• Title/Summary/Keyword: fractures

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Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States

  • Jennifer M. Brewer;Owen P. Karsmarski;Jeremy Fridling;T. Russell Hill;Chasen J. Greig;Sarah E. Posillico;Carol McGuiness;Erin McLaughlin;Stephanie C. Montgomery;Manuel Moutinho;Ronald Gross;Evert A. Eriksson;Andrew R. Doben
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.48-59
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    • 2024
  • Purpose: Research on rib fracture management has exponentially increased. Predicting fracture patterns based on the mechanism of injury (MOI) and other possible correlations may improve resource allocation and injury prevention strategies. The Chest Injury International Database (CIID) is the largest prospective repository of the operative and nonoperative management of patients with severe chest wall trauma. The purpose of this study was to determine whether the MOI is associated with the resulting rib fracture patterns. We hypothesized that specific MOIs would be associated with distinct rib fracture patterns. Methods: The CIID was queried to analyze fracture patterns based on the MOI. Patients were stratified by MOI: falls, motor vehicle collisions (MVCs), motorcycle collisions (MCCs), automobile-pedestrian collisions, and bicycle collisions. Fracture locations, associated injuries, and patient-specific variables were recorded. Heat maps were created to display the fracture incidence by rib location. Results: The study cohort consisted of 1,121 patients with a median RibScore of 2 (range, 0-3) and 9,353 fractures. The average age was 57±20 years, and 64% of patients were male. By MOI, the number of patients and fractures were as follows: falls (474 patients, 3,360 fractures), MVCs (353 patients, 3,268 fractures), MCCs (165 patients, 1,505 fractures), automobile-pedestrian collisions (70 patients, 713 fractures), and bicycle collisions (59 patients, 507 fractures). The most commonly injured rib was the sixth rib, and the most common fracture location was lateral. Statistically significant differences in the location and patterns of fractures were identified comparing each MOI, except for MCCs versus bicycle collisions. Conclusions: Different mechanisms of injury result in distinct rib fracture patterns. These different patterns should be considered in the workup and management of patients with thoracic injuries. Given these significant differences, future studies should account for both fracture location and the MOI to better define what populations benefit from surgical versus nonoperative management.

Effects of Music Therapy on Pain, Discomfort, and Depression for Patients with Leg Fractures

  • Kwon In-Sook;Kim Jung-Nam;Park Kyung-Min
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.630-636
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    • 2006
  • Purpose. To determine the effects of music therapy on pain, discomfort, and depression for patients with leg fractures. Methods. Data were collected from 40 patients admitted in an orthopedic surgery care unit. The subjects included 20 intervention group members and 20 control group members. Music therapy was offered to intervention group members once a day for 3 days for 30-60 minutes per day. Pain was measured with a numeric rating scale and by measuring vital signs. Discomfort and depression were measured with self-administered questionnaires. Results. Patients who received music therapy had a lower degree of pain than patients who did not receive music therapy as measured by the numeric pain score (p < 0.001), systolic blood pressure (p < 0.01), diastolic blood pressure (p < 0.001), pulse rate (p < 0.001) and respiration (p < 0.001). Patients who were provided with music therapy also had a lower degree of discomfort than patients who were not provided with this therapy (p < 0.01). Effects of Music Therapy on Pain, Discomfort, and Depression for Patients with Leg Fractures Conclusions. These results demonstrate that music therapy is an effective method for decreasing pain and discomfort for patients with leg fractures.

A CLINICAL STUDY OF FACIAL BONE FRACTURES IN WEST-KYUNGSANGNAMDO (서부 경남 지역에서 발생한 악안면부 골절에 관한 임상적 연구)

  • Kim, Jin;Ro, Hong-Sup
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.201-206
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    • 1998
  • We reviewed 240 patients with facial bone fractures treated at the department of oral and maxillofacial surgery between Jan. 1. 1997 to Dec. 31. 1997. These results were obtained as follows : 1. The ratio of men to women was 3.5 : 1 2. The age frequency was highest for people in their 20's 34.2%, in their 10's 21.63%, and in their 30's 20.41%. 3. The fractures were at the highest incidence in September at 13.3%, followed by in May at 11.25%. 4. The frequent causes were traffic accidents 47.9%, fisticuffs 20%, accidents caused by falling or slipping 16.25%, working traumas 8.75%, and sports 7.1%. 5. The most common location of facial bone fractures was the mandible 67.2%. The frequent fracture sites of the mandible were symphysis, angle, condyle, and body in the order. 6. The associated injuries of facial bone fractures were neurosurgry, orthopedic surgery, cardiothoracic surgery, ophthalmic surgery and general surgery. 7. In respect of treatment, open reduction used 84.3% of the time. 8. Post operation complicatins were as follows : neurological problem 2.08%, malunion 1.67%, facial asymetry 0.83%, malocclusion 0.83%, and infection 0.41%.

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CLINICAL EVALUATIONS OF INTRAORAL APPROACH ON THE MANDIBULAR ANGLE FRACTURES (하악 우각부 골절의 구내접근법에 대한 임상적 평가)

  • Bang, Man-Hyeok;Lee, Dong-Keun;Min, Seung-Ki;Chang, Dong-Ho;Jin, Kuk-Beom;Park, Kyeong-Ok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.63-71
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    • 1994
  • Recently, we have used internal fixation with titanium miniplate which introduced by Champy in 1976 in facial bone fractures. In cases of mandibular fractures, particulary mandibular angle fractures, we usually underwent the open reduction extraorally. But extraoral approaches may leave scars and put the facial nerve at greater risk. So, we had undergone the intraoral approaches in 31 patients of mandibular angle fractures (male : 29, female : 2). These patients visited in Wonkwang university hospital from October 1991 to June 1993. We got easy operation time as average 20 minutes than extraoral approach. And reduced the postoperative nerve injury(14.2%), but postoperative infection is 6.1% nearly as same as extraoral approach. TMJ problems after intraoral open reduction was similar to extraoral approaches.

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Surgical Management of Edentulous Atrophic Mandible Fractures in the Elderly

  • Chee, Nam Seok;Park, Seong June;Son, Min Ho;Lee, Eoy Jung;Lee, Soo Woon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.5
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    • pp.207-213
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    • 2014
  • Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.

Comparative Evaluation of Infection Rate according to Extraction of Teeth in the Line of Mandibular Angle Fractures Treated with Stable Internal Fixation (안정된 내고정이 시행된 하악각 골절에서 골절선상의 치아 발거에 따른 감염률 비교평가)

  • Kim, Jin-Ha;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.32-35
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    • 2011
  • Purpose: Mandibular angle fractures constitute approximately 30% of mandibular fractures, and the mandibular third molar is usually in line with the fracture. This study evaluated the relationship between the extraction of a tooth in line with a mandibular angle fracture and the infection rate. Methods: One hundred and forty seven patients with mandibular angle fractures containing a tooth in line with the fracture from 2005 to 2008 were enrolled in this study. The patients were divided into two groups based on an extraction, and the infection rates were evaluated in both groups. Results: An extraction was performed in 70 patients (47.6%) and postoperative infections occurred in 14 patients (9.5%). Six (8.6%) of the 70 patients in the extraction group and 8 (10.4%) of the 77 patients in the non-extraction group had an infection. There was no significant difference between the two groups (P=0.708). Conclusion: These results show that there is no increased risk of postoperative complications when a tooth is present

Developing brittle transparent materials with 3D fractures and experimental study

  • Wang, Jing;Li, Shucai;Zhu, Weishen;Li, Liping
    • Steel and Composite Structures
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    • v.22 no.2
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    • pp.399-409
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    • 2016
  • The fracture propagation mechanism and fractured rock mass failure mechanism were important research in geotechnical engineering field. Many failures and instability in geotechnical engineering were related on fractures propagation, coalescence and interaction in rock mass under the external force. Most of the current research were limited to two-dimensional for the brittleness and transparency of three-dimensional fracture materials couldn't meet the requirements of the experiment. New materials with good transparent and brittleness were developed by authors. The making method of multi fracture specimens were established and made molds that could be reused. The tension-compression ratio of the material reached above 1/6 in normal temperature. Uniaxial and biaxial loading tests of single and double fracture specimens were carried out. Four new fractures were not found in the experiment of two-dimensional fractures such as the fin shaped crack, wrapping wing crack and petal crack and anti-wing crack. The relationship between stress and strain of the specimens were studied. The specimens with the load had experienced four stages of deformation and the process of the fracture propagation was clearly seen in each stage. The expansion characteristics of the fractured specimens were more obvious than the previous research.

Clinical and scanning electron microscopic analysis of fractured dental implants: a retrospective clinical analysis

  • Kwon, Kyung-Hwan;Sim, Kyu-Bong;Cha, Jae-Won;Kim, Eun-Ja;Lee, Jae-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.6
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    • pp.371-378
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    • 2012
  • Many longitudinal studies have reported the successful osseointegration of dental implants, with survival rates approaching 90-95%. However, implants regarded as a "success" may have also failed to undergo osseointegration. A variety of complications and failures have been observed, including implant fracture - a rare and delayed biomechanical complication with serious clinical outcomes. Given the increasing popularity of dental implants, an increase in the number of failures due to late fractures is expected. This study sought to determine the rate of implant fractures and factors associated with its development. This retrospective evaluation analyzed implants placed at Wonkwang Dental Hospital (from 1996 to the present). In our study we found that the frequency of dental implant fractures was very low (0.23%, 8 implant fractures out of 3,500 implants placed). All observed fractures were associated with hybrid-surface threaded implants (with diameter of 4.0 or 3.75 mm). Prosthetic or abutment screw loosening preceded implant fracture in a majority of these cases.

Operative Treatment of Fractures of the Fifth Metatarsal Base (제5 중족골 기저부 골절의 수술적 치료)

  • Suh, Jin-Soo;Kim, Jung-Hoon;Choi, Jun-Young
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.189-196
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    • 2008
  • Purpose: Nonunions and delayed unions are possible complications of fractures of fifth metatarsal base. We tried to report the results of the surgical treatment, which is not prevalent yet. Materials and Methods: Retrospective study of thirty nine patients undergoing operation at our institution between 2003 and 2008 was conducted. Six patients were excluded with loss of follow up before bony union, multiple trauma, pediatric fractures, stress fracture, open fracture. There were 18 males and 15 females with 45.1 years old mean age. The average follow-up period was 18.3 months. We used a midfoot scoring system of AOFAS for clinical assessment and radiologic findings to evaluate bony union, alignment. Results: According to Lawrence's classification, Zone 1 fractures were thirteen and Zone 2 were twenty. Average AOFAS score was 93.61. Conclusion: Early operative treatment with cannulated screw fixation in fractures of the fifth metatarsal base is thought to be an useful and easy treatment option with faster rates of union.

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The Fracjection: An analytical system for projected fractures onto rock excavation surface from boreholes and outcrops (시추 및 야외조사 자료의 절취면 투영 분석 시스템 Fracjection)

  • Hwang, Sang-Gi;Lim, Yu-Jin
    • Proceedings of the KSR Conference
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    • 2007.05a
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    • pp.1882-1889
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    • 2007
  • Surveying rocks for engineering aims for prediction of geological feature of the construction site. Conventionally, survey information at outcrops and bore holes are projected to the construction sites, such as tunnel and slopes, and rock properties of the sites are predicted by interpretations of specialists. This system, the "Fracjection", aims to assist the specialist for visualization of the projected fractures from borehole and outcrop survey. The Fracjection accepts the BIPS and outcrop survey data to its database and allows plotting them in AutoCad map. The software also reads elevation data from contours of the topographic map and constructs DEM of the construction sites. With user's guide, it generates 3D excavation sites such as slopes and tunnels at the topographic map. The s/w projects borehole and outcrop surveyed fractures onto the modeled excavation surface and allows analysis of failure criteria, such as plane, wedge, and toppling failures by built-in stereonet function. Projected fractures can further be analyzed for structural homogeneities and rock mass quality. Moving window style correlation comparison of stereonet plots are used for formal analyses, and RQD type counts of the projected fractures are adopted for the latter analyses.

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