• 제목/요약/키워드: Surgical fixation

검색결과 542건 처리시간 0.028초

상악골 Le Fort I 골절 환자에서 경구 기관 내 삽관 하에서의 악간고정 및 정복: 증례보고 (Intermaxillary Fixation under Oral Intubation in a Patient with Le Fort I Fracture: a Case Report)

  • 최은주;이석련
    • 대한치과마취과학회지
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    • 제14권4호
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    • pp.233-236
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    • 2014
  • In order to reduce jaw fracture accompanied by basal skull or nasal fracture, submental intubation could be generally performed. Albeit submental intubation has been widely accepted, it could develop complications such as nerve injury, glandular duct injury, and orocutaneous fistula. Here, we suggest oral intubation for overcoming complications and providing more stable surgical environment in emergency case. Under oral intubation maintaining in retromolar triangle and buccal corridor space, intermaxillary fixation was successfully underwent in 38-years-old female patient with Le Fort I fracture accompanied by pneumocephalus.

Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail

  • Kim, Beom-Soo;Cho, Jae-Woo;Yeo, Do-Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • 제31권2호
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    • pp.96-102
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    • 2018
  • Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

Comparison of Ulnar Collateral Ligament Reconstruction Techniques in the Elbow of Sports Players

  • Moon, Jun-Gyu;Lee, Hee-Dong
    • Clinics in Shoulder and Elbow
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    • 제23권1호
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    • pp.41-47
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    • 2020
  • Ulnar collateral ligament injuries have been increasingly common in overhead throwing athletes. Ulnar collateral ligament reconstruction is the current gold standard for managing ulnar collateral ligament insufficiency, and numerous reconstruction techniques have been described. Although good clinical outcomes have been reported regarding return to sports, there are still several technical issues including exposure, graft selection and fixation, and ulnar nerve management. This review article summarizes a variety of surgical techniques of ulnar collateral ligament reconstructions and compares clinical outcomes and biomechanics.

흡수성 망상판과 나사를 이용한 안면골절의 견고정법 (Rigid Fixation using Bioabsorbable Mesh and Screws in Facial Bone Fracture)

  • 신동혁;김덕중;김수영;황은아;최현곤;김순흠;엄기일
    • Archives of Plastic Surgery
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    • 제37권5호
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    • pp.717-720
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    • 2010
  • Purpose: Absorbable plate and screw fixation is widely used technique for internal rigid fixation in craniomaxillofacial surgery. However, there are some potential problems associated with the use of plate. The purpose of this study is to evaluate the feasibility of bone fixation in facial fracture using absorbable mesh in place of absorbable plate. Methods: The records of 55 patients with zygomaticomaxilla fractures treated by open reduction, performed by the author from February 2008 to May 2009, were retrospectively reviewed. Patients were selected to receive absorbable mesh fixation. The incidence of all complications including infection, hypoesthesia, and deformity was examined. Analysis with postoperative computed tomography follow-up demonstrates degree of reduction. Results: Forty-six patients met criteria for inclusion in the study. All patients went on to satisfactory healing without complication. Postoperative computed tomography revealed good bony alignment similarly non affected side. Conclusion: This study demonstrates that the rigid internal fixation of fractured bone fragments using absorbable mesh is more effective than absorbable plate, especially in comminuted fracture of maxilla.

Bone Cement-Augmented Short Segment Fixation with Percutaneous Screws for Thoracolumbar Burst Fractures Accompanied by Severe Osteoporosis

  • Jung, Hyun Jin;Kim, Seok Won;Ju, Chang Il;Kim, Sung Hoon;Kim, Hyen Sung
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.353-358
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    • 2012
  • Objective : The purpose of this study was to determine the efficacy of bone cement-augmented short segment fixation using percutaneous screws for thoracolumbar burst fractures in a background of severe osteoporosis. Methods : Sixteen patients with a single-level thoracolumbar burst fracture (T11-L2) accompanying severe osteoporosis treated from January 2008 to November 2009 were prospectively analyzed. Surgical procedures included postural reduction for 3 days and bone cement augmented percutaneous screw fixation at the fracture level and at adjacent levels without bone fusion. Due to the possibility of implant failure, patients underwent implant removal 12 months after screw fixation. Imaging and clinical findings, including involved vertebral levels, local kyphosis, canal encroachment, and complications were analyzed. Results : Prior to surgery, mean pain score (visual analogue scale) was 8.2 and this decreased to a mean of 2.2 at 12 months after screw fixation. None of the patients complained of pain worsening during the 6 months following implant removal. The percentage of canal compromise at the fractured level improved from a mean of 41.0% to 18.4% at 12 months after surgery. Mean kyphotic angle was improved significantly from $19.8^{\circ}$ before surgery to 7.8 at 12 months after screw fixation. Canal compromise and kyphotic angle improvements were maintained at 6 months after implant removal. No significant neurological deterioration or complications occurred after screw removal in any patient. Conclusion : Bone cement augmented short segment fixation using a percutaneous system can be an alternative to the traditional open technique for the management of selected thoracolumbar burst fractures accompanied by severe osteoporosis.

다분절 퇴행성 경추질환에서의 전방 금속판 사용 유무에 따른 환자의 예후분석 (Outcome Analysis of the Patients with and without Anterior Plating in Multi-Level Degenerative Cervical Diseases)

  • 김상우;김성민;신동익;조용준;심영보;최선길
    • Journal of Korean Neurosurgical Society
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    • 제30권12호
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    • pp.1369-1374
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    • 2001
  • Objectives : The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. Methods : Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. Results : The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. Conclusion : Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.

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Midterm outcomes of suture anchor fixation for displaced olecranon fractures

  • Michael J. Gutman;Jacob M. Kirsch;Jonathan Koa;Mohamad Y. Fares;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • 제27권1호
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    • pp.39-44
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    • 2024
  • Background: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures. Methods: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed. Results: Suture anchor fixation was performed on 17 patients with displaced olecranon fractures. Functional outcome scores were collected from 12 patients (70.6%). The mean age at the time of surgery was 65.6 years, and the mean follow-up was 5.6 years. Sixteen of 17 patients (94%) achieved osseous union in an acceptable position. No hardware-related complications or fixation failure occurred. Mean postoperative shortened disabilities of the arm, shoulder, and hand (QuickDASH) score was 3.8±6.9, and mean Oxford Elbow Score was 47.5±1.0, with nine patients (75%) achieving a perfect score. Conclusions: Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. Additionally, this technique resulted in high rates of osseous union without any hardware-related complications or fixation failures.

편측 하악 과두골절의 관혈적 치료에 있어서 예후에 영향을 줄 수 있는 인자들에 관한 임상 통계학적 연구 (CLINICO-STATISTICAL ANALYSIS OF POSSIBLE FACTORS LEADING TO PROBLEMS IN THE SURGICAL TREATMENT OF UNILATERAL MANDIBLAR CONDYLE FRACTURES)

  • 성헌모;이동근;민승기;오승환;장관식
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권1호
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    • pp.31-39
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    • 2001
  • The purpose of this study is to reveal the factors leading to the problem of unilateral condylar fractures and suggest a treatment guideline of treatment for good prognosis in surgical treatment. The factors can be age, sex, fracture site, degree of displacement, posterior occlusion loss, post-operative alteration of condylar head position, post-operative condylar head resorption, and maxillomandibular fixation period. One hundred and eleven patients with unilateral condylar fractures, who were treated by surgical method from 1990 Feb. to 2000 Feb., were studied. Minimum follow-up period was 6 months. The results were as follows ; 1. In the age group of $41{\sim}60$, females had significantly higher complication rate than males, therefore we must be careful about treatment of female in this age group 2. In level I fractures of the mandibular condyle, because there were abundant complications when the patients were treated with fragment removal, conservative treatment is recommended over the surgical approach. 3. There were no differences in the complication rate, in the level II, III fractures. but were severe complications in the cases of patients treated by Dr.Nam's method or fragment removal. Therefore, open reduction and internal fixation is recommended over Dr.Nam's method or fragment removal. 4. In level IV fractures, open reduction and internal fixation is recommended 5. Although there was a higher complication rate depending on the degree of deviation, there was no correlation between the degree of deviation and development of complications in each level of fracture 6. Because the complication rate was higher in cases of condylar resorption, vertical dimension loss, and alteration of condylar head position, we must make an effort to prevent such complications during treatment

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상하악 동시 악교정수술에서 흡수성 고정판을 이용한 골편고정시 술후 안정성에 대한 연구 (POSTOPERATIVE STABILITY OF FIXATION WITH ABSORBABLES IN SIMULTANEOUS MAXILLOMANDIBULAR ORTHOGNATHIC SURGERY)

  • 박정민;박영욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권2호
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    • pp.126-131
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    • 2010
  • Objectives: This study is aimed to determine any differences in the postoperative stability between absorbable and titanium plate systems for fixation in orthognathic surgery with simultaneous maxillomandibular procedures especially including maxillary posterior impaction and advancement. Study Design: Forty patients with dentofacial deformities were randomly assigned into titanium (4 males and 6 females) and absorbable (17 males and 13 females) fixation group. All patients had undergone surgical alterations of maxilla with posterior impaction and advancement. A comparison study of the change in the maxillary position after the simultaneous surgery was performed with 1-day, 6-months postoperative lateral cephalograms compared to preoperative lateral cephalogram by tracing. Wilcoxon rank sum test was used for statistical analysis. Result: The position of the maxilla was stable after surgery and was not changed significantly from 1 day to 6 month after the simultaneous maxillomandibular surgery both in the experimental (absorbable plates) and control (titanium plates). Conclusion: This study suggests that application of absorable plating system in the fixation of maxillary segment in the simultaneous maxillomandibular procedures, leads to a predictable short-term postoperative skeletal stability comparable to the titanium plating system. Long term follow-up and further studies will be needed.

외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술 (Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture)

  • 배장호
    • Journal of Yeungnam Medical Science
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    • 제13권2호
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    • pp.234-242
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    • 1996
  • 영남대학교 의과대학 부속병원 신경외과에서 1994년 l월부터 1994년 12월까지 1년간 흉요추접합부 파열골절로 입원한 환자중 전측방경유법으로 10례를 수술로 치료경험 하였던 바, 척추골절이 척수원추 상부이면서 전방의 골편에 의해 척수신경이 압박되고 있는 불안정 파열골절시는 전방도달술에 의한 늑골 골융합 및 Kaneda기기내고정술로 좋은 결과를 기대할 수 있겠고, 척수 후주의 심한 손상이나 또는 3 column을 전체가 손상된 불안정 파열골절의 경우에는 후방접근법이나 후측방접근법으로 신경감압 및 내고정술 시행하는 것이 좋은 치료법이라 할 수 있겠다.

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