• Title, Summary, Keyword: ORIF

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Evaluation of postoperative complications according to treatment of third molars in mandibular angle fracture

  • Lim, Hye-Youn;Jung, Tae-Young;Park, Sang-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.1
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    • pp.37-41
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    • 2017
  • Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

Outcomes of open versus closed treatment in the management of mandibular subcondylar fractures

  • Kim, Seong-Yong;Ryu, Jae-Young;Cho, Jin-Yong;Kim, Hyeon-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.297-300
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    • 2014
  • Objectives: To compare the clinical and radiological outcomes after closed reduction (CR) and open reduction and internal fixation (ORIF) in the management of subcondylar fractures. Materials and Methods: Forty-eight patients presenting with subcondylar fracture between January 2010 and March 2013 were evaluated retrospectively. Fifteen patients were treated with CR and 33 patients with ORIF. The clinical and radiologic parameters were evaluated during follow-up (mean, 7.06 months; range, 3 to 36 months). Results: In the CR group, no patients had any problems with regard to the clinical parameters. The average period of maxillomandibular fixation (MMF) was 5.47 days. The preoperative average tangential angulation of the fractured fragment was $3.67^{\circ}$, and loss of ramus height was 2.44 mm. In the ORIF group, no clinical problems were observed, and the average period of MMF was 6.33 days. The preoperative average tangential angulation of the subcondylar fragment was $8.66^{\circ}$, and loss of ramus height was 3.61 mm. Conclusion: CR provided satisfactory clinical results, though ORIF provided more accurate reduction of the fractured fragment. So there is no distinct displacement of fractured fragment, CR should be selected than ORIF because of no need for surgery.

Application of Minimally Invasive Plate Osteosynthesis to Tibial Shaft Fractures in Dogs

  • Rahman, Md. Mahbubur;Jeong, In-Seong;Kim, Nam Soo
    • Journal of Veterinary Clinics
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    • v.34 no.3
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    • pp.200-203
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    • 2017
  • The objective of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) method for treatment of tibial shaft fractures in dogs by comparing MIPO radiographic and fracture healing time results with those from the popular open reduction and internal fixation (ORIF) technique. In this clinical study at the Royal Animal Medical Center, five consecutive dogs with diagnoses of comminuted tibial shaft fractures were treated with the MIPO surgical approach. For comparison, an additional five breed-, age-, and weight-matched dogs with comminuted tibial shaft fractures were treated with the ORIF technique. Mean healing time was $75.6{\pm}12.5$ days in the MIPO group and $131.8{\pm}18.6$ days in the ORIF group (p < 0.01). The mean surgery time in the MIPO group ($36.4{\pm}3.5$ minutes) was significantly shorter (p < 0.01) than that for the ORIF group ($47.0{\pm}2.2$ minutes). Based on the short surgical and healing times, the MIPO approach is clinically superior to the ORIF approach and should be the preferred approach in tibial fracture cases.

Comparison of open reduction and internal fixation with total elbow arthroplasty for intra-articular distal humeral fractures in older age: a retrospective study

  • Baik, Jong Seok;Lee, Sung Hyun;Kang, Hyun Tak;Song, Tae Hyun;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.94-99
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    • 2020
  • Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion-extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

Postoperative Rehabilitation of Korean Medicine for Ankle Fractures Treated by Open Reduction with Internal Fixation: 2 Case Reports with 5 Months Follow-Up (개방적 내고정술을 시행한 발목 골절환자 2례에 대한 수술 후 한의 재활치료: 증례보고 및 5개월 추적관찰)

  • Kwon, Min-Goo;Jo, Hee-Geun;Park, Hye-Rin;Sul, Jae-Uk
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.1
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    • pp.167-173
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    • 2018
  • The purpose of this study is to report the effect of Korean medicine rehabilitation therapies in two patients with ankle fractures who underwent Open Reduction with Internal Fixation (ORIF). Two patients with fractures who received ORIF received acupuncture, electroacupuncture, herbal medicine, and physical therapy during hospitalization. Patients were evaluated for AOFAS score, NRS, ROM, and ankle circumference. Case 1 was improved from 30 points to 62 points on the AOFAS score, from 8 to 2 on the NRS, and from 33 cm to 30 cm on the ankle perimeter. ROM was improved in all directions. Case 2 showed an AOFAS score of 64 to 90 points, frome 5 to 2 on the NRS, and from 25 cm to 23.5 cm on the ankle perimeter. ROM was improved in all directions. The results of this study suggest that the treatment of Korean medicine has a meaningful effect on improvement and rehabilitation of ankle fracture patients who have received ORIF.

Open versus closed reduction of mandibular condyle fractures : A systematic review of comparative studies

  • Kim, Jong-Sik;Seo, Hyun-Soo;Kim, Ki-Young;Song, Yun-Jung;Kim, Seon-Ah;Hong, Soon-Min;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.1
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    • pp.99-107
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    • 2008
  • Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

TREATMENT OF CONDYLE FRACTURE WITH RESORBABLE SCREW (흡수성 스크류를 이용한 하악과두 골절의 치료)

  • Yeo, In-Bum;Min, Seung-Ki;Oh, Sung-Hwan;Kwan, Kyung-Hwan;Choi, Sang-Moon;Park, Sang-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.559-564
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    • 2006
  • According to the development of operation technique and biologic materials, oromaxillofacial surgery department have used many kinds of metal and biologic materials in ORIF and plastic surgery. In maxillofacial fracture, ORIF with metal plate and screw have short healing period and good prognosis. But ORIF with metal materials have many complications as maxillofacial abnormal growth, screw loosening, bone malunion. And metal materials have not used in infection site. The purpose of this study is to evaluate the clinical value of 10 condylar fracture patients operated with absorbable screw at Wonkwang university. Ten patients(8 males, 2 female, mean aged 28) who had mandibular condyle process fracture treated with PLLA implants(poly-l-lactide) was recalled for follow-up clinical and radiologic examination for 10 years. Mouth opening recorvered to more than 35mm and occlusion was stable in all patients. All fractured mandibular condyles showed anatomic good reduction and long-term stability with the use of resorbable miniplates and screw. Bone healing was satisfactory in all patients, and there was no evidence of abnormal resorption of condylar process.

A working paradigm for managing mandibular fractures under regional anesthesia

  • Chellappa, Natarajan;Meshram, Vikas;Kende, Prajwalit;Landge, Jayant;Aggarwal, Neha;Tiwari, Manish
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.6
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    • pp.275-281
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    • 2018
  • Objectives: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. Materials and Methods: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. Results: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. Conclusion: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.

National Surgical Trends for Distal Radius Fractures in Korea

  • Jo, Young-Hoon;Lee, Bong-Gun;Kim, Joo-Hak;Lee, Chang-Hun;Kim, Sung-Jae;Choi, Wan-Sun;Koo, Ja-Wook;Lee, Kwang-Hyun
    • Journal of Korean Medical Science
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    • v.32 no.7
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    • pp.1181-1186
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    • 2017
  • The objective of this study was to investigate national surgical trends for distal radius fractures (DRFs) in Korea and analyze healthcare institution type-specific surgical trends. We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service (HIRA) from 2011 to 2015. International Classification of Diseases, 10th revision (ICD-10) codes and procedure codes were used to identify patients aged ${\geq}20years$ with newly diagnosed DRFs. A total of 459,388 DRFs occurred from 2011 to 2015. The proportion of DRF cases treated by surgery tended to increase over time, from 32.6% in 2011 to 38.3% in 2015 (P < 0.001). Open reduction with internal fixation (ORIF) using a plate steadily gained in popularity each year, increasing from 39.2% of overall surgeries in 2011 to 60.9% in 2015. The type of surgery for DRFs differed depending on the type of healthcare institution. ORIF (91%) was the most popular procedure in tertiary hospitals, whereas percutaneous pinning (58%) was most popular in clinics. In addition, general hospitals and hospitals with 30-100 beds used external fixation more frequently than tertiary hospitals and clinics did. Overall, our findings indicate that surgical treatment of DRF, particularly ORIF, continues to increase, and that the component ratio of operation codes differed according to the healthcare institution type.

Proximal Humaral Fractures (근위 상완골 골절)

  • Kim, Jeong-Woo
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • pp.189-195
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    • 2007
  • $\cdot$ Difficult & Challenging Fracture $\cdot$ Most Treated Nonoperative $\cdot$ ORIF in Young Patients with Unstable Fractures $\cdot$ Fixed Angles Device is Promising $\cdot$ Prosthetic Arthroplasty in Elderly $\cdot$ Loss of Motion Very Common

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