• Title/Summary/Keyword: fractures

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Reduction of Zygomatic Fractures Using the Carroll-Girard T-bar Screw

  • Baek, Ji Eun;Chung, Chan Min;Hong, In Pyo
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.556-560
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    • 2012
  • Zygomatic fractures are the second most common facial bone fractures encountered and treated by plastic surgeons. Stable fixation of fractured fragments after adequate exposure is critical for ensuring three-dimensional anatomic reduction. Between January 2008 and December 2010, 17 patients with zygomatic fractures were admitted to our hospital; there were 15 male and 2 female patients. The average age of the patients was 41 years (range, 19 to 75 years). We exposed the inferior orbital rim and zygomatic complex through a lateral brow, intraoral, and subciliary incisions, which allowed for visualization of the bone, and then the fractured parts were corrected using the Carroll-Girard T-bar screw. Postoperative complications such as malar asymmetry, diplopia, enophthalmos, and postoperative infection were not observed. Lower eyelid retraction and temporary ectropion occurred in 1 of the 17 patients. Functional and cosmetic results were excellent in nearly all of the cases. In this report, we describe using the Carroll-Girard T-bar screw for the reduction of zygomatic fractures. Because this instrument is easy to use and can rotate to any direction and vector, it can be used to correct displaced zygomatic bone more accurately and safely than other devices, without leaving facial scars.

A Survey Study on Characteristics Associated with Fractures in Elderly People (노인골절 환자의 골절 관련 특성에 대한 연구)

  • Lee Jong-Kyung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.3
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    • pp.326-334
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    • 2003
  • Purpose: The purpose of this study was to identify characteristics associated with fractures in elderly people in order to provide basic data for fracture preventive programs for the elderly people. Method: The participants were 84 patients over age of 65, who were admitted to the orthopedic department in a hospital in Chungnam province. Data were collected from Sep. 1, 2002 to Aug, 30, 2003 through personal interviews using a structured questionnaire. The data were analyzed using SPSSPC program. Result: Physical characteristics before the fracture included weakness or paralysis in the extremities (29.8%), need of assistance or appliances (13.1%), difficulty on balance (28.6%), visual disturbances (26.2%), hearing impairment (17.9%), speech disturbances (2.4%), urinary dysfunction (21.4%), and sleep disturbances (54.8%). The fractures occurred most frequently in winter (32.1%), between 1 pm and 6 pm (48.8%), on weekends (41.6%), in the road (58.3%) while wearing snickers (27.4%) or shoes (27.4%). The region of fractures occurred most frequently was lower extremities (57.1%), and the causes of fractures were loss of balance (31.0%) and car accident (25.0 %). A significance difference was found for type of accident, footwear at the time of the accident, place of the accident according to gender and age. Also a significance difference was found for type of accident and place of accident according to season(p<.05). Conclusion: Therefore, these results should be considered when a fracture preventive program for elderly people is designed.

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Cementing failure of the casing-cement-rock interfaces during hydraulic fracturing

  • Zhu, Hai Y.;Deng, Jin G.;Zhao, Jun;Zhao, Hu;Liu, Hai L.;Wang, Teng
    • Computers and Concrete
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    • v.14 no.1
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    • pp.91-107
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    • 2014
  • Using the principle of damage mechanics, zero-thickness pore pressure cohesive elements (PPCE) are used to simulate the casing-cement interface (CCI) and cement-rock interface (CRI). The traction-separation law describes the emergence and propagation of the PPCE. Mohr-coulomb criteria determines the elastic and plastic condition of cement sheath and rock. The finite element model (FEM) of delamination fractures emergence and propagation along the casing-cement-rock (CCR) interfaces during hydraulic fracturing is established, and the emergence and propagation of fractures along the wellbore axial and circumferential direction are simulated. Regadless of the perforation angle (the angle between the perforation and the max. horizontal principle stress), mirco-annulus will be produced alonge the wellbore circumferential direction when the cementation strength of the CCI and the CRI is less than the rock tensile strength; the delamination fractures are hard to propagate along the horizontal wellbore axial direction; emergence and propagation of delamination fractures are most likely produced on the shallow formation when the in-situ stresses are lower; the failure mode of cement sheath in the deep well is mainly interfaces seperation and body damange caused by cement expansion and contraction, or pressure testing and well shut-in operations.

Multiple Cervical Spinous Process Fractures in a Novice Golf Player

  • Kim, Sei-Yoon;Chung, Sang Ki;Kim, Dong-Yun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.570-573
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    • 2012
  • Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

  • Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.301-308
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    • 2012
  • In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

  • Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.291-300
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    • 2012
  • The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

Surgical Treatment of Olecranon Fractures

  • Koh, Kyoung-Hwan;Oh, Hyoung-Keun
    • Clinics in Shoulder and Elbow
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    • v.20 no.1
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    • pp.49-56
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    • 2017
  • Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.

Hapkido-related Clavicle Fractures :Preventable Injuries (합기도 훈련중 발생한 쇄골 골절과 예방)

  • Moon Young-Lae;Lee Kyung-Il;Kim Jeoung-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.163-166
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    • 2002
  • Introduction: It is frequently occur in sports injury of clavicular fractures in Hapkido players. Weevaluated Hapkido related clavicular fractures and preventive measure. Methods: We experienced 12 cases of Hapkido related clavicle fracture. The age ranged from 13 to18-years-old. All cases were treated by conservative managements. We examined the relationship between the clavicle fractures and Hapkido related pathomechanics.Results: All cases were injured during the practice for the falling-technique. Results were evaluatedby Weitzman and all cases were revealed more than good. Conclusions: In most cases, the correction of the wrong way of falling-technique will reduce theclavicle fractures in the Hapkido players.

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Combination Therapy of Conventional and Korean Medicine for Multiple Vertebral Compression Fractures Associated with Postpartum Osteoporosis: A Case Report

  • Lee, Ki-Beom;Yang, Kyu-Jin;Gi, Yu-Mi;Kim, Tae-Gyu;Jo, Hooin;Choi, Jongho
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.244-247
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    • 2018
  • Multiple vertebral compression fractures are a rare condition and are a serious consequence of postpartum osteoporosis. This report describes the case of a 35-year-old woman who had given birth to her first child 2 months before the onset of pain. Magnetic resonance imaging showed compression fractures of 7 vertebrae. The patient was treated with both conventional, and Korean medicine methods including acupuncture and herbal prescriptions. The patient's progress was assessed using self-reported symptoms, scale scores and laboratory test results. Her pain was gradually alleviated and biochemical inflammation marker levels improved, but her functional status remained severely impaired. Clinical practitioners who treat women in the postpartum period must be aware of osteoporosis and potential vertebral fractures and need to consider Korean medicine as an alternative therapy to help such patients.

Bony Fragment Excision Followed by Multiple Drilling and Fragment Fixation Using Bio-absorbable Pins for Bilateral Osteochondral Fracture of the Lateral Talar Dome: A Case Report (양측 족관절에 발생한 외측 거골원개 골연골의 골절에 대한 골편제거 후 다발성 천공술 및 생흡수성 핀을 이용한 골편고정: 증례 보고)

  • Lee, Yong Jae;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.201-207
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    • 2019
  • An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favorable clinical outcome was obtained at 18 months follow-up.