Restoration of the Fronto-Orbital Buttress with Primary Bone Fragments / 대한신경손상학회지

OBJECTIVE: Forehead deformities are often caused by lack of treatment or incorrect restoration of the frontal buttress, so the underlying frontal buttress should be restored to its previous position to ensure that the previous forehead contour is restored in cases of complex depressed skull fractures. However, since brain injuries from skull fractures could have fatal consequences, the clinical concern in primary surgery has been to save the patient's life, and cosmetic concerns have always been secondary. We retrospectively reviewed fronto-orbital fracture patients who underwent primary restoration with primary bone fragments or an alloplastic implant and compared the surgical outcomes of autologous bone (group 1) and artificial materials (group 2). METHODS: A retrospective review was conducted of 47 patients with fronto-orbital fractures between March 2012 and January 2018. The patients underwent primary reconstruction with primary bone fragments or an alloplastic implant. The surgical results were evaluated by the incidence of infection and cosmetic satisfaction of patients. RESULTS: Infections occurred in one patient (5%) in group 1 and in two patients (15.3%) in group 2, which was not a statistically significant difference. In contrast, at 6 months after surgery, patient satisfaction showed a statistically significant between-group difference (group 1: 4.32 points, group 2: 3.54 points, p=0.001). CONCLUSION: Primary reconstruction using fractured bone fragments is an effective and preferable method that could result in better surgical outcomes than restoration using an alloplastic implant.

Changing trends in maxillofacial trauma: A 15 years retrospective study in the Southern Part of Haryana, India

The aim is to analyze the pattern of maxillofacial injuries and treatment outcomes in the past 15 years (2002–2016). Materials and Methods: One thousand eight hundred and fifty patients from two tertiary referral center hospitals were studied retrospectively in which the age, sex, etiology, site of fracture, and treatment modality was recorded. Results: One thousand two hundred and twenty-eight males and 622 females were operated between 2002 and 2016. Mean age was 29 ± 17.2 years. Maximum incidence was seen in the age group of 16–30 years in males, whereas in females, the predominance of trauma was seen in both 16–30 and 31–45 age groups. Road traffic accidents were responsible for the majority of fractures (42.2%), followed by assaults (26.4), sports injuries (17.6%), and fall (10.7%). Maximum fractures were of the mandible (53.5%) followed by midface (25.6%) and panfacial trauma (20.8%). Nearly 53.6% of patients underwent open reduction, and internal fixation (ORIF), 34.2% managed by the closed method and 12.1% were kept under observation. Conclusion: This study verified a young male predominance, a shift toward more assault related fractures, especially in females. Mandibular fractures were the most common of all. Moreover, the changing trend toward ORIF in the past 15 years.

Results of bone fracture treatment by electrophoresis with plant drug / Монголын Анагаах Ухаан

Introduction: The biologically active substances from medicinal plants contributed to humankind’s development. Thus the medicinal plants are used for medicinal purpose throughout the world from ancient time until now. Nowadays more than 300 medicinal plant species are used in the medicine. The type and quantity of phytopreparation, obtained from medicinal plants, is increasing in the recent times. Goal: We have three goals for implementing the study purpose.1. To decrease or reduce pain of bone fracture2. To reduce or relieve edema (less or more)3. To recover joint movement.Materials and Methods: In the rehabilitation department of Second General Hospital we observed 59 patients, who is fractured tibia or forearm bone three months ago, during 21-42 days. The electrophoresis treatment with 5% solution of plant “Rhodiola rosea” is done by 3-6 times in connection with patient’s age, gender, stage of disease and clinical feature.Results: In the result of the electrophoresis treatment with solution of plant “Rhodiola rose” the pain, swallowing, and limitation of movement have been increased by 71-80% after 3 times of the treatment. Besides effect of the electrophoresis have been increased by 97-98,9% after six times of the treatment. Discussion and conclusion: The study proposed that electrophoresis treatment with extract of plant Rhodiola rosea have healing effect on bone fracture. The plant contains 13 essential microelements which absorbs to the body through application of electrophoresis treatment with 5% of the plant solution. In our study, we observed that patient’s complains as pain, swallowing, limitation of movement in first three month of injury reduced in 56%-56,5% after the treatment. Effect of electrophoresis treatment with 5% of Rhodiola rosea increases to 74,2%-76,6% after three times, and effect of 97,9%-98,5% observed after six times of the treatment.

Tratamiento de fracturas en mandíbulas atróficas: presentación de dos casos clínicos / Management of Atrophic Mandible Fractures: Report of Two Clinical Cases

El siguiente trabajo tiene por objetivo presentar la experiencia del equipo de Cirugía Maxilofacial del Hospital San José, para el manejo de las fracturas en mandíbulas atróficas, reportando el tratamiento médico-quirúrgico y evolución post operatoria de casos clínicos. Se presentan dos casos clínicos de pacientes de sexo femenino, con enfermedades sistémicas de base, edéntulas, con diagnóstico de fractura en mandíbula atrófica consecutivos a caídas de nivel. De los casos tratados, el equipo logró resultados satisfactorios, mediante un tratamiento integral para los pacientes con este tipo de fracturas, basado en protocolos actuales encontrados en la literatura. El tratamiento de elección para este tipo de fracturas corresponde a la reducción anatómica quirúrgica y fijación mediante placas y tornilos de osteosíntesis. Fundamentado por sus favorables resultados y a la rápida rehabilitación funcional del paciente. El manejo multidisciplinario es fundamental para tratar este tipo de pacientes, por la posible concomitancia de enfermedades de base que pudiesen poseer estos pacientes.

The objective of the present case report is to present the experience of the maxillofacial surgery team of the Hospital San Jose in the management of atrophic mandible fracture, through the medical-surgical treatment and post-operatory evolution of two clinical cases. We studied two women with systemic conditions, edentulous with a diagnosis of atrophic mandible fracture subsequent to fall injury. In all treated cases the surgical team achieved satisfactory results through an integral treatment of patients with this type of fracture, based on actual literature reported protocols. The treatment of choice for this type of fractures is an anatomical open reduction, by internal fixation with osteosynthesis plates and screws on the basis of favorable results and functional rehabilitation of patients. The multidisciplinary management is fundamental for treatment of this type of patient due to the concomitant systemic conditions of these patients.

Restoration of crown fractures with a fiber post, polyethylene fiber and composite resin / Restauração de fraturas coronárias com pinos de fibra, de polietileno e de resina composta: técnica restauradora combinada com dois relatos de caso

OBJECTIVE: To describe the treatment of two patients who had horizontal crown fractured maxillary incisors a few years after endodontic treatment. METHOD: The 23 and 19-year-old male patients presented to Atatürk University Dentistry Faculty with complex crown fractures. The treatment includeda glass fiber reinforced root canal post, a fiber ribbon core and restoration with a universal resin composite. RESULTS AND CONCLUSION: The one-year follow-up examinations showed thatthe restorations were still in place and successful.

OBJETIVO: Descrever o tratamento de dois pacientes com fraturas horizontais de coroas de incisivos superiores, alguns anos após tratamento endodôntico. MÉTODO: Os pacientes, ambos do sexo masculino, com 23 e 19 anos de idade, apresentaram-se na Faculdade de Odontologia da Universidade Ataturk com fraturas coronárias complexas de incisivos superiores. O tratamento consistiu de utilização de pinos intracanais reforçados com fibra de vidro, tiras de fibra de vidro e restauração com uma resina composta universal. RESULTADOS E CONCLUSÃO: Oacompanhamento do paciente por um ano mostrou o sucesso do tratamento.

Treatment of Ankle Fracture by Surgery Combined with Early Rehabilitation / 中国康复理论与实践

@#Objective To investigate the management of ankle fracture with surgery and postoperative rehabilitation.Methods The data of 39 inpatients with ankle fracture from 2001 to 2005 were analyzed retrospectively. All patients were treated surgically with open reduction and internal fixation (ORIF) except one medial ankle fracture with closed reduction. All patients were encouraged to perform active and passive range of motion exercises of ankle and the involved limb on the 2nd day after surgery, and partial weight-bearing was allowed at 4th week after surgery.Results No patients had wound-healing problems and deep venous thrombosis, no significant calf muscle atrophy exist at discharging. 29 patients showed excellent ankle joint function and normal gait when the internal fixation was removed at an average 17.9 postoperative months.Conclusion The surgery combined with early rehabilitation used for ankle fracture can improve the recovery of ankle function.

Treatment of Osteoporotic Vertebral Collapses of the Thoracolumbar Spine with Neurologic Deficits using Anterior Approach / 대한척추외과학회지

STUDY DESIGN: Retrospective OBJECTIVES: To evaluate the clinical and radiological results of treatment for thoracolumbar spine fractures, with neurological deficits, using an anterior approach in a senile osteoporotic spine. SUMMARY OF BACKGROUND DATA: With osteoporotic vertebral collapses, an operative treatment may be indicated for lesions that are considered unstable, especially if there is spinal canal compromise with neurological deficits. As for the treatment of these cases, a posterior approach destabilizes, and increases, the kyphotic deformity, resulting in the need for a longer fusion period. A combined anterior-posterior approach increases the morbidity. A one stage anterior decompression and anterior reconstructive stabilization is often the most reasonable operative choice. MATERIALS AND METHODS: Between January 1999 and August 2001, 12 cases of thoracolumbar osteoporotic vertebral collapse, with neurological deficits, were performed. There were 10 female and 2 male cases. The mean age for the patient was 69.3 years, ranging from 60 to 79 years. The numbers of each level of fractured vertebrae were; 2, 5, 4 and 1, in eleventh thoracic, twelfth thoracic, first lumbar and second lumbar vertebrae, respectively. All patients reported minor injury or trauma, and the average interval between injury and operation was 8.3 months, ranging from 1 to 36 months. There were 4 and 8 cases of neurological deficits in the Frankel D2 and D3 groups, respectively. The average preoperative local kyphotic angle was 23.8 degrees, ranging from 5 to 35 degrees, with a 66% loss in height, ranging from 42 to 83%). The average T score from the Bone Densitometry was -3.7 S.D, ranging from -3.2 to -4.4. The operations were performed by an extrapleural-retroperitoneal approach. The anterior instrumentation was performed with the Kaneda system and a titanium mesh cage. All cases were followed for more than 12 months. RESULTS: All cases had a solid bony fusion. The immediate postoperative average local kyphotic angle was 10.3 degrees, ranging from -14 to 22 degrees, and the correction loss at the last follow-up was 2.6 degrees, ranging from 0 to 9 degrees. All 12 patients with incomplete preoperative neurological deficits improved, postoperatively, to Frankel group E. CONCLUSIONS: The one stage anterior spinal decompression and reconstruction, with a Kaneda instrument and a titanium mesh cage, afforded enough stability in patient with an osteoporotic vertebral collapse to enable early ambulation and to achieve realignment and solid fusion, and seems to have merit in the neurological recovery following an operation.

Results of treating closed fracture of 1/3 of clavicle by improved No8 plaster dressing at Thai Nguyen Centre Hospital

Improved No8 plaster dressing was used in Thai Nguyen Centre Hospital from August 2001 to August 2002. Results were as follows: 56/56 subjects ahd good fixation without secondary dislocations, without other complications. After the procedure, shoulder joints got good movements. Good results were comfirmed by X-ray examinations

Experimental Study for the Treatment of Long Bone Shaft Fracture with Non-reamed Flexible Intramedullary Nail / 대한정형외과학회잡지

Intramedullary rodding has been the treatment of choice for long bone shaft fracture when operative fixation is necessary. The present technology on rodding has been the use of a single, rigid intramedullary rod. However, an undesirable consequence of the use of such a rigid rodding is the post-union osteopenia along the rod, which is believed to be secondary to the over-protection of the surrounding bone from normal stresses, the so called “stress bypass effect”. Another disadvantage of the rodding procedure is interruption of intramedullary vascularity by reaming which may contribute to non-union. To evalvate these parameters, experiments were performed on mature dogs, using flexible multiple rods which can be inserted without reaming. The fracture healing was studied biomechanically by measuring the nondestructive bending and torsion stiffness, maximum torque and energy absorption to failure. Using two expermental dogs a zero time test of the osteotomized femur in which one bone was fixed with multiple rods and the contralateral bone fixed with a Kiintscher rod, showed that the bending stiffness was higher in the Kuntscher rod than in the multiple rods fixed bone. This fact means the flexible multiple rods fixation gives more elastic fixation than Kiintscher rod. The bending and torsion stiffness of the femur as expressed by repair per control percentage showed the multiple rods were significantly higher than Kuntscher rod at 6 weeks study but not in 9 weeks study. In the six month study, the repaired femur of the multiple-rods had significantly high bending and torsion stiff-ness, maximum torque and energy. Through these results, it was found that there was some advantage to the multiple rods in terms of early fracture healing at the 6 weeks study but no significant difference between two rod systems at the 9 weeks study. And there was significant advantage in the late remodelling phase of fracture healing in flexible rod.

The Treatment of Fractures by the External Skeletal Fixation Devices (Hoffmann Apparatus, Pin and Resin Fixation) / 대한정형외과학회잡지

We have employed the external akeletal fixation devices, that is Hoffmann apparatus and Pin and Resin fixation method, for the treatment of 44 cases of long bone fractures from Dec. 1978 to Dec. 1981. The following are our impressins. 1. Hoffmann apparatus and Pin and Resin fixation method proved to be effective and useful measure for the management of fractures of long bones, particulary in cases of the open tibial fractures. 2. Employing the Hoffmann apparatus to the tibial model, the possible limit of correction of the fracture alignment was calculated. It was found that the average angle of correction of deformity can be managed up to 20 degrees in varus and valgus deformity, 70 degrees in anterior angulation, 40 degrees in posterior angulation and 70 degrees in rotation. 3. Pin and Resin fixation method is one of effective means in immobilization of long bones. It is simple to apply, easy to manipulate and inexpensive while offering fair fixation without much complications and therefore we recommend the method as the best alternative to expensive Hoffmann apparatus. 4. The complications of Hoffmann apparatus and Pin and Resin fixation method were pin tract infections and ankle stiffness which were generally minor and prevented by more careful aseptic technique and encouraging early joint motion.