• Title/Summary/Keyword: delayed fracture

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Effect of perioperative buccal fracture of the proximal segment on postoperative stability after sagittal split ramus osteotomy

  • Lee, Sang-Yoon;Yang, Hoon Joo;Han, Jeong-Joon;Hwang, Soon Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.217-223
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    • 2013
  • Objectives: Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery. Materials and Methods: Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture. Results: Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible. Conclusion: Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.

Surgical management of edentulous/atrophic mandibular fracture: a report of two cases

  • Lim, Jae-Seok;Kwon, Jin-Il;Kim, Bong-Chul;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.50-54
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    • 2012
  • According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

Operative Treatment of Displaced Talar Neck Fracture (전위된 거골 경부 골절의 수술적 치료)

  • Ahn, Jae-Hoon;Baek, Chang-Hyun;Choy, Won-Sik;Kim, Yong-In
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.190-195
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    • 2006
  • Purpose: To evaluate the results of open reduction and internal fixation for displaced talar neck fracture. Materials and Methods: Fourteen patients were followed for more than 1 year after open reduction and internal fixation of displaced talar neck fracture. The mean age was 41.5 years, and the mean follow-up period was 3.8 years. There were 10 type II, 3 type III and 1 type IV fractures per Hawkins. There were 3 open fractures. Clinically AOFAS ankle-hindfoot scale and Hawkins criteria were utilized. Radiologically quality of reduction, duration of bony union, avascular necrosis and posttraumatic arthritis were evaluated. Results: At last follow-up, AOFAS scale was mean 89.1 points. There were 8 excellent, 4 good, and 2 fair results according to Hawkins criteria. Radiologically anatomical reduction was obtained in 13 cases. Mean duration of bony union was 11.8 weeks. There were 3 avascular necrosis and 2 post-traumatic arthritis. There was no significant difference in the incidence of avascular necrosis between early operation group and surgically delayed group. Conclusion: Accurate open reduction and rigid internal fixation seem to be prerequisites for satisfactory treatment of a displaced talar neck fracture.

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Hemiarthroplasty for Fractures or Fracture-Dislocations of the Proximal Humerus (상완골 근위부 골절 또는 골절 및 탈구에서의 상완골 두 치환술)

  • Kim Young Kyu;Eom Gi Serk
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.20-25
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    • 2000
  • Purpose : To evaluate functional results and study factors influencing results after humeral hemiarthroplasty for comminuted fractures of the proximal humerus. Materials and Methods: We reviewed 12 patients with average follow-up period of 23 months(12 to 42). The proximal humeral fractures consisted of one anatomical neck fracture, five three-part and six four-part fractures or fracture-dislocations. Constant score and Compito et al' evaluation system were used for clinical assessment. Statistical analysis was done with the Wilcoxon test. Results: Six cases of anatomical neck, three-part fractures or fracture-dislocations showed 61 points on the average Constant score and three unsatisfactory results on the Compito et al' evaluation; Six of four-part fractures or fracture-dislocations showed 51 points and three unsatisfactory results. There were 59(two unsatisfactory) for five non-associated dislocation and 53(four unsatistactory) for seven associated dislocation; 66(one unsatisfactory) for three under 60 years and 41(five unsatisfactory) for nine over 60 years; 67(two unsatisfactory) for seven tuberosity union and 41(four unsatisfactory) for five tuberosity non-union or resorption; 58(four unsatisfactory) for ten early operation within two weeks and 43(all unsatisfactory) for two delayed operation; and 18(unsatisfactory) for one case of a accompanied rotator cuff tear. Conclusion: We concluded that tuberosity union was important factor influencing the results. Also, we thought that age, timing of operation and accompanied rotator cuff tear could be influenced to results.

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Delayed Foreign Body Reaction around the Absorbable Implants in Facial Bone Fracture: A Case Report (안면부 골절에 사용된 흡수성 보형물의 지연성 이물반응: 증례보고)

  • Suh, Yong-Hoon;Kim, Young-Joon
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.875-878
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    • 2011
  • Purpose: Absorbable implants are frequently used to fix facial bone fractures, because they are radiolucent and compatible with magnetic resonance imaging (MRI). Despite their increasing usage, however, there have been few reports about their long-term side-effects. In this paper, a case in which absorbable implants led to a foreign body reaction 17 months after their insertion is presented. Methods: A previously healthy 19-year-old male fell from a flight of stairs and visited the authors' hospital with right periorbital pain. Zygomaticomaxillary fracture involving right orbital floor was detected via a facial bone computed tomography (CT). Internal fixation with absorbable implants was followed by open reduction. 17 months after the surgery, the patient complained of localized periorbital swelling. Removal of the granulomatous lesion including the absorbable implants along with their biopsy and culture was performed. Results: The granulomatous lesion around the implants was firm and extended into the maxillary sinus. The histologic finding showed a microabscess with a foreign body reaction. Methicillin-sensitive Staphylococcus aureus growth was confirmed in the culture. No definite abnormal symptoms ensued after the complete removal. Conclusion: A microabscess-forming granulomatous lesion around the absorbable implant can cause delayed symptomatic foreign body reaction despite its rare occurrence. Complete removal of the lesion including implants is expected to have a successful outcome if it is encountered.

Endodontic Drainage in Delayed Replantation after Prolonged Extra-alveolar Period of the Avulsed Teeth: Report of a Case (외상 후 오랜 시간 지체된 탈락 치아 재식술 시행 시 근관 통한 배농: 증례보고)

  • Yoo, Jae-Ha;Kim, Jong-Bae;Son, Jeong-Seog
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.4
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    • pp.280-285
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    • 2012
  • From the standpoint of general guidelines of a dentist, the following conditions should be considered before replanting a permanent tooth. The avulsed tooth should be without advanced periodontal disease. The alveolar socket should be reasonably intact in order to provide a seat for the avulsed tooth. The extra-alveolar period should be considered, i.e. periods exceeding. 2 hours are usually associated with marked root resorption. But, the above mentioned regulations are often difficult to keep in the actual situation of the medical emergency room, owing it to the delay of primary medical care in multiple trauma patients. The successful cases have been reported with minimal root resorption in the long-term periods, in spite of extra-alveolar periods of several hours and combined alveolar bone fracture. This is a case report regarding the effect of endodontic drainage in delayed replantation after a prolonged extra-alveolar period of the avulsed teeth with alveolar bone fracture.

Delayed Tension Pneumocephalus Caused by Ventriculoperitoneal Shunt

  • Lee, Woo-Yong;Kim, Seong-Ho;Kim, Oh-Lyong;Choi, Byung-Yon
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.47-49
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    • 2007
  • The authors describe a rare case of tension pneumocephalus, caused by ventriculoperitoneal[V-P] shunting for communicating hydrocephalus. The patient had a history of a right frontal skull fracture and pneumocephalus after a traffic accident five months prior to the present presentation of gait disturbance and memory impairment. A CT scan showed hydrocephalus and a V-P shunt was put in place. On the fourth day after surgery, the mental status of the patient gradually deteriorated due to a tension pneumocephalus; this was treated by repairing a fistula in the frontal sinus and a dural defect. The patient's mental status improved and symptoms were completely recovered. We report a case of tension pneumocephalus following V-P shunt for hydrocephalus in a patient who sustained a right frontal skull fracture.

Acromion Fracture after Hook Plate Fixation for Distal Clavicle Injury: A Report of 2 Cases

  • Kang, Suk;Lee, Ho Min;Back, In Hwa
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.168-171
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    • 2016
  • Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

Rectal Perforation Associated with a Pelvic Fracture Managed with Lateral Caudal Axial Pattern Flap Surgery Using the Tail to Skin Defect in a Mixed-Breed Dog

  • Lee, Jongjin;Kang, Jinsu;Kim, Namsoo;Heo, Suyoung
    • Journal of Veterinary Clinics
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    • v.38 no.5
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    • pp.240-243
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    • 2021
  • Complications of pelvic fractures and sacroiliac joint luxation include hemoabdomen, pulmonary trauma, and soft tissue injury. Among them, rectal perforation accounts for 1% of pelvic fracture complications. Delayed diagnosis is commonly associated with a poor prognosis. A mixed-breed dog was presented to Jeonbuk Animal Medical Center (JAMC) after a traffic accident with no signs of rectal perforation. After fracture surgery, rectal perforation was seen as a perianal fistula. This report describes a case of a perianal fistula progressed from rectal perforation after a traffic accident that was curatively treated with lateral caudal axial pattern flap surgery to the perianal skin.

Median nerve entrapment in a callus fracture following a pediatric both-bone forearm fracture: A case report and literature review

  • Fourati, Amine;Ghorbel, Iyadh;Karra, Amir;Elleuch, Mohamed Habib;Ennouri, Khalil
    • Archives of Plastic Surgery
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    • v.46 no.2
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    • pp.171-175
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    • 2019
  • Forearm fractures are common injuries in childhood. Median nerve entrapment is a rare complication of forearm fractures, but several cases have been reported in the literature. This case report discusses the diagnosis and management of median nerve entrapment in a 13-year-old male who presented acutely with a both-bone forearm fracture and numbness in the median nerve distribution. Following the delayed diagnosis, surgical exploration revealed complete nerve entrapment and a nerve graft was performed.