• Title/Summary/Keyword: fractures

Search Result 2,684, Processing Time 0.032 seconds

The Effectiveness of Vacuum-Assisted Closure (V.A.C) Dressing combined with Silver Dressing Material in Open Fracture of the Foot and Ankle (족부 및 족관절의 개방성 골절 환자에서 음압 치료와 실버 드레싱 제재 복합 치료의 유용성)

  • Lee, Yu-Sang;Cho, Jae-Ho;Park, Jin;Han, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
    • /
    • v.12 no.2
    • /
    • pp.156-162
    • /
    • 2008
  • Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy, insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum- Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together with silver antimicrobial dressing materials in contaminated open fracture wounds. Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed. Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship was found between wound size, VAC application time and silver dressing material application time. No complications such as osteomyelitis were found after treatment. Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC technique together with silver dressing materials in the treatment of open fractures and achieved complication free results.

  • PDF

THE LONG-TERM RESULT OF CONDYLE FRACTURE IN CHILDREN (성장기 아동 하악 과두 골절의 예후에 관한 장기 추적 조사)

  • Choi, Jin-Ho;Ryu, Seung-Hyun;Ryu, Mun-Gwang;Kim, Jae-Woo;Kim, Il-Kyu;Ha, Tae-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.30 no.2
    • /
    • pp.121-130
    • /
    • 2004
  • The purpose of this study was the long-term clinical and radiological evaluation of conservatively treated condylar fractures in children. This study was therefore undertaken to analyze the long-term effects of treating condylar fractures in children with conservative therapy in order to resolve the controversial question of whether complete remodeling occurs in this age or, if not, whether it is more likely to be associated with certain types of fracture or with other factors. This study was based on a series of 11 consecutive children and adolescents, aged between 3 and 15 years, with fractures of the condylar process who had been treated with conservative therapy at the Department of Oral & Maxillofacial surgery, Inha University Hospital, Inchon, Korea. All patients underwent a clinical investigation with special emphasis on Temporomandibular joint function and facial asymmetry. The patients also underwent a radiologic investigation, focusing on fracture remodeling and symmetry of mandible. It consists of panoramic radiograph, PA & lateral cephalogram and 3-D CT. No patient described impaired temporomandibular joint(TMJ) function or pain on the affected side. 2 of 8 (25%) unilateral and 1 bilateral fractures show slight facial asymmetry. Despite apparently excellent recovery of function, there were marked remodeling changes evident on the CT scan. Such changes are not usually evident on panoramic radiograph. Radiologic investigation showed incomplete remodelling(54.5%) and asymmetry of the mandible (27.3%) in some patients. Conservative treatment of condyle fracture in children results in satisfactory long-term outcome of jaw function despite a relative high frequency of radiologically noted aberrations.

The Effect of Heat Treatment on the Microstructures and Mechanical Properties of Inconel 713C Alloy Vacuum Investment Castings (진공 정밀주조한 Inconel 713C 합금의 조직과 기계적 성질에 미치는 열처리의 영향)

  • Yoo, Byung-Ki;Choi, Hak-Kyu;Park, Heung-Il;Jeong, Hae-Yong
    • Journal of Korea Foundry Society
    • /
    • v.40 no.2
    • /
    • pp.16-24
    • /
    • 2020
  • The effect of a heat treatment on the microstructure and mechanical properties of Inconel 713C alloy vacuum investment castings were investigated. The microstructure of the as-cast state was observed, showing well-developed dendrite structures and distributed carbide particles and solidified massive precipitates in the grain or grain boundary during solidification, in this case the γ′ phase and MC particles. During a heat treatment, the γ phase matrix was reinforced by solid solution elements, carbide particles from the film morphology precipitated along the grain boundary, and many micro-precipitates of second γ′ phases 0.2 ㎛~2 ㎛ in size were newly formed in the γ phase matrix according to SEM-EDS analysis results. The tensile strength at a high temperature (850℃) decreased slightly becoming comparable with the room-temperature result, while the hardness value of the specimen after the vacuum heat treatment increased by approximately 19%, becoming similar to that of the as-cast condition. However, the impact values at room temperature and low temperature (-196℃) were approximated; this alloy was mostly not affected by an impact at a low temperature. In the observations of the fracture surface morphologies of the specimens after the tensile tests, the fractures at room temperature were a mix of brittle and ductile fractures, and an intergranular fracture in the inter-dendrite structure and some dimples in the matrix were observed, whereas the fractures at high temperatures were ductile fractures, with many dimples arising due to precipitation. It was found that a reinforced matrix and precipitates of carbide and the γ′ phase due to the heat treatment had significant effects, contributing greatly to the excellent mechanical properties.

Estimation of the hydraulic conductivity profile in fractured rocks using the borehole flowmeter test (시추공 유속 검층을 이용한 암반 대수층의 수리전도도 분포 산정)

  • 구민호;차장환
    • The Journal of Engineering Geology
    • /
    • v.12 no.3
    • /
    • pp.257-271
    • /
    • 2002
  • The vertical distribution of hydraulic conductivity of 3 boreholes located at Kongju National University was estimated by the ambient flow and the pump-induced flow measurements using a heat-pulse flowmeter. The ambient flow measurements showed that a great amount of groundwater (1~2 m$^3$/day) flowed in the boreholes through the conductive fractures. The analyzed conductivity profiles we similar to those of the packer test performed for the same boreholes. The conductive fractures in which the differential net flow changed greatly could be identified by the BIPS logging. The water-quality logging data showed that quality of groundwater changed abruptly at some depths of the boreholes. This change in water quality can be attributed to the presence of conductive fractures that have resulted in the mixing of groundwater of different quality flowing in different fracture channels. However, compared to the flowmeter test, the water-quality logging showed low capability in identifying locations of conductive fractures.

PHILOS Plate Osteosynthesis in Metaphyseal Fractures of the Distal Humerus through an Anterolateral Approach

  • Park, Jung Ho;Kim, Jung Wook;Oh, Chi Hun;Choi, Keun Seok;Hong, Jae Young;Kim, Jae Gyoon
    • Clinics in Shoulder and Elbow
    • /
    • v.18 no.3
    • /
    • pp.128-132
    • /
    • 2015
  • Background: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. Methods: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. Results: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. Conclusions: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed.

Hemiarthroplasty for Distal Humerus Fracture: A Systematic Review and Meta-analysis for Functional Outcome

  • Kwak, Jae-Man;Kholinne, Erica;Sun, Yucheng;Lee, Gwan Bum;Koh, Kyoung Hwan;Chun, Jae-Myeung;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
    • /
    • v.21 no.3
    • /
    • pp.120-126
    • /
    • 2018
  • Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included 'distal humerus fracture' and 'hemiarthroplasty'. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion ($107.6^{\circ}$ flexion-extension, $157.5^{\circ}$ for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.

Relation between Location of Pelvic bone Fractures and the Injury to the Urinary bladder, Urethra or Lower gastrointestinal tract (골반 골절 위치와 방광, 요도, 하부 위장관계 손상의 관련성)

  • Kim, Chang Ho;Park, Jung Bae;Ryoo, Hyun Wook;Seo, Kang Suk;Seo, Jun Seok;Chung, Jae Myung;Je, Dong Wook;Sung, Ae Jin
    • Journal of Trauma and Injury
    • /
    • v.20 no.2
    • /
    • pp.90-95
    • /
    • 2007
  • Purpose: This research was conducted to study whether the specific location of pelvic-bone fractures could increase the risk for injury to the urinary bladder, urethra, or lower gastrointestinal tract. Methods: We retrospectively reviewed the data of 234 patients with pelvic-bone fractures who visited the emergency department of Kyungpook National University Hospital from January 2004 to December 2006. The location of the pelvic-bone fracture was divided into 8 parts. The association of fracture location with injury to the urinary bladder, urethra, or lower gastrointestinal tract was analyzed with Fisher' s-exact test and multiple logistic regression. Results: Nineteen(19) patients had urinary bladder injury, 8 had urethral injury, and 9 had lower gastrointestinal tract injury. The following fracture locations were found to be significant; urinary bladder: sacroiliac (SI) joint (p<0.001), symphysis pubis (p=0.011), and sacrum (p=0.005); urethra: SI joint (p=0.020); lower gastrointestinal tract: symphysis pubis (p=0.028). After the multiple logistic regression analysis, the primary and the independent predictors for each of the injuries were as follows; urinary bladder: sacroiliac joint (p=0.000, odds ratio [OR]=10.469); lower gastrointestinal tract: symphysis pubis (p=0.037, OR=7.009). Conclusion: Consideration of further workup for injuries to the lower gastrointestinal and urinary tract is needed for some locations of pelvic-bone fractures because certain pelvic-bone fracture locations, especially the sacroiliac joint and the symphysis pubis, are associated with increased risk for injury to the lower gastrointestinal and urinary tracts.

A retrospective computed tomography analysis of maxillary fractures and the clinical outcomes of their unreduced parts

  • Chung, Chan Min;Tak, Seung Wan;Lim, Hyoseob;Cho, Sang Hun;Lee, Jong Wook
    • Archives of Craniofacial Surgery
    • /
    • v.20 no.6
    • /
    • pp.370-375
    • /
    • 2019
  • Background: Some parts of a maxillary fracture-for example, the medial and posterior walls-may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. Methods: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. Results: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). Conclusion: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.

A Study on effect that position of contact area at adjacent side has on fractures of porcelains in case of porcelain fused to metal crown (금속 소부 도재관의 경우 인접면에서 접촉점의 위치가 도재 파절에 미치는 영향에 관한 연구)

  • Kim, Yong-Won
    • Journal of Technologic Dentistry
    • /
    • v.29 no.2
    • /
    • pp.173-180
    • /
    • 2007
  • There was a great problem about the deposition between materials of a different kind at the beginnings of the introduction of porcelains, however, thereafter the deposition efficiency was settlded to the sufficient level of all user thanks to effort to have studied by many scholars and clinical authorities. But in a clinical process, as the difference of designs has an effect on fractures of porcelains, this researcher divided them into 4 groups of A: 1 mm, B: 2 mm, C: 3 mm, and D: 4 mm, and made 40 pieces to each 10 as the test samples to consider a length axis of tooth for studies in accordance with a position of a finishing line to meet between porcelain and metal at the contact point at the adjacent side to a metal porcelain. The sample materials are those to be use at the open market and the test samples wer completed by the same manufacturing technique to that of existent metal porcelain tube. s a result of the strength test on fractures, the average value is as in the following, A: 1 mm - 8.5bar, B: 2 mm - 10.5bar, C: 3 mm - 14.3bar, and D: 4 mm - 15.0bar. In case of the metal porcelain tube, the more faraway to process parts of metal and porcelain from the contact point of adjacent side has the stronger strength of fractures, Accordingly, the research shows that it had better to keep off more than 3 to consider a ledngth axis of tooth.

  • PDF

Comparative Study for the Fixation Method in the Danis-Weber Type B Lateral Malleolar Fractures: An Antiglide Plate Fixation versus A Lateral Plate Fixation (Danis-Weber B형 족관절 외과 골절의 고정방법 비교연구 : Antiglide 금속판 고정술 대 외측 금속판 고정술)

  • Shin, Hun-Kyu;Choi, Jae-Yeol;Kang, Dong-Ho
    • Journal of Korean Foot and Ankle Society
    • /
    • v.10 no.2
    • /
    • pp.201-206
    • /
    • 2006
  • Purpose: To evaluate the advantages of the antiglide plate fixation procedure for Danis-Weber type B lateral malleolar fractures of ankle compared to other methods of lateral plate fixation. Materials and Methods: We reviewed 70 cases that antiglide plate fixation and lateral plate fixation procedures were performed from Mar. 2001 through Mar. 2006. Of the total 70 cases, they were divided into two groups ; 22 cases were treated with the antiglide plate procedure (Group I) and 48 cases were treated with the lateral plate procedure (Group II). The results of the two groups were analyzed both radiographically and clinically using Ankle-Hindfoot scale of the American Orthopedic Foot and Ankle Society (AOFAS). Results: All fractures were healed at average of 8 weeks both radiographically and clinically. According to the Ankle-Hindfoot scale, all cases of Group I and 48 cases of Group II were above 80 points. 2 cases (9%) in Group I complained of peroneal tendinitis, while 19 cases (39%) in Group II showed skin irritation resulting from the screw or the plate. A total of 6 cases (27%) in Group I and 27 cases (55%) in Group II complained cosmetic problems. Conclusion: we concluded that the antiglide plate fixation for Danis-Weber type B lateral malleolar fractures is one of the good methods. But, further analysis will be need to find a solution for the peroneal tendinitis.

  • PDF