• Title/Summary/Keyword: complex fracture

Search Result 367, Processing Time 0.025 seconds

Unrecognized bony Bankart lesion accompanying a dislocated four-part proximal humerus fracture before surgery: a case report

  • Lee, Seungjin;Shin, Daehun;Hyun, Yoonsuk
    • Clinics in Shoulder and Elbow
    • /
    • v.25 no.1
    • /
    • pp.68-72
    • /
    • 2022
  • Proximal humerus fractures are the third most common fractures, totaling 4% to 5% of all fractures. Here, we present the case of a 39-year-old man with a dislocated four-part fracture of the proximal humerus with a huge bony Bankart lesion. Preoperatively, the bony Bankart lesion of the glenoid was not visualized on computed tomography scans or magnetic resonance imaging because the fracture of the proximal humerus was comminuted, displaced, and complex. It was planned for only the humerus fracture to be treated by open reduction and internal fixation using a locking plate. However, a fractured fragment remained under the scapula after reduction of the dislocated humeral head. This was mistaken for a dislocated bone fragment of the greater tuberosity and repositioning was attempted. After failure, visual confirmation showed that the bone fragment was a piece of the glenoid. After reduction and fixation of this glenoid part with suture anchors, we acquired a well-reduced fluoroscopic image. Given this case of complex proximal humerus fracture, a glenoid fracture such as a bony Bankart lesion should be considered preoperatively and intraoperatively in such cases.

Treatment for Acute Stage Complex Regional Pain Syndrome Type II with Polydeoxyribonucleotide Injection

  • Jang, Kun Soo;Kim, Hyeun Sung
    • Journal of Korean Neurosurgical Society
    • /
    • v.59 no.5
    • /
    • pp.529-532
    • /
    • 2016
  • Complex regional pain syndrome (CRPS) type II is a syndrome that develops after nerve injury. Symptoms may be severe, and vary depending on the degree of sympathetic nerve involvement. As yet, there is no satisfactory treatment. We report the case of a female patient who had an L5 left transverse process fracture and an S2 body fracture, who developed symptoms of CRPS type II in her left lower leg that were aggravated during ambulation in spite of absolute bed rest for one month after the trauma. Several treatments, including bed rest, medication, and numerous nerve blocks were attempted, but the pain persisted. We finally tried injection of polydeoxyribonucleotide (PDRN) solution at the left L5 transverse process fracture site because we knew of the anti-inflammatory effect of PDRN. One day after this treatment, her symptoms had almost disappeared and three days later, she was discharged. We will also further discuss the possibility of using PDRN solution for the treatment of CRPS.

4 Cases of Patients That Improved from Traffic Accident Which Caused Lumbar Spine Compression Fracture by Complex Korean Medical Admission Treatment: Retrospective Case Study (교통 사고 이후 발생한 요추부 압박골절에 한방복합입원치료로 호전된 환자 4례: 후향적 증례 연구)

  • Hong, Je-Rak;Kim, Yu-Jong;Kim, Ji-Su;Lee, Jeong-Ryol;Kim, Tae-Gyu;Yoo, Do-Hyun;Choi, In-Seok;Lee, Sang-Won
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.27 no.4
    • /
    • pp.163-170
    • /
    • 2017
  • Objectives The objective of this study is to report 4 patients who had vertebral compression fracture after traffic accident, that had a complex korean medical admission treatment. Methods In this study we collected the data of traffic accident patients that came to receive intense Korean medical treatment, and had compression fracture of the lumbar spine. A total of 4 patients were studied and we compared the Visual Analogue Scale (VAS) score and the Pain-Free Walking Distance (PFWD) at addmission date and 19th day of hospitalization. Results After receiving an average of 22.25 days of admission treatment, all patients showed a significant decrease in VAS scores and increase in PFWD. The median VAS score at date of admission was 6.5 (VAS 6~9) and decreased to 3.5 (VAS 3~5), median PFWD was 37.5 (30~45) m and increased to 435 (420~450) m. Conclusions After complex korean medicine admission treatment, 4 patients with vertebral compression fracture caused by traffic accident showed decrease of pain and increase of walking distance. But there is a need for further studys to be done on treatment methods and evaluation methods.

Effect of Bee Venom Acupuncture Complex Therapy of Thoracolumbar Compression Fracture (흉(胸).요추압박골절(腰椎壓迫骨折)에 대한 봉약침(蜂藥鍼) 복합치료(複合治療) 효과(效果))

  • Yang, Ka-Ram;Song, Ho-Sueb
    • Journal of Acupuncture Research
    • /
    • v.25 no.3
    • /
    • pp.29-39
    • /
    • 2008
  • Methods : We investigated 28 cases of patients with thoracolumbar compression fracture. We divided patients into two groups : We treated one group with complex oriental medical treatment focusing on Bee Venom Acupuncture therapy, and did the other group with complex oriental medical treatment focusing on acupuncture therapy. To investigate the effectiveness of treatment applied for two groups, we used Visual Analog Scale(VAS) and Oswestry Low-back Pain Disability Index(ODI). We compared the VAS score and ODI score of two groups statistically. Results : 1. Female is prominent in distribution of sex, the average age bracket is 70's, and the largest group was Faccidental fall in the distribution of cause. 2. In regard to level of injury, T12 was found to be most prominent, followed in turn by L1, L2. In regard to grade of clinical symptoms, Grade III was most prominent, followed by Grade IV, Grade II. 3. As a result of evaluation by using VAS score and ODI score, treatment score at final was significantly different from that at the baseline in each group. 4. After treatment, Bee Venom acupuncture therapy group showed significant difference on VAS score and ODI score compared with acupuncture therapy group. Conclusions : Bee Venom acupuncture therapy can be available for relieving symptoms related with thoracolumbar compression fracture.

  • PDF

A Modeling Study on the AVO and Complex Trace Analyses of the Fracture Bone Reflection (파쇄대 반사에너지의 AVO 및 복소트레이스 분석에 관한 모형연구)

  • Han Soo-Hyung;Kim Ji-Soo;Ha Hee-Sang;Min Dong-Joo
    • Geophysics and Geophysical Exploration
    • /
    • v.2 no.1
    • /
    • pp.33-42
    • /
    • 1999
  • AVO and complex trace analyses mainly used to characterize natural gas reservoir were tested in this paper for a possible application to detection of major geological discontinuities such as fracture zones. The test data used in this study were calculated by utilizing a viscoelastic numerical program which was based on the generalized Maxwell body for a horizontal fracture model. In AVO analysis of a horizontal fracture zone, p-wave reflection appears to be variant depending upon the acoustic-impedence contrast and the offset distance. The fracture zone is also effectively clarified both in gradient stack and range-limited stack in which fracture zone reflection is attenuated with the increasing offset distance. In complex attribute plots (instantaneous amplitude, frequency, and phase), the top and bottom of the fracture Tone are characterized by a zone of strong amplitudes and an event of the same phase. Low frequency characteristics appear at the fracture zone and the underneath. Amplitude attenuation and waveform dispersion are dependent on Q-contrast between the fracture zone and the surrounding media. They were properly compensated by optimum inverse Q-filtering.

  • PDF

Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up

  • Kim, Du-Han;Kim, Beom-Soo;Baek, Chung-Sin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
    • /
    • v.23 no.1
    • /
    • pp.20-26
    • /
    • 2020
  • Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

Clinical Experiences of Facial Asymmetries in Zygomaticomaxillary Complex Bone Fracture Patients (관골상악골 복합체 골절 환자에서의 안면 비대칭에 대한 임상경험)

  • Kang, Nak-Heon;Choi, Sang-Mun;Kim, Joo-Hak;Song, Seung-Han;Oh, Sang-Ha
    • Archives of Plastic Surgery
    • /
    • v.38 no.2
    • /
    • pp.161-165
    • /
    • 2011
  • Purpose: Zygomaticomaxillary complex (ZMC) fracture is one of the most common facial injuries after facial trauma. As ZMC composes major facial buttress, it is a key element of the facial contour. So, when we treat these fractures, the operator should have a concern with the symmetry to restore normal appearance and function. But sometimes, unfavorable results may occur. The aim of this study is to analyze the unsatisfied midfacial contour after ZMC fractures reduction retrospectively and to point out the notandum. Methods: 369 patients, treated for fractures of the ZMC were included in the study. After the operation, such as open reduction and internal fixation (ORIF with titanium or absorbable materials), open reduction, and closed reduction, midfacial contour was evaluated with plain films and 3-dimensional computed tomography. And unfavorable asymmetric midfacial contours were correcterd by secondary correction and re-evaluated. Gross photographs were obtained at outpatient clinic. Results: Total of 38 patients had got a facial asymmetry and among of them 24 patients were treated secondary revisional ORIF operations for correction of unfavorable result of after primary reduction. Two of them had received tertiary operations, three patients had got osteotomy more than after one year and six patients had got minor procedures. The etiology of asymmetry were lateral displaced simple fracture of arch (n=2), lateral displaced comminuted fracture of arch (n=6), comminuted arch fracture combined posterior root fracture (n=9), and communited arch and body fracture (n=12), severely contused soft tissue (n=9). After the manipulations outcomes were acceptable. Conclusion: To prevent the asymmetry in ZMC fracture reduction, complete analysis of fracture, choice of appropriate operation technique, consider soft tissue, and secure of zygoma position are important. Especially, we should be more careful about communited fracture of zygomatic body and lateral displacement, root fracture of zygomatic arch. Because they are commom causes that make facial asymmetry. To get optimal result, ensure the definite bony reduction.

Two Patients Who Were Hospitalized for Clavicle Fracture Caused by a Traffic Accident and Improved with Korean Medicine Complex Treatment (교통사고로 발생한 쇄골 골절로 입원하여 한방복합치료로 호전된 환자 2예)

  • Kang, Deok;Kang, ByungSoo;Jeong, Hwe-Joon;Shin, Dong-Hoon;Shin, Kyung-Moon;O, Ji-Hoon;Yang, Jae-Woo
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.32 no.3
    • /
    • pp.179-187
    • /
    • 2022
  • To report improvement of 2 hospitalized patients who had clavicle fractures due to traffic accident with Korean medicine complex treatment. We collected a data from February 2020 to April 2022. A total of 2 patients were studied and we compared numeric rating scale (NRS), neck disability index (NDI), range of motion (ROM) at admission and discharge date of hospitalization. After receiving an average of 28.5 days of Korean medicine inpatient treatment, both patients had reduced NRS, NDI scores and increased ROM. After Korean medicine complex treatment, 2 patients with clavicle fracture showed to have been effective. But further studies need to be done.

A CLINICAL AND STATISTICAL STUDY FACIAL BONE FRACTURE (춘천지역의 안면골 골절에 관한 임상적 연구)

  • Lee, Jeong-Gu;Han, Myoung-Soo;Kim, Sang-Bond;Kim, Hag-Beom
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.12 no.1
    • /
    • pp.103-113
    • /
    • 1990
  • The study was based on a series of 252 patient with facial bone fractures who visited to Chun Cheon Sacred Heart Hospital, College of Medicine, Hallym University during the period of Dec., 1984 trough Nov., 1989. The results obtained are as follows; 1. The most frequent etiologic factor was traffic accident(45.2%). 2. The ratio of male to female was 5.5 : 1 and 2nd decade(44%) was the highest age group in incidence. 3. Monthly incidence was the highest in Aug(14.3%). 4. The most common site of fracture was mandible(55.3%) and zygoma complex(24.2%), nasal bone(11.6%), maxilla(8.9%) were next in order of frequeny. 5. In mandible fractures, the most frequent site was symphyseal area(36.9%) and 142 cases(85%) had fractures only in mandible. 6. In maxillary fractures, fracture with other facial bones(85.2%) was more frequent than fracture on maxilla only. The major fracture type on maxilla was Le Fort II type. 7. In fracture of zygoma complex, zygoma & zygomatic arch was the most frequent site(52.0%) and zygomatic arch(24.7%), zygoma(23.3%) were next in order. 8. Open reduction was major method of treatment in facial bone fractures except nasal bone ; mandible(62.9%), maxilla(77.8%), zygoma complex(65.8%). 9. Maxillofacial fractures were most frequently combined with head & neck injury(43.1%), and upp. & low. extremities(29.4%), chest and abdomen(11.9%) were in order of frequency.

  • PDF

A Clinical and Statistical Study on Maxillofacial Fractures. (악안면골(顎顔面骨) 골절환자(骨折患者)의 임상(臨床) 통계적(統計的) 연구(硏究))

  • Kim, Seung-Lyong;Jin, Woo-Jeong;Shin, Hyo-Keun;Kim, Oh-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.11 no.1
    • /
    • pp.1-11
    • /
    • 1989
  • This is a retrospective study on maxillofacial fractures. This study was based on a series of 442 patients with maxillofacial fractures treated at Dept, of oral and Maxillofacial Surgery, College of Dentistry, Chon Buk National University from Jan, 1984 to Sep. 1988. The results obtained were as follows: 1. The ratio of Male/Female was 4.8 : 1, and 3rd decade (43.9%) was the highest age group in incidence. 2. Monthly incidence was the highest in Oct,(10.6%). 3. The most frequent maxillofacial fracture site was mandible (70.0%), and zygoma & zygomatic arch (13.6%), maxilla(11.7%) and nasal bone (4.7%) were next in order of frequency. 4. Traffic accidents (47.5%), fight(24.8%) were the most common causes of maxillofacial fractures. 5. The most frequent chief complaint was painful swelling(40.7%). 6. In mandibular fractures, the most frequent fracture site was symphyseal area(28.9%) and simple fracture was the most frequent in type of fracture (71.2%). 7. In maxillary fractures, fracture with other facial bones (64.5%) was more frequent than fracture of maxilla only. The most common type of fracture was unilateral fractures(37.1%). 8. In fracture of zygoma complex, zygoma fracture was the most frequent fracture type(40.3%), zygoma and zygomatic arch fx, (30.6%), zygomatic arch fx, (29.1%) were next in order 9. Open reduction was major method of treatment in maxillofacial fractures : Mandible (77.5%), Maxilla (61.3%), Zygoma complex(43.1%). 10. Maxillofacial fractures were most frequently combined with head injury(39.3%), and lower extremities(17.0%), upper extremities(13.6%) were next in order.

  • PDF