is at the core of important clinical problems such as osteoporosis, as well as basic biological issues such as bone formation and adaptation. These observations motivated the present work in which simplified adaptive-beam buckling model is formulated within the context of the adaptive elasticity (Cowin and Hegedus 1976, Hegedus and Cowin 1976). Our results indicate that bone loss activation process leads systematically to the apparition of new elastic instabilities that can conduct to bone-buckling mechanism of fracture.

• YAKHAK HOEJI
• /
• v.53 no.4
• /
• pp.206-216
• /
• 2009

3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (Statins) are potent inhibitors of cholesterol biosynthesis. Cholesterol-lowering therapy using statins significantly reduces the risk of coronary heart disease. Various discovery of statins as bone anabolic agents has spurred a great deal of interest among both basic and clinical bone researchers. In-vitro and some animal studies suggest that statins increase the bone mass by enhancing bone morphogenetic protein-2 (BMP-2)-mediated osteoblast expression. Clinical and animal test results of statins focusing on the prevention and treatment of bone fractures was collected. Three independent literature searches were performed by using from January 1, 2002 to September 2008 for clinical and animal test results. Search term included statins, HMG-CoA reductase inhibitors, pleiotropic effects, fracture, osteoporosis and clinical and animal test. No consensus has been reached whether clinical use of statins has beneficial effects on bone health, partly due to lower statin concentrations because of first-pass metabolism by the liver. Experimental use of statins as stimulators of bone formation suggests that they may have widespread applicability in the field of orthopaedics. With their combined effects on osteoblasts and osteoclasts, statins have the potential to enhance resorption of synthetic materials and improve bone ingrowth. In conclusion, The use of statins in the prevention and treatment of bone fractures requires further study. But observational studies suggest that statins for decreasing bone fractures including osteoporosis have to be considered local direct administration like transdermal or subcutaneous type over oral adminstration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.1
• /
• pp.43-52
• /
• 2010

Purpose: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. Materials and methods: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. Conclusion: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.

• Archives of Craniofacial Surgery
• /
• v.14 no.2
• /
• pp.89-95
• /
• 2013

Background: If patients have a better understanding about their problem and treatment, compliance and satisfaction with treatment will increase. For this purpose, simple repeated explanations regarding a patients' problem and treatment are essential. Critical pathway (CP) has a very wide range in medicine with the exception of the plastic surgery field. The authors developed a CP for facial bone fractures and implemented it clinically. The aim of this study was to evaluate the effectiveness of the CP on the degree of recognition of the problem along with patient satisfaction with the treatment process. Methods: From May 2011 to October 2011, a total of 82 patients suffering from facial bone fractures were studied. The CP for facial bone fractures was developed by plastic surgeons, residents and nurses. Subsequently, the authors investigated the degree of recognition of the disease and patient satisfaction with the treatment through the use of a questionnaire. The authors compared the score of the questionnaires before and after implementation of the clinical pathway. Results: The degree of the recognition of the problem changed from 3.1 to 4.2 (p<0.001). Further, the degree of satisfaction with the treatment process changed from 3.6 to 4.3 (p<0.05). Overall, there was a two point increase in improvement. Conclusion: Implementation of the CP for facial bone fractures was effective in improving the degree of recognition and satisfaction. The authors expect that hereafter, the CP for facial bone fractures will be implemented actively in the plastic surgery field.