• 대한족부족관절학회:학술대회논문집
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• 대한족부족관절학회 2008년도 추계학술대회 및 총회
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• pp.41-41
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• 2008

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.255-260
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• 1989

Unfavorable healing of maxillary fractures may impose functional and esthetic burdens upon the trauma victim. Malunited maxillary fractures are generally a result of treatment delay, incomplete or inaccurate immobilization of the fracture fragments, or infection. Dysfunctions of mastication, distortions in speech, gross defects in facial contour, and related psychic changes are problems which may require secondary correction. When it is necessary to delay definitive treatment or when inadequate maxillary fracture reduction is recognized within the first week following injury, the maxilla can be mobilized by heavy handed dental manipulation under anesthesia or by elastic traction to an external fixation appliance attached to the maxilla by arch bars or an acrylic splint. But malunited maxillary fracture that have progressed to bony malunion require osteotomy procedure in order to establish normal anatomic relationships. This report parents two cases of malunited unilateral maxillary fracture surgically corrected by unilateral Le Fort I osteotomy.

• 대한치과의사협회지
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• 제17권12호통권127호
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• pp.923-926
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• 1979

In patient of long standing malunited maxillary fracture, maxillary osteotomy or refracture seems to be justifiable. This is a case of the patient, a 60 year old Korean female patient, presented a long-standing malunited maxillary fracture with dish-type face and functional disturbance in mouth opening. We performed upon her Le Fort I osteotomy only via labial-buccal horizontal incisions in one-stag operation. The result was good in esthetics and function.

• Journal of Yeungnam Medical Science
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• 제13권1호
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• pp.22-31
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• 1996

본 교실에서는 1994년 11월부터 1996년 4월까지 수상 후 혹은 일차 교정 후 평균 3.2개월 경과한, 7명의 환자에서 제한된 접근방식으로 2차석 교정술을 시행하여 평균 4.5개월의 추적 조사한 후 만족할 만한 결과를 얻었으며 다음과 같은 결론을 내렸다. 1. 술전에 X-ray 검토, 사고 전의 사진, 충분한 대화 등을 토대로 가능한 정확한 절골선과 변형정도 등의 교정을 위한 계측이 필요하다. 2. 관골의 삼각골절 후 안면변형인 경우는 반드시 광범위 노출법보다는 제한적 방법으로 교정이 가능했다. 3. 절골된 관골은 내측 및 전상방으로 과교정해야 한다. 4. 절골 및 재배치시 저작근을 포함하여 주위 연부조직을 분리시키는 것이 중요하다. 5 안구함몰의 교정을 위해서 안와기저부 및 측부에 자가 골이식이나 고밀도 폴리에틸렌($Medpor^{(R)}$)의 삽입 후 결과의 차이는 발견할 수 없었다.

• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.25-30
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• 2014

Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.384-386
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• 2020

This report describes osteotomy and iliac bone graft for malunion caused by failed mandibular fracture reduction. A 27-year-old man was referred 3 months after a motor vehicle accident. At another hospital, two operations had been performed for symphyseal fracture using two resorbable plates. Malocclusion was noted, and panoramic radiography and computed tomography revealed a misaligned dental arch, with a 9.37-mm gap between the central and the lateral incisor of the left mandible. A wafer was made from the patient's dental model, and a maxillary arch bar was applied. Through a lower gingivolabial incision, osteotomy was performed between the malunited symphyseal fracture segments. Both segments were reduced to their original position using the wafer and fixed with titanium miniplates via intermaxillary fixation (IMF). The intersegmental gap was filled with cancellous bone from the iliac crest. The gingival defect was covered with a mucosal transposition flap from the gingivolabial sulcus. IMF and the wafer were maintained for 5 and 9 weeks, respectively. At postoperative week 13, the screws were removed from the mandible and satisfactory occlusion was noted. His mouth opening improved from 2.5 to 3 finger breadths (40 mm). This case demonstrates the need for sufficient IMF when using resorbable plates.

• 대한치과의사협회지
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• 제17권1호통권116호
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• pp.25-28
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• 1979

An instance of difficulty in mouth opening as around 2mm due to impingement of fractured coronoid process and zygomatic arch in 30-year-old man who had met with a traffic accident was observed and surgical operation was done. After removal of the fractured coronoid process and elevation of the depressed malunited zygomatic arch, the patient could open mouth by now about 30mm.

• 대한족부족관절학회지
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• 제5권1호
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• pp.43-54
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• 2001

Treatment of calcaneal fraclure is difficult and full of controversy still and choice of treatment of the displaced intracalcaneal fracture is not available yet. Furthermore, the treatment of old calcaneal fracture with displaced subtalar joint or malunited calcaneal fracture is really difficult and painful to solve the problem other than subtalar arthrodesis, ignoring conservative treatment, excision of bone mass and/or adhesiolysis, which is/are a kind of palliative or salvage treatment in stead of definitive treatment that restores smooth articular surface of the subtalar joint as far as we can. Authors had some experiences treating this difficult old and displaced calcaneal fractures. Some of them were malunited already. Hereby we report our favorable results to treat the fractures with surgical reduction (reconstruction) and internal fixation without bone graft. We recommend reconstruction of the displaced subtalar joint even though it is not congruent and partly gone to get subtalar motion insead of palliative operation such as subtalar fusion, which can be done later and long term potential cause of mid tarsal arthrosis of the foot.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권2호
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• pp.91-95
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• 2014

The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.

• 대한두개안면성형외과학회지
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• 제18권4호
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• pp.264-268
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• 2017

The zygomaticomaxillary complex (ZMC) functions as a buttress for the face and is the cornerstone to a person's aesthetic appearance, by both setting the midfacial width and providing prominence to the cheek. Malar deficiency is often acquired by blunt injury incurred in a traumatic accident, resulting in ZMC fracture. A 48-year-old male patient presented a right ZMC fracture after contusion injury by a baseball. He only received conservative management and later he suffered discomfort during mouth opening at the moment of mastication, due to trismus involving the temporomandibular joint. In the current case, we describe a surgical technique, by which the malar body is shifted anteriorly and laterally after combined oblique-vertical osteotomy. The technique presented, eventually restored the former aesthetic position of the malar complex and symmetry, and, moreover, improved mastication function.