• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.254-259
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• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• Archives of Craniofacial Surgery
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• v.22 no.4
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• pp.193-198
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• 2021

Background: Nasal bone fractures are frequently encountered in clinical practice. Although fracture reduction is simple and correction requires a short operative time, low patient satisfaction and relatively high complication rates remain issues for many surgeons. These challenges may result from inaccuracies in fracture recognition and assessment or inappropriate surgical planning. Findings from immediate postoperative computed tomography (CT) scans and those performed at 4 to 6 weeks postoperatively were compared to evaluate the accuracy and outcomes of nasal fracture reduction. Methods: This retrospective study included patients diagnosed with nasal bone fractures at our department who underwent closed reduction surgery. Patients who did not undergo additional CT scans were excluded from the study. Clinical examinations, patient records, and radiographic images were evaluated in 20 patients with nasal bone fractures. Results: CT findings from immediately after surgery and a 1month follow-up were compared in 20 patients. Satisfactory nasal projection and aesthetically acceptable results were observed in patients with accurate correction or mild overcorrection, while undercorrection was associated with unfavorable results. Conclusion: Closed reduction surgery for correcting nasal bone fractures usually provides acceptable outcomes with relatively few complications. If available, immediate postoperative CT scans are recommended to guide surgeons in the choice of whether to perform secondary adjustments if the initial results are unsatisfactory. Based on photogrammetric data, nasal bone reduction with accurate correction or mild overcorrection achieved acceptable and stable outcomes at 1 month postoperatively. Therefore, when upward dislocation is observed on postoperative CT, one can simply observe without a subsequent intervention.

• Journal of Yeungnam Medical Science
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• v.25 no.1
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• pp.19-30
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• 2008

Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and fracture risk, is a major public health problem. The diagnostic methods for osteoporosis include simple radiography, bone scan, DXA (Dual energy X-ray Absortiometry) and biochemical markers of bone turnover. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women and in osteoporotic men as well. Risedronate is more potent and has fewer side effects than alendronate and reduces the incidence of fractures in osteoporotic women. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide and strontium increase bone formation and are effective in the treatment of osteoporotic women and men. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodeling increases, although issues of tissue specificity may remain to be addressed.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.91-96
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• 2009

Purpose: Frontal sinus fractures are relatively less common than other facial bone fractures. They are commonly concomitant with other facial bone fractures. They can cause severe complications but the optimal treatment of frontal sinus fractures remains controversial. Currently, many principles of treatment were introduced variously. The authors present valid and simplified protocols of treatment for frontal sinus fractures based on fracture pattern, nasofrontal duct injury, and complications. Methods: A retrospective chart review was performed on 36 cases of frontal sinus fractures between January, 2004 and January, 2009. The average age of patients was 33.7 years. Fracture patterns were classified by displacement of anterior and posterior wall, comminution, nasofrontal duct injury. These fractures were classified in 4 groups: I. anterior wall linear fractures; II. anterior wall displaced fractures; III. anterior wall displaced and posterior wall linear fractures; IV. anterior wall and posterior wall displaced fractures. Also, assessment of nasofrontal duct injury was conducted with preoperative coronal section computed tomographic scan and intraoperative findings. Patients were treated with various procedures including open reduction and internal fixation, obliteration, galeal frontalis flap and cranialization. Results: 12 patients are group I (33.3 percent), 14 patient were group II (38.8 percent), group III, IV were 5 each (13.9 percent). Frontal sinus fractures were commonly associated with zygomatic fractures (21.8 percent). 9 patients had nasofrontal duct injury. The complication rate was 25 percent (9 patients), including hypoesthesia, slight forehead irregularity, transient cerebrospinal fluid leakage. Conclusion: The critical element of successful frontal sinus fracture repair is precise diagnosis of the fracture pattern and nasofrontal duct injury. The main goal of management is the restoration of the sinus function and aesthetic preservation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.53.1-53.6
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• 2019

Background: The nasal bone is the most protruding bony structure of the facial bones. Nasal bone fracture is the most common facial bone fracture. The high rate of incidence of nasal bone fracture emphasizes the need for systematical investigation of epidemiology, surgical techniques, and complications after surgery. The objective of this study is to investigate the current trends in the treatment of nasal bone fractures and the effectiveness of closed reduction depending on the severity of the nasal bone fracture. Patients and methods: A total of 179 patients with a nasal bone fracture from 2009 to 2017 were enrolled. Their clinical examination, patient's records, and radiographic images of nasal bone fractures were evaluated. Results: Patients ranged from children to elderly. There were 156 (87.2%) males and 23 (12.8%) females. Traffic accident (36.9%) was the most common cause of nasal fracture. Orbit fracture (44 patients, 24.6%) was the most common fracture associated with a nasal bone fracture. Complications after surgery included postoperative deformity in 20 (11.2%) patients, nasal obstruction in 11 (6.1%) patients, and olfactory disturbances in 2 (1.1%) patients and patients with more severe nasal bone fractures had higher rates of these complications. Conclusion: Closed reduction could be performed successfully within 2 weeks after injury.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.326-333
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• 2021

Purpose: A retrograde intramedullary nail is commonly used to treat femoral shaft and distal femur fractures. The authors analyzed the treatment results and the factors affecting the period of bone union for thirty-five patients treated with a retrograde intramedullary nail. Materials and Methods: Thirty-five patients who could be followed up for more than twelve months after the treatment with retrograde intramedullary nailing were analyzed retrospectively. The treatment results and the relationship between the period of bone union and the patient's age, sex, comminution of fracture, presence of open fracture, location of the fracture, and accompanying fractures were evaluated. Results: The average bone union time was 4.50 months. The period of bone union was unaffected by the age, sex, location, and presence of open fractures but was affected by the presence of comminution and accompanying fractures. Conclusion: Retrograde intramedullary nailing is effective for distal and shaft of fractures of the femur. The period of bone union is affected by the presence of comminution and accompanying fractures.

• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.806-831
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• 2020

Musculoskeletal injury is the most common cause of children visiting the department of emergency medicine. Since the bone is still developing, pediatric patients have characteristic radiological manifestations, including plastic deformation, greenstick fractures, and buckle (or torus) fractures. Furthermore, growth arrest can occur in those with physeal fractures. Various mechanisms are responsible for pediatric musculoskeletal injury since children have different ranges of activities, depending on their age, such as birth injury and fall and traffic accidents. Some fractures have characteristic locations and radiological manifestations. In this review, we will discuss various radiological manifestations of fractures involving both upper and lower limbs in pediatric patients.

• Journal of Nutrition and Health
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• v.29 no.9
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• pp.943-949
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• 1996

Bone mineral density depends largely on the status of dietary minerals such as Ca, P, Mg, and F and proteins, physical activities, parathyroid hormone(PTH), calcitonin(CT), and vitamin D. The decrease of bone density often results in bone fractures and osteoporosis which is prevalent among postmenopausal women. This study was intended to examine the role of parathyroid hormone, calcitonin and cholecaliferol in bone density of mice that were fed different dual photon energy beams. We have measured three major parts of the bone : whole body, head and femur. The results are summarized as follows : 1) Bone mineral density (BMD) was more increased by feeding high Ca diet compared to that of the low Ca diet. 2) Both PTH and Vit D3 enhanced BMD in all of the different Ca levels. 3) When the dietary Ca was deequate CT showed a synergistic effect with PTH in boosting bone density, while CT+Vit D3 showed a negative effect. 4) CT tended to inhibit the effect of increasing bone density by PTH and Vit D3 in medium and low Ca groups. 5) The effect of increasing bone density by PTH in the head of mouse increased when dietary Ca was lower : The increment of bone density by PTH in high, medium, and low Ca was 3%, 8%, 19%, respectively. 6) Femur bone density was affected significantly by dietary Ca levels than hormones. The above observations indicate that bone mineral density can be improved by high dietary Ca and hormone injections including PTH, CT and cholecalciferol, and thus proper dietary and hormonal treatment may be used in preventing bone fractures and osteoporosis.

• Journal of Korean Neurosurgical Society
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• v.50 no.1
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• pp.17-22
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• 2011

Objective : In the present study, authors retrospectively reviewed the clinical outcomes of halo-vest immobilization (HVI) versus surgical fixation in patients with odontoid fracture after either non-surgical treatment (HVI) or with surgical fixation. Methods : From April 1997 to December 2008, we treated a total of 60 patients with upper cervical spine injuries. This study included 31 (51.7%) patients (22 men, 9 women; mean age, 39.3 years) with types II and III odontoid process fractures. The average follow-up was 25.1 months. We reviewed digital radiographs and analyzed images according to type of injury and treatment outcomes, following conservative treatment with HVI and surgical management with screw fixation. Results : There were a total of 31 cases of types II and III odontoid process fractures (21 odontoid type II fractures, 10 type III fractures). Fifteen patients underwent HVI (10 type II fractures, 5 type III fractures). Nine (60%) out of 15 patients who underwent HVI experienced successful healing of odontoid fractures. The mean period for bone healing was 20.2 weeks. Sixteen patients underwent surgery including anterior screw fixation (6 cases), posterior C1-2 screw fixation (8), and transarticular screw fixation (2) for healing the odontoid fractures (11 type II fractures, 5 type III fractures). Fifteen (93.8%) out of 16 patients who underwent surgery achieved healing of cervical fractures. The average bone healing time was 17.6 weeks. Conclusion : The overall healing rate was 60% after HVI and 93.8% with surgical management. Patients treated with surgery showed a higher fusion rate and shorter bony healing time than patients who received HVI. However, prospective studies are needed in the future to define better optimal treatment and cost-effective perspective for the treatment of odontoid fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.530-534
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• 2007

Nasal fractures are the most common type of facial fractures. Nowdays computed tomography is found to be very helpful in diagnosing nasal fracture, especially in findings the nasal septal fractures. From August 2004 to July 2005, 36 cases of nasal fracture were admited and reviewed to oral and maxillofacial surgery of Ulsan University Hospital, not including other facial bone fracture. Out of 223 cases of facial bone fractures, we treated 47 cases of nasal fractures. We reviewed and examined the 36 patients of nasal fractures 2months postoperative. The results were 28cases of male and 8cases of female. The highest age frequency was in the fourth decades group. The most frequent causes of injury were falling down and fist trauma. The 25(69%) patients were found to have septal fractures, after computed tomography findings. The treatment methods of nasal fracture were closed reduction(13cases), open reduction(20cases), ORIF(1case), non operation(2cases). Complications of nasal deformity were found in 2patients. Septoplasty was performed on 21 patients. Septal fractures in combination with nasal fracture are usually unrecognized and untreated at the time of injury, usually ended in nasal deformities. It is important to find out the exact type of nasal fractures. We will report the results of treatment of nasal fractures with a literature review.