• 제목/요약/키워드: Internal fracture fixation

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Panfacial bone fracture: cephalic to caudal

  • Yun, Seonsik;Na, Youngcheon
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.1-2
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    • 2018
  • Theoretically, panfacial bone fractures involve all three areas of the face: frontal bone, midface, and mandible. In practice, when two out of these three areas are involved, the term "panfacial bone fracture" has been applied. We can use physical examination, simple radiologic examination, and computed tomography study for diagnosis. Linear fracture are treated by conservative treatment. But, most of panfacial bone fracture patients need to be treated by open reduction and internal fixation. Facial width is most important thing that we need to care during operation. There are many ways about sequence like "top to bottom," "bottom to top," "outside to inside," or "inside to outside" and the authors prefer "top to bottom" and "outside to inside" ways. The authors apply arch bar from the first of surgery and then, set frontal bone fracture, midface fracture and mandible fracture in sequence. Usually, we remove the stitches for 5 days after surgery and the intraoral stitch removed after 2 weeks. Usually arch bar is going to be removed 4 weeks after surgery. We could get acceptable results with the above way.

A Irreducible Ankle Fracture and Dislocation Due to Injured Tibialis Posterior Tendon Interposition: A Case Report (손상된 후경골건 감입에 의한 족관절 골절 및 탈구의 정복 실패: 증례 보고)

  • Lee, Jun Young;Bak, Yi Gyu;Jang, Hyun Woong
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.2
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    • pp.70-74
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    • 2017
  • Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.

Clinical Features of Distal Tibial Fractures and Treatment Results of Minimally Invasive Plate Osteosynthesis (원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과)

  • Kim, Weon-Yoo;Ji, Jong-Hun;Kwon, Oh-Soo;Park, Sang-Eun;Kim, Young-Yul;Kil, Ho-Jin;Jeong, Jae-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.94-100
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    • 2012
  • Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

Treatment of Transverse Patella Fracture with Minimally Invasive Load-Sharing Patellar Tendon Suture and Cannulated Screws (최소 침습 기법 슬개건 부하 분산 봉합술과 유관 나사못을 이용한 슬개골 횡골절의 치료)

  • Lee, Beom-Seok;Park, Byeong-Mun;Yang, Bong-Seok;Kim, Kyu-Wan
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.540-545
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    • 2021
  • A transverse fracture is the most common type of displaced patella fracture requiring surgery. These fractures are commonly fixed with parallel Kirschner wires or screws that cross the fracture line, often with an additional tension band. Nevertheless, conventional fixation methods of patella fractures have prevalent complications caused by the protrusion of wires or pins. These complications necessitate additional surgery for hardware removal, increase medical cost, and can limit the function of the knee joint. This paper reports cases treated with a minimally invasive load-sharing percutaneous suture of the patella tendon. The procedure provides reliable fixation for transverse patella fractures, minimizes soft tissue injuries, preserves blood flow, and reduces postoperative pain. In addition, the procedure also reduces the irritation and pain caused by the internal fixture, thereby reducing the risk of restricted knee joint movement.

Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures (원위 경골 골절에서 금속정 및 금속판 고정술의 결과 비교)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Chang-Rack;Jung, Yang-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.86-90
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    • 2015
  • Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

Clinical Outcome of a Precontoured Symphysis Pubis Plate with Tension Band Wiring for Traumatic Symphysis Pubis Rupture in Pelvic Fractures

  • Lee, Jeong Moon;Yoon, Sun Jung;Park, Myung Sik;Song, Kyung Jin
    • Journal of Trauma and Injury
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    • v.29 no.1
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    • pp.22-27
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    • 2016
  • Purpose: The optimal method of fixation of symphysis pubis (SP) diastasis in pelvic ring injuries is still controversial. In this study, we investigated the radiological and the clinical results of a precontoured 4.5-mm symphysis pubis (SP) plate with tension band wiring (TBW) after an anterior pelvic injury in pelvic fractures. Methods: We treated 25 patients with traumatic SP diastasis by open reduction and internal fixation with plates and wires. We used a four-hole 4.5-mm precontoured SP plate with a tension band wiring. Results: Patients with a SP with TBW fixation achieved excellent or good results at final follow-up. Post-operative complications included two (8%) patients with metal work movement. The mean symphyseal width was smaller in 4.5 mm SP plate with TBW during 1-year follow up period. Conclusion: A precontoured symphysis pubis plate (4.5 mm) with figure-of-eight fashion tension band wiring shows favorable radiological results, excellent or good clinical outcome, and a lower complication (hardware failure and revision surgery).

Fracture and Dislocation of the Midtarsal Joint: A Case Report (중족근 관절의 탈구 및 골절: 증례 보고)

  • Choi, Jun Cheol;Jung, Yu-Hun;Park, Sang Jun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.3
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    • pp.108-112
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    • 2017
  • The midtarsal joint is composed of the talonavicular and calcaneocuboid joints. It is also known as the Chopart joint. Midtarsal joint fracture and dislocation are relatively rare and frequently missed or misdiagnosed. A proper understanding about the anatomy of the midtarsal joint is an essential part in comprehending the mechanism of injury and rationale for treatment. Anatomical reduction of midtarsal joint with correction of the column in length and shape are important; however, it is technically challenging and may require open procedure. Herein, we described a case of initial open reduction and internal fixation for midtarsal joint fracture and dislocation with a brief literature review.

A Comparative Study of the Subjective Symptoms of Bioabsorbable and Metallic Osteofixation System in Zygomatic Bone Fracture (흡수성과 비흡수성 내고정물 사용 후 관골 골절 환자의 자각증상의 차이)

  • Park, Woo Jin;Shin, Hye Kyoung
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.227-230
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    • 2005
  • The surgical treatment of craniofacial disorders, using metallic internal osteofixation system has inspired an evolution with advanced operative technique and fixation devices over past two decades. As any other surgical procedures, this procedure also associates problems such as infection, palpability, loosening, and restrict craniofacial skeleton growth, which lead to undue secondary operations for removal. These problems are improved by using bioabsorbable osteofixation system. We compared the patient's subjective symptoms using bioaborbable system versus metallic osteofixation system in zygomatic bone fracture. we should take the individual steps (postoperative 2 weeks, and 1 year) in treating fractured zygoma. From August, 2001 to August, 2003, we used bioabsorbable osteofixation system in 28 patients in zygomatic fracture ($Biosorb^{TM}FX^{(R)}$) and compared 23 patients who were treated with metallic osteofixation system. There was no significant difference in the both groups in subjective symptoms and postoperative result.

Ultrasonographic Finding of Trochanteric Pain after Proximal Femoral Nailing in Patients with Intertrochanteric Fracture - 2 Cases Report - (대퇴 전자간 골절의 근위 대퇴 골수정 삽입술 후 발생한 전자부 통증의 초음파 소견 - 2예 보고 -)

  • Nam, Woo Dong;Han, Kye Young;Cha, Seong Moo
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.1
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    • pp.38-41
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    • 2011
  • After closed reduction and internal fixation with proximal femoral nail for intertrochanteric fracture, some patients complained lateral hip pain. We report two cases of lateral hip pain due to tendinopathy confirmed by ultrasonography.

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Treatment for the Stress Fracture of the Proximal Phalanx of the Great Toe in a Basketball Player with Hallux Valgus (A Case Report) (무지외반증이 있는 농구 선수에서 발생한 족무지 근위 지골의 피로 골절에 대한 치료(1예 보고))

  • Park, Chul-Hyun;Lee, Woo-Chun
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.70-72
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    • 2012
  • Stress fractures of the proximal phalanx of the great toe are rare. This fractures have been associated with halux valgus deformity in most reports. We performed open reduction and internal fixation with distal chevron osteotomy for the stress fracture of the proximal phalanx of the great toe in a basketball player with hallux valgus, and obtained successful bony union and rapid return to sports.