• Title/Summary/Keyword: Trauma outcome

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The Treatment of on Ankylosed Canine : Luxation and Forced Eruption (골유착된 견치의 교정적 치험례 : 탈구 및 인위적 맹출)

  • Im, Dong-Hyuk;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.32 no.6 s.95
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    • pp.395-400
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    • 2002
  • This paper outlines the case of a 56 year-old man undertaking treatment by means of luxation and forced eruption of an ankylosed canine. At the time of diagnosis, the ankylosis of the tooth was not suspected, because there were not signs of intrusive luxation nor horizontal diaplacement. Only after the application of a vertical elastic force failed to erupt the maxillary left canine, was the ankylosis of that tooth suspected. At the time of reevaluation, the maxillary left canine hads no physiologic tooth mobility and emitted a sharp, ringing sound upon percussion. Hence, the maxillary left canine was considered ankylosed. The treatment course then changed to the extrusion of the canine through the surgical luxation of the tooth and the prompt application of vertical extrusive forces. The above outcome was successful for the patient not only in the orthodontic aspect, but also in terms of the periodontal considerations

Reconstruction of High-Pressure Paint Gun Injection Injured Finger Using Free Flaps with T-Shaped Pedicles and Multiple Venous Anastomoses

  • Lee, Jun Beom;Choi, Hwan Jun;Kim, Jun Hyuk;Cheon, Nam Ju;Lee, Young Man
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.75-78
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    • 2015
  • High-pressure (HP) injection injury to the upper extremity often causes a very serious clinical problem, leading to poor outcomes, including amputation, so that a true surgical emergency is required. The outcomes can be improved with emergent wide surgical debridement. However the diagnosis of these injuries is often delayed due to underestimated evaluation at first appearance and lack of common knowledge of the seriousness of this injury. The type and pressure of the infecting material is an important factor in prognosis and organic solvents infected pressure injury can cause poor outcome and increased amputation rate. In this case, we report on reconstruction of HP oil-based paint injection injuries of the finger using T-shaped pedicles and multiple venous anastomoses. In this concept, arterial flow can be maintained by the reverse flow of distal anastomosis when there is difficulty with the proximal anastomosis. And venous flow can be preserved by deep and superficial vein anastomosis. This concept has various advantages including preserving patency of the pedicle in chronic vasculopathy or trauma cases and maintaining the arterial flow by the reverse flow of distal anastomosis and can improve the free flap survival by a two vascular anastomosis system.

Arthroscopic Assessment of Potential Intra-articular Ankle Injury in Treatment of Ankle Fracture (족관절 골절의 치료에 있어 잠재적 관절 내 손상의 관절경적 평가)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Hyeong-Joo
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.151-155
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    • 2015
  • Purpose: The purpose of this study was to analyze the frequency and patterns of intra-articular lesions detected during ankle fracture surgery using ankle arthroscopy. Materials and Methods: Thirty patients (31 ankles) who underwent open reduction and internal fixation combined with ankle arthroscopy for acute ankle fracture at Inje University Busan Paik Hospital from June 2011 to September 2013 were evaluated. The ankle fractures were classified according to the AO/OTA (AO Foundation and Orthopaedic Trauma Association) classification and the intraarticular injuries were identified by ankle arthroscopy. Osteochondral lesions of the talus were divided into nine subtypes based on their locations, and the ligament injuries were classified according to avulsion fracture and rupture. Results: Using arthroscopy, abnormality in the distal tibiofibular ligament was found in 21 cases and osteochondral lesions and defects of the talus larger than 5 mm were detected in 26 cases. Among ligament injuries, anterior inferior tibio-fibular ligament injury was found in 14 cases, posterior inferior tibio-fibular ligament injury was found in two cases, deep deltoid ligament injury was found in three cases, and deep transverse tibio-fibular ligament injury was found in five cases. The locations of the osteochondral lesions were on the antero-lateral, antero-medial, centro-medial, centro-central, centro-lateral, and postero-lateral talus in 11, one, two, one, two, and nine cases, respectively. Conclusion: With early diagnosis and treatment arthroscopy performed at the time of intra-articular fracture surgery is expected to result in a good outcome.

Results of the Closed Treatment of Displaced Middle-Third Fractures of The Clavicle (전위된 쇄골간부 골절에서 보존적 치료의 결과)

  • Lee Kwang-Won;Song Dae-Hwa;Ong Sang-Suk;You Soo-Guen;Choy Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.83-92
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    • 1998
  • Fractures of the clavicles are extremely common, accounting for 5 to 10% of all injuries in the adult skeletal trauma. Despite this, nonunions and symptomatic malunions after clavicular fracture are uncommon. When these complications occur, however, they may be associated with 11 pattern of disability that includes not only pain but also impairment of upper extremity function. The purpose of this study was to clarify the outcome of clavicular fractures treated by conservatively, and emphasize treatment and factors that possibly predispose a clavicular fracture to poor function or nonunion. We evaluated 9] consecutive fractures of the middle-third of the clavicle in adults which had been treated conservatively. There were 59 males and 33 females ranging in age from 17 to 80 years (average 36.8 years). Nine of the 91 fractures (10%) had developed nonunion, and 4 fractures (4.4%) reported unsatisfactory results. No patients had significant impairment of range of motion or strength as a result of the injury. We found that initial shortening at the fracture of≥20mm(6 cases) had a highly significantly association with nonunion(P<0.0001). Final shortening of 20mm or more (4 cases) was associated with an unsatisfactory result, but not with nonunion(P<0.0001). Our results have led us to recommend the open reduction and internal fixation of severely displaced fractures of the middle third of the clavicle in adults patients.

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A Case of Trigger Finger Following Longitudinal Tear of Flexor Digitorum Superficialis after Repeated Closed Injury (반복적인 얕은손가락굽힘근힘줄 폐쇄성 손상 후 발생한 방아쇠 손가락 증례)

  • Choi, Hwan-Jun;Choi, Eui-Chul;Kim, Yong-Bae
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.304-308
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    • 2010
  • Purpose: Many causes for triggering or locking of the fingers have been discussed in other literatures. The most common one is known stenosing tenosynovitis, which causes, a mismatch between the volume of the flexor tendon sheath and its contents. However, repeated trauma to the hand is uncommon cause of trigger finger. Therefore, we present a case of a rare condition of stenosing tenosynovitis which developed from a repeated relatively weak superficial flexor tendon injury. Methods: The patient was a 62-year-old woman who showed a painless, fixed and round mass on her right hand with no particular cause. Active and passive range of motion of the metacarpophalangeal joint of long finger was limited in flexion and extension. Ultrasonographic finding showed injured flexor digitorum superficialis tendon had fibrillar architecture with swelling between hyperechoic synovial membrane and hypoechoic surrounding area. Surgical exploration revealed that a bunched portion of the flexor digitorum superficialis and A1 pulley cause triggering during operation after adhesiolysis of scar tissue. Results: After releasing the A1 pulley, the range of motion of the metacarpophalangeal joint of long finger showed no limitation and histological examination of the subcutaneous tissue revealed fibrous fatty degeneration. In this case, releasing the A1 pulley with adhesiolysis of the subcutaneous scar tissue was successful and we obtained good functional outcome. Conclusion: We examined a patient in whom a repetitive impact forces to the palm caused longitudinal tear of the flexor tendon, leading to trigger finger. We experienced a rare case of stenosing tenosynovitis and trigger finger caused after close injury to flexor digitorum superficialis and its degenerative changes that caused mass like effect. To the best of authors' knowledge, our case of close injury to the flexor digitorum superficialis and unique morphologic change before rupture of tendon is rarely to be reported.

Anterior Screw Fixation of Type II Odontoid Fracture (제 II 형 치상돌기 골절에서 전방경유 나사못 고정술)

  • Kim, Myung-Jin;Hwang, Jeong-Hyun;Sung, Joo-Kyung;Hwang, Sung-Kyu;Hamm, In-Suk;Park, Yeun-Mook;Kim, Seung-Lae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1461-1468
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    • 2000
  • Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

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Clinical Results of Silicone Oil Injection following Vitrectomy as a Primary Procedure in Retinal Detachment (망막박리에서 일차수술로 유리체절제술과 실리콘 주입술에 대한 임상결과 분석)

  • Gyeong, Gil-Hyeon;Lee, Moo-Sik;Hwang, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3919-3924
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    • 2009
  • To evaluate clinical results of silicone oil injection for retinal detachment. The 45 eyes of 44 patients underwent vitrectomy and silicone oil injection from 1999 to 2002. 1.There were no history of previous retinal surgery and ocular trauma. In 24 of the 45 eyes(53%) visual acuity increased and stabilized in 18 of the 45 eyes(40%). 2. 1 of 16 eyes(6.3%) had recurred retinal detachment after silicone oil removal. 3. Final retinal reattachment was achieved in 44 eyes(97%). Postoperative complications were cataract(16 eyes), glaucoma(10 eyes), emulsification of silicone oil(5 eyes), keratopathy(2 eyes) and recurrent retinal detachment(1 eye). These results show that silicone oil injection for primary retinal detachment yields a high rate of anatomic success and the good visual outcome

Changes of Clinical Practice in Gastrointestinal Perforation with the Increasing Use of Computed Tomography

  • Park, Ji-Min;Yoon, Young-Hoon;Horeczko, Timothy;Kaji, Amy Hideko;Lewis, Roger J
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.25-32
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    • 2017
  • Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.

A Size Change of Bone Defect Area after Autogenous Calvarial Bone Graft (자가 머리뼈 이식 후 뼈결손부의 면적 변화)

  • Hyun, Kyung Bae;Kim, Dong Suk;Yoo, Sun Kook;Kim, Hee Joung;Kim, Yong Oock;Park, Be-young Yun
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.467-473
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    • 2005
  • Calvarial bone grafting in craniomaxillofacial trauma and facial reconstructive surgery is now widely recognized and accepted as a standard procedure. One of the commonly reported problems of calvarial bone graft is the contour defect caused by partial resorption of the graft. But, there are few reports that discuss the fate of the calvarial bone graft based on the quantitative data. In this article, the changes of grafted calvarial bone were evaluated using 3-dimensional computed tomography(CT). 9 patients were observed with the CT scans at 2mm thickness immediately after operation and at the time of last follow-up. The area of the bone defect was segmented on the 3-dimensional CT image and calculated by AnalyzeDirect 5.0 software. The immediate postoperative bone defect area of the recipient site and the donor site were $612.9mm^2$ and $441.5mm^2$, respectively, which became $1028.1mm^2$ and $268.8mm^2$, respectively at the last follow-up. In conclusion, the bone defect area was less increased on the donor site of calvarial bone graft than on the recipient site. And the CT scan is a valuable imaging method to assess and follow-up the clinical outcome of calvarial bone grafting.

Study of Life History of Elderly Women who had Six Times of Imprisonment (여섯 번의 수감 생활을 한 여성 노인의 생애사 재구성)

  • Yang, Eun-Sook;Lee, Dong-Hun
    • The Journal of the Korea Contents Association
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    • v.18 no.8
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    • pp.210-226
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    • 2018
  • This study was to explore the life history of an elderly woman who had six times of imprisonment and entered a Samchung re-education camp. This study of life history followed the analysis of Mandelbaum(1973) pointing three perspectives of life: dimensions, turnings, and adaptations. Participant's dimensions of life were exploitation of labor, hostess life for U.S. military, prison life, Samchung re-education camp, marriage with the disabled, life of a farm worker. Turnings of life were serving as a maid, confinement of prison, life of hostess for living, being remanded to Samchung re-education camp by state violence, marriage and divorce, denial of social welfare service. Adaptations of life were downright adaptation in early life, exaggerated act in juvenile reformatory, prostituted women as a simple fortune-maker, adaption as a good wife and wise mother after marriage, resistive adaption as a self-employed. and farm worker. Based upon this results outcome, discussions and implications were suggested.