• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.594-602
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• 2019

Objective : Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs. Methods : Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures. Results : Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months. Conclusion : We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.445-448
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• 2006

Purpose: The nose is the most prominent skeletal feature of the face and is thus prone to frequent injury. Closed reduction of nasal bone fractures can be performed under general or local anesthesia. However, the benefits and the drawbacks in either form of anesthesia chosen are seldom perceived by the surgeon. A retrospective study was performed to assess the differences in the outcome among the two groups subjected to surgery under different type of anesthesia and to introduce our method of local anesthesia and its adequacy. Methods: Two hundred and fifteen patients during a 2-year period were included in the study. 2% Lidocaine mixed with 1:100,000 epinephrine was injected on the anterior ethmoid nerve and the periosteum. Assessment factors included intra-operative adequacy of analgesia, post-operative analgesic requirement and functional and aesthetic outcome of surgery. Results: 19 patients were manipulated under general anesthesia and 196 patients were manipulated under local anesthesia on the anterior ethmoidal nerve and dorsal periosteum. No statistically signigicant variable in performance of surgery could be attributed to the mode of anesthesia employed(p > 0.05). Four patients experienced complications after reduction. One developed septal deviation and three nasal obstruction. But, no secondary operations were needed. Conclusion: Anterior ethmoidal nerve block and dorsal periosteal injection of 2% Xylocaine, combined with topical intranasal 4% lidocaine and epinephrine provided sufficient analgesia comparable to that of general anesthesia.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권2호
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• pp.182-190
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• 2008

본 증례에서는 자기강화 흡수성 고정판을 사용하여 하악골 골절을 정복하였다. 하악각 부위와 정중부, 부정중부, 하악지 부위의 골절이 발생하여 직경 2.0mm의 4-hole plate와 직경 2.4mm의 6-hole plate를 1개 혹은 2개를 사용하였다. 발생한 합병증에는 4명의 환자에 있어서 감각저하 이외에는 어떠한 합병증도 관찰되지 않았다. 본 연구의 추적 조사 기간이 너무 짧고 환자 수가 너무 적어 생체 흡수성 고정판을 사용한 골절 정복의 장기간의 효과를 결정할 수 없지만 하악골 골절의 초기 골 치유를 가능하게 하는 적절한 견고성과 안정성을 보여주었다.

• Clinics in Shoulder and Elbow
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• 제11권1호
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• pp.62-65
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• 2008

견갑골의 견봉에서 일어나는 골절은 오구돌기, 관절와와 같은 다른 견갑골 부위의 골절과 동반되거나 견봉쇄골 관절 탈구와 동반되는 경우가 흔하며, 이들 대부분의 골절은 전위가 많지 않아 보존적인 방법으로 치료가 가능하다. 저자들은 견갑부 주위 골절의 동반 없이 단독으로 견봉 후외측부위에 골절 및 전위가 있는 환자에서 유관나사 및 K-강선을 이용한 내고정으로 좋은 기능적 결과를 경험하였기에 견봉 골절 내고정을 위한 술기적 특징 및 문헌적 고찰을 보고하고자 한다.

• 한국임상수의학회지
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• 제15권1호
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• pp.222-227
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• 1998

This survey was based on the data of one hundred four dogs with 108 case,T of fracture admitted to the veterinary teaching hospital, College of Veterinary Medicine, Kyungpook National University and 24 private small animal hospitals from January, 1995 to Decemberi 1996. The results were analyzed as following criteria; the distribution of fractures causes of fractured age and sexual distributions month of the most frequencel total body weights presence of communicating external wound, extent of damaged direction of fracture line, location of fracture liner fracture managements fixations methods, fixations methods according to location of fracture. The results of survey were as follow: 1. Main distribution of fracture; radius . ulna (23.1%).2. Causes of fracture; road toraffic accident (39.4 T,). 3. Age; over 24 months (27.9%). 4. Sex; male (53.89)), female (46.2%). 5. Month of the most frequence; July (14.4%) 6. Total body weight: 2-5 kg (45.27)). 7. Presence of communicating external wound; closed fracture (94.2%). 8. Extent of damage; complete fracture (92.6%). 9. Direction of fracture line: comminuted fracture (27.8 To). 10. Location of fracture line; diaphysis (62.0%). 11. Fracture management; open reduction (58.3% ). 12. Fixation methods; not treat (22.2%). 13. Fixation methods according to location of fracture; radius ulna-Kirschner wire fixation (45.5%), femur. shaft-intramedullary pinning (71.4%), pelvis-bone plate (53.3%), metacarpus-not treat, Kirschner wire fixation (each 30.8%).

• 대한정형외과학회지
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• 제55권2호
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• pp.178-182
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• 2020

하부 천골의 단독 골절은 일반적으로 저에너지 손상으로 안정된 골절이 많아 대부분의 경우에서 보존적 치료가 이루이지고 있고 그 결과도 좋은 것으로 보고되고 있다. 하지만 전위된 불안정 골절에서는 수술적 치료의 필요성이 요구되나 치료 방법이 정립되어 있지 않으며 증례보고마저 매우 드물다. 이에 저자들은 하부 천골의 전위된 횡골절에 대해 관혈적 정복 및 이중 금속판을 이용한 내고정술을 치험한 증례를 보고하고자 한다.

• 기본간호학회지
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• 제17권3호
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• pp.334-342
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• 2010

Purpose: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. Method: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. Results: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. Conclusion: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.

• 대한기계학회논문집A
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• 제38권5호
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• pp.497-503
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• 2014

골절 치료에서 최소 침습 수술 방법은 그 효용성이 입증 되었지만, 의료진이 골편을 직접 볼 수 없기 때문에 방사선 투시영상장치(C-armed fluoroscopy)에 의존하여 수술을 진행하게 된다. 최소침습 수술은 환자에게는 감염이 적고 회복이 빠르다는 장점이 있지만 의료진에게는 과도한 방사선 피폭과 부정확한 골절정복 가능성이 높아지는 문제점이 발생할 수 있다. 본 연구에서는 이와 같은 문제를 해결하기 위해 수술 항법장치와 수술 지원로봇을 활용하는 방법을 제안한다. 골편의 3D CT 모델을 실제 골편과 특징점을 이용해서 정합하는 오픈 소스 기반으로 구성된 수술 항법 장치와 2D 투시 영상에서 골편간의 회전 변위를 정상측 투시 영상과 비교하여 확인 할 수 있는 방법을 제안하였고, 모델 뼈를 이용한 실험으로 제안한 방법의 임상적 타당성을 확인하였다. 그 결과 3D CT-기반 수술 항법 장치의 모델 뼈와 영상정합 정확도는 약 2mm 로 정형외과 수술에서 요구되는 사양을 만족했으며, 2D 투시 영상에서는 ${\pm}15^{\circ}$범위의 골편간의 회전에서 $2.5^{\circ}$이하의 변별력을 나타내었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권1호
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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 the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.145-148
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• 2010

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.