• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.228-231
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• 2010

Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권4호
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• pp.376-379
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• 2001

본 교실에서는 외상에 의한 발생한 악안면 골절의 정복 후 오훼돌기와 관골 상악 복합체 후외측벽 사이의 기계적 간섭에 의해 발생한 2명의 개구장애 환자에서 호훼돌기 절제술과 하악운동에 대한 물리치료술 후 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.46-54
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• 1995

Postoperative infection following orthognatic surgery is rare. When postoperative infections occur, the initial treatment consists of incision and drainage of the affected area, culturing to identify bacterial stains and verify antibiotic sensitivity, and the institution of the appropriate antibiotic regimen. Some plates and screws may eventually require removal, the initial therapy should be attempted to retain the plates and screws until adequete healing has taken place. In orthoganthic surgery, intra-operative complications as a lesion of inferior alveolar nerve, fracture of osteomised segments, incomplete sectioning, malposition of segments, haemorrhage may occur. The surgeon should be familiar with possible complications to be caused and how to manage them. Prevention of postoperative infection following the orthognathic surgery consists of minimal periosteal reflection, aseptic management of operation field, proper surgical technique, rigid fixation, prophylactic antibiotics.

• 대한관절경학회지
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• 제12권3호
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• pp.217-221
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• 2008

오구 충돌 증후군은 상완골 전상방 면과 오구견봉 궁 후외측면의 비정상적 접촉에 의해 발생하며, 그 원인으로는 외상성, 특발성 및 의인성 인자가 있다. 그 중 외상에 의한 경우는 견갑골 경부, 오구 돌기, 또는 상완골 소결절 골절이 원인이 될 수 있다. 상완골 소결절 부정 유합에 의한 오구 충돌 증후군은 드문 질환으로 치료에 대해서는 주로 개방적 수술이 사용되어 왔으나 관절경적 오구 돌기 성형술과 함께 소결절의 경피적 고정술을 보고한 예는 없었다. 이에 저자들은 상완골 소결절 부정 유합으로 발생한 오구 충돌 증후군에 대하여 관절경적 수술로 치유된 1 예를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.556-560
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• 2012

Zygomatic fractures are the second most common facial bone fractures encountered and treated by plastic surgeons. Stable fixation of fractured fragments after adequate exposure is critical for ensuring three-dimensional anatomic reduction. Between January 2008 and December 2010, 17 patients with zygomatic fractures were admitted to our hospital; there were 15 male and 2 female patients. The average age of the patients was 41 years (range, 19 to 75 years). We exposed the inferior orbital rim and zygomatic complex through a lateral brow, intraoral, and subciliary incisions, which allowed for visualization of the bone, and then the fractured parts were corrected using the Carroll-Girard T-bar screw. Postoperative complications such as malar asymmetry, diplopia, enophthalmos, and postoperative infection were not observed. Lower eyelid retraction and temporary ectropion occurred in 1 of the 17 patients. Functional and cosmetic results were excellent in nearly all of the cases. In this report, we describe using the Carroll-Girard T-bar screw for the reduction of zygomatic fractures. Because this instrument is easy to use and can rotate to any direction and vector, it can be used to correct displaced zygomatic bone more accurately and safely than other devices, without leaving facial scars.

• 대한치과마취과학회지
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• 제14권4호
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• pp.227-232
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• 2014

The indication for submandibular intubation is the requirement for intraoperative maxillomandibular fixation (MMF) in the presence of injuries that preclude nasotracheal intubation. Thus, We reported 2 cased of endotracheal intubations via submandibular approach that is applicable in patients with skull base fractures for a reliable general anesthesia. Endotracheal intubation via submandibular approach was applied during general anesthetic procedures for open reduction in three patients with Le Fort II, III or nasoorbitoethmoid (NOE) fractures. No complications due to submandibular intubation, such as infection, postoperative scarring, nerve injury, hematoma, bleeding, or orocutaneous fistula, were observed following submandibular intubation. Endotracheal intubation via submandibular approach is effective in patients with skull base fractures. In our method, the tube connector is removed in orotracheal intubation in order to avoiding the tube removal or displacement. The advantages of this method are very simple, safe, and to provide the good operation field.

• Biomaterials and Biomechanics in Bioengineering
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• 제5권1호
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• pp.37-50
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• 2020

Development of lightweight implant plates are important to reduce the stress shielding effect for a prosthesis of femur bone fractures. Stainless steel (SS-316L) is a widely used material for making implants. Stress shielding effect and other issues arise due to the difference in mechanical properties of stainless steel when compared with bone. To overcome these issues, composite materials seem to be a better alternative solution. The comparison is made between two biocompatible composite materials, namely Ti-hydroxyapatite and Ti-polypropylene. "Titanium (Ti)" is fiber material while "hydroxyapatite" and "polypropylene" are matrix materials. These two composites have Young's modulus closer to the bone than stainless steel. Besides the variety of bones, present paper constrained to femur bone analysis only. Being heaviest and longest, the femur is the most likely to fail among all bone failures in human. Modelling of the femur bone, screws, implant and assembly was carried out using CATIA and static analysis was carried out using ANSYS. The femur bone assembly was analyzed for forces during daily activities. Ti-hydroxyapatite and Ti-polypropylene composite implants induced more stress in composite implant plate, results less stress induced in bone leading to a reduction in shielding effect than stainless steel implant plate thus ensuring safety and quick healing for the patient.

• 한국학교보건학회지
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• 제20권1호
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• pp.45-52
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• 2007

Purpose: The purpose of this study was to examine the types of school accidents and their first aids at Elementary, Middle, High Schools in a local area. Methods: The subjects were 1062 students who have had episodes of school accidents from 730 (Elementary = 429, Middle = 188, High = 113) schools in Chungnam province from January to December, 2006. Data were collected from accident-related record from school nurse and 'School Safety Fund', and analyzed using the SPSS Version 13.0 programs and the results and conclusions are as follows: Results: The proportion of school accidents occurred were in middle(0.43%), high(0.35%), primary(0.30%) school students. And the most frequent type of accident was fracture and then sprain. Most school accidents broke out in playground during resting time, and followed by physical education class. The most frequent cause of school accidents was carelessness and first aid was fixation the injury. Conclusion: Based on these findings, school-based and continuous safety education programs and emergency care system within school and in community can be suggested in collaboration with health-related resources. Further longitudinal study to identify causes and kinds of school accidents and can also be recommended.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.168-171
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• 2019

The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.451-453
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• 2023

We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.