• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.72-79
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• 2021

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group. Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6-210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.94-97
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• 2013

Vertebroplasty (VP) can effectively treat pain and immobility caused by vertebral compression fracture. Because of complications such as extravasation of bone cement (polymethylmethacrylate, PMMA) and adjacent vertebral fractures, some practitioners prefer to inject a small volume of PMMA. In that case, however, insufficient augmentation or a subsequent refracture of the treated vertebrae can occur. A 65-year-old woman visited our clinic complaining of unrelieved severe low back and bilateral flank pain even after she had undergone VP on the $1^{st}$ and $4^{th}$ (L1 and L4) lumbar vertebrae a month earlier. Radiologic findings showed the refracture of L1. We successfully performed the repeat VP by filling the vertebra with a sufficient volume of PMMA, and no complications occurred. The patient's pain and immobility resolved completely three days after the procedure and she remained symptom-free a month later. In conclusion, VP with small volume cement impaction may fail to relieve fracture-induced symptoms, and the refracture of an augmented vertebral body may occur. In this case, repeat VP can effectively resolve both the persistent symptoms and problems of new onset resulting from refracture of the augmented vertebral body due to insufficient volume of bone cement.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.95-100
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• 2003

Purpose: To evaluate the incidence, contributing factors, and clinical results of refracture of proximal 5th metatarsal stress fracture treated operatively in athletes Materials and Methods: This study included 8 patients who had been treated for refracture of proximal 5th metatarsal stress fracture with operaton. Their charts & radiologic findings were evaluated retrospectively. Results: The overall incidence of refracture was 13%. Main contributing factors were time of return to sports activity and associated deformities such as cavus foot or flat foot. Seven cases were managed with nonoperative treatment, and we added percutaneous pin fixation under local anesthesia in one case. Bony union was seen at average 8. 5 weeks in 7 cases except 1 nonunion and all of 8 patient returned to athletics at average 16 weeks. Conclusion: The incidence of refracture of proximal 5th metatarsal stress fracture treated operatively in athletes was relatively high. Time of rerum to sports activity must be decided very carefully on individual situation and further imaging study may be helpful for bony union evaluation. The non-operative treatment may have a good result if bone graft was done initially.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2004.09a
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• pp.61-61
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• 2004

• The Journal of the Korean dental association
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• v.17 no.12 s.127
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• pp.923-926
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• 1979

In patient of long standing malunited maxillary fracture, maxillary osteotomy or refracture seems to be justifiable. This is a case of the patient, a 60 year old Korean female patient, presented a long-standing malunited maxillary fracture with dish-type face and functional disturbance in mouth opening. We performed upon her Le Fort I osteotomy only via labial-buccal horizontal incisions in one-stag operation. The result was good in esthetics and function.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.249-253
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• 1995

The fibrous dysplasia is a progressive and disabling condition that lead to deformity, especially weight bearing bones. The morbidity that is associated with the polyostotic fibrous dysplasia is the recurrent fracture and deformity. Various methods of treatment had been failed to control this problem. We used osteotomy and reconstruction nailing for polyostotic fibrous dysplasia occured in the proximal part of right femur with varus deformity and reconstruction nailing in left femur without osteotomy, and interlocking intramedullary nailing in right tibia to prevent pathologic fracture. These methods brought a good result of bone union and full weight bearing ambulation after 1 year and 6 month follow up. We think these methods are useful methods to control refracture and deformity, so we reported this case with bibliographic reviews.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.243-249
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• 2007

Purpose: Posttraumatic nasal deformities might not be corrected adequately by conventional osteotomy techniques when the configuration of the nasal bone has been changed due to malunion. To consistently obtain good aesthetic and functional results, the anatomic reduction of malunion sites of the nasal bone is important. The purpose of this study is to present an osteotomy technique, including refracture along malunion sites and anatomical reduction of a malformed nasal bone, for the correction of a posttraumatic deviated nose. Methods: From March of 2003 to May of 2004, 27 patients, who underwent corrective rhinoplasty for the correction of bony pyramid deviation, were included in this study. Postoperative results of the technique were evaluated objectively at 1 year after surgery regarding nasal midline location, nose symmetry, and nasal contour. Results were rated as excellent, good, fair, or poor. All patients were also evaluated subjectively for cosmetic improvement, changes in breathing, and overall satisfaction. Results: Objective analysis of the outcomes revealed an excellent result in 17 patients(63%), good in 9(33%), and fair in 1 patient(4%). No case evaluated had a poor result. Regarding subjective analysis, 19 patients(70%) evaluated the cosmetic outcome as perfect. Among the 21 patients with preoperative airway problems, 19 patients(90%) reported improved breathing post-operatively. Patients' overall satisfaction levels were also very positive. No postoperative complications occurred during the 14 month mean follow-up period. Conclusion: The osteotomy technique presented in this study is simple, effective, and safe for correcting posttraumatic nasal deviation, and also produces consistent results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.356-360
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• 1999

PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF"in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.102-107
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• 2014

This study was conducted to analyze the results of inhalation anesthesia performed at the equine hospital of Korea Racing Authority (KRA) and to find out the influencing factors on mortality during and/or after inhalation anesthesia. Among 585 cases of anesthesia, orthopedic surgery (410) was performed the most frequently, followed by colic surgery (85) and upper airway surgery (45). Twenty out of 585 horses were either euthanized or died during and/or after anesthesia. Among those twenty horses, fourteen horses received colic surgery, three received orthopedic surgery, and three others received upper airway surgery. The major causes of mortality were rupture of intestine in colic surgery and airway obstruction during recovery in upper airway surgery. Myopathy, refracture, laminitis were the causes of mortality in orthopedic surgery. Consequently, the horses that received colic and upper airway surgeries showed significantly high mortality rate rather than horses that received orthopedic surgery (p < 0.01). According to the results, horses that received colic surgery showed the highest mortality rate from euthanasia due to poor and grave prognosis. To reduce the perioperative mortality of horses, it is recommended to perform perioperative intensive care for colic surgery and careful monitoring for upper airway surgery during recovery.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.383-389
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• 2009

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group. the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core-post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n = 12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core-post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.