• Title/Summary/Keyword: Open reduction and internal fixation

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Transmasseteric Approach for Open Reduction and Internal Fixation of Mandible Subcondylar Fracture (깨물근을 통한 하악골 관절돌기하부골절의 관혈적 정복 및 내고정술)

  • Kim, Hak-Soo;Kim, Seong-Eun
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.161-168
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    • 2010
  • Purpose: Surgical approaches to the condylar neck and subcondyle area can cause some morbidity such as, facial nerve injury, time-consuming nature and external scar etc. So many surgeons hesitate using open reduction and internal fixation for the treatment of subcondylar fractures. We report open reduction and internal fixation of subcondylar fractures in 13 adult patients via transmasseteric approach. Methods: From 2007 to 2009, 13 adults with subcondylar fracture of mandible were treated with open reduction and internal fixation via transmasseteric approach. A preauricular incision was extended downwards in a curvilinear fashion in the cervicomastoid skin crease. Skin flap was elevated above the SMAS layer. Masseter muscle was splitted at the anteroinferior edge of the parotid gland. After the fracture was reduced, fixed with appropriate plates and screws. All operation were performed under general anesthesia. Results: Mean follow-up period was 13.3 months. There were no signs and symptoms of facial nerve injury, difficulty in mouth opening, or malocclusion. Dissection time was roughly within 30 minutes. Conclusion: Transmasseteric open reduction and internal fixation of mandible subcondylar fracture can be performed with excellent visualization, and inconspicuous scar. It also offers swift access to the subcondylar area while substatially reducing the risk to the facial nerve and eliminating the complications associated with transparotid approaches.

Clinical Applications of Endoscopic-Assisted Open Reduction and Internal Fixation of Subcondylar Fractures (아래턱뼈 관절돌기밑 골절에서 내시경을 이용한 관혈적 정복술 및 내부고정술의 임상적 적용)

  • Han, Seung Youl;Kang, Seok Joo;Park, Jin Hyung
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.735-742
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    • 2009
  • Purpose: The management of fractures of mandibular subcondyle continues to be controversial between open and closed treatment. The purpose of this article is to explain the endoscopic assisted open reduction and internal fixation and minimize the controversy. Methods: Nine patients of mandibular subcondylar fracture were reduced and fixed by using intraoral endoscopic - assisted open reduction and internal fixation and were followed up for 14 ~ 24 months after surgery. Results: Eight patients of mandibular subcondylar fracture had been treated without significant complications. One patient, whose malocclusion had been remained, was recovered normal occlusion by maxillomandibular fixation using intermaxillary screws for 3 weeks. Conclusion: The advantages of endoscopic - assisted open reduction and internal fixation are direct visualization, accurate fracture repair, minimized scar, decreased morbidity. And maxillomandibular fixation is not needed when it is done by accurate reduction and rigid fixation with one miniplate in the region of subcondylar fracture. With the above consideration, endoscopic - assisted open reduction and internal fixation can be considered as one of the best treament for subcondylar fracture of the mandible.

Management of Displaced Intra-articular Calcaneal Fracture (전위된 관절 내 종골 골절의 치료)

  • Lee, Jun Young;Na, Woong Chae
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.137-141
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    • 2015
  • Recently, open reduction and internal fixation has been the treatment of choice for displaced intra-articular calcaneal fractures for many orthopaedic surgeons. However controversy still surrounds the optimal treatment with regard to whether displaced intra-articular calcaneal fractures should be treated operatively or conservatively. Conservative treatments include use of splint, rest, leg elevation, icing, use of analgesics and early mobilization. Operative treatment is open reduction and internal fixation, performed through an extensile lateral approach with interfragmentary screws and application of a neutralization plate. We reviewed the question of whether operative treatment by open reduction and internal fixation provides a benefit compared with conservative treatment for displaced intra-articular calcaneal fractures.

The result of endoscope-assisted open reduction and internal fixation (EAORIF) of lateral overridden subcondyle fracture (Lateral override 과두하골절에서 내시경을 이용한 관혈적 정복술 및 내고정의 결과)

  • Choi, Eun-Joo;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.62-66
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    • 2011
  • Introduction: Endoscope-assisted open reduction and internal fixation (EAORIF) reduces the amount of facial scaring, but limitations, such as the possibility to convert to the open technique and the large learning curve, remain. Materials and Methods: The medical records of 19 patients diagnosed as lateral overridden subcondyle fractures and treated with endoscope-assisted open reduction and internal fixation at Yonsei University Health System from December 2006 to August 2010 were reviewed. Results: 11 patients underwent temporary discomfort or pain such as limitation of mouth opening, temporomandibular joint discomfort, lip paresthesia or facial weakness, but the symptoms disappeared within 3 months. There was no severe long-term complication except 2 patients with re-fractures of operated subcondyles. Conclusion: Subcondyle fracture with lateral overridden proximal segment is a better indication of endoscope-assisted open reduction and internal fixation than a condylar head/neck fracture, or medial overridden subcondyle fracture: allowing an anatomic reduction.

Treatment of Intra-articular Calcaneal Fracture with Open Reduction and Internal Fixation (관혈적 정복 및 내고정을 이용한 관절내 종골 골절의 치료)

  • Choi, Jun-Won;Choi, Joon-Cheol;Lee, Young-Sang;Na, Hwa-Yeop;Kim, Woo-Sung;Han, Sang-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.226-231
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    • 2007
  • Purpose: To evaluate the clinical outcomes and radiographic results of open reduction and internal fixation for intraarticular calcaneal fractures. Materials and Methods: We reviewed 20 cases of calcaneal fractures managed with open reduction and internal fixation from March 2003 to January 2005. We used the computed tomographic classification system proposed by Sanders et al to classify these fractures. Preoperative and postoperative Bohler's angle, heel height (calcaneal facet height) and calcaneal length, calcaneal width were measured. The Creighton-Nebraska Health Foundation Assessment score was used for clinical evaluation. Results: There were 12 cases of type II fractures, 5 of type III fractures and 3 of type IV fractures. The mean clinical score was 84.3 for type II, 82.6 for type III and 56.1 for type IV. The mean preoperative $B{\ddot{o}}hler$ angle was $6.1^{\circ}$ and final was $22.8^{\circ}$. The mean preoperative calcaneal facet height was 76.6 mm and final was 80.3 mm (The mean calcaneal facet height was changed from preop 76.6 mm to postop 80.3 mm). The mean preoperative calcaneal length was 88.2 mm and final was 92.6 mm. The mean preoperative width was 38.1 mm and final was 35.6 mm. Conclusion: Open reduction and internal fixation showed good results for type II and III fractures, but for type IV fractures the clinical result was significantly worse than the other types. However, type IV fractures still had restoration of (should be restored in) $B{\ddot{o}}hler's$ angle, calcaneal facet height, calcaneal length and width which may be helpful in later subtalar fusion.

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Open Reduction and Internal Fixation of Displaced Intra-Articular Fractures of the Glenoid (전위된 견갑골 관절내 골절의 관혈적 정복 및 내고정술)

  • Kim Seung Key;Park Jong Beom;Choi Woo-Sung;Kwon Young-Jeong;Chang Han
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.230-235
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    • 1998
  • Fractures of the scapula are relatively uncommon injuries and treatment in the vast majority of cases remains nonsurgical and the results have been quite satisfactory. But the scapular fracture itself may be neglected because of its high incidence of many kinds of associated injuries so its delayed treatment sometimes gives bad and unpredictable results. Although open reduction and internal fixation has been accepted as the treatment of choice for displaced intra-articular fractures in many anatomical regions, there has been no definite treatment principles of surgical indications and approaches in the glenohumeral joint. At our institution, II displaced intra-articular fractures of the glenohumeral joint were treated with open reduction and internal fixation from March 1993 to February 1997. This paper reports the results of treating 11 displaced intra­articular fractures of the glenoid by open reduction and internal fixation. There were 10 men and one woman and the fractures were classified according to Ideberg : Type Ⅰa(4), Type Ⅱ(3), Type Ⅲ(1), Type IV(1), Type Va(1), and Type Vc(1).

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Operative Treatment of Displaced Talar Neck Fracture (전위된 거골 경부 골절의 수술적 치료)

  • Ahn, Jae-Hoon;Baek, Chang-Hyun;Choy, Won-Sik;Kim, Yong-In
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.190-195
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    • 2006
  • Purpose: To evaluate the results of open reduction and internal fixation for displaced talar neck fracture. Materials and Methods: Fourteen patients were followed for more than 1 year after open reduction and internal fixation of displaced talar neck fracture. The mean age was 41.5 years, and the mean follow-up period was 3.8 years. There were 10 type II, 3 type III and 1 type IV fractures per Hawkins. There were 3 open fractures. Clinically AOFAS ankle-hindfoot scale and Hawkins criteria were utilized. Radiologically quality of reduction, duration of bony union, avascular necrosis and posttraumatic arthritis were evaluated. Results: At last follow-up, AOFAS scale was mean 89.1 points. There were 8 excellent, 4 good, and 2 fair results according to Hawkins criteria. Radiologically anatomical reduction was obtained in 13 cases. Mean duration of bony union was 11.8 weeks. There were 3 avascular necrosis and 2 post-traumatic arthritis. There was no significant difference in the incidence of avascular necrosis between early operation group and surgically delayed group. Conclusion: Accurate open reduction and rigid internal fixation seem to be prerequisites for satisfactory treatment of a displaced talar neck fracture.

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Distal Tibiofibular Synostosis after Open Reduction and Internal Fixation in a Military Soldier (A Case Report) (관혈적 정복술 및 내고정술 후 군인에게 발생한 경비골 원위부 골결합증(1예 보고))

  • Lee, Jun-Young;Nam, Ki-Young;Song, Kyoung-Chul
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.105-107
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    • 2010
  • The scanty literature on distal tibiofibular synostosis includes descriptions of relatively few specific complaints. Here we report a case of a 24-year-old young soldier who sustained a left ankle lateral malleolar fracture about 6 months ago and was initially treated by the open reduction and internal fixation with plate & screw. But 6 months later, he suffered from an vague ankle pain, each time the symptoms occurred right after an active ambulation, ankle dorsiflexion, especially when he had exercised aggressively. The radiographs revealed that there was a mature distal tibiofibular synostosis. We treated the patient with surgical excision of synostosis. Post-operative condition was satisfied to all concern and the result was found to be excellent during one-year follow-up.

The Subclavian Artery Thrombosis after Open Reduction and Internal Fixation of Clavicular Fracture - A Case Report - (쇄골 골절의 관혈적 정복 및 내 고정술 후 발생한 쇄골하 동맥의 혈전증 - 증례 보고 -)

  • Moon, Eun-Sun;Kim, Myung-Sun;Jeong, Kwang-Cheul;Lim, Keun-Young
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.211-215
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    • 2006
  • Reported in this article is a case report of a patients who developed limb threatening ischemia as a consequence of a subclavian artery thrombosis resulting from screws. The subclavian artery thrombosis after open reduction and internal fixation of clavicle fracture, when it occurs, should be treated promptly by plate removal and claviculectomy. It can be prevented by placing screws in locations away from the underlying neurovascular structures.