• 제목/요약/키워드: fractures

검색결과 2,660건 처리시간 0.026초

Treatment of pathologic fracture following postoperative radiation therapy: clinical study

  • Kim, Chul-Man;Park, Min-Hyeog;Yun, Seong-Won;Kim, Jin-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제37권
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    • pp.31.1-31.5
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    • 2015
  • Background: Pathologic fractures are caused by diseases that lead to weakness of the bone structure. This process sometimes occurs owing to bony change after radiation therapy. Treatment of pathologic fractures may be difficult because of previous radiation therapy. Methods: In this study, we analyzed clinical and radiographic data and progress of five patients with mandibular pathological fractures who had received postoperative radiation therapy following cancer surgery. Result: Patients received an average radiation dose of 59.2 (SD, 7.2) Gy. Four of five patients exhibited bone union regardless of whether open reduction and internal fixation (OR/IF) was performed. Patients have the potential to heal after postoperative radiation therapy. Treatment of a pathologic fracture following postoperative radiation therapy, such as traditional treatment for other types of fractures, may be performed using OR/IF or CR. OR/IF may be selected in cases of significant bone deviation, small remaining bone volume, or occlusive change. Conclusion: Patients have the potential to heal after postoperative radiation therapy.

안면골 외상환자의 전산화단층상을 이용한 삼차원재구성상의 비교연구 (A COMPARATIVE STUDY OF THREE DIMENSIONAL RECONSTRUCTIVE IMAGES USING COMPUTED TOMOGRAMS OF FACIAL BONE INJURIES)

  • 최은숙;고광준
    • 치과방사선
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    • 제24권2호
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    • pp.413-423
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    • 1994
  • The purpose of this study was to clarify the spatial relationship in presurgical examination and to aid surgical planning and postoperative evaluation of patients with facial bone injury. For this study, three-dimensional images of facial bone fracture were reconstructed by computed image analysis system and three-dimensional reconstructive program integrated in computed tomography. The obtained results were as follows: 1. Serial conventional computed tomograms were value in accurately depicting the facial bone injuries and three-dimensional reconstructive images demonstrated an overall look. 2. The degree of deterioration of spatial resolution was proportional to the thickness of the slice. 3. Facial bone fractures were the most distinctly demonstrated on inferoanterior views of three-dimensional reconstructive images. 4. Although three-dimensional reconstructive images made diagnosis of fracture lines, it was difficult to identify maxillary fractures. 5. The diagnosis of zygomatic fractures could be made equally well with computed image analysis system and three-dimensional reconstructive program integrated in computed tomography. 6. The diagnosis of mandibular fractures could be made equally well with computed image analysis system and three-dimensional reconstructive program integrated in computed tomography.

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골다공증과 동반된 족관절 외과 골절의 지연나사를 이용한 치료 (Treatment of Ankle Lateral Malleolar Fractures Accompanying Osteoporosis using Lag Screw)

  • 이준영;이광철
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.207-212
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    • 2006
  • Purpose: To evaluate the results of ankle lateral malleolar fractures classified as Danis-Weber type B accompanying osteoporosis that were treated with lag screw. Materials and Methods: 15 cases of Danis-Weber type B ankle lateral malleolar fractures that had T score of less than -2.5 in BMD(bone mineral density) test were selected from June 2003 to December 2005. 10 cases were males and 5 cases were females with mean age of 59 years. The main injury mechanism was supination and external rotation. Mean follow-up period was 16 months. Clinical and radiologic evaluation was done according to Meyer and Kumler's criteria. Results: All cases showed satisfying result and mean radiologic bone union period was 3 months. Anatomic reduction and bone union was acquired in all cases without complications including wound infection, skin necrosis, delayed union and nonunion Conclusions: Lag screw fixation seem to be excellent treatment of Danis-Weber type B lateral malleolar fractures with osteoporosis as it can minimize soft tissue injury and enable anatomic reduction with firm fixation.

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Internal Fixation Using Clavicle Hook Plates for Distal Clavicle Fractures

  • Kim, Kwang-Yul;Kim, Hyung-Chun;Cho, Sung-Jun;Ahn, Su-Han;Kim, Dong-Seon
    • Clinics in Shoulder and Elbow
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    • 제18권1호
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    • pp.21-27
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    • 2015
  • Background: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. Methods: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. Results: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. Conclusions: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

Three-Dimensional Pre-Bent Titanium Implant for Concomitant Orbital Floor and Medial Wall Fractures in an East Asian Population

  • Lee, Kyung Min;Park, Ji Ung;Kwon, Sung Tack;Kim, Suk Wha;Jeong, Eui Cheol
    • Archives of Plastic Surgery
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    • 제41권5호
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    • pp.480-485
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    • 2014
  • Background The objective of this article is to evaluate clinical outcomes of combined orbital floor and medial wall fracture repair using a three-dimensional pre-bent titanium implant in an East Asian population. Methods Clinical and radiologic data were analyzed for 11 patients with concomitant orbital floor and medial wall fractures. A combined transcaruncular and inferior fornix approach with lateral canthotomy was used for the exposure of fractures. An appropriate three-dimensional preformed titanium implant was selected and inserted according to the characteristics of a given defect. Results Follow-up time ranged from 2 to 6 months (median, 4.07 months). All patients had a successful treatment outcome without any complications. Clinically significant enophthalmos was not observed after treatment. Conclusions Three-dimensional pre-bent titanium implants are appropriate for use in the East Asian population, with a high success rate of anatomic restoration of the orbital volume and prevention of enophthalmos in combined orbital floor and medial wall fracture cases.

Non-Operatively Treated Thoracolumbar Burst Fracture with Posterior Ligamentous Complex Injury: Case Report and Consideration on the Limitation of Thoracolumbar Injury Classification and Severity (TLICS) Score

  • Kwon, Woo-Keun;Oh, Jong-Keon;Cho, Jun-Min;Kwon, Taek-Hyun;Park, Youn-Kwan;Moon, Hong Joo;Kim, Joo Han
    • Journal of Trauma and Injury
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    • 제31권2호
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    • pp.76-81
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    • 2018
  • Fractures at the thoracolumbar region are commonly followed after major traumatic injuries, and up to 20% of these fractures are known to be burst fractures. Making surgical decisions for these patients are of great interest however there is no golden standard so far. Since the introduction of Thoracolumbar Injury Classification and Severity (TLICS) score in 2007, it has been widely used as a referential guideline for making surgical decisions in thoracolumbar fractures. However, there is still limitations in this system. In this clinical case report, we introduce a L1 burst fracture after motor vehicle injury, who was successfully treated conservatively even while she was graded as a TLICS 5 injury. A case report is presented as well as discussion on the limitations of this grading system.

Application of Minimally Invasive Plate Osteosynthesis to Tibial Shaft Fractures in Dogs

  • Rahman, Md. Mahbubur;Jeong, In-Seong;Kim, Nam Soo
    • 한국임상수의학회지
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    • 제34권3호
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    • pp.200-203
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    • 2017
  • The objective of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) method for treatment of tibial shaft fractures in dogs by comparing MIPO radiographic and fracture healing time results with those from the popular open reduction and internal fixation (ORIF) technique. In this clinical study at the Royal Animal Medical Center, five consecutive dogs with diagnoses of comminuted tibial shaft fractures were treated with the MIPO surgical approach. For comparison, an additional five breed-, age-, and weight-matched dogs with comminuted tibial shaft fractures were treated with the ORIF technique. Mean healing time was $75.6{\pm}12.5$ days in the MIPO group and $131.8{\pm}18.6$ days in the ORIF group (p < 0.01). The mean surgery time in the MIPO group ($36.4{\pm}3.5$ minutes) was significantly shorter (p < 0.01) than that for the ORIF group ($47.0{\pm}2.2$ minutes). Based on the short surgical and healing times, the MIPO approach is clinically superior to the ORIF approach and should be the preferred approach in tibial fracture cases.

관혈적 정복술로 치료한 하악골 골절에서의 합병증 (COMPLICATIONS ASSOCIATED WITH OPEN REDUCTION OF MANDIBULAR FRACTURES)

  • 박영아;손우일;장익준;송재철;진병로
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제27권5호
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    • pp.474-480
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    • 2001
  • Purpose: The aim of this study was to evaluate the complications of open reduction and internal fixation of mandibular fracture with miniplates. Patients and Methods: A total of 134 patients who presented with 196 fractures were analyzed retrospectively. Complications were evaluated for factors such as age, the site of fracture, the severity of fracture, delayed operation, preoperative wound contamination, the site and disposition of teeth in the fracture line and midfacial fractures. Statistical analysis was used to compare complications to risk factors. Results: Of the 134 patients, 20 patients had some form of postoperative complications and complication rate was 14.9%. These complications included infection, plate fracture, malocclusion, wound dehiscence, nerve injury and nonunion. There was a significant correlation between complication rate and the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth(p<0.05). Conclusion: The occurrence of postoperative complications in the treatment of mandibular fractures was related to the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth.

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하악 과두 골절 환자에서 Lag-screw를 이용한 관혈적 정복 후 임상적 연구 (CLINICAL STUDIES OF LAG -SCREW OSTEOSYNTHESIS IN CONDYLAR FRACTURES OF THE MANDIBLE)

  • 정종철;송민석;최재욱;김성범;서지훈;이계혁
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제27권5호
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    • pp.442-446
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    • 2001
  • Purpose : This study evaluated clinical and radiographic results after open reduction and lag-screw fixation of mandibular condyle fractures. Patients and Methods : 26 patients had been treated by lag-screw fixation for madibular condyle fracures via submandibular approach and follow up for over 6 months. The lag-screw used in this study was designed by Eckelt. Results : Radiographically, resorption of the condyle head found in 4 cases (15%) and minimal displacement of the condyle head was found in 3 cases (12%). Post-operative infection were not found in all cases. Clinically, All patiens had a stable occlusion and normal mouth opening (over 40mm). TMD problems with crepitus or some discomfort encountered in 4 patients but tolerable to the patients. Conclusion : Lag screw fixation can be a good option especially high level condylar fractures, however this procedure must be used in cautiously because of slipping of the fragments and possible to resorption of the fragments.

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A Study on Validation of Variable Aperture Channel Model: Migration Experiments of Conservative Tracer in Parallel and Wedge-Shaped Fracture

  • Keum, D.K.;Hahn, P.S.;Vandergraaf, T.T.
    • Nuclear Engineering and Technology
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    • 제30권3호
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    • pp.245-261
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    • 1998
  • In order to validate the variable aperture channel model that can deal with the non-uniform How rate in flow domain, migration experiments of conservative tracer were performed in two artificial fractures, a parallel and a wedge-shaped fracture. These different fracture shapes were designed to give different flow pattern. The fractures were made from a transparent acrylic plastic plate and a granite slab with dimensions of 10 $\times$ 61 $\times$ 61 cm. Uranine (Fluorescein sodium salt) was used as a conservative tracer. The volumetric flow rates of uranine feed solution were 30 mL/ hr, giving a mean residence time in the fracture of approximately 24 hours for the parallel fracture and 34 hours for the wedge-shaped fracture. The migration plumes of uranine were photographed to obtain profiles in space and time for movement of a tracer in fractures. The photographed migration plume was greatly affected by the geometric shape of fractures. The variable aperture channel model could have predicted the experimental results for the parallel fracture with a large accuracy. It is expected that the variable aperture channel model would be effective to predict the transport of the contaminant, especially, with the flow rate variation in a fracture.

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