• Title/Summary/Keyword: Fracture of long bone

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A Clinical Observation of the Traumatic Sternal Fracture (흉골 골절에 대한 임상적 고찰)

  • 심재영
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.916-921
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    • 1990
  • Clinical observations were performed on 17 cases of the traumatic sternal fracture, those were admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 6 years 5months period from January 1983 to May 1989. Obtained results were as follows: 1. The frequency was about 4.8% of the nonpenetrating chest trauma. 2. The ratio of male to female was 16: 1 in male predominance and age distribution was from 24 to 62 years old. 3. The common cause were high decelerating injury [impact of the steering column] and falling down[more than 3 m in high]. 4. The most common fracture site was sternal body and next was sternomanubrial junction. 5. Associated intrathoracic organ injuries were cardiac contusion [6 cases], hemopneumothorax[1 Case], mediastinal bleeding[1 case], and thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture, and long bone fracture. 6. Abnormal EGG findings were sinus bradycardia[1 case], bundle branch block [2 cases], and sinus tachycardia[3 cases]. 7. The operative reduction and fixation was necessary in only one case and the others were treated with conservative treatment.

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Effective Reconstruction of Extensive Orbital Floor Fractures Using Rapid Prototyping Model (신속 조형 모델을 이용한 안와바닥 골절 정복술)

  • Kim, Hye-Young;Oh, Deuk-Young;Lee, Woo-Sung;Moon, Suk-Ho;Seo, Je-Won;Lee, Jung-Ho;Rhie, Jong-Won;Ahn, Sang-Tae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.633-638
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    • 2010
  • Purpose: Orbital bone is one of the most complex bones in the human body. When the patient has a fracture of the orbital bone, it is difficult for the surgeon to restore the fractured orbital bone to normal anatomic curvature because the orbital bone has complex curvature. We developed a rapid prototyping model based on a mirror image of the patient's 3D-CT (3 dimensional computed tomography) for accurate reduction of the fractured orbital wall. Methods: A total of 7 cases of large orbital wall fracture recieved absorbable plate prefabrication using rapid prototyping model during surgery and had the manufactured plate inserted in the fracture site. Results: There was no significant postoperative complication. One patient had persistent diplopia, but it was resolved completely after 5 weeks. Enophthalmos was improved in all patients. Conclusion: With long term follow-up, this new method of orbital wall reduction proved to be accurate, efficient and cost-effective, and we recommend this method for difficult large orbital wall fracture operations.

Sinus bone graft and simultaneous vertical ridge augmentation: case series study

  • Kang, Dong-Woo;Yun, Pil-Young;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.36.1-36.8
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    • 2019
  • Background: This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods: From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results: The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of periimplantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions: When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.

Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients

  • Jin, Ki-Su;Lee, Ho;Sohn, Jun-Bae;Han, Yoon-Sic;Jung, Da-Un;Sim, Hye-Young;Kim, Hee-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.29.1-29.11
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    • 2018
  • Background: For proper recovery from craniofacial fracture, it is necessary to establish guidelines based on trends. This study aimed to analyze the patterns and causes of craniofacial fractures. Methods: This retrospective study analyzed patients who underwent surgery for craniofacial fractures between 2010 and 2017 at a single center. Several parameters, including time of injury, region and cause of fracture, alcohol intoxication, time from injury to surgery, hospitalization period, and postoperative complications, were evaluated. Results: This study analyzed 2708 fracture lesions of 2076 patients, among whom males aged 10 to 39 years were the most numerous. The number of patients was significantly higher in the middle of a month. The most common fractures were a nasal bone fracture. The most common causes of fracture were ground accidents and personal assault, which tended to frequently cause more nasal bone fracture than other fractures. Traffic accidents and high falls tended to cause zygomatic arch and maxillary wall fractures more frequently. Postoperative complications-observed in 126 patients-had a significant relationship with the end of a month, mandible or panfacial fracture, and traffic accidents. Conclusions: The present findings on long-term craniofacial fracture trends should be considered by clinicians dealing with fractures and could be useful for policy decisions.

Clinical evaluation of chest trauma (흉부손상의 임상적 고찰)

  • 김영호
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.414-421
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    • 1982
  • 200 patients admitted to the Chest Surgery Department of Jeonbug National University Hospital from January, 1974 to December, 1981 were analyzed clinically. The ratio of male to female was 7: 1, which showed male predominance. Distribution of patients according to age disclosed that over half [62%] of the patients was social age between 20 and 49 years. The most common cause of chest trauma was traffic accident [39%], and the next were stab wound, fall down [17.5%], and hit [8.5%] in decreasing order. Common lesions due to chest trauma were as follows; rib fracture [51%], hemopneumothorax, hemothorax, and pneumothorax in decreasing number. The most common cause of rib fracture was traffic accident [50%] and the associated organ injuries were long bone fracture, head injury, spine and pelvic bone fracture, spleen rupture, and liver laceration. Hemothorax, pneumothorax, and hemopneumothorax were treated with insertion of thoracic catheter in 90 cases, pure thoracentesis in 11 cases, and emergency thoracotomy in 11 cases. In flail chest, 6 patients were treated by intramedullary insertion of Kirschner`s wire and the results were good. The incidence of complication was 17%, including atelectasis [11 cases], pyothorax, fibrothorax, pneumonia, and acute respiratory failure. Four patients were died [2%], and the causes were acute respiratory failure in 2 cases, spinal cord injury in one case and head injury in one case.

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The measurement of nose dimensions through the three-dimensional reformation images after nasal bone fracture

  • Jang, Seung Bin;Han, Dong Gil
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.31-36
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    • 2019
  • Background: After closed reduction, patients are sometimes concerned that their external nasal shapes have changed. The aim of this study was to investigate and explain changes in nasal shape after surgery through objective photogrammetric anthropometry measurements taken through three-dimensional (3D) reformed computed tomography (CT) images. Methods: Our study included 100 Korean patients who underwent closed reduction of isolated nasal bone fracture from January 2016 to June 2017. Using the ruler tool in Adobe Photoshop CS3, we measured preoperative and postoperative nasal base heights, long nostril axis lengths, both nasal alar angles, and amount of nasal deviation through the 3D reformation of soft tissue via CT scans. We then compared the dimension of nose. Results: The amount of postoperative correction for nasal base height was 1.192 mm. The differences in nostril length between each side were found to be 0.333 mm preoperatively and 0.323 mm postoperatively. The differences in the nasal alar angle between each side was $1.382^{\circ}$ preoperatively and $1.043^{\circ}$ postoperatively. The amount of nasal deviation was found to be 5.248 mm preoperatively and 1.024 mm in postoperatively. Conclusion: After the reduction of nasal bone fractures, changes in nasal dimensions were noticeable in terms of nasal deviation but less significant in nasal tips, except for changes in nasal alar angles, which were notable.

Risk Factors for Postmenopausal Osteoporosis in Korea (한국 폐경 여성의 골다공증 위험 인자에 관한 연구)

  • Lee, Dong-Yun;Gu, Seung-Yeop;Kim, Seok-Hyeon;Choe, Yeong-Min;Mun, Sin-Yong;Kim, Jeong-Gu
    • Journal of Korea Association of Health Promotion
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    • v.2 no.2
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    • pp.137-148
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    • 2004
  • Objective : To identify the risk factors for postmenopausal osteoporosis in Korea Materials and methods : Bone mineral density (BMD) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry in 808 apparently normal postmenopausal Korean women. Questions about life style, demographic parameters, medical history and social habits etc. were asked on these women; 2ll women with normal bone mineral density, and 597 women with osteopenia or osteoporosis. Results 'Age of >50 years, low body mass index (BMI; <18.5 kg/m2), long duration of menopause(>10 years), and previous history of fracture were associated with increased prevalence of osteopenia or osteoporosis. Women without the outside activity also showed a higher frequency of low bone mass, Risk for osteopenia or osteoporosis was low in women with high BMI (>23 kg/m2) and women with job. The prevalence of low bone mass appeared to be independent of the following parameters: socioeconomic status, familial history, smoking, drinking, exercise, previous use of oral contraceptive, coffee or milk consumption, and degree of sunlight exposure. Conclusion 'Age, BMI, duration of menopause, previous history of fracture and degree of outside activity are the risk factors for postmenopausal osteoporosis in Korea.

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Biochemical Markers of Bone Turnover (골대사의 생화학지표)

  • Kim, Deog-Yoon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.341-351
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    • 1999
  • Biochemical markers of bone turnover has received increasing attention over the past few years, because of the need for sensitive and specific tool in the clinical investigation of osteoporosis. Bone markers should be unique to bone, reflect changes of bone loss, and should be correlated with radiocalcium kinetics, histomorphometry, or changes in bone mass. The markers also should be useful in monitoring treatment efficacy. Although no bone marker has been established to meet all these criteria, currently osteocalcin and pyridinium crosslinks are the most efficient markers to assess the level of bone turnover in the menopausal and senile osteoporosis. Recently, N-terminal telopeptide (NTX), C-terminal telopeptide (CTX) and bone specific alkaline phosphatase are considered as new valid markers of bone turnover. Recent data suggest that CTX and free deoxypyridinoline could predict the subsequent risk of hiP fracture of elderly women. Treatment of postmenopausal women with estrogen, calcitonin and bisphosphonates demonstrated rapid decrease of the levels of bone markers that correlated with the long-term increase of bone mass. Factors such as circadian rhythms, diet, age, sex, bone mass and renal function affect the results of biochemical markers and should be appropriately adjusted whenever possible. Each biochemical markers of bone turnover may have its own specific advantages and limitations. Recent advances in research will provide more sensitive and specific assays.

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Clinical Effect of Guide Bone Regeneration of Mandibular Nonunion in a Geriatric Dog (노령견의 하악골절 불유합 1례에서 골유도재생술의 임상적 효과)

  • Kim, Se-Eun;Shim, Kyung-Mi;Bae, Chun-Sik;Choi, Seok-Hwa;Jeong, Soon-Jeong;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.127-130
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    • 2013
  • A 13-year-old, 4.2 kg female poodle was referred for failure of first bilateral mandibular surgery at a local animal hospital after pathologic fracture. Surgery was performed with 2.0-mm miniplates/screws and porcine cancellous bone grafts. In addition, because of the large size of the right segmental defect, a barrier absorbable membrane was employed for guide bone regeneration on right mandible. After surgery, follow-ups performed at 1 day, 1, 4, 8, and 12 weeks; there were no signs of dental malocclusion, nonunion or soft tissue infection. However, a 1-year long-term follow-up showed nonunion in the left mandibular fracture site for which a collagen membrane had not been used. It is considered that use of porcine bone graft with barrier absorbable membrane may be effective for the repair of mandibular nonunion in a geriatric dog.

Post Pelvic Radiotherapy Bony Changes (골반 방사선 치료후의 골 변화와 손상)

  • Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.1-9
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    • 2009
  • There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as $8.2{\sim}20%$ after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.