• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.51-54
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• 2008

Purpose: The choice of open versus closed reduction for mandibular subcondylar fracture is a debatable issue. To evaluate the advantage of open approach to closed method with IMF(intermaxillary fixation), we conducted a retrospective study to compare the outcomes of each method. Methods: From 2002 to 2006, 29 patients with mandibular subcondylar fractures were treated by open or closed reduction. 17 patients were treated by open reduction and 12 patients by closed reduction and IMF. Each group was assessed for duration of mandibular immobilization, incidences of buccal palsy, malocclusion, TMJ(temporomandibular joint) pain, and deviation of the mandible on mouth opening. Results: All cases showed accurate reduction in anatomical position, no significant displacement and no deviation on mouth opening during the follow-up period. IMF period is statistically shorter in open reduction (p<0.05). Differences in incidence of other complications were not significant statistically. Conclusion: As there are significant independent morbidities associated with IMF which requires postoperative rehabilitation, prolonged temporomandibular immobilization should not be overlooked. Some patients with poor compliances will not tolerate IMF in nonsurgical treatment. In the aspect of patient's convenience and early recovery by short IMF period, open reduction would be recommended as a better treatment method.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.6-12
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• 2024

Purpose: Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures. Methods: Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching. Results: Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6-30 days vs. median 5 days, IQR 2-13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6-30 days vs. median 8 days, IQR 4-19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different. Conclusions: The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.372-380
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• 2005

Condylar process of mandible, has the specialized anatomic structure compared with any other body structure, acts directly in connection with mastication and speech and so on. In general, mandibular condyle fractures have been managed by two methods as open and closed reduction. But, there are no reasonable consensus about the proper management of this injury. This study was designed for analysis of the prognosis of two methods of treatment, open and closed reduction, with positional change of fractured condyle and complications within 6 months post-intermaxillary fixation period. We conducted a retrospective analysis of 154 patients whose unilateral mandibular condyle fractures were treated by open or closed reduction in our department. The horizontal, sagittal, and coronal change of the condyle was examined using modified Towne's and panoramic radiographs before intermaxillary fixation(IMF), immediately after IMF, and at 6 months after IMF. Patients, whose mandibular condyle fractures were treated by closed reduction, had significantly shorter ramus height on the side of injury(P<0.05). But, fractured condylar fragments were displaced insignificantly with aspect to sagittal and coronal plane(P>0.05). The level of the fracture influenced the ramus length and the degree of coronal change in the closed reduction group(P<0.05). There was no significant correlation among the level of the fracture, treatment methods and complications(P>0.05). From the results obtained in this study, fractured mandibular condyles, were treated by closed reduction, had a tendency that continuous condylar displacement was occurred with aspect to horozontal and coronal plane in treatment period including intermaxillary fixation. And then there was a correlation between the level of the fracture and the position change in close reduction group statistically. These result suggested that care must be taken in basing treatment decisions on the degree of displacement of the condyle and in treating the mandibular condyle fractures for a long time.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2212-2220
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• 2020

Background: Repetitive damage to the ankle joint causes chronic ankle instability, and studies comparing the effects of exercise in open and closed chains as a treatment method are very rare. Objectives: To investigate the effects of open and closed kinetic exercises on muscle activity and dynamic balance of ankle joint in adults with chronic ankle instability. Design: Single-blind randomized controlled trial. Methods: The selected 30 subjects are randomly divided into open kinetic chain exercise experimental group (EGI, n=10), closed kinetic chain exercise experimental group (EGII, n=10), and stretching control group (CG, n=10). Open and closed kinetic exercises lasted 30 minutes three times a week for six weeks and stretching exercises performed four actions for 20 seconds and five sets. The measurement tools using surface electromyography to measure muscle activity in the ankle joint. The dynamic balance of the ankle was evaluated using the Y-Balance test. Results: Following the intervention, closed and open kinetic chain exercise group showed significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance (P<.05). However, no significant difference in tibialis anterior and gastrocnemius muscle activity and dynamic balance between closed and open kinetic chain exercise group (P<.05). Conclusion: This study provides evidence that closed and open kinetic chain exercise can be presented as an effective exercise for the muscle activity of ankle muscle and dynamic balance of the subject with chronic ankle instability.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.301-308
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• 2012

In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.5
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• pp.303-308
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• 2022

Objectives: Selection of treatment methods for mandibular condylar fractures remains controversial. In this study, we investigated treatment methods for condylar fractures to determine the indications for open or closed reduction. Patients and Methods: Patients >12 years of age treated for mandibular condylar fractures with a follow-up period of ≥3 months were included in this study. The medical records of enrolled patients were reviewed for sex, age, fracture site, treatment method (open or closed reconstruction), postoperative intermaxillary fixation period, operation time, and complications. Radiological analysis of fracture fragment displacement and changes in ramal height difference was performed using computed tomography and panoramic radiography. Results: A total of 198 patients was investigated, 48.0% (n=95) of whom underwent closed reduction and 52.0% (n=103) underwent open reduction. There was no significant correlation between reduction method and patient sex, age, or follow-up period. No statistically significant difference between the incidence of complications and treatment method was observed. None of the patients underwent open reduction of condylar head fracture. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. There was no statistically significant correlation between the groups and fracture fragment displacement. However, there was a significant difference between the treatment groups in amount of change in ramal height difference between the fractured and the non-fractured sides during treatment. Conclusion: No significant clinical differences were found between the open and closed reduction methods in patients with mandibular condylar fractures. According to fracture site, closed reduction was preferred for condyle head fractures. There was no significant relationship between fracture fragment displacement and treatment method.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.1
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• pp.99-107
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• 2008

Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

• Journal of Veterinary Clinics
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• v.33 no.6
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• pp.362-367
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• 2016

The aim of the study was to evaluate ultrasonographic findings, affected age, hematology, blood chemistry and clinical signs according to open or closed cervix in 102 bitches presented for treatment of pyometra. The prevalence of pyometra according to breed was observed in Maltese 22.5%, Yorkshire Terrier 13.7% and Shih Tzu 12.7%. The mean age of dogs was $9.6{\pm}0.3years$, and open cervix pyometra was more prevalent than closed cervix pyometra. Clinical signs included anorexia, vaginal discharge, depression, polyuria/polydipsia, vomiting, and abdominal distension. The concentration of BUN and the activity of ALP in dogs with closed cervix pyometra were significantly higher than those in dogs with open cervix pyometra (p < 0.05). The white blood cell and neutrophils in dogs with closed cervix pyometra were significant higher than those in dogs with open cervix pyometra (p < 0.05). Ultrasonographic findings of the uterus with open or closed cervix pyometra showed variable patterns. The uterine wall was variable in appearance, from thick and irregular to smooth and thin. The uterine wall was thicker in open cervix pyometra than in closed cervix pyometra. The luminal cavity included smaller amount of anechoic fluid in open cervix pyometra than in closed cervix pyometra.

• Asian-Australasian Journal of Animal Sciences
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• v.1 no.4
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• pp.201-208
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• 1988

Fifty-six lactating Surti buffaloes, fed rice straw, were allocated to seven treatment groups as follows: 1. Straw supplemented with 2% urea (SS) + 1.5kg rice bran (RB) 2. Straw treated with 4% urea in an open stack (TS open) 3. TS open + 1.5 kg RB 4. TS open + 3.0 kg RB 5. TS open + 1.5 kg RB + 3.0 kg Gliricidia (Gl) 6. Straw treated with 4% urea in a closed pit (TS closed) 7. TS closed + 1.5 kg RB + 3.0 kg Gl Milk production, butterfat percentage and liveweight gain of cows and calves were measured and tested with analysis of variance. The results are: - The animals on urea treated straw (group 2) had a higher milk production (p<0.05), higher butterfat production (p<0.05) and less liveweight gain loss (p<0.05) than the animals on urea supplemented straw (group 1). Butterfat percentage also increased by treatment, although not significantly (p>0.05). - Increasing levels of rice bran (groups 3 and 4 compared to 2) increased total milk production and milked quantity of butterfat, while butterfat percentage decreased (p < 0.05). - Milk production increased (p <0.05) with extra rice bran added (group 4 compared to 3), but was not affected (p > 0.05) by Gliricidia addition (group 5 compared to 3). Butterfat percentage dropped with extra rice bran supplement (p <0.05). The lack of response to Gliricidia indicated that protein is not limiting in treated straw, or that Gliricidia protein is partly insoluble. - System of treatment had no effect on milk production (p >0.05), while supplementation with 1.5 kg RB and 3.0 kg Gliricidia increased production and caused a lower butterfat percentage (p <0.05) (groups 2, 5, 6 and 7 compared). A significant (p <0.05) interaction treatment system x supplementation was present. It was concluded, that both treatment and supplementation did affect milk production as well as milk composition. Gliricidia addition gave less effect than rice bran, indicating different requirements for starchy substances in the feed. Treatment of straw does not negatively affect butterfat production, it can increase butterfat production and even butterfat percentage.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.2
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• pp.173-182
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• 2012

Purpose : This study was investigated the effect of lower extremity muscle activity during open kinetic chain exercise (OKC) and closed kinetic exercise (CKC) in normal young adults. Methods : The participants were consisted of forty-one. All subjects were randomly assigned to two groups of open kinetic chain exercise group (n=21) and closed kinetic chain exercise group(n=20). It was perform 3 sets, 3 times per week for 6 weeks both open kinetic chain exercise group and closed kinetic chain exercise group. Subjects were assessed for each subject took pre-test, post-test in 2 weeks, post-test in 4 weeks, post-test in 6 weeks measurement the surface EMG data for vastus medialis and lateralis, lateral and medial hamstring, lateral and medial gastrocnemius, tibialis anterior. Results : The vastus medialis and lateralis muscle activity was significantly increased within the intervention period both group(p<.05). The lateral and medial part of hamstring muscle activity was significantly increased with in the intervention period(p<.05). The tibialis anterior muscle activity of open kinetic chain exercise group and closed kinetic chain exercise group was significantly increased in the intervention period(p<.05). The lateral and medial part of gastrocnemius muscle activity of open kinetic chain exercise group and closed kinetic chain exercise group was significantly increased with in the intervention period(p<.05). Conclusion : It was found that both open kinetic chain exercise and closed kinetic chain exercise was significantly increased muscle activity. Further studies are needed to analyzed long term effects and subjects resulting from these changed. these exercises can be selectively adapted not only as treatment exercise for patients but also as preventive exercise for normal person to improve balancing ability by conducting proper amount of exercise for each individual's condition and stage.