• Title/Summary/Keyword: Severe compression fracture

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The Usefulness of Transcatheter Arterial Embolization for Panfacial Injury (전체얼굴손상 환자에서 영상중재시술의 유용성)

  • Kim, Jae Woo;Choi, Hwan Jun;Kim, Mi Sun;Yang, Seung Boo
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.358-364
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    • 2007
  • Purpose: A life-threatening hemorrhage resulting from a severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture which may result from the rupture of the internal maxillary artery. With the recent advances in the radiologic intervention, its use has increased for managing these life threatening case. We reviewed its usefulness with our experiences and literatures. Methods: A retrospective review was performed to determine the usefulness of the transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Oronasal bleeding was controlled with nasal packing and electrocautery. All injured regions were studied by radiologic study including CT. Even after primary management, if the oronasal bleeding was persistent, radiologic intervention was performed 10 patients were treated with transcatheter arterial embolization and the bleeding focus controlled by embolization with polyvinyl alcohol and gelfoam. Results: After the intervention, the vital signs became stable and there were no complications from embolization in the follow-up for 6 months. Also patients could recover through appropriate operations. Conclusion: Transcatheter arterial embolization for maxillofacial injury has many advantages for both, the doctor and the patient. First, less pain is induced than a compression device or an operation, which is another way to treat oronasal bleeding. Second, it does not need general anesthesia. And through a single procedure not only we can know the accurate bleeding point, but we can also bleeding by embolization.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

ABRASION RESISTANCE OF DENTURE BASE RESIN INCLUDING VINYLOLIGOSILSESQUIOXANE (Vinyloligosilsesquioxane 함유 의치상용 아크릴릭 레진의 마모 저항성)

  • Park Ran;Shim June-Sung;Han Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.5
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    • pp.626-639
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    • 2003
  • Statement of problem : Recently, in attempts to reinforce the acrylic resin and to reduce the polymerization shrinkage, it has been reported that adding vinyloligo-silsesquioxane (vinyl-POSS) to PMMA significantly compensates for polymerization shrinkage and somewhat increases the fracture resistance. Purpose : There haven't been any studies on abrasion that can affect the adaptation of the denture in long-term use. In this study abrasion resistance was compared between acrylic resin with vinyl-POSS and commercialized acrylic resin for denture base. In addition, the difference in abrasion resistance according to molding methods was compared. Material and method : Using PaladentR 20 including vinyl-POSS. PaladentR 20, Lucitone 199R, SR IvocapR, denture bases were fabricated using compression molding technique and continuous-pressure injection technique. Surface hardness and abrasion were measured for each group, and the worn surfaces were observed under a scanning electron microscope. Results : 1. When surface hardness was measured for each material and molding technique, there was no statistically significant difference among the materials. (p<0.05) 2. When same denture base material and molding technique were used, the abrasion due to toothpaste solution was 5 times as severe as the abrasion due to soap solution. 3, When toothpaste solution was used, the abrasion decreased in the order of PaladentR20, PaladentR 20 including vinyl-POSS, SR IvocapR, and Lucitone 199R. However statistically significant difference was seen only among PaladentR 20, SR IvocapR, and Lucitone 199R. (p<0.05). 4. When soap solution was used, the abrasion was more severe in PaladentR 20 and including vinyl-POSS PaladentR 20 groups than in SR IvocapR and Lucitone 199R groups. (p<0.05). Conclusion : Addition of vinyl-POSS doesn't improve the abrasion resistance, and the abrasion resistance was similar to those of existing materials. Additional studies under different conditions are needed. For clinical application of vinyl-POSS, further investigations with different requirements and conditions are necessary.

Comparison of Three Surgical Method Outcomes for Dorsal Communition Distal Radial Fractures: External Fixation, External Fixation with Allogenous Bone Graft (DBM) and Volar Locking Plate Fixation (배측 분쇄가 있는 원위부 요골 관절내 골절의 3가지 수술적 치료 결과 비교: 외고정 기구 단독, 외고정 기구와 동종골이식 및 수장측 잠김 압박 금속판)

  • Choi, Joon-Cheol;Na, Hwa-Yeop;Lee, Young-Sang;Kim, Woo-Sung;Oh, Kyung-Soo;Song, Woo-Suk;Kim, Se-Jun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.115-120
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    • 2009
  • Purpose: To evaluate the outcomes of three different surgical approaches in treating a distal radius fracture with dorsal communition. Materials and Methods: From April, 2006 to May, 2009, 49 patients over age of 60years old with unstable dorsal communition distal radius fracture were analyzed. We compared maintainability of reduction by radiological follow-up observations and clinical outcomes using Mayo wrist scores. One-Way ANOVA test was performed to examine the statistical correlation between the methods. Results: All three approaches provided satisfactory post-op reduction results. However, follow-up observations showed significant loss of reduction in the external fixation only group compared to the added bone graft group and the volar anatomical locking plate group (P<0.05). Mayo wrist score was indifferent between the three groups. Conclusion: Treatment of a distal radius fracture with severe dorsal communition using an external fixation only appears to be insufficient in maintaining reduction of a cancellous bone defect.

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Is the Agricultural Work a Risk Factor for Koreans Elderly Spinal Sagittal Imbalance?

  • Hong, Jong-Hwan;Han, Moon-Soo;Lee, Seul-Kee;Lee, Jung-Kil;Moon, Bong Ju
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.623-630
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    • 2020
  • Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

Tardy Ulnar Nerve Palsy due to Cubitus Varus Deformity (내반주 변형에 의한 지연성 척골 신경 마비)

  • Jeon, In-Ho;Kim, Poong-Taek;Park, Byung-Chul;Ihn, Joo-Chul
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.29-36
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    • 2002
  • Purpose : Cubitus varus deformity has been reported to cause ulnar neuropathy. We present five cases of tardy ulnar nerve palsy due to cubitus vus and analyzed the factors related to the nerve plasy caused by the deformity. Materials and Methods : Three men and two women were reviewed retrospectively and the mean age of the patients were 26 (range, 14-38). The average interval from initial fracture to nerve palsy was 19 years (8-32 years). The severity of symptoms, according to McGowan's classification, was grade I of 2 patients, grade Ⅱ of 3 patients. Carrying angle was an average of 18。 (30° -45° ). Internal rotation angle measured by Yamamoto's method was an average of 33° (30° -45° ). Results ㆍ The mean follow-up period was 53 months (35-70 months). Elbow pain and numbness of the fingers were relieved shortly after surgery. It revealed that anterior subluxation of the nerve due to internal rotation deformity and compression of the nerve between the medially shifted medial head of triceps and the medial epicondyle. Conclusion : The major entrapment point of the nerve is the fibrous band between the two heads of the flexor carpi ulnaris. The severe internal rotation deformity may contribute the cause of tardy ulnar nerve palsy in cubitus varus deformity.