• Journal of Trauma and Injury
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• 제18권2호
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• pp.107-111
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• 2005

Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

• Journal of Soil and Groundwater Environment
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• 제12권3호
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• pp.66-74
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• 2007

Stationary and trolling methods in measuring flow using flowmeter were adopted to investigate the hydraulic connectivity of fractures and to evaluate the applicability of the measurement methods. Stationary method was useful for identifying the inflow and outflow patterns in the measured section, which enabled us to analyze the hydraulic connectivity of fractures between the wells. Trolling method failed to find the inflow and outflow patterns in the well, but was very effective for locating the conductive fractures. Measuring flow in the borehole by both stationary and trolling methods was found to be very efficient for identifying conductive fractures and their hydraulic connectivity in fractured rock aquifer.

• Journal of Veterinary Clinics
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• 제24권4호
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• pp.658-662
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• 2007

The simple and easy treatment with cast or splint has been applied to stabilize long bone fractures in farm animals. Applying cast or splint is relatively easier than surgical fixation and may temporarily stabilize fracture site. However, the internal fixation provides strong stabilization and early recovery of limb function. In this report, we describe six cases of limb fractures in calves repaired by internal fixation. Fracture sites are various and affected ages are between 1 day and several months old. In some cases, patients were treated with cast or splint before admitting to Veterinary Medical Center. In these patients, regardless of initial treatment fractures were not immobilized. Consequently we decided to treat these patients with open reduction and internal fixation. The fracture repair with implants(bone plate, screw, cerclage wire, and intramedullary pin) were effective and satisfactory in calves which had been failed by application of cast. Although the cost of orthopedic treatment in farm animal is one of the most important considerations from the practical point of view, internal fixation has many benefits in newborn and young calves. And simplicity of postoperative management is also practically significant benefit expected from infernal fixation In conclusion, we suggest that internal fixation will produce better result than external coaptation in calve.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권1호
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• pp.89-98
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• 1994

This study was based on a series of 213 patients with facial bone fractures treated at college of Medicine, Dong-A university from Mar. 1990 to Jun. 1993. The results obtained were as follows : 1. The ratio of male to female was 8.3 : 1 and 3rd decade(34.3%) was the highest age group in incidence. 2. Monthly incidence was the highest in Jan. & Jun.(10.3%) 3. Onset time and daily incidence was the highest in pm. 9:00-12:00(21.4%), Sunday(18.8%). 4. Traffic acidents(38.5%) were the most frequent etiologic factor. 5. The most common site of fracture was zygoma & zygomatic arch(42.3%) and mandible (37.8%), maxilla (10.9%) and nasal bone(9.0%) were next in order of frequency. 6. In mandible fractures, the most frequent site was symphyseal area(43.0%) and IMF & open reduction was major method of treatment. 7. In zygoma & zygomatic arch fractures, zygoma(62.0%) was the most common fracture site and open reduction was the most frequent treatment method. 8. In maxilla fractures, the major fracture type was Le Fort I type (72.4%) and treatment was done by IMF & open reduction primarily. 9. postoperative complications were mal-union, fibrous-union, infection, osteomyelitis etc.

• Archives of Plastic Surgery
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• 제42권4호
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• pp.424-430
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• 2015

Background Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. Methods We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. Results In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. Conclusions We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon.

• Journal of Chest Surgery
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• 제50권5호
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• pp.346-354
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• 2017

Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score. Results: Forty-six patients (45.5%) had at least 1 episode of VAP, 10 (21.7%) of whom died in the ICU. Of the 55 (54.5%) patients who did not have pneumonia, 9 (16.4%) died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029). Conclusion: Severe pulmonary contusion (pulmonary lung contusion score 6-12) is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.

• Archives of Plastic Surgery
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• 제43권6호
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• pp.518-522
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• 2016

Background Enophthalmos may not appear immediately after trauma due to periorbital swelling in a blowout fracture, and preoperative measurements of enophthalmos cannot be used as a reliable guideline. It is important to predict the eventual final extent of enophthalmos in order to determine whether to perform surgery, and there have been several attempts to predict the degree of late enophthalmos using preoperative orbital volume. The purpose of this study is to investigate the correlation between the orbital volume ratio (OVR) with final enophthalmos and the palpebral fissure, and to find the OVR that induced 2 mm of enophthalmos in unilateral unoperated blowout fractures. Methods We retrospectively reviewed the medical records of 38 patients and divided them into 3 groups, determined by the fracture location. The relationships between the OVR and both the degree of enophthalmos and the palpebral fissure ratio (PFR) were assessed and, in particular, the OVR that induced 2 mm of enophthalmos was sought. Results Enophthalmos increased in proportion to the OVR, and there was a highly significant correlation between the increase in the OVR and the degree of enophthalmos (P<0.05). On the other hand, there was no correlation between OVR and PFR (P>0.05). The OVR that induced 2-mm enophthalmos was 112.18%. Conclusions The final degree of enophthalmos can be estimated by the preoperative measurement of OVR. Preoperative measurements of OVR can be used as quantitative values to predict the final degree of enophthalmos in pure blowout fractures.

• Journal of the korean academy of Pediatric Dentistry
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• 제30권3호
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• pp.385-390
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• 2003

Traumatic injuries in the young permanent dentition are common, but root fractures, defined as fractures involving dentin, cementum and pulp, are relatively uncommon. Appropriate management of root fracture involves repositioning the coronal portion of the tooth fragment and firm immobilization with a splint for 2 to 3 month. Root canal treatment should not be initiated until the sign of necrosis or resorption are apparent because in most cases, the apical fragments maintain their vitality. The following case report describes a patient with root fractures injured three times over the period of 7 years. The results, clinically and radiographically, were acceptable, but long term periodic evaluation is required.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.101-105
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• 1998

Compound comminuted mandibular fracture is defined as the presence of multiple fracture lines with open wound resulting in many small pieces within the same area. The incidence of mandibular comminution is difficult to determine but reported as 2.7~18.6 % incidence among mandibular fractures. There are controversies in the treatment of mandibular comminuted fractures. Treatment of comminuted mandibular fracture has traditionally involved closed reduction in an effort to avoid stripping periostcum from the bony segments, but rigid internal rigid fixation is used more popular at present. The extent of comminution, displacement of bony fragments and patient general conditions are important factors in decision of the treatment methods. When significant bone displacement is present, it is necessary to reduce these comminuted fragments to an anatomic, pretraumatic relationship to restore facial form and function. In these cases, ORIF allows anantomic reduction of comminuted segments as well as pretraumatic occlusion. Gentle handling of the soft tissue, rigid fixation of bony fragments and adequate immobilization are essential for reducing the complications. This is the report the incidence, causes, complications and treatment of the patients who visited our department for compound comminuted mandibular fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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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.