• Title/Summary/Keyword: delayed fracture

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Therapeutic effects of 1α,25 dihydroxycholecalciferol on osteoporotic fracture in a rat model (랫드에서 1α,25 dihydroxycholecalciferol의 골다공증성 골절 치유효과)

  • Bae, Chun-sik
    • Korean Journal of Veterinary Research
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    • v.39 no.5
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    • pp.974-985
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    • 1999
  • Osteoporosis is defined as a decrease in bone mass that leads to an increased risk of fracture. The therapeutic effect of $1{\alpha}$,25 dihydroxycholecalciferol, the hormonal form of vitamin $D_3$ that mediates calcium translation in intestine and bone, on the healing process of fracture has still been controversial. These studies were designed to understand the healing process of normal fibular fracture, the osteoporotic changes after ovariectomy, and the therapeutic effects of $1{\alpha}$,25 dihydroxycholecalciferol on the osteoporotic fracture in rats. The simple transverse fractures of rat fibulae were produced with a rotating diamond saw. The changes of the biochemical and mechanical indices of rats were investigated. The mechanical study based on bending test revealed the healing of the fibular fracture in the 5th week after simple transverse fracture. The osteoporosis impaired more the healing of osteoporotic fibular fracture than normal non-osteoporotic fibular fracture. The healing process of osteoporotic fracture was facilitated by the treatment with $1{\alpha}$,25 dihydroxycholecalciferol, however, was delayed more than the healing process of normal fracture. The bone strength based on the bending test also confirmed this tendency. The bone strengths in the 5th week after fracture of normal bone, osteoporotic bone, and $1{\alpha}$,25 dihydroxycholecalciferol-treated osteoporotic bone were 75%, 41%, and 67%, respectively, in comparison with those of intact bone. In conclusion, $1{\alpha}$,25 dihydroxycholecalciferol was effective in promoting the osteoporotic fracture healing.

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Leaflet Fracture and Embolization of a CarboMedics Prosthetic Mitral Valve: Case Report

  • Kim, Tae Yeon;Kim, Myoung Young
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.419-421
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    • 2021
  • Fracture of prosthetic valve leaflets in the absence of traumatic injury is very rare. Leaflet fracture can cause acute pulmonary edema and cardiogenic shock and is potentially life-threatening, requiring emergency surgery. Thus, a leaflet fracture must be diagnosed quickly and accurately. We present the case of a 46-year-old man with CarboMedics prosthetic aortic and mitral valve replacements implanted 24 years previously. The patient presented at our emergency department with abrupt dyspnea and fever. We diagnosed severe mitral valve regurgitation with anterior leaflet fracture. The patient underwent venoarterial extracorporeal membrane oxygenation and delayed mitral valve replacement. The foreign body was removed step by step because the diagnosis was missed. Two pieces of broken leaflets were found in the left common iliac artery and left external iliac artery. The patient was treated successfully and remains asymptomatic 1 year following surgery.

DELAYED VISUAL LOSS BY INDIRECT TRAUMATIC OPTIC NEUROPATHY RELATED TO PANFACIAL FRACTURE: A CASE REPORT (범안면 골절과 연관된 간접적 외상성 시신경 병증에 의한 시력상실 증례)

  • Lee, Jong-Bok;Lee, Dae-Jeong;Choi, Moon-Ki;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.81-85
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    • 2009
  • As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.

DELAYED HYDRIDE CRACKING IN ZIRCALOY FUEL CLADDING - AN IAEA COORDINATED RESEARCH PROGRAMME

  • Coleman, C.;Grigoriev, V.;Inozemtsev, V.;Markelov, V.;Roth, M.;Makarevicius, V.;Kim, Y.S.;Ali, Kanwar Liagat;Chakravartty, J.K.;Mizrahi, R.;Lalgudi, R.
    • Nuclear Engineering and Technology
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    • v.41 no.2
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    • pp.171-178
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    • 2009
  • The rate of delayed hydride cracking (DHC), V, has been measured in cold-worked and stress-relieved Zircaloy-4 fuel cladding using the Pin-Loading Tension technique. At $250^{\circ}C$ the mean value of V from 69 specimens was $3.3({\pm}0.8)x10^{-8}$ m/s while the temperature dependence up to $275^{\circ}C$ was described by Aexp(-Q/RT), where Q is 48.3 kJ/mol. No cracking or cracking at very low rates was observed at higher temperatures. The fracture surface consisted of flat fracture with no striations. The results are compared with previous results on fuel cladding and pressure tubes.

COMPLICATIONS ASSOCIATED WITH OPEN REDUCTION OF MANDIBULAR FRACTURES (관혈적 정복술로 치료한 하악골 골절에서의 합병증)

  • Park, Young-Ah;Sohn, Woo-Ill;Chang, Ic-Jun;Song, Jae-Chul;Chin, Byung-Rho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.474-480
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    • 2001
  • Purpose: The aim of this study was to evaluate the complications of open reduction and internal fixation of mandibular fracture with miniplates. Patients and Methods: A total of 134 patients who presented with 196 fractures were analyzed retrospectively. Complications were evaluated for factors such as age, the site of fracture, the severity of fracture, delayed operation, preoperative wound contamination, the site and disposition of teeth in the fracture line and midfacial fractures. Statistical analysis was used to compare complications to risk factors. Results: Of the 134 patients, 20 patients had some form of postoperative complications and complication rate was 14.9%. These complications included infection, plate fracture, malocclusion, wound dehiscence, nerve injury and nonunion. There was a significant correlation between complication rate and the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth(p<0.05). Conclusion: The occurrence of postoperative complications in the treatment of mandibular fractures was related to the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth.

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Delayed rupture of a posttraumatic retromaxillary pseudoaneurysm causing massive bleeding: a case report

  • Hwang, Jae Ha;Kim, Woo Hyeong;Choi, Jun Ho;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.22 no.3
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    • pp.168-172
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    • 2021
  • Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

Probabilistic Integrity Assessment of CANDU Pressure Tube for the Consideration of Flaw Generation Time (결함발생 시점을 고려한 CANDU 압력관 결함의 확률론적 건전성평가)

  • Kwak, Sang-Log;Lee, Joon-Seong;Kim, Young-Jin;Park, Youn-Won
    • Proceedings of the KSME Conference
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    • 2001.11a
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    • pp.155-160
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    • 2001
  • This paper describes a probabilistic fracture mechanics (PFM) analysis based on Monte Carlo (MC) simulation. In the analysis of CANDU pressure tube, it is necessary to perform the PFM analyses based on statistical consideration of flaw generation time. A depth and an aspect ratio of initial semi-elliptical surface crack, a fracture toughness value, delayed hydride cracking (DHC) velocity, and flaw generation time are assumed to be probabilistic variables. In all the analyses, degradation of fracture toughness due to neutron irradiation is considered. Also, the failure criteria considered are plastic collapse, unstable fracture and crack penetration. For the crack growth by DHC, the failure probability was evaluated in due consideration of flaw generation time.

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A Case of Delayed Intracerebellar Hematoma after Head Injury (두부외상 후 발생한 지연성 소뇌 혈종 1례)

  • Kim, Sahng Hyun;Whang, Kum;Pyen, Jin Soo;Hu, Chul;Hong, Soon Ki;Han, Young Pyo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.407-410
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    • 2000
  • The traumatically induced mass lesions of the posterior cranial fossa are unusual. Various types of traumatic posterior fossa hematoma have been described ; the most common forms is epidural hematomas, and frequently traumatic intracerebellar hemorrhage is encountered. A sixty-six-old male patient was initially presented with the occipital skull fracture and contusional hemorrhage on the both frontal lobe, a developed delayed cerebellar hemorrhage. The patient was operated for hematoma removal with good postoperative recovery. We advise a consideration for delayed intracerebellar hematoma in patients with cerebellar contusion following trauma.

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Risk Factors for Delayed Hinge Fracture after Plate-Augmented Cervical Open-Door Laminoplasty

  • Hur, Junseok W.;Park, Youn-Kwan;Kim, Bum-Joon;Moon, Hong-Joo;Kim, Joo-Han
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.368-373
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    • 2016
  • Objective : Delayed hinge fracture (HF) that develops after cervical open door laminoplasty can be a source of postoperative complications such as axial pain. However, risk factors related to this complication remain unclear. We performed a retrospective clinical series to determine risk factors for delayed HF following plate-only open-door cervical laminoplasty. Methods : Patients who underwent plate-only open-door laminoplasty and had available postoperative computed tomography (CT) scans (80 patients with 270 laminae) were enrolled. Hinge status, hinge gutter location, open location, hinge width, number of screws used, operation level, and open angle were observed in the CT to determine radiographic outcome. Demographic data were collected as well. Radiographic and clinical parameters were analyzed using univariate and multivariate logistic regression analysis to determine the risk factors for HF. Results : Univariate logistic regression analysis results indicated poor initial hinge status, medially placed hinge gutter, double screw fixation on the elevated lamina, upper surgical level, and wide open angle as predictors for HF (p<0.05). Initial hinge status seemed to be the most powerful risk factor for HF (p=0.000) and thus was collinear with other variables. Therefore, multivariate logistic regression analysis was performed excluding initial hinge status, and the results indicated that medially placed hinge gutter, double screw fixation on the elevated lamina, and upper surgical level were risk factors for HF after adjustment for other confounding factors. Conclusion : To prevent HF and to draw a successful postoperative outcome after cervical laminoplasty, surgical and clinical precautions should be considered.

Conversion to Internal Fixation after Temporary External Fixation for Femoral Shaft Fractures in Polytrauma Patients (다발성 외상 환자의 대퇴골 간부 골절에서 임시 외고정술 후 내고정술로의 전환)

  • Choo, Suk-Kyu;Kang, Kyung-Woon;Kim, Young-Woo;Oh, Hyoung-Keun
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.151-157
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    • 2014
  • Purpose: We report the surgical outcomes for femoral shaft fractures in polytrauma patients who were temporarily treated with external fixation and subsequently converted to internal fixation. Methods: From August 2008 to April 2012, we enrolled 13 patients with multiple traumas due to high-energy injuries and concurrent femoral shaft fractures in which temporary external fixation was carried out. The mean age was 39 years, with a range from 18 to 55 years. Ten were men and 3 were women. According to the AO/OTA classification of fractures, type A was found in 5 patients, type B in 6, and type C in 2, with open fractures being found in 6 patients and femoral artery rupture occurring in 2. For internal fixation, intramedullary nailing was performed in 7 patients, and minimally-invasive fixation of locking compression plates was used in 6. Results: Of the 7 patients converted to intramedullary nailing, 1 experienced delayed union. Of the 6 patients treated with minimally-invasive plate fixation, delayed union occurred in 5, and an auto-bone graft was performed within, on average, 8 months (range: 5~10 months), leading to bone union in all cases in the final follow-up. None of the patients experienced infections or complications involving other organs after having been converted to internal fixation. During the mean follow-up of 19 months, patients achieved satisfactory functional outcomes. Conclusion: In polytrauma patients with a femoral shaft fracture who have been treated with temporary external fixation and who may need internal fixation due to the occurrence of delayed union, an appropriate internal fixation method needs to be selected based on the patient's physical status, and the fracture type.