• Title/Summary/Keyword: Injury of Bone

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Analysis of Posterior Cervical Fixation and Fusion in Subaxial Cervical Spine Injury (중하부 경추손상에서 후방 경추 내고정술 및 골유합술의 분석결과)

  • Lee, Dong Hoon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1388-1393
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    • 2001
  • Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than $5^{\circ}$, 2 cases(12%) $5-20^{\circ}$, and 1 case(6%) more than $20^{\circ}$. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.

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Anterior Cruciate Ligament Reconstruction using the Autogenous Bone-Patellar Tendon-Bone Graft (관절경적 전방십자인대 재건술)

  • Jung, Young-Bok;Yum, Jae-Kwang
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.47-51
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    • 1997
  • A torn anterior cruciate ligament(ACL) is the most common serious ligamentous injury to the knee joint. The incidence of ACL tears seems to be increasing, at least partly as a result of the increasing participation of individuals of all ages in high-risk sports. The most commonly used graft source for ACL reconstruction is the autogenous bone-patellar tendon-bone graft unit. Despite a good success record. postoperative complications, such as infection, patellar contracture/patellar baja, patellar fracture, rupture of the patellar tendon, graft failure without reinjury, can occur following ACL surgery. The purpose of this paper is to provide guidelines regarding the key points of the reconstructive procedure in a sequence and how to prevent or minimize the complications that can follow ACL reconstructive surgery. We want this knowledge can help orthopaedic surgeons to understand the reasons for previous and current successes and failures of reconstruction of the ACL, and it can help them to plan the care of patients who have an injury of the ligament.

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Delayed Reduction of Nasal Bone Fractures

  • Yoon, Han Young;Han, Dong Gil
    • Archives of Craniofacial Surgery
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    • v.17 no.2
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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.

An Unusual Case of Cerebral Penetrating Injury by a Driven Bone Fragment Secondary to Blunt Head Trauma

  • Lee, Jae-Il;Ko, Jun-Kyeung;Cha, Seung-Heon;Han, In-Ho
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.532-534
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    • 2011
  • Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right temple while cutting the rod. Initial brain computed tomography (CT) and magnetic resonance imaging demonstrated scanty subdural hematoma at right temporal lobe and left falx and intracerebral hematoma at both frontal lobes. Facial CT with 3-D reconstruction images showed a small bony defect at the right sphenoid bone's greater wing and a small bone fragment at the left frontal lobe, crossing the falx. We present the unusual case of a temple trauma patient in whom a sphenoid bone fragment migrated from its origin upward, to the contralateral frontal lobe, producing hematoma along its trajectory.

Correlation Analysis of Sports injuries and Body Composition and Bone Density in National Water Pool Players (국가대표 수구선수들의 스포츠 손상과 신체 조성 및 골밀도의 상관관계 분석)

  • Kim, Hyun-Chul;Park, Ki-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.3
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    • pp.134-141
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    • 2019
  • PURPOSE: This study conducted aA forward-looking study of elite water polo athletes, who trained at National Training Center, was conducted to determine the correlation between the incidence of sports injuries and the bone density among national water polo players. METHODS: Data on the general characteristics of all study subjects were analyszed usingin descriptive statistics. The incidence of sports injuries was calculated from the incidence of sports injuries per 1,000 hours and the incidence of sports injuries resulting from exposure to 1,000 training sessions. The incidence of all sports injuries was calculated with a 95% confidence interval. Furthermore, Pearson's correlation was calculated conducted to determine the correlation between sports injuries and bone density, bone mass and body composition. RESULTS: Water polo athletes suffered a total of 127 sports injuries in the three-year period, while the athletes suffered 3.5 sports injuries each year. The Ooverall injury rate of 3.2(95% CI 2.68-3.81) per 1,000h, 18.0(15% CI 14.89-21.16) of sports injuries per 1,000AE. For all athletes, 50.4% of the injuries were classified as mild, followed by moderate (26.8%) and severe (22.8%). The lower the bone density in all areas of sports injuries, the higher the incidence of sports injuries. In addition, and the lower the bone mass in all areas except for light injuries, the higher the incidence of sports injuries. CONCLUSION: In tThe correlation between sports injuries and bone density and bone composition of water polo athletes, revealed a significant correlation between the bone density and bone mass were statistically significant, and the lower the bone density and bone mass, the higher the incidence of sports injuries.

Comparisons of Fracture Types and Pelvic Angiographic Findings in Hemodynamically Unstable Pelvic Bone Fracture (혈역학적으로 불안정한 골반골 골절 환자에서 골반골 골절 소견과 혈관조영술 소견의 비교)

  • Lee, Kwon Il;Lee, Kang Hyun;Kang, Sung Chan;Park, Sung Min;Jang, Yong Su;Shin, Tae Yong;Hwang, Sung Oh;Kim, Hyun
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.26-32
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    • 2007
  • Purpose: Hemorrhagic shock is the leading cause of death in patients with pelvic bone fractures. The majority of blood loss is due to injured pelvic arteries and retroperitoneal veins and to bleeding from the fracture site itself. Pelvic angiography and embolization of injured vessels is an effective way to control continuous bleeding. However, identifying the bleeding focus in hemodynamically unstable patients before diagnostic intervention is difficult. The purpose of this study was to determine the correlation between fracture patterns in hemodynamically unstable patients with pelvic fractures and later pelvic angiography findings. Methods: We performed a retrospective study of 21 hemodynamically unstable patients with pelvic fractures admitted to our emergency department between April 2001 to April 2006. All 21 patients underwent pelvic angiography. Pelvic fractures were assessed according to the Tile's classification and the degree of injury was assessed using the Injury Severity Score (ISS) and Revised Trauma Score (RTS). The hemodynamic status of the patients was defined using vital signs, base excess, and blood lactate. Fracture patterns were compared with hemodynamic status and angiography findings. Results: In the 5year study period, 21 hemodynamically unstable pelvic bone fracture patients were admitted; ten were men (47.6%), and 11 were women (52.4%). The mean age was 41.1 years (range: ${\pm}20.1$). Of the 21 embolization was performed in 6 patient (28.6%): 1 patient of the 5 unstable pelvic bone fracture patients (20%), and 5 patients of 16 the stable pelvic bone fracture patients (31.3%). There were no significant differences between the RTS (p=0.587) and embolization rate (p=0.774) for either the stable patients or the unstable patients. Patients with arterial injury on angiography had a lower RTS compared with patients without arterial injury but there was no significant difference in ISS between the two groups. The angiographic injured sites were five internal femoral arteries and one external femoral artery. Conclusion: The findings in this study suggest that the pelvic fracture pattern in hemodynamically unstable patients with pelvic fractures does not correlate with pelvic angiography findings.

Operative Treatment for Midshaft Clavicle Fractures in Adults: A 10-Year Study Conducted in a Korean Metropolitan Hospital

  • Baek, Jeong Kook;Lee, Young Ho;Kim, Min Bom;Baek, Goo Hyun
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.105-115
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    • 2016
  • Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

Clinical Epidemiologic Study of Facial Bone Fractures in Daegu (대구지역 안면골 골절의 임상역학적 연구)

  • Kwon, Hyuk Joon;Han, Joon;Kim, Jun Hyung;Jung, Ho Yoon;Kim, Jong Yeop;Yoon, Sin Hyuk;Song, Cheol Hong;Ryu, Min Hee;Kim, Yong Ha;Seo, Man Soo
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.365-370
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    • 2007
  • Purpose: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. Methods: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. Results: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in-hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. Conclusion: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.

A Retrospective Analysis of 303 Cases of Facial Bone Fracture: Socioeconomic Status and Injury Characteristics

  • Kim, Byeong Jun;Lee, Se Il;Chung, Chan Min
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.136-142
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    • 2015
  • Background: The incidence and etiology of facial bone fracture differ widely according to time and geographic setting. Because of this, prevention and management of facial bone fracture requires ongoing research. This study examines the relationship between socioeconomic status and the incidence of facial bone fractures in patients who had been admitted for facial bone fractures. Methods: A retrospective study was performed for all patients admitted for facial bone fracture at the National Medical Center (Seoul, Korea) from 2010 to 2014. We sought correlations amongst age, gender, fracture type, injury mechanism, alcohol consumption, and type of medical insurance. Results: Out of the 303 patients meeting inclusion criteria, 214 (70.6%) patients were enrolled in National Health Insurance (NHI), 46 (15.2%) patients had Medical Aid, and 43 (14.2%) patients were homeless. The main causes of facial bone fractures were accidental trauma (51.4%), physical altercation (23.1%), and traffic accident (14.2%). On Pearson's chi-square test, alcohol consumption was correlated significantly with accidental trauma (p<0.05). And, the ratio of alcohol consumption leading to facial bone fractures differed significantly in the homeless group compared to the NHI group and the Medical Aid group (p<0.05). Conclusion: We found a significant inverse correlation between economic status and the incidence of facial bone fractures caused by alcohol consumption. Our findings indicate that more elaborate guidelines and prevention programs are needed for socioeconomically marginalized populations.