• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.2
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• pp.9-20
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• 1990

A series of 19 cases with maxillary hyperplasia and mandibular retrognathia were operated on by simultaneous superior repositioning of the maxilla after Le Fort I osteotomy and anterior repositioning of the mandible after bilateral sagittal split ramus osteotomies with or without osteotomy of the inferior border of the mandible. These were evaluated by retrospective cephalometric and computer analysis for the longitudinal skeletal and dental changes for an average of 17.1 months after surgery. For stabilization of the osteotomized segments, the authors used wire osteosynthesis by means of bilateral infraorbital and zygomatic buttress suspension wire at the maxilla, and direct interosseous wire at the split segments of the mandibular rami. Results show generally good stability after simultaneous maxillary and mandibular surgery with wire osteosynthesis, and a minimal to moderate tendency toward skeletal and dental relapse. This article is a preliminary study to defy the efficiency of the wire osteosynthesis (wo)compared with rigid internal fixation (RIF) for simultaneous maxillary and mandibular surgery. 1. The vertical relapse rate of the A point after superior repositioning of the maxilla is 2.2%. 2. The horizontal relapse rate of the B point after advancement of the mandible is 18.3%. 3. The condyle is distracted inferiorly and slightly posteriorly at the immediate postoperative period. 4. At the long term follow up examination, the condyle presents tendency of return to the preoperative position. 5. Condylar segment angle is decreased at the immediate postoperative period, and at the long term follow up evaluation, the angle is increased. 6. Gonial angle is increased at the immediate postoperative period, and then is decreased at the long term follow up evaluation. 7. The dentition is satisfactory with acceptable movement at the long term follow up evaluation. 8. At the mandibular free body analysis, genioplasty shows good stability. 9. Wire osteosynthesis provides excellent stabilization for the simultaneous maxillary and mandibular surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.4
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• pp.174-181
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• 2016

Objectives: This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. Materials and Methods: The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Results: Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were $35.0{\pm}11.8$ years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P <0.001). Conclusion: The most common etiology of maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.3
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• pp.103-110
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• 2014

Objectives: In this study, we assessed soft tissue asymmetry that occurred after open reduction of unilateral zygomaticomaxillary complex (ZMC) fractures. We proposed a simple method to assess soft tissue asymmetry after reduction surgery by evaluating the symmetry between the affected and the unaffected sides. The factors affecting soft tissue contour after surgery were also analyzed. Materials and Methods: Subjects included patients admitted to Wonkwang University Dental Hospital from 2008 to 2013. Cone-beam computed tomography (CBCT) images of asymmetric patients who underwent open reduction at least 3 months prior were compared with healthy patients. Results: The degree of asymmetry was measured in both the open reduction and control groups. Landmarks that showed a statistically significant difference between the two groups were zygion ($1.73{\pm}0.24mm$), bucclae ($1.08{\pm}0.26mm$), point of cheek ($2.05{\pm}0.33mm$) and frontozygomatic point ($1.30{\pm}0.31mm$). Conclusion: When compared with the normal group, asymmetry can occur in the affected side, which usually shows depression of overlying soft tissue and is statistically significantly different. Evaluation of soft tissue asymmetry with CBCT images after open reduction of ZMC fracture is useful.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.94-98
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• 2005

Purpose: To compare the radiographic evaluations between two radiographic views (AP and lateral views) and four radiographic views (AP, lateral and both oblique views) in ankle fractures. Materials and Methods: From January 2000 to June 2002, 60 cases of ankle fractures were treated with open reduction and internal fixation and its followed up periods were at least 2 years. All cases were classified into three groups according to the method of preoperative radiographic evaluation. Two radiographic views (AP and lateral views) were taken in group A and four radiographic views (AP, lateral and both oblique views) were taken in group B. 12 Cases were evaluated with three dimensional computed tomography (3D CT). Four radiographic views and 3D CT were taken in group C. All cases were classified according to the Danis-Weber and Lauge-Hansen classification. Displacement of fracture fragment of medial, lateral, posterior malleolus and size of fracture fragment of posterior malleous were measured using picture archiving communication system (PACS). Results: Although kappa value between two or four radiographic views were good or excellent in Danis-Weber classification and Lauge-Hansen classification of ankle fractures, the displacements of medial and lateral malleoli were statistically different. Four radiographic views evalulated the degree of displacement of medial and lateral fragments more accurately compared to two radiographic views. Conclusion: Four radiographic views will be more useful than two radiographic views to decide the method of treatment and operation considering the displacement of fracture fragment.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.151-156
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• 2010

Purpose: To analyze the clinical and radiological results of operative treatment in patients with tongue type intra-articular calcaneal fracture, and to compare the open reduction and Essex-Lopresti technique. Materials and Methods: We examined a consecutive series of 42 patients who received surgical treatment for tongue type calcaneal fracture (24 cases of the open reduction and 18 cases of the Essex-Lopresti technique) and the postoperative data was compared with a minimum 1 year follow-up. The clinical outcome was analyzed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale and Salama's criteria. The preoperative, postoperative, and last follow-up changes in the Bohler angle was radiologically analyzed. Results: There were no significant differences between the two groups in terms of the clinical and radiological results at the last follow-up. However, for the Sander's type 3 and 4 fractures, the open reduction group showed more improvement of AOFAS score and less reduction loss in the Bohler angle. Conclusion: Although the clinical results were good irrespective of surgical technique, the open reduction and internal fixation can improve clinical outcome and reduce the reduction loss as compared with the Essex-Lopresti technique in the comminuted tongue type calcaneal fracture.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.163-167
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• 2008

Purpose: To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck. Materials and Methods: We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system. Results: AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor. Conclusion: Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins' sign should not be considered a totally reliable indicator of development of avascular necrosis.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.174-179
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• 2008

Purpose: We evaluated the clinical results of the intraarticular calcaneal fractures treated using Ollier approach by inexperienced orthopaedic surgeon. Materials and Methods: Between August 2003 and May 2007, Of the total 46 cases, 12 cases (9 patients) of displaced intraarticular calcaneal fracture who underwent open reduction and internal fixation using Ollier approach were evaluated. The means of age was 50.5 years. According to the Sanders classification, there was no type I case and 8 cases of type II, 1 case of type III, and 3 cases of type IV. We evaluated the treatment result by assessing radiologic parameters ($B{\ddot{o}}hler$ angle, Gissane angle, and calcaneal height/width) and clinical outcomes (VAS and AOFAS score). Results: The means of follow-up period was 25.3 months. The means of B.hler angle was improved from $2.4^{\circ}$ to $26.1^{\circ}$. Radiologic and clinical union was achieved in all cases without additional procedures. Excellent result were noted in 2 cases, good in 5 cases, fair in 4 cases, and poor in 1 case. We experienced 2 cases of minor complications; 1 case of mild wound infection and 1 case of hypoesthesia on foot dorsum. Radiologic findings of subtalar arthritis were present in 2 cases. Conclusion: Ollier approach seems to be helpful to inexperienced orthopaedic surgeons for the treatment of intraarticular calcaneal fractures in that it enables them to achieve considerable clinical outcomes without serious complications.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.143-149
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• 2013

Purpose: Open reduction and internal fixation of calcaneal fracture using plate has been used. While numerous plates have been manufactured, most of the conventional plates are designed for westerners, realistically the size is larger for Korean. The domestic products, on the other hand, often have the undesirable screw holes and path. Therefore, we measured the radiologic parameter of Korean calcaneus for providing the plate and screw hole placements. Materials and Methods: We measured the outer lines and angles with over the 20 years old 291 females and 322 males. A: Length of inferior plane of calcaneus, B: Length of anterior plane of calcaneus, C: Length from line A to sinus tarsi, D: Length from line A to posterior point of posterior facet, E: Length from line A to calcaneal tuberosity, F: Length of posterior facet, G: Length from anterior point of line A to C, H: Length from line C to line D, a: Angle between A and B, b: Gissane angle, c: Bohler angle, d: Calcaneal pitch angle using Marosis m-view$^{(R)}$. Results: Mean A, B, C, D, E, F, G, H were 63.6, 26.4, 23.2, 43.7, 40.5, 26.9, 12.8, 18.1 mm. Mean a, b, c, d angle were 105.8, 122.4, 32.4, $20.5^{\circ}$. Male's calcaneus is significantly bigger than female's (p<0.001). Conclusion: AP calcaneus length 63.6 mm, maximal height 43.7 mm is considered to be helpful in making the Korean calcaneal plate.

• Journal of Korean Foot and Ankle Society
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• v.21 no.4
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• pp.151-155
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• 2017

Purpose: Reducing tenderness or pain on the ankle joint and improving the range of motion are thought to be possible using hyaluronate-based anti-adhesive agents. On the other hand, there are more aspects to be studied regarding the incidence of complications, such as resting pain, tenderness, and stiffness, after surgery. Therefore, the aim of this study was to prove the effectiveness of the agents after ankle fracture surgery. Materials and Methods: Patients, who underwent open reduction and internal fixation surgery due to ankle joint fractures from June 2015 to May 2016, were studied prospectively. Thirty patients of them received a $Guardix^{(R)}$ injection during their surgeries and were included in the injection group. The other 30 patients were included in the control group. Postoperatively, tenderness on the scar, a delay in wound healing, and the active range of motion were evaluated at 2, 6, and 12 weeks after surgery. Results: A significant difference in tenderness on the scar was observed 2 weeks after surgery. On the other hand, there was no significant difference at 6 and 12 weeks after the surgery. The agent-using group showed a 6.7% delay in wound healing and a 93.3% nondelaying. In the non-using group, the delay was 63.3%, while non-delay was 36.7% (p<0.001). The group that underwent $Guardix^{(R)}$ usage showed an effective result in the visual analogue scale, which was statistically significant (p<0.001). The result at 6 and 12 weeks after surgery showed a significant difference. Conclusion: Improvement was observed in the patients who underwent a $Guardix^{(R)}$ injection, regarding the range of motion, visual analog scale, and healing of the wound postoperatively.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.92-101
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• 2010

The Hamstring autograft and the bone patellar bone tendon autograft have been widely used for anterior cruciate ligament reconstruction. In recent years, use of hamstring autograft for ACL reconstrution has been increased. The reason seems to be the advantages of the hamstring tendon such as high ultimate tensile load, low donor site morbidity and development of graft fixation method. These theoretical advantages have been increased as studies have shown that hamstring tendons actually regenerate after harvesting for ACL reconstruction. However, the concerns have arisen regarding the disadvantages of hamstring harvest, which were weakness of tibial internal rotation, the loss of flexion strength. The flexion strength loss has been controversial, therefore it needs to study whether restoration of flexion strength after hamstring regeneration is or not. In this study, we reviewed the current research of concerns on the advantage and disadvantage of hamstring tendon autograft and the hamstring regeneration. Furthermore, we compared the earlier studies and experiences regarding Hamstring regeneration with our research.