• 대한두개안면성형외과학회지
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• 제20권1호
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• pp.24-30
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• 2019

Background: Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction. Methods: Patients who visited the plastic and reconstructive surgery department between November 2016 and November 2017 with nasal bone fractures and treated by a single surgeon were prospectively followed up. Patients with simple unilateral or bilateral nasal bone fractures were treated with bedside finger reduction under local anesthesia and patients with comminuted nasal bone or septal fractures were scheduled for closed reduction under general anesthesia. Results: Of 84 patients, 28 met the inclusion criterion and underwent bedside finger reduction under local anesthesia. Twenty-seven patients (96.4%) were successfully contacted via telephone for survey. Twenty-three (85.2%) showed good and three (11.1%) showed fair results. All 27 patients (100%) were satisfied with their postoperative function and 25 (92.6%) were satisfied with their postoperative aesthetic result. Twenty-five patients (92.6%) preferred the finger reduction method under local anesthesia over closed reduction under general anesthesia. Conclusion: Finger reduction under local anesthesia in patients with mild unilateral or bilateral nasal bone fractures is an easy and efficient procedure with high patient satisfaction and favorable postoperative functional and aesthetic outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권2호
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• pp.175-180
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• 2001

목적: 공기 정복술은 조작이 간단하고 정복 시간이 빠르며 방사선 노출 시간이 짧고 천공 이환률이 낮다는 장점이 있다. 장중첩증 치료에 정복술에 실패한 경우 수술적 치료를 하게 되는데 대부분은 장절제 없이 단순 도수 정복만으로 치료되는 경우가 많으며 상당수에서는 이미 정복된 상태로 발견되기도 한다. 일차 공기 정복술에 실패한 장중첩증 환자에서 반복 지연 정복술을 시행하여 그 유용성 및 안전성을 알아보고자 본 연구를 시행하였다. 방법: 1998년 1월부터 1999년 12월까지 일차 공기 정복술을 시행하여 실패한 환자 중 복막염, 쇼크, 독성 증상이 없는 임상적으로 안정된 21명을 대상으로 1시간에서 3시간(평균 2.2 시간)후에 이차 지연 정복을 시행하였다. 결과: 정복술 시행 전 환자들의 증상 및 징후의 지속 시간은 6~48시간이었으며 평균 24시간이었다. 일차 정복 후 1~3시간 후(평균 2.2 시간)에 이차 지연 정복술을 시행하였고 76.2% (21례 중 16례)에서 성공적으로 정복되었으며 나머지 5례는 수술적 치료를 하였다. 이중 4례는 도수 정복되었으며 1례는 자연 정복되어 있었다. 결론: 초기 정복에 실패한 장중첩증 환자에서 임상적으로 안정적일 경우 시간 간격을 두고 반복지연 정복술을 시행하는 것은 불필요한 수술의 빈도를 줄일 수 있을 것으로 사료된다.

• 동의생리병리학회지
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• 제32권4호
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• pp.283-290
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• 2018

The aim of the study was to investigate the effect of Korean medicine treatments on pain reduction of thoracolumbar compression fracture patients. We analysed 48 patients who have been diagnosed as thoracolumbar compression fracture on Computed Tomography(CT) or Magnetic Resonance Imaging(MRI) scan and had admitted to Dunsan Korean Medical hospital from January 1,2014 to April 4, 2017. The analysis was conducted as retrospective study which analyzes patient's medical records. Statistical analysis was performed using the IBM SPSS statistics 24 program. We used Visual Analog Scale(VAS) and pain reduction scale to evaluate pain reduction of patients. The result showed that there were statistically significant pain reduction on thoracolumbar compression fracture patients treated with korean medicine treatments. In conclusion, we found that the korean medicine treatments showed positive effect on pain reduction of thoracolumbar compression fracture patients.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.7-14
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• 2020

Background: It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type. Methods: The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded. Results: There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types. Conclusion: The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.

• 대한두개안면성형외과학회지
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• 제9권1호
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• pp.12-16
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• 2008

Purpose: Closed reduction is most common treatment method for nasal bone fracture but it requires secondary correction operation commonly. For preventing secondary revision, we applied ultrasonography during closed reduction of nasal bone fracture and examined the result of operation. Methods: 80 patients were sorted into 2 groups, ultrasound-guided closed reduction group(n=40) and manual closed reduction group(n=40). We classified the unilateral fracture involving lower 1/2 of nasal bone into type I, the bilateral fracture involving lower 1/2 of nasal bone into type III and the fracture of upper 1/2 of nasal bone into type III. The occurrence rate of overcorrection and undercorrection were evaluated by comparing preoperative and postoperative MDCT(Multi Direction Computed Tomography). Results: In manual closed reduction group, overcorrection were found in 4 patients and undercorrection were found in 3 patients. In ultrasound-guided closed reduction group, overcorrection was not observed and undercorrection was observed in 2 patients. Conclusion: Intraoperative ultrasound evaluation of nasal bone fracture resulted in reduced occurrence rate of secondary nasal deformities, showed easier detection of the fractured site and have superiority upon simple physical examination or simple x-ray.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.202-209
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• 2020

Objective : The purpose of this study was to evaluate the efficacy of the anterior approach following intraoperative reduction under general anesthesia in patients with cervical facet fracture and dislocation. Methods : Twenty-three patients with single level cervical facet fracture and dislocation who were subjected to the anterior approach alone following immediate intraoperative reduction under general anesthesia from March 2013 to December 2017 were enrolled in this study. Neurological status, clinical outcome, and radiological studies were evaluated preoperatively, postoperatively, and during the follow-up period. Results : The cohort comprised 15 men and eight women with a mean age of 57 years (from 24 to 81). All patients were operated on within the first 8 hours following the injury. After gentle manual reduction or closed reduction with Gardner-Wells traction, under general anesthesia monitored by somatosensory-evoked potentials, all operations were successfully completed using the anterior approach alone except in two patients, who had a risk of over-distraction. In them, a satisfactory gentle manual reduction or closed reduction was not possible, and required open posterior reduction of the locked facets followed by anterior cervical discectomy and fusion. In one patient, screw retropulsion was observed in 1 month after surgery. There were no reduction-related complications or neurological aggravations after surgery. All patients showed evidence of stability at the instrumented level at the final follow-up (mean follow-up, 12 months). Conclusion : Anterior approach following intraoperative reduction monitored by somatosensory-evoked potentials under general anesthesia for cervical dislocation and locked facets is a relatively safe and effective alternative when cervical alignment is achieved by intraoperative reduction.

• The Journal of Korean Physical Therapy
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• 제13권3호
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• pp.677-683
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• 2001

The object of this study is in the comparison of level of depression between patients with chronic low back pain & normal adult, of the relation between reduction of pain & level of depression and in the examination of the influence of traditional physical therapy against the reduction of pain & level of depression of the patients with chronic low back pain for the new recognition of psychological factors to the physical therapists as well as patients. This study was targeted for 40 patients with chronic low back pain who were diagnosed as lumbar sprain & herniated intervertebral disk and compared & analyzed how traditional physical therapy has an influence to their reduction of pain and level of depression by questioning with visual an analog scale of Beck's depression inventory & pain inventory to them. The results are as follows. 1. Traditional physical therapy has an effect in the reduction of pain of the patients with chronic low back pain. 2. Although traditional physical therapy relieved a little the level of depression of patients with chronic low back pain. there was no evident effect statistically. 3. In the relation between the reduction of pain and level of depression, level of depression also showed somewhat relief according to the reduction of pain and appeared that they have some relationship. However, it's degree was not big. 4. In the comparison of the level of depression between the normal adult and the patient with chronic low back pain, the level of depression of the patient with low back pain are high rather than that of normal adult.

• Advances in pediatric surgery
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• 제15권2호
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• pp.132-140
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• 2009

The purpose of this study was to determine the success rate of air reduction as the primary treatment of intussusception and whether the success of air reduction could be predicted by plain x-ray. The authors reviewed the medical records of 54 consecutive patients diagnosed with intussusception from Jan 2005 to Dec 2007 at the Department of Surgery, Masan Samsung Hospital. The natures of symptoms and findings of plain abdominal radiography performed in the emergency department (ED) were reviewed. Air reduction failed more frequently (26.3 %) in patients who visited ED more than 24 hours after symptom onset (p=0.009). The mean duration of symptom for operated patients was longer than air reduction group (p=0.01). Also, 3/4 of patients having localized distension of small bowel in the left upper quadrant abdomen had unsuccessful air reduction (p=0.002). In conclusion, the time interval from symptom onset to arrival at ED and localized distension of small bowel in the left upper quadrant abdomen significantly increased the failure rate of air reduction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권6호
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• pp.266-272
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• 2014

Purpose: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. Methods: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. Results: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. Conclusion: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.

• Clinics in Shoulder and Elbow
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• 제5권2호
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• pp.102-109
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• 2002

Purpose: To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods in adults Materials and Methods: Seven patients, aged 55 to 52 years (average,69 years), were reviewed after a mean follow-up of 37 months (range, 11-65 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). Six patients underwent closed reduction and one patient, open reduction after failure of closed reduction. Percutaneous fixation with cannulated screws was performed to the 4 patients, per- cuta)leous fixation with Kirschner wires in 3 patients. All except one patients have associated medical problems. The results were assessed based on the Mayo Elbow Performance Score. Results: All the patients with cannulated screw fixation had stable bony union with excellent ranges of motion (mean: 5-125 degrees). All the three patients who received percuatnaous smooth K-wire fixation had nonunion with poor results, one of them had changed into cannulated screw. and then had good result. Conclusion: Although simple supracondylar fracture is similar to the pediatric fracture in nature, it should be firmly fixed with the method such as threaded cannualted screw rather than the simple fixation with K-wires.