• Title/Summary/Keyword: open fracture

검색결과 634건 처리시간 0.036초

Interlocking Intramedullary Nail을 이용한 경골 골절의 치료 (Treatment of Tibial Fractures by Interlocking Intramedullary Nailing)

  • 정광용;이동철;서재성;김세동
    • Journal of Yeungnam Medical Science
    • /
    • 제10권2호
    • /
    • pp.388-399
    • /
    • 1993
  • 1983년 2월부터 1993년 5월까지 저자들이 interlocking IM nail정을 이용하여 치료한 경골 골절을 평균 14개월 추시하여 다음과 같은 결론을 얻었다. 1. 총 38례 중 37례에서 골유합을 이루어 97.3%의 골유합율은 보였으며 평균골유합기간은 18.7주였다. 2. 금속정의 사용 범위는 경골 간부 및 근위부나 원위부 골절에서 만족할 만한 결과를 얻었다. 3. interlocking nail은 심한 분쇄성 골절, 개방성 골절, 골소실이 있는 개방성 골절 동에서 견고한 고정을 얻을 수 있었다. 4. 불유합 및 지연유합된 경우 모두 골유합을 이루어 나사못 맞물림을 이용한 금속정 고정법은 경골 간부 골절에서 훌륭한 치료법으로 생각된다. 5. 가장 중요한 합병증은 Valgus 각형성 2례 및 varus 1례와 심부감염 1례 등이었다. 6. 금속정은 고정력이 견고하여 조기 관절운동 및 보행이 가능하여 관절 강직이나 근위축을 방지할 수 있었다.

  • PDF

송아지에서 발생한 긴뼈골절의 내고정 치료 6례 (Internal Fixation of Long Bone Fractures in 6 Calves)

  • 박진욱;조기래;김중현;최석화;김근형
    • 한국임상수의학회지
    • /
    • 제24권4호
    • /
    • pp.658-662
    • /
    • 2007
  • The simple and easy treatment with cast or splint has been applied to stabilize long bone fractures in farm animals. Applying cast or splint is relatively easier than surgical fixation and may temporarily stabilize fracture site. However, the internal fixation provides strong stabilization and early recovery of limb function. In this report, we describe six cases of limb fractures in calves repaired by internal fixation. Fracture sites are various and affected ages are between 1 day and several months old. In some cases, patients were treated with cast or splint before admitting to Veterinary Medical Center. In these patients, regardless of initial treatment fractures were not immobilized. Consequently we decided to treat these patients with open reduction and internal fixation. The fracture repair with implants(bone plate, screw, cerclage wire, and intramedullary pin) were effective and satisfactory in calves which had been failed by application of cast. Although the cost of orthopedic treatment in farm animal is one of the most important considerations from the practical point of view, internal fixation has many benefits in newborn and young calves. And simplicity of postoperative management is also practically significant benefit expected from infernal fixation In conclusion, we suggest that internal fixation will produce better result than external coaptation in calve.

FDM 방식의 3D 프린터를 이용한 골반 골절 환자의 맞춤형 모델제작 (Customized Model Manufacturing for Patients with Pelvic Fracture using FDM 3D Printer)

  • 오왕균
    • 한국콘텐츠학회논문지
    • /
    • 제14권11호
    • /
    • pp.370-377
    • /
    • 2014
  • 최근 3D 프린팅 기술은 다양한 의학 분야에서 활용하고 있으며, 기존의 절삭가공 보다 제작시간과 비용, 과정측면에서 매우 효율적이다. 특히 정형외과에서는 수술시간, 수술 정확성 등의 개선과 환자의 고통 감소와 재수술을 최소화하는 방법으로 관심이 집중되고 있다. 그러나 기존 연구에 사용된 3D 프린터는 하드웨어 및 소프트웨어의 기술적 활용성, 재정적 가용성 등의 문제로 현재 병원에서 일반적으로 널리 사용되지 못하고 있는 실정이다. 본 연구에서는 이를 해결하기 위해 CT 영상을 Open Source DICOM Viewer와 STL 파일변환 프로그램, FDM 와이어 적층가공방식의 조립형 3D 프린터로 골반 골절 모델을 직접 제작하여 비용과 시간을 단축하고 사전 수술계획에 활용하였다. 6명의 불안정성 골반골절 수술환자의 맞춤형 골 모델을 제작한 후 대학병원 정형외과 임상의에게 골절수술 전에 제공하여 임상적 활용 가능 여부에 대한 검토와 분석의견 결과 정밀도, 해상도가 수술계획에 사용하여도 유용한 것으로 판단되었다.

보급형 3D 프린터로 제작한 쇄골 골절 모델을 이용한 정형외과 수술에 대한 유용성과 활용가능성 평가 (Evaluation of Usefulness and Availability for Orthopedic Surgery using Clavicle Fracture Model Manufactured by Desktop 3D Printer)

  • 오왕균
    • 대한방사선기술학회지:방사선기술과학
    • /
    • 제37권3호
    • /
    • pp.203-209
    • /
    • 2014
  • 쇄골 CT 영상을 이용하여 보급형 3D 프린터로 제작된 모델로 사전 수술계획을 실시하여 수술효율에 대한 유용성과 임상적 활용가능성을 평가하였다. CT 영상을 Open Source DICOM Viewer Osirix에서 STL 파일로 변환하여 FDM 와이어 척층가공방식의 보급형 3D 프린터로 환자 맞춤형 쇄골 골절 모델을 제작하였다. 또한, 인체의 좌우 대칭 특성을 이용하여 골절되지 않은 반대편 쇄골의 STL 파일을 Mirror 기법으로 손상되기 전 원형의 모델을 복원, 제작하였다. 모델은 골절의 위치와 크기, 정도가 동일하게 출력되었다. 영상의학과에서 적은 비용과 시간으로 직접 제작한 쇄골 모델을 활용하면 수술시 2차 손상을 줄이고, 최소 침습적 피하금속판 골유합술(MIPO)로 수술효율을 높일 수 있어 임상적으로 유용할 것으로 생각된다.

Comparison of open reduction and internal fixation with total elbow arthroplasty for intra-articular distal humeral fractures in older age: a retrospective study

  • Baik, Jong Seok;Lee, Sung Hyun;Kang, Hyun Tak;Song, Tae Hyun;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
    • /
    • 제23권2호
    • /
    • pp.94-99
    • /
    • 2020
  • Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion-extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

안면골 골절에 관한 임상적 연구 (The Clinical Study of Maxillofacial Bone Fracture)

  • 조병욱;이용찬;남종훈;김태영;고백진
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제11권1호
    • /
    • pp.32-40
    • /
    • 1989
  • This study is based on 247 patients(348 cases) with facial bone fracture who were admitted to the department of oral and maxillofacial surgery, Kangnam sacred heart Hospital during the period of Jan. 1983 through sep. 1988. The patients with mandible fracture were analysed with the following items such as complications with treatment method undertaken : Bicortical osteosynthesis vs Monocortical osteosynthesis, advantages and Disadvantages. The results obtained are as follows : 1) The most common age groups for the facial bone fracture were 20 years 2) The ratio of Men to women was 5 : 1 3) The most frequent location of facial bone fractures was the Mandible(76.7%), Maxillae(10.6%), Zygoma(9.5%), Nasal bone(3.2%) 4) The ratio of Mandible to Maxillae was 7.2 : 1 5) In mandible fractures, the most frequent fracture site was Symphysis(48.7%) 6) In maxilla fractures, the most frequent case was Le fort III fracture(51.4%), followed by Le fort I fracture(29.7%), Le fort II fracture(18.9%) 7) The main contributing causes of facial bone fractures were Traffic Accident(37.7%), Fight(31.6%), Accident(27.5%) 8) In open reduction methods of mandible fracture, the frequency of postop, malocclusion was 15% in interosseous wiring, 7% in Bicortical osteosynthesis, 3% in Monocortical osteosynthesis. The miniplates show advantages over other forms of fixation, in that they are malleable and easy to insert, they achieve rigid fixation and stability.

  • PDF

족관절 삼과 골절에 대한 치료 후 결과 비교 (Comparison of the Results after the Surgical Treatments of the Trimalleolar Ankle Fractures)

  • 라종득;박현수;임창석;장영수;박상원;정태원;전용수
    • 대한족부족관절학회지
    • /
    • 제8권1호
    • /
    • pp.86-91
    • /
    • 2004
  • Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

  • PDF

하악 과두 골절 환자에서 Lag Screw를 이용한 치료시 예후에 관한 임상적 연구 (CLINICAL STUDY OF PROGNOSIS USING LAG SCREW OSTEOSYNTHESIS IN MANDIBULAR CONDYLE FRACTURE)

  • 이동근;민승기;배진오;양희창
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제19권2호
    • /
    • pp.157-166
    • /
    • 1997
  • Treatment of condylar fracture is still controversial, but the indication of surgical mangement is increased due to improved fixation methods and surgical techniques. In this article, we report our clinical and radiological results with the use of lag screw osteosynthesis for fixation of fractured mandibular condyle. 12 case of condyle fracture treated by open reduction and fixation with lag screw were monitored for an average of 10 months (range from 6 months to 19 months) postoperatively. The obtained results are as follows : 1. Postoperative maximum mouth opening is achieved over 40mm except one patient. 2. Although slight crepitus and deviation of mandible during mouth opening were found, Temporomandibular joint problem is satisfactory in all but one patient. 3. Distal migration of screw and resorption of fractured fragment were found in each 2 patients, but good functional recovery was achieved in all. According to the above results, we think that lag screw osteosynthesis is relatively indicated in level III or IV condylar fracture.

  • PDF

Late-onset Brachial Artery Occlusion caused by Subclavian Artery Stenosis after Clavicular Fracture: A Case Report

  • 조철현;송광순;민병우;배기채
    • 대한견주관절학회:학술대회논문집
    • /
    • 대한견주관절학회 2008년도 제16차 학술대회
    • /
    • pp.175-175
    • /
    • 2008
  • We report a rare case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture. When he referred to us, the right hand were pale and the radial and ulnar pulses at the wrist were absent. CT-angiogram showed compression of subclavian artery by excessive scar tissue beneath the fracture site and angiography revealed stenosis of subclavian artery with thrombus and complete obstruction of blood flow in the brachial artery with emboli. Therefore, we performed embolectomy. 2 years after operation, patient was essentially asymptomatic except mild pain after long standing elevation of arm. We recommend that minimal soft tissue dissection should be needed in the operative treatment of clavicular fracture, especially soft tissue beneath the clavicle should be protected maximally.

  • PDF