• Title/Summary/Keyword: malunion

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A CLINICAL STUDY OF FACIAL BONE FRACTURES IN WEST-KYUNGSANGNAMDO (서부 경남 지역에서 발생한 악안면부 골절에 관한 임상적 연구)

  • Kim, Jin;Ro, Hong-Sup
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.201-206
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    • 1998
  • We reviewed 240 patients with facial bone fractures treated at the department of oral and maxillofacial surgery between Jan. 1. 1997 to Dec. 31. 1997. These results were obtained as follows : 1. The ratio of men to women was 3.5 : 1 2. The age frequency was highest for people in their 20's 34.2%, in their 10's 21.63%, and in their 30's 20.41%. 3. The fractures were at the highest incidence in September at 13.3%, followed by in May at 11.25%. 4. The frequent causes were traffic accidents 47.9%, fisticuffs 20%, accidents caused by falling or slipping 16.25%, working traumas 8.75%, and sports 7.1%. 5. The most common location of facial bone fractures was the mandible 67.2%. The frequent fracture sites of the mandible were symphysis, angle, condyle, and body in the order. 6. The associated injuries of facial bone fractures were neurosurgry, orthopedic surgery, cardiothoracic surgery, ophthalmic surgery and general surgery. 7. In respect of treatment, open reduction used 84.3% of the time. 8. Post operation complicatins were as follows : neurological problem 2.08%, malunion 1.67%, facial asymetry 0.83%, malocclusion 0.83%, and infection 0.41%.

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LATE TREATMENT OF MALUNITED MAXILLARY FRACTURE (부정유합된 상악골 골절의 처치)

  • Chang, Se-Hong;Ann, Jye-Jynn;Kim, Doe-Gyeun;Jeong, Min-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.255-260
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    • 1989
  • Unfavorable healing of maxillary fractures may impose functional and esthetic burdens upon the trauma victim. Malunited maxillary fractures are generally a result of treatment delay, incomplete or inaccurate immobilization of the fracture fragments, or infection. Dysfunctions of mastication, distortions in speech, gross defects in facial contour, and related psychic changes are problems which may require secondary correction. When it is necessary to delay definitive treatment or when inadequate maxillary fracture reduction is recognized within the first week following injury, the maxilla can be mobilized by heavy handed dental manipulation under anesthesia or by elastic traction to an external fixation appliance attached to the maxilla by arch bars or an acrylic splint. But malunited maxillary fracture that have progressed to bony malunion require osteotomy procedure in order to establish normal anatomic relationships. This report parents two cases of malunited unilateral maxillary fracture surgically corrected by unilateral Le Fort I osteotomy.

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Operative Treatment of Ipsilateral Fractures of Clavicle and Scapula (동측에 발생한 쇄골 골절과 견갑골 골절의 수술적 치료)

  • Park Jung Ho;Suh Seung Woo;Park Sang Won;Lee Kwang Suk
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.46-50
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    • 1998
  • The superior shoulder suspensory complex is composed of glenoid fossa, coracoid process, coracoclavicular ligament, distal clavicle, acromioclavicular ligament, acromion. Traumatic double disruptions of this complex lose its suspensory action on the shoulder joint and result in functional loss and deformity. Careful radiologic evaluation and appropriate management are required for injuries to this complex. Ipsilateral fractures of clavicle and scapula create unstable anatomic situation on shoulder joint. Conservative treatment usually fails to achieve good functional recovery due to rotator cuff weakness, nonunion, delayed union, malunion and neurovascular injury. Authors studied the result of operative treatment of ipsilateral clavicle and scapular fractures to prevent such complications. Seven cases were treated with open reduction and internal fixations of clavicle alone or clavicle and scapula simultaneously and followed up for nineteen months(twelve months - thirty-eight months). All but one patient showed good or excellent functional result according to the scoring system of Rowe. Poor result was developed in the case which had brain injury. Rigid fixations of clavicle alone or clavicle and scapular fractures both can achieve stable reduction of the fractures and prevent sequelae. We concluded that operative treatment of ipsilateral fractures of clavicle and scapula is safe and yields predictable good results.

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Complex sternal and rib reconstruction with allogeneic material

  • Maliska, Charles Miles III;Archer, Robert Lloyd;Tarpley, Sharon Kaye;Miller III, Archibald Sanford
    • Archives of Plastic Surgery
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    • v.45 no.6
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    • pp.593-597
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    • 2018
  • Sternal malunion, or loss, developed after a median sternotomy cannot only be difficult to manage and treat, but also may diminish one's quality-of-life drastically. The technique presented here represents a multispecialty approach in one stage for the reconstruction of an unstable thoracic cage. The procedure utilized a donated sternum and ribs. The sternum with ribs harvested from a single donor included adipose derived stromal vascular fraction (ADSVF) cells with marrow also from the same donor. Autologous muscle flaps, stabilized with acellular dermal matrix were utilized to provide a robust blood supply to the ADSVF cells and bone grafts. Acellular dermal matrix was used to construct the ribs and stabilize the plugs of stem cells and bone. These procedures, in the hands of multispecialty physicians, have led to several successful reconstructions involving complex chest wall deformities. This surgical intervention was performed in a one stage operation. This represents the first successful complete sternal transplant in a patient with return to normal activities and increased quality-of-life.

Reconstruction of the Extremity Injury using by Free Rectus Abdoninis Muscle or Myocutaneous Flap (유리 복직근 및 복직근피판술을 이용한 사지의 재건술)

  • Ahn, Ki-Young;Jang, Kyoung-Soo;Han, Dong-Gil
    • Archives of Reconstructive Microsurgery
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    • v.4 no.1
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    • pp.23-32
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    • 1995
  • Severe upper and lower extremity trauma may result in soft tissue loss with exposed bone and the subsequence of risk of chronic osteomyelitis or malunion of fracture fragments. Such injuries present a major reconstructive problem. But Since the introduction of microsugical technique, free muscle and myocutaneous flaps were employed to provide coverage of severely injured defects. Since Tai and Hasegawa(1974) first reported a breast reconstruction using by rectus abdominis myocuraneous flap, the free rectus myocutaneous flap has been widely employed for breast reconstuction, head and neck reconstruction, and extremity reconstruction in these days. The authors present their successful experience with free rectus abdominis muscle and rectus abdominis myocutaneous flaps for upper and low extremity reconstruction. From Nov. 94, to May 95, Five cases of severely injured extremites due to trauma or contact burn were treated with free rectus abdominis muscle flap or free rectus abdominis myocutaneous flap. All flaps except 1 case were survived without severe complications. As free muscle or myocutaneous flap, the free rectus abdominis flap has the advantages of a reliable pedicle, easy dissection, and an acceptable donor site, so it seems logical to apply the free rectus abdominis flap to apply in upper and lower extremity reconstruction.

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Treatment of the Intraarticular Calcaneal Fractures and its Complications (관절내 종골 골절 및 합병증에 대한 치료)

  • Chung, Hyung-Jin;Han, Yong-Taek;Song, Seung-Taek;Lee, Chang-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.68-77
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    • 2003
  • Purpose: The treatment of calcaneal fractures remains a controversy in orthopaedic field because of its complications. The purpose of this study is to evaluate the efficacy of the treatment of calcaneal fractures and its complications. Materials and Methods: Clinical and radiological results were retrospectively analyzed in 28 patients, 34 cases with fractures of calcaneus which were treated in our department from September 1998 to march 2003. Results: According to the Creighton-Nebraska Foundation Assessment score, there were 3 excellent, 11 good, and 12 fair 6 poor results. Bohler angle was corrected from $8.3^{\circ}$ to $18.3^{\circ}$, Gissane angle was corrected from $121^{\circ}$ to $135^{\circ}$, and calcaneal width was corrected from 46.8mm to 37mm. Conclusion: Open reduction and internal fixation for joint depression type calcaneal fractures thought to be a good method of treatment. Closed reduction and percutaneous axial pinning should be chosed in selected cases of tongue type fractures. In treatment of complicated calcaneal fractures as malunion, subtalar distraction arthrodesis and lateral wall exostectomy will reduce disability of the disease.

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Closed Reduction and Fixation of Metatarsal Head and Neck Fractures Using Antegrade Intramedullary K-wire (6 Cases Report) (전향성 골수내 K-강선을 이용한 중족골 두 및 경부 골절의 비관혈적 정복 및 고정술(6예 보고))

  • Kim, Hyong-Nyun;Lim, Hee-Joon;Park, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.91-94
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    • 2009
  • Metatarsal head and neck fractures are injuries that often result from a direct blow of a heavy objects to the metatarsal head. The head is often impacted or displaced to the plantar aspect that if not treated may cause malunion which later induces painful plantar calluses. If the fracture fragment is large enough, closed reduction may be successfully performed, but when the fragment is small or closed reduction is unsuccessful, open reduction is needed. We present our reduction and fixation technique for the metatarsal head and neck fractures using antegrade intramedullary Kirschner wire (K-wire) without opening the fracture site or infringing the metatarsophalangeal (MTP) joint which allows immediate motion of the joint and partial weight bearing in a stiff soled shoe.

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Tardy Ulnar Nerve Palsy Caused by Bilateral Cubitus Varus Deformities - A Case Report - (양측성 내반주 변형에 동반된 지연성 척골 신경 마비(1례 보고))

  • Lee Sang Yup;Kim Jeong Hwan;Lee Sang Gug;Chung Chae Ik;Kim Young Hwan;Hwang Sik
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.209-213
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    • 1999
  • It is well known that tardy ulnar nerve palsy occurs with cubitus valgus deformity as a late complication after a nonunion of lateral condyle fracture of the humerus in childhood. On the other hand, cubitus varus deformity often results from malunion of supracondylar fractures of the humerus. However, reports of tardy ulnar nerve palsy in cubitus varus deformity are few. We report a patient with bilateral cubitus varus deformities with bilateral tardy ulnar nerve palsy which was confirmed with EMG. She was treated by step cut osteotomy(DeRosa and Graziano) with sub­cutaneous anterior transposition of ulnar nerve.

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Application of Bioabsorbable Plates in Orthognathic Surgery

  • Kim, Young-Kyun;Shim, Cheong-Hwan;Bae, Ji-Hyun;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.1
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    • pp.60-64
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    • 2006
  • Backgrounds: Though they are considered as reliable devices, titanium plates and screws have limitations due to some potential problems. To overcome these problems, researches on bioabsorbable materials for internal fixation have been continuing. Recently, there are many clinical trials to apply biodegradable internal fixation devices in oral and maxillofacial surgery. The purpose of this study was to evaluate the clinical results of application of bioabsorbable plates and screws in orthognathic surgery. Methods: Fifty-four patients with dentofacial deformity (17 male patients and 37 female patients) were selected in this study. The patients were treated by internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm pretapped screws (Biosorb FX, Bionix Implants, Inc., Finland). The patients were evaluated for complications during the follow-up period. Results: Five patients (9.3%) experienced complications. All complications in these cases were infection. No other complications related with physical or mechanical properties of bioabsorbable plates were found such as malunion or nonunion, fractures of plates and loosening of screws. All complications were minor and adequately managed with drainage and supportive care with antibiotics coverage. Conclusions: From the results, the use of these fixation systems in orthognathic surgery will provide a promising alternative titanium fixation in appropriate cases.

Scarf(Z) osteotomy of the First metatarsal shaft in the Treatment of Hallux Valgus (무지 외반증 환자에서 스카프 절골술을 이용한 치료)

  • Young, Ki-Won;Lee, Kyung-Tai;Kim, Jae-Young;Lee, Hui-Dong
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.157-165
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    • 2003
  • Purpose: The purpose of this study was to the evaluate the clinical and radiographic results and complication of the Scarf osteotomy which is one of the surgical treatment of Hallux valgus. Material and Method: Fifty feet (30 patients) of moderate to severe hallux valgus deformity were operated by Scarf osteotomy procedure from January 2002 to July 2002. Patients were asked about their satisfaction in terms of pain, appearance and motion. The AOFAS clinical ratio scales and radiographic results for hallux valgus were evaluated. Result: The mean Hallux valgus angle improved from an average of 30.6 degrees to 9.0 degrees and the first intermetatarsal angle improved from an average 13.3 degrees to 5.2 degrees respectively. The preoperative mean AOFAS score was 58 points and on last follow up AOFAS score improved to 88 points. Complication which including troughing, nonunion, malunion was not developed. Conclusion: We found that Scarf osteotomy is a reliable operation for mild to moderate Hallux valgus deformity as regards firm fixation and early postoperative ambulation and large contact area for union.

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