• The Journal of the Korean dental association
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• v.50 no.9
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• pp.566-573
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• 2012

Purpose : This study evaluated the impact of the presence and aspect of mandibular third molars to the mandible angle fracture or condyle fractures in Korean. Materials and Methods : A retrospective study was designed for patients attending the division of Oral and Maxillofacial Surgery, Kang-dong sacred heart hospital for treatment of mandibular fracture from January 2006 to September 2010. The primary variable was the presence of mandibular third molar and the secondary variable was the aspects of third molar impaction. Mandibular third molars were classified by the impaction depth and the available space as Pell & Gregory system. Outcome variables were the presence of mandibular angle fracture or condyle fracture. Also the source of trauma, age, sex were studied. Hospital charts, radiographs were used for study. Statistic analysis was done with descriptive statistics, the X2-test, linear-by-linear association. P value under 0.05 was considered significant statistically. Results : The number of involved patients was 86. The ratio of male to female patients was about 9:1 for angle fracture and 7:3 for condyle fracture. The most common source of trauma was assault for angle fracture and fall down for condyle fracture. The presence of mandibular third molar increased frequency of angle fracture and decreased condyle fracture with larger impaction depth. But available space of mandibular third molar did not show high association with angle or condyle fractures. Conclusion: Preventive extraction of mandibular third molar is recommended for patients with high risk of angle fracture. Male patients at their third decade or martial artists, police officer could be the case. But it is not recommended for patients with low risk of angle fracture and high risk of condyle fracture relatively. Elder female patients without any symptom on their third molar could be the case.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.351-355
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• 2009

Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.

• Journal of Trauma and Injury
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• v.23 no.1
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• pp.38-42
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• 2010

Purpose: The clinical utility of brain computed tomography (CT) in detecting temporal bone fracture is not well established. We performed this study to determine the utility of brain computed tomography (CT) in detecting fractures of the temporal bones in correlation with fracture patterns. We used high resolution computed tomography (HRCT) as the gold standard for diagnosing temporal bone fracture and its pattern. Methods: From January 2007 to December 2009, patients who underwent both brain CT and HRCT within 10 days of head trauma were investigated. Among them, 58 cases of temporal bone fracture confirmed by HRCT were finally included. Fracture patterns (transverse or non-transverse, otic capsule sparing or otic capsule violating) were determined by HRCT. Brain CT findings in correlation with fracture patterns were analyzed. Results: Among 58 confirmed cases of temporal bone fracture by HRCT, 14 cases (24.1%) were not detected by brain CT. Brain CT showed a significantly lower ability to detect temporal bone fracture with transverse component than without transverse component (p=0.020). Moreover, brain CT showed lower ability to detect otic capsule violating pattern than otic capsule sparing pattern (p=0.015). Among the 14 cases of temporal bone fracture that were not detected by brain CT, 4 cases lacked any objective physical findings (facial palsy, hemotympanum, external auditory canal bleeding) suggesting fractures of the temporal bones. Conclusion: Brain CT showed poor ability to detect temporal bone fracture with transverse component and otic capsule violating pattern, which is associated with a poorer clinical outcome than otic capsule sparing pattern. Routine use of HRCT to identify temporal bone fracture is warranted, even in cases without evidence of temporal bone fracture on brain CT scans or any objective physical findings suggestive of temporal bone fracture.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.590-597
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• 2020

Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.292-300
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• 2004

Orbital blowout fractures are common consequence to blunt periorbital trauma. Pure orbital blowout fractures first occur at the weakest point of the orbital wall. Computed tomography(CT) is recognized to be the best imaging technique to evaluate orbital fractures. The extent and location of a blowout fractures in the CT scan were noted to have an effect on the clinical outcome. In the early posttraumatic period, the presence of significant enophthalmos is difficult to detect because of orbital edema. Early surgical intervention may improve the ultimate outcome because open reconstruction becomes more difficult if surgery is delayed. In this study, we evaluated isolated blowout fractures of the orbital floor by region-of-interest measurements from CT scans and their relationship to ophthalmologic findings. Six patients of the medial orbital wall fractures, eleven patients of the inferior orbital wall fractures, nineteen of the medial and the inferior orbital wall fractures confirmed by CT scan, were evaluated. The area of fracture and the volume of the displaced orbital tissue were determined from CT scan using linear measurements. Each of the calculated values for the area and the volume were compared with the degree of the enophthalmos, the diplopia, and the eyeball movement limitation to determine whether there was any significant relationship between them. The fracture area and the volume of the herniated orbital tissue were significantly positively correlated with the enophthalmos and the ocular motility limitation and not correlated with the diplopia. For the enophthalmos of 2mm or greater, the mean fracture area was 3.55{\pm}1.25cm^2$ and the volume of the herniated orbital tissue was $1.74{\pm}0.97cm^3$; for less than 2mm enophthalmos, $1.43{\pm}0.99cm^3$ and $0.52{\pm}0.49cm^3$, respectively. The enophthalmos of 2mm can be expected with $2.92cm^2$ of the fracture area and $1.40cm^3$ of the herniated orbital tissue. In conclusion, the enophthalmos of 2mm or more, which is a frequent indication for surgery. It can be expected when area of fracture is $2.92cm^2$ or more, or the volume of herniated orbital tissue is $1.40cm^3$ or more. And the CT scan using linear measurements has an application in the assessment of patients with blowout fractures and provides useful information in the posttraumatic evaluation of orbital fractures.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.17-24
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• 2011

The aim of this study was to assess the outcome of MTA apexification in young permanent anterior teeth. Among the patients with the traumatized permanent incisors which were treated with MTA apexification, the dental records and radiographs were examined only for the patient who had follow-up examination at least 3 months after the treatment. Forty nine patients with 64 teeth were included in this study. Demographic information, location and type of teeth and periodontal injury, pre-treatment periapical lesion, clinical symptoms, status of MTA filling, healing of apical lesion and apical barrier formation after treatment were investigated. The outcome based on clinical and radiographic criteria were assessed. The results were as follows 1. Of 64 immature permanent incisors with MTA apexification, the clinical and radiographic success rates were 89.1% and 73.4%, respectively. 2. The maxillary incisors showed significantly higher success rates than the mandibular incisors. 3. There was no statistically significant difference in success rates among the teeth with different types of teeth and periodontal injury. 4. The status of MTA filling did not influence the clinical and radiographic success.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.121-125
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• 2010

Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.214-219
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• 2006

Background: Perforation of esophagus is relatively uncommon. but it is associated with high morbidity and mortality. Treatment and outcome are largely determined by the time of presentation. We performed a retrospective review of patients with esophageal perforation to assess the outcome of current management techniques. Material and Method: A retrospective chart review was performed on all patients treated for perforation of esophagus from March 1990 to March 2005. There were 28 patients (22 men and 6 women: mean age 51 years, range 17 to 82 years) The causes of the perforations were as follows: foreign body retention (9 patients), trauma (7 patients), spontaneous rupture (7 patients), and iatrogenic (5 pati-ients). 18 patients were presented within 24 hours and 10 patients were presented after 24 hours., Esophageal repair was performed in 21 ($75\%$) of them, 4 patients were treated with esophagectomy, 3 patients were treated with feeding gastrostomy and drainage. Result: Hospital mortality was $18\%$ and iatrogenic was increase the mortality rate (p < 0.05). Site of perforation, time from perforation, and treatment method had no influence on mortality. Postoprative leaks occurred in 4 patients after primary repair and were treated conservatively. Conclusion: Esophageal perforation remains a devastating event which is difficult to diagnose and manage. Primary repair can be performed in most patients with esophageal perforation regardless of time to presentation with a low mortality. Accurate diagnosis and early treatment are essential to the successful management of patients.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.93-98
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• 2023

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.155-160
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• 2005

Background: Falls are a major cause of emergency room visits. Injury secondary to falls is a largely preventable public health problem. This study helps to better understand the epidemiology of falls from height, then develops prevention strategies. Methods: We reviewed the medical records of 192 patients admitted to the emergency department of Konyang university hospital with a history of falls from January 2004 to December 2004. Collected data included the patient's age, gender, height of fall and method, outcome of management, Injury Severity Score(ISS). Results: According to the characteristics of height of fall, the ISS was higher when the patient fell from height of 2 meters or more($13.79{\pm}12.17$) than not($8.13{\pm}9.25$)(p<0.05). There were positive correlation between mean age and ISS(p<0.001, r=0.7). To gender, ISS was higher in the male group($12.73{\pm}11.78$) than the female group($8.48{\pm}10.00$)(p<0.05). Conclusion: Falls often results from multiple concurrent problems including environmental and behavioral factors. This study suggests that we need to improve the occupational environment, especially above 2meters, for decreasing injuries of fall from heights. Also we consider the prevention of children from injuries of fall from heights.