• 대한족부족관절학회지
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• 제28권1호
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• pp.8-14
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• 2024

Purpose: Ankle fracture fixation is the gold standard of treatment but it does have its own complications. There is inadequate data regarding the comparative effectiveness of early vs. delayed fixation for open ankle fracture outcomes. This study compares the clinical and functional outcomes of open ankle fractures treated by early or delayed definitive fixation and identifies the limitations of both methods. Materials and Methods: All 73 patients enrolled in the study underwent surgical intervention within 24 hours of injury. The early fixation group (group A) consisting of 39 patients underwent definitive fixation as an index procedure, while the delayed fixation group (group B) consisted of 34 patients who underwent debridement and external fixator application as an index procedure and definitive fixation when soft tissue condition was conducive. All patients were evaluated at 2, 6, and 12 weeks postoperatively and then three monthly for a year. Results: Enneking and American Orthopaedic Foot and Ankle Society scores were markedly higher in the early fixation group at 6 months postoperatively (p-values <0.001 and 0.011, respectively). However, no discernible intergroup difference was evident at 12 months postoperatively. Between 6 and 12 months, group functional outcome scores were significantly different. At 6 months, there was a substantial difference in dorsiflexion between the two groups (p-values 0.001 and <0.001, respectively), but no difference was observed at 12 months postoperatively. At 6 and 12 months, group average plantar flexions were non-significantly different. Conclusion: Early definitive fixation of complex ankle fractures using a targeted approach produced promising results for lower grade open fractures (grades 1 and 2), and delayed definitive fixation, after initial external fixation to allow for soft tissue stabilization, produced promising results for higher grade open fractures (grades 3A and 3B). At 12-month follow-ups, clinical and functional outcomes achieved using these strategies were equivalent.

• 대한핵의학회지
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• 제38권6호
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• pp.522-527
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• 2004

목적 : 본 연구는 골다공증에 의한 척추 골절 환자를 대상으로 골SPECT를 시행하고 골 섭취 증가 병변의 형태와 분포를 분석하여, 척추 골절에서 골SPECT의 유용성을 알아보고자 하였다. 대상 및 방법: 골다공증에 의한 척추 골절이 있었던 32명의 환자를 대상으로 하였다. 평균 연령은 $67{\pm}8$세였으며, 남자 5명, 여자 27명이었다. 79개의 척추골절이 발견되었으며, 병소는 흉부 및 흉요추부 척추가 38개, 요추부 척추가 41개였다. 척추체의 골절 형태는 압박 형태에 따라 쐐기형, 양요형, 압박형으로 분류하였고, SPECT 상 척추체의 골 섭취 증가 병변은 국소성 혹은 미만성, 대칭성 혹은 비대칭성으로 분류하였다. 척추 후방부의 SPECT 소견은 척추경, 척추 후관절, 관절간부, 극상 돌기의 골섭취 증가 병변 유무로 분류하였다. 척추체 골절 형태와 골절 척추의 위치에 따른 골 SPECT소견에 차이가 있는지를 분석하였다. 결과: 79개의 척추제 압박 골절 중 쐐기형 병소가 47개, 양요형 병소가 20개, 압박형 병소가 12개이었다. 골 SPECT에서는 척추체의 섭취 증가가 모든 예에서 관찰되었으며, 골절의 형태와 관계없이 국소형 보다는 미만형이, 대칭성 보다는 비대칭성 골 섭취 증가가 많았다. 척추 후방부에 병소가 발견된 경우는 69개(87.3%) 였으며, 쐐기형이 40개(85.1%), 양요형 17개(85.0%), 압축형 12개(100%)에서 관찰되었다. 흉부 및 흉요추부 척추에서는 쐐기형 골절이 많은 반면, 요추부 척추에서는 골절형태 분포가 비교적 균일한 것으로 나타났다(p=0.04). 극상돌기의 골섭취는 흉부 및 흉요추부 골절의 5예(13.2%)에서 있었던 반면 요추부 척추 골절에서는 16개(39.0%)에서 발견되어 분포의 차이가 있었다(p=0.009). 요추부 척추에서 발생한 양요형 골절에서 척추 후관절에 골 섭취 증가를 보인 경우가 12개(92.3%)인데 반해 흉부 및 흉요추부 척추에 발생한 경우 4개(57.1%) 에서만 골섭취 증가 병변이 있었다. 극상돌기의 골섭취에도 차이가 있어서 요추가 8개(38.5%)인데 비해 흉부 및 흉요추부 척추에서는 1개(14.3%)에서만 골섭취가 있었다(p=0.043). 결론: 골SPECT는 골다공증에 의한 척추 골절 진단에 유용하며, 특히 척추 후방부의 골 섭취 증가 병변의 평가에 유용하였다.

• Journal of Korean Neurosurgical Society
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• 제51권5호
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• pp.305-307
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• 2012

Oblique basal skull fractures resulting from lateral crushing injuries involving both clivus and occipital condyle are rare due to their deep locations. Furthermore, these fractures may present clinically with multiple cranial nerve injuries because neural exit routes are restricted in this intricate region. The authors present an interesting case of basal skull fractures involving the clivus and occipital condyle and presenting with sixth and contralateral twelfth cranial nerve deficits. Clinico-anatomic correlations and the courses of cranial nerve deficits are reiterated. To the authors' knowledge, no other report has been previously issued on concomitant sixth and contralateral twelfth cranial nerve palsies following closed head injury.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.356-360
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• 2017

The tympanic plate is a small part of the temporal bone that separates the mandibular condyle from the external auditory canal. Fracture of this small plate is rare and usually associated with other bony fractures, mainly temporal and mandibular bone. There is a limited amount of literature on this subject, which increases the chance of cases being overlooked by physicians and radiologists. This is further supported by purely isolated cases of tympanic plate fracture without evidence of other bony fractures. Cone-beam computed tomography is an investigative three-dimensional imaging modality that can be used to detect fine structures and fractures in maxillofacial trauma. This article presents four cases of isolated tympanic plate fracture diagnosed by cone-beam computed tomography with no evidence of fracture involving other bones and review of the literature.

• 대한추나의학회지
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• 제3권1호
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• pp.167-174
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• 2002

흉요추 이행부의 안정성 압박골절은 통증의 소실과 후만각 증가 억제에 의한 척추의 안정화이다. 이의 원인을 후방인대의 손상에 의한 손상으로 보고 프로로테라피(Prolotherapy)로 이의 치료를 시행 할 수 있다고 생각되며 한방적인 방법으로 화침을 적용할 수 있었다. 최근 저자는 흉요추 이행부의 안정성 압박골절에 의한 요배통 환자를 발견하고 화침치료를 통해 증세 회복에 도움이 되었기에 치료내용과 경과를 문헌고찰과 함께 보고하는 바이다.

• 한국지반공학회:학술대회논문집
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• 한국지반공학회 1999년도 가을 학술발표회 논문집
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• pp.147-152
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• 1999

Distribution of fracture system is an important factor to analyse instability of jointed rock slope. In the most case of rock slopes, joint distribution properties are related to potential, shape, size and locality of slope failure. The purpose of this paper is to present an application of fracture characterization related to rock slope failure. Fracture data used in this study are collected by scanline survey. Two aspects of fracture characterization for rock slope are handled in this study First, In order to determine the potential and shape of slope failure, trace length of joints is considered as the weighting factor about collected orientation data. Second, Relationship between trace length and spacing is analysed to estimate failure location and size. The distribution of fracture system is directly influenced on wedge failure. It is effective to analyse the orientation of fractures by using weighting factors associated with the trace length of fractures rather than to analyse only that of fractures. It gives a conclusion that the wedge failure occurred along the peak of fracture density(or intensity) cycles.

• 대한족부족관절학회지
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• 제19권4호
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• pp.137-141
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• 2015

Recently, open reduction and internal fixation has been the treatment of choice for displaced intra-articular calcaneal fractures for many orthopaedic surgeons. However controversy still surrounds the optimal treatment with regard to whether displaced intra-articular calcaneal fractures should be treated operatively or conservatively. Conservative treatments include use of splint, rest, leg elevation, icing, use of analgesics and early mobilization. Operative treatment is open reduction and internal fixation, performed through an extensile lateral approach with interfragmentary screws and application of a neutralization plate. We reviewed the question of whether operative treatment by open reduction and internal fixation provides a benefit compared with conservative treatment for displaced intra-articular calcaneal fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권2호
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• pp.91-95
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• 2014

The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.

• 한국지하수토양환경학회:학술대회논문집
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• 한국지하수토양환경학회 2002년도 총회 및 춘계학술발표회
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• pp.102-105
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• 2002

A new finite difference model is developed for solute transport in a fractured medium that can consider advection, adsorption, first-order decay, and scale-dependent dispersivity of individual fractures. In the model, the dispersivity of individual fractures is employed as a variable increasing with travel distance from a source. The model is verified using an analytical solution for a single fracture. A solution from the new model is independent of the outlet boundary condition of fractures, and has little numerical dispersion error.

• The Korean Journal of Pain
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• 제10권1호
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• pp.138-141
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• 1997

Rib fracture due to intense pain, may restrict patients from inadequate coughing. These conditions may produce varying degrees of complications such as atelectasis, pneumonia and arterial hypoxemia. Thoracic epidural analgesia has been used to treat pain associated multiple rib fractures because of its marked improvement in vital capacity and dynamic lung compliance. However, there are complications related to thoracic epidural analgesia which may include damage to spinal cord, perforation of dura, respiratory depression, decrease heart rate and arterial blood pressure. We experienced such a case of cardiac arrest during thoracic epidural analgesia while treating a patient for multiple rib fractures.