• Journal of Korean Foot and Ankle Society
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• v.19 no.4
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• pp.161-164
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• 2015

Purpose: The purpose of this study is to define the geographic patterns of partial avascular necrosis (AVN) of the talar body and to determine whether there were any predictors of both the location and occurrence of partial AVN. Materials and Methods: Nineteen patients with fracture of the talar neck treated by open reduction and internal fixation and followed up for more than 1 year were analyzed. The radiographs were examined 6 to 8 weeks after the operation for Hawkins sign and if it was not observed, magnetic resonance scans were performed. The three-dimensional analysis was performed using Mimics 17.0 (Materialise). The incidence of collapse and time to operative intervention was recorded. Results: Partial AVN of the talar body was observed in six out of 19 patients. The avascular segment of the talar body was located predominantly in the anterolateral portion. The average volume of the avascular segment was $289mm^3$, and it occupied 1% of total volume of the talus, and 10% of the talar dome. Collapse occurred in one patient in the area of the avascular process. There were no observable trends with regard to Hawkins classification, incidence of collapse, or time to operative intervention to the location of the avascular segment. Conclusion: Partial AVN can occur after fracture of the talar neck. The predominant location of the avascular segment was the anterolateral portion of the talar body. This information may be helpful to understanding the process of avascular necrosis of the talar body.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.204-208
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• 2012

Background : Isolated pure blowout fractures are clinically important because they are the main cause of serious complications such as diplopia and limitation of extraocular movement. Many reports have described the incidence of blowout fractures associated with diplopia and limitation of extraocular movement; however, no studies have statistically analyzed this relationship. The purpose of this study was to demonstrate the correlation between the location of isolated pure blowout fractures and orbital symptoms such as diplopia and limitation of extraocular movement. Methods : We enrolled a total of 354 patients who had been diagnosed with isolated pure blowout fractures, based on computed tomography, from June 2008 to November 2011. Medical records were reviewed, and the prevalence of extraocular movement limitations and diplopia were determined. Results : There were 14 patients with extraocular movement limitation and 58 patients complained of diplopia. Extraocular movement limitation was associated with the following findings, in decreasing order of frequency: floor fracture (7.1%), extended fracture (3.6%), and medial wall (1.7%). However, there was no significant difference among the types of fractures (P=0.60). Diplopia was more commonly associated with floor fractures (21.4%) and extended type fractures (23.6%) than medial wall fractures (10.4%). The difference was statistically significant (Bonferroni-corrected chi-squared test P<0.016). Conclusions : Data indicate that extended type fractures and orbital floor fractures tend to cause diplopia more commonly than medial wall fractures. However, extraocular movement limitation was not found to be dependent on the location of the orbital wall fracture.

• Archives of Craniofacial Surgery
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• v.17 no.4
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• pp.198-201
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• 2016

Background: Zygomatic arch is a bony arch constituting the lateral midface, which consists of 25% of all midface fractures. There are a number of ways to evaluate the extent of zygomatic arch fracture. Some authors have reported successful treatment outcomes using ultrasound (U/S). To add to the previous methods, we have considered ways to accurately display the location of the fracture line while using U/S with 23 gauge needle marking. We introduce our method, which provided satisfactory results for reduction using a portable U/S, and it can evaluate the fracture line simultaneously when reduction of an isolated zygomatic arch fracture is necessary, and needle marking, which can easily point out the fracture line on U/S. Methods: We studied 21 patients with an isolated zygomatic arch fracture who underwent closed reduction using U/S and needle marking between 2013 and 2015. Results: We achieved satisfactory results in all our cases with respect to reduction by using the Dingman elevator after performing a temporal approach incision, while confirming relative positioning between needle marking and zygomatic fracture at the same time, after insertion of a 23 gauge needle in the skin above the zygomatic arch fracture line parallel to it. Conclusion: We treated 21 patients with an isolated zygomatic arch fracture using U/S and the needle marking method, which provided satisfactory results because the extent of reduction of the fracture could be evaluated in real-time during the operation and exposure to radiation was reduced.

• Geomechanics and Engineering
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• v.33 no.1
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• pp.11-18
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• 2023

This study explores a new energy partitioning approach to determine the fracture toughness of 3-D printed pristine/recycled high density polyethylene (HDPE) blends employing the essential work of fracture (EWF) concept. The traditional EWF approach conducts a uniaxial tensile test with double-edge notched tensile (DENT) specimens and measures the total energy defined by the area under a load-displacement curve until failure. The approach assumes that the entire total energy contributes to the fracture process only. This assumption is generally true for extruded polymers that fracture occurs in a material body. In contrast to the traditional extrusion manufacturing process, the current 3-D printing technique employs fused deposition modeling (FDM) that produces layer-by-layer structured specimens. This type of specimen tends to include separation energy even after the complete failure of specimens when the fracture test is conducted. The separation is not relevant to the fracture process, and the raw experimental data are likely to possess random variation or noise during fracture testing. Therefore, the current EWF approach may not be suitable for the fracture characterization of 3-D printed specimens. This paper proposed a new energy partitioning approach to exclude the irrelevant energy of the specimens caused by their intrinsic structural issues. The approach determined the energy partitioning location based on experimental data and observations. Results prove that the new approach provided more consistent results with a higher coefficient of correlation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.6
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• pp.273-279
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• 2014

Purpose: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis. Methods: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed. Results: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was $192.6mm^2$ and the mean volume was $673.2mm^3$. Group B area was $316.2mm^2$ and volume was $1,710.6mm^3$. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume. Conclusion: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.2
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• pp.101-111
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• 2002

The purpose of this study was to evaluate the fracture strength of porcelain fused to gold crown and gold electroformed crown according to incisal and incisal under 3mm. In this study, 28 gold electroformed crown and 28 porcelain fused to gold crown were fabricated. Fracture strength testing was carried out using an Instron 8871(Instron Corporation, U.S.A) at a cross head speed of 5mm/min. All of the measurements were statistically analyzed by Independent t-testing, and k-s testing. Statistical significance was set in advance at the probability level of less than 0.05. All measurements were analized with Windows $SPSS^{(R)}$ Version 10.0 software for the personal computer. The results of this study were as follows; 1. Comparison by location (1) A compared fracture strength of incisal and incisal under 3 mm, there was statistical significant difference between gold electro -formed crown and porcelain fused to gold crown (p<0.05). 2. Comparison by loading (1) When compared fracture strength of incisal, there was no significant difference between gold electroformed crown ($619.90{\pm}53.54N$)and porcelain fused to gold crown($674.68{\pm}87.42N$). (2) When compared fracture strength of incisal under 3 mm, there was significant difference between gold electroformed crown($688.29{\pm}14.88N$) and porcelain fused to gold crown($1931.81{\pm}29.64N$) (p<0.05). 3. Mode of fracture When compared of fracture mode, gold electroformed crown showed mode of fracture and fracture line reaching coping region and porcelain fused to gold crown showed only in porcelain region.

• Journal of Acupuncture Research
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• v.18 no.6
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• pp.53-58
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• 2001

Objective : The purpose of this study is to investigate the characteristics of patients with fracture admitted in oriental hospital. Methods : From october 1996 to october 2001, we retrospectively evaluated the simple radiographic proven 8441 patients with musculoskeletal pain in oriental hospital. The patients included 3899 men and 4542 women. All fractures were analyzed in terms of location, age and sex. Results : 1. The fracture rate of radiologic study was relatively high in foot, chest, upper extremity and hand. The frequent fractures were in spine (257 cases), foot (119 cases), upper extremity (83 cases). and chest (68 cases). 2. The male patients with fracture were significantly higher than female in 0-40 years group: in 0-20 years group(8.5 % vs 4.0 %, p<0.01), in 21-40 years group (4.1 % vs 2.6, p<0.05), while female patients with fracture were significantly higher than male patients in more than 60 years group( 10.1 % vs 15.4 %, p<0.01). 3. The incidence of fracture showed significant association with increased age except 0-20 years group(p<0.01). Spine and chest cage in mate, and upper extremity, pelvis, spine, ankle and chest cage in female were significantly higher on older age groups. Conclusion : The overall fracture rate of radiologic study was 6.6 % for patients with musculoskeletal problem admitted in oriental hospital. The distribution of fracture showed significant difference in terms of age, sex and site. So we believe the radiologic study is helpful to evaluate fracture in oriental hospital.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.40-46
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• 2019

Purpose: We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery. Methods: We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS. Results: Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor. Conclusions: The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.50-56
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• 2021

Purpose: Fractures are common in the military population, but limited studies have investigated the incidence of fractures among Korean military personnel. Hence, this study aimed to clarify this issue. Methods: Eligible subjects were patients who had sustained a fracture and were registered in the N-DEMIS (the medical records system of participating hospitals) from June 2017 to May 2019. Fractures were categorized according to the fracture site, patients' age, sex, and type of duty. Results: In total, 23,687 patients with 23,981 fractures were included. There were 216 patients with multiple fractures, of whom 156 had fractures at two sites, 42 had fractures at three sites, and 18 had fractures at four sites. Of the 23,687 patients, 23,340 were men and 347 were women. The incidence of fractures in men and women was 12.96 per 1,000 person-years and 0.19 per 1,000 person-years, respectively. In terms of the broad location of fractures, the percentage of fractures was the highest in the hand, followed by the foot and lower leg. When the location of fractures was analyzed more specifically, the percentage of fractures was the highest in the phalanx (thumb and fingers), followed by the ankle and metacarpal bones. Conclusions: Hand, foot, ankle, and wrist fractures were the most commonly encountered fractures in the Korean military population. To prevent the loss of combat power due to non-battle-related injuries, thorough preparation is necessary, including protective equipment and preliminary training for areas with a high frequency of fracture occurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.32-40
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• 1989

This study is based on 247 patients(348 cases) with facial bone fracture who were admitted to the department of oral and maxillofacial surgery, Kangnam sacred heart Hospital during the period of Jan. 1983 through sep. 1988. The patients with mandible fracture were analysed with the following items such as complications with treatment method undertaken : Bicortical osteosynthesis vs Monocortical osteosynthesis, advantages and Disadvantages. The results obtained are as follows : 1) The most common age groups for the facial bone fracture were 20 years 2) The ratio of Men to women was 5 : 1 3) The most frequent location of facial bone fractures was the Mandible(76.7%), Maxillae(10.6%), Zygoma(9.5%), Nasal bone(3.2%) 4) The ratio of Mandible to Maxillae was 7.2 : 1 5) In mandible fractures, the most frequent fracture site was Symphysis(48.7%) 6) In maxilla fractures, the most frequent case was Le fort III fracture(51.4%), followed by Le fort I fracture(29.7%), Le fort II fracture(18.9%) 7) The main contributing causes of facial bone fractures were Traffic Accident(37.7%), Fight(31.6%), Accident(27.5%) 8) In open reduction methods of mandible fracture, the frequency of postop, malocclusion was 15% in interosseous wiring, 7% in Bicortical osteosynthesis, 3% in Monocortical osteosynthesis. The miniplates show advantages over other forms of fixation, in that they are malleable and easy to insert, they achieve rigid fixation and stability.