• 대한두개안면성형외과학회지
• /
• 제17권2호
• /
• pp.51-55
• /
• 2016

Background: Nasal bone fractures are managed by closed reduction within the 2-week period, and are managed by secondary correction after this time. There is little literature on the delayed reduction for nasal bone fractures beyond the 2-week duration. We report our experience with nasal fractures, which were reduced beyond this period. Methods: A retrospective review was performed for all patients who had undergone closed reduction of isolated nasal bone fracture. Patients were included for having undergone reduction of nasal bone fractures at or more than 2 weeks after the injury. Medical records were reviewed for demographic information, injury mechanism, fracture type, delay in treatment, and cause for delay. Postoperative outcomes were evaluated using computed tomography images. Results: The review identified 10 patients. The average reduction time was 22.1 days. Five of patients underwent reduction between days 15 and 20, and the remaining five patients underwent reduction between days 21 and 41. The postoperative outcomes were excellent in 8 patients and good in 2 patients. Conclusion: Outcomes were superior for nasal fractures with displaced end plates and multiple fracture segments. Our study results appears to support delayed reduction of isolated nasal fractures in the presence of factors that delay bony reunion.

• Clinical Pain
• /
• 제20권2호
• /
• pp.145-149
• /
• 2021

Ankylosing spondylitis (AS) is a chronic inflammatory disease presenting progressive spinal stiffness and sacroiliitis. Cervical spine fracture combined with AS should be treated with operation, but it is closely related with increased rates of surgical site infection, which are associated with an elevated erythrocyte sedimentation rate and elevated C-reactive protein. We report a case of delayed postoperative infection appeared in cervical paravertebral space, which was masked by laboratory findings and clinical characteristics represented in this rheumatic disease. A 53-year-old man who had medical history of AS got operation after cervical spine fracture. During hospitalization, he experienced aching pain originating from left posterior neck to shoulder, which was revealed out to be delayed postoperative infection, diagnostically obscured by elevated values of inflammatory markers. This case emphasizes detailed evaluation considering symptoms and comorbidity of the patient should be performed to apply proper management.

• 대한두개안면성형외과학회지
• /
• 제20권1호
• /
• pp.44-47
• /
• 2019

A carotid-cavernous sinus fistula is a rare condition in which an abnormal communication exists between the internal or external carotid artery and the cavernous sinus. It typically occurs within a few weeks after craniomaxillofacial trauma. In most cases, the carotid-cavernous sinus fistula occurs on the same side as the craniomaxillofacial fracture. We report a case of delayed carotid-cavernous sinus fistula that developed symptoms 7 months after the craniomaxillofacial fracture. The fistula developed on the side opposite to that of the craniomaxillofacial fracture. Based on our experience with this case, we recommend a long follow-up period of 7-8 months after the occurrence of a craniomaxillofacial fracture. We also recommend that the follow-up should include consideration of the side contralateral to the injury.

• Journal of Trauma and Injury
• /
• 제32권4호
• /
• pp.243-247
• /
• 2019

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1-4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors' knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.

• Journal of Korean Neurosurgical Society
• /
• 제61권1호
• /
• pp.1-9
• /
• 2018

Posttraumatic delayed vertebral collapse, known as Kummell's disease, is increasing in number of patients. This disease is already progressive kyphosis due to vertebral collapse at the time of diagnosis and it causes intractable pain or neurologic deficit due to intravertebral instability. Treatment is very difficult after progression of the disease, and the range of treatment, in hospital day, and cost of treatment are both increased. Clinical features, pathogenesis and radiologic findings of these disease groups were reviewed to determine risk factors for delayed vertebral collapse. The purpose of this article is to suggest appropriate treatment before vertebral collapse for patients with osteoporotic vertebral compression fracture who have risk factors for posttraumatic delayed vertebral collapse.

• Archives of Plastic Surgery
• /
• 제37권4호
• /
• pp.489-491
• /
• 2010

Purpose: Retrobulbar hemorrhage is a rare complication followed by blepharoplasty, trauma, orbital reconstruction, and so on. Most of the cases occur within 24 hours, half of them in the first 6 hours. Some authors have reported delayed retrobulbar hemorrhage after blepharoplasty and trauma within 1 day to 9 days. However, there have been few reports of delayed retrobulbar hemorrhage resulting from the complication of orbital reconstruction. Methods: A 22-year-old male underwent orbital floor reconstruction due to the orbital floor fracture. In 84 hours after the surgery, he complained sudden onset orbital pain and decreased visual acuity immediately after defecation. Intraocular pressure was unmeasurable due to the swelling at that time. Emergency computed tomography was performed. Results: Computed tomography revealed subperiosteal hematoma on inferior orbital wall extended to the apex. Emergency decompressive surgery was performed within 1 hour. After evacuation of hematoma, orbital symptom was improved and visual acuity was restored. Conclusion: Delayed retrobulbar hemorrhage is rare but vision-threatening. Therefore early diagnosis and treatment of delayed retrobulbar hemorrhage is thought to be crucial. The cause of delayed hemorrhage was not clear, however, valsalva maneuver might be the cause of hemorrhage.

• Restorative Dentistry and Endodontics
• /
• 제37권2호
• /
• pp.110-113
• /
• 2012

본 증례의 편측성 하악 과두 골절 환자는 외상 후 1개월간 다수의 상악 전치부 치아 외상이 간과되어 교합이 붕괴된 상태로 내원하였다. 변위된 상악 전치부 치아들의 외과적 정복 후 지속적인 기능 운동을 진행하여, 10개월 후 정상 교합 및 하악 과두 골절부의 골유합이 확인되는 양호한 결과를 얻을 수 있었다.

• 대한정형외과 초음파학회지
• /
• 제4권2호
• /
• pp.66-71
• /
• 2011

목적: 보존적인 치료를 시행 받은 쇄골 골절 환자 중 단순 방사선학적 검사에서 가골 형성이 관찰 되지 않아 지연유합이나 불유합이 의심되는 경우 초음파 검사가 가골 형성여부를 확인하는 검사로서 유용한 가를 알아보고자 하였다. 대상 및 방법: 쇄골 골절로 진단되어 보존적인 치료를 시행 받았으나, 불유합 또는 지연 유합이 의심되는 여섯 명의 남자와 한 명의 여자 환자(평균 38.3세; 범위: 7~70세)를 대상으로 초음파를 시행하였다. 초음파 검사상 가골 형성이 관찰된 경우는 보존적 치료를 지속하였고, 가골 형성이 관찰 되지 않은 경우는 수술적 치료를 시행하였다. 결과: 초음파 검사상 가골 형성을 관찰 할 수 있었던 6예는 보존적인 치료를 지속하여 최종 추시 단순 방사선 검사상 골유합을 확인 할 수 있었다. 초음파 검사상 가골 형성이 관찰되지 않았던 1예는 수술적 치료를 시행하였으며, 수술소견상 골유합 소견을 관찰할 수 없었다. 결론: 초음파 검사는 보존적 치료를 받는 쇄골 골절 환자에서 임상적 및 방사선학적으로 불유합 또는 지연 유합이 의심되는 경우 가골 형성을 평가하는데 있어 유용한 검사 방법으로 불필요한 수술을 피하는 데 기여할 수 있을 것으로 생각한다.

• 대한금속재료학회지
• /
• 제50권1호
• /
• pp.52-58
• /
• 2012

Hydrogen-delayed fracture (HDF) was analyzed from the deposited weld metals of 600-MPa and 800-MPa flux-cored arc (FCA) welding wires, and then from the diffusible hydrogen behavior of the weld zone. Two types of deposited weld metal, that is, rutile weld metal and alkali weld metal, were used for each strength level. Constant loading test (CLT) and thermal desorption spectrometry (TDS) analysis were conducted on the hydrogen pre-charged specimens electrochemically for 72 h. The effects of microstructures such as acicular ferrite, grain-boundary ferrite, and low-temperature-transformation phase on the time-to-failure and amount of diffusible hydrogen were analyzed. The fracture time for hydrogen-purged specimens in the constant loading tests decreased as the grain size of acicular ferrite decreased. The major trapping site for diffusible hydrogen was the grain boundary, as determined by calculating the activation energies for hydrogen detrapping. As the strength was increased and alkali weld metal was used, the resistance to HDF decreased.

• 대한약리학회지
• /
• 제7권1호
• /
• pp.53-65
• /
• 1971

It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.