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Sample records for maxillofacial fractures results

  1. Radiographic evaluation of maxillofacial fractures

    International Nuclear Information System (INIS)

    Litwan, M.; Fliegel, C.

    1986-01-01

    The course and configuration of typical maxillofacial fractures (type Le Fort I-III) and lateral maxillary fractures including the zygomatic arch were reconstructed in detail by application of barium paste on a bony skull and radiogrpahs in standard projections were performed and evaluated. It was obvious from the resulting radiographs that for most maxillofacial fractures a half axial or Water's view was most helpful. Lateral views only give additional information when there is a considerable degree of dislocation of fragments. Comparison with a prediatric skull of 8 years of age demonstrated that fractures of the zygomatic arch in this age group cannot be demonstrated by the typical submento-vertical view, but are shown on a Towne projection. The radiographic appearance of important maxillofacial fractures is demonstrated. The necessity of further studies in cases where reconstructive surgery appears necessary is discussed and CT rather then conventional tomography is advocated. (orig.) [de

  2. Maxillofacial fractures sustained during baseball and softball.

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    Yamamoto, Kazuhiko; Murakami, Kazuhiro; Sugiura, Tsutomu; Ishida, Jun-ichi; Imai, Yuichiro; Fujimoto, Masaki; Kirita, Tadaaki

    2009-04-01

    The purpose of this study was to investigate the demographics, the type of impact, the site and the treatment of maxillofacial fractures sustained during baseball and softball to develop an effective preventive strategy. Data of 82 patients treated for baseball- and softball-related maxillofacial fractures at the Department of Oral and Maxillofacial Surgery, Nara Medical University between 1982 and 2007 were retrospectively analyzed. Injuries were found in 64 men in baseball and 16 men and two women in softball with average ages of 19.6 and 30.0 years, respectively. Fractures were caused by being hit by the ball in 61 patients followed by collision in 16 patients. Fractures of the mandible and the mid-face were found in 44 and 38 patients, respectively. The mental and angle region of the mandible and zygoma and alveolar bone of the maxilla were frequently involved. Treatment was mostly conservative. Open reduction and internal fixation were performed only in 15 patients. Most maxillofacial fractures in these sports were ball-related. Therefore, effective preventive means should be considered to protect against such injuries.

  3. Maxillofacial fractures among patients attended at Muhimbili ...

    African Journals Online (AJOL)

    Objective: To determine the pattern of occurrence, types, and treatment and prognosis of patients with maxillofacial fractures at the dental school of the Muhimbili University College of Health SciencesNational Hospital, Dar es Salaam, Tanzania. Methodology: ... comprised of 25 (accounting for 21.3%) of the cases (p<0.001).

  4. Maxillofacial fractures: twenty years of study in the department of maxillofacial surgery in kosovo.

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    Loxha, Mergime Prekazi; Sejfija, Osman; Salihu, Sami; Gjinolli, Fellanza; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida Namani; Gecaj-Gashi, Agreta

    2013-01-01

    The aim of this study was to analyze maxillofacial region fractures during the past 20 years in the Department of Maxillofacial Surgery in Prishtina. We have analyzed the histories of all patients with trauma who were hospitalized in the Department of Maxillofacial Surgery in Prishtina since the opening of the clinic in 1983 through 2005. Narrowing the subject of our research, we concentrated on fractures of the maxillofacial region treated at the Clinic of Maxillofacial Surgery for the period 2001-2005. We have analyzed those fractures and compared them with the period from 1983 to 2005 only when it was reasonable. During this period, 1,945 patients were treated for trauma in the maxillofacial region by the Department of Maxillofacial Surgery. This group included 19.8% females and 80.2% males. The largest age group were those between 20 and 20 years of age. Causes of trauma for both periods were predominantly traffic accidents; however, during the period 2001-2005, interpersonal conflicts were increasingly the cause of fractures. Interpersonal conflict as a cause of maxillofacial trauma has risen in recent years. With this increase the methods of treating fractures in this region are also changing.

  5. Maxillofacial fracture experiences: a review of 152 cases.

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    Aydin, Osman Enver; Tan, Onder; Algan, Said; Kuduban, Selma Denktas; Barin, Ensar Zafer; Cinal, Hakan; Sarici, Murat; Avsar, Umit

    2012-12-01

    The fractures of facial structures lead to great morbidity. Cross-sectional studies are needed to evaluate the current state of maxillofacial traumas. Thus, this study aims to evaluate these experiences and to compare these results with the current literature. The medical records of the maxillofacial fracture cases hospitalized between January 2004 and November 2011 were examined. The age, sex, etiology, fracture localization and treatment method for each case were documented. The affected facial bones were grouped as mandible, maxilla, zygoma, naso-orbitoethmoid complex (NOEC) and blow-out. Nasal fractures were excluded. The cases were assigned to 3 groups with respect to age (below 16, above 65 and between 17 and 64). The chi Square test was used to assess the significance of the difference in mandibular fracture rates in the pediatric population compared to others. The total number of cases was 152. The total number of fractures was 185. Of the 152 cases, 117 were male and 35 were female. The average age was 31.4 (±18.3), ranging between 2 and 81. Thirty-one cases were 16 years old or less. Nine cases were 65 years old or more. Mandibular and zygomatic fractures were the most prevalent fractures in the adult group. Mandibular fractures were significantly more common in the pediatric age group compared to rest of the population (X(2), pOpen reduction and internal fixation was the most frequently conducted treatment modality in all age groups. Retrospective studies are important for the projection of future prospects. In summary, our results indicate that pediatric fractures are mostly in the lower face and usually affect the condylar region, which is consistent with the literature.

  6. Multiple maxillofacial fractures in a patient undergoing orthodontic ...

    African Journals Online (AJOL)

    A multi-disciplinary team approach for the management of maxillofacial fractures in patients undergoing orthodontic treatment with fixed appliances is suggested. Orthodontic treatment with surgical involvement has been found to improve both facial aesthetics and occlusal function. Key words: Maxillofacial, trauma, ...

  7. Orthodontic treatment for oral rehabilitation after multiple maxillofacial bone fractures.

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    Nakamura, Yoshiki; Ogino, Tomoko Kuroiwa; Hirashita, Ayao

    2008-09-01

    We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures.

  8. Elderly patients with maxillofacial trauma: study of mandibular condyle fractures.

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    Nogami, Shinnosuke; Yamauchi, Kensuke; Yamashita, Toshio; Kataoka, Yoshihiro; Hirayama, Bunichi; Tanaka, Kenko; Takahashi, Tetsu

    2015-02-01

    The aim of this study was to investigate the trends and characteristic features of mandibular condyle fractures in elderly patients in terms of etiology, patterns, and treatment modalities. Records of 201 patients aged 65 years and older, who were treated for maxillofacial fractures at the Department of Oral and Maxillofacial Surgery, Kyushu Dental University, and Tohoku University from January 2002 to December 2013, were retrospectively analyzed. Patient records and radiographs were examined, with the following information: relevant medical history, cause of fracture, the presence and state of premolars and molars in the maxilla and mandible, number and location of mandible fracture, and method of treatment. As for the state of premolars and molars, premolars or molars in the mandible in contact with the maxilla were regarded as contacted. A fall was responsible for the majority of the fractures (173/201). With condyle fractures, there was a significant difference between the contacted and non-contacted group in regard to incidence. Furthermore, there was a significantly greater number of cases with symphysis and condyle combination fractures in the non-contacted group (70.9%) than in the contacted group (51.9%). As for the method of treatment, arthrocentesis was the most commonly employed. The present findings suggest that contacted molars in the maxilla and mandible have an influence on condyle fractures in elderly individuals. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Computed tomography in the diagnosis of fractures of the maxillofacial area

    International Nuclear Information System (INIS)

    Angelova, I.; Yordanov, G.; Sirakov, V.; Velkova, K.

    2013-01-01

    Computed tomography (CT) is the current method of study in maxillofacial region, which produces cross-sectional images of a specific area. There are still questions about methodology and radiation exposure. The aim of the present study is to evaluate the CT in diagnosis of fractures in maxillofacial region. 42 patients with traumatic injuries to the facial skeleton are examined. Fractures of maxilla are occurring in 14.6 % of patients with traumatic diseases. Fractures of maxilla and zygomatic bone are found in 29.3 percent of the traumatic event. Isolated nasal bone fracture is observed in 2.4% of ail fractures. Compound fractures constitute 17.1% of the tested fractures. This group of patients are positioned at second place in frequency. Mandibular fractures ranked first in frequency -36.6% of all traumatic lesions. The methods include: 1. Slice computed tomography in the axial and coronary projection 2. Spiral CT in axial projection and coronary one. 3. Cone Beam Computed Tomography. CT diagnosis is based on an analysis of all the images. It must comply with the data from other studies. When analyzing the results we found that the percentage of patients with primary diagnosis of fractured upper jaw is 11 %, while CT diagnosis of this percentage increases to 16%. The percentage of patients with primary diagnosis fracture of mandibula and CT diagnosis is almost identical. In the present study, 3D and CT have similar results in the detection of fractures. Three-dimensional images dearly show the spatial anatomy of the face, the presence of fragments, as well as monitoring of fracture lines. Key words; Fractures. Maxillofacial Area. CT

  10. Quality of Postoperative Pain Management After Maxillofacial Fracture Repair.

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    Peisker, Andre; Meissner, Winfried; Raschke, Gregor F; Fahmy, Mina D; Guentsch, Arndt; Schiller, Juliane; Schultze-Mosgau, Stefan

    2018-05-01

    Effective pain management is an essential component in the perioperative care of surgical patients. However, postoperative pain after maxillofacial fracture repair and its optimal therapy has not been described in detail. In a prospective cohort study, 95 adults rated their pain on the first postoperative day after maxillofacial fracture repair using the questionnaire of the Quality Improvement in Postoperative Pain Management (QUIPS) project. Quality Improvement in Postoperative Pain Management allowed for a standardized assessment of patients' characteristics and pain-related parameters. Overall, the mean maximal pain and pain on activity (numeric rating scales) were significantly higher in patients with mandibular fractures than in patients with midface fractures (P = 0.002 and P = 0.045, respectively). In patients with mandibular fractures, a longer duration of surgery was significantly associated with higher satisfaction with pain intensity (P = 0.015), but was more frequently associated with postoperative vomiting (P = 0.023). A shorter duration of surgery and an absence of preoperative pain counseling in these patients were significantly correlated to desire for more pain medication (P = 0.049 and P = 0.004, respectively). Patients with mandibular fractures that received opioids in the recovery room had significantly higher strain-related pain (P = 0.017). In patients with midface fractures, a longer duration of surgery showed significantly higher levels of decreased mobility (P = 0.003). Patients receiving midazolam for premedication had significantly less minimal pain (P = 0.021). Patients with mandibular fractures seem to have more postoperative pain than patients with midface fractures. Monitoring of postsurgical pain and a procedure-specific pain-treatment protocol should be performed in clinical routine.

  11. Analysis of the pattern of maxillofacial fractures in north western of Iran: A retrospective study

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    Mesgarzadeh Ali

    2011-01-01

    Full Text Available Background : Maxillofacial fractures can lead to substantial long-term functional, esthetic and psychological complications. Aim : The aim of this study is to evaluate these injuries in a Turkish Iranian population. Materials and Methods : A retrospective study of 170 patients with 210 maxillofacial fractures admitted to the emergency department of a central referral emergency hospital in the area over a 5 year period is presented. Patients′ data included demographic information, etiology, site and associated injuries and complications. Results : Road traffic accident was the commonest cause (40% and the age group of 21-30 comprised the biggest group (30%. Mandibular fractures outnumbered midface fractures (150vs.60. Ramus (21.5% and zygoma (26.5% were the commonest fracture regions respectively in mandible and midface. Male: female ratio was 3.8:1 Almost half of patients (46% had sustained associated injuries most of which was soft tissue laceration of the face (17.5%. 22 patient (13% had associated complication and the hemorrhage was the commonest form of that (9%. Conclusion : It seems that road traffic accidents continue to be the leading cause of maxillofacial fractures and there is an urgent need to implement enhanced regulations and monitoring on motor vehicular traffic.

  12. To evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures: A prospective study

    OpenAIRE

    Bali, Rishi K.; Sharma, Parveen; Jindal, Shalu; Gaba, Shivani

    2013-01-01

    Aims: The present study was undertaken to evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures and to study the morbidity associated with the use of biodegradable plates and screws. Materials and Methods: This prospective study consisted of 10 patients with maxillofacial fractures requiring open reduction and internal fixation. Fractures with infection, comminuted and pathological fractures were excluded. All were plated with biodegradable system (Inio...

  13. Pattern of Maxillofacial fracture in Western and Central Nepal: An experience in 3 tertiary level health institutions

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    S Subedi

    2015-06-01

    Full Text Available BACKGROUND: There are only few studies regarding the pattern and causes of maxillofacial fractures till date in Nepal and no such study in western and central Nepalese population has been conducted. The purpose of this study, therefore, was to describe the causes and the pattern of maxillofacial fractures in western and central part of Nepal over the period of 5 years. MATERIAL AND METHODS A retrospective analysis of maxillofacial fractures was conducted on 328 patients who were treated in the department of maxillofacial surgery. Data was extracted and analyzed based on age, sex, cause of injury and anatomic location. RESULT Young males of 3rd decade of life most commonly sustained the maxillofacial trauma. The commonest site involved was the zygomatic complex (42% when only mid face fractures was considered and parasymphysis (32% when only mandible was considered.The most common cause of injuries was road traffic accidents (289 patients; 88.1% followed by interpersonal violence (25 patients; 7.6 % and falls accounting for 4.2% of the all injuries. CONCLUSION The findings of this study suggest the need for expansion of the motorway network, ensuring compliance of strict traffic rules and regulations, replacing old vehicles without safety measures and implement school education in alcohol abuse.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12771 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 8-13

  14. Fracture patterns in the maxillofacial region: a four-year retrospective study

    Science.gov (United States)

    2015-01-01

    Objectives The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures. PMID:26734557

  15. Characteristics of maxillofacial injuries resulting from road traffic accidents – a 5 year review of the case records from Department of Maxillofacial Surgery in Katowice, Poland

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    Drugacz Jan

    2006-08-01

    Full Text Available Abstract Background In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland from January 2001 to December 2005. Methods The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident. Results The traffic accidents were the cause of 19,93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22,21%, followed by tooth and alveolar process injuries (20,71% and mandibular fractures (18,69%. All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. Conclusion Our results

  16. Treatment cost of patients with maxillofacial fractures at the University Hospital in Mostar 2002-2006.

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    Jurić, Mario; Novakovic, Josip; Carapina, Mirela; Kneiević, Ervin

    2010-03-01

    The aim of this study was to establish the costs structure of medical treatment for the patients with maxillofacial fractures, to perform a treatment cost evaluation, describe the factors which considerably influence the costs and discover the ways of achieving financial savings in treated patients. The study group consisted of patients with maxillofacial fractures who were admitted and treated at the Department of Maxillofacial Surgery of the University Hospital Mostar in the period from January 2002 until December 2006. Data for the study were collected from the patients' databases, case histories and data obtained on the basis of individual payments for the treatment that was collected by Finance Department of the University Hospital of Mostar Most patients in this study were men (83%), of average age 34 +/- 19 years. Zygomatic bone fracture was the commonest injury. Open surgical procedure was performed in 84.7% of treated cases. The costs for the open procedure were considerably higher than conservative treatment. Medication cost made up a total of 37.9% and cost of hospital accommodation 27.3% out of total hospital charge. Cost reduction in treated patients with maxillofacial fractures should be achieved through protocols of urgent treatment of maxillofacial trauma patients immediately after sustaining an injury and with earlier discharge of the patients when postoperative complications are not expected.

  17. [Epidemiology of maxillofacial fractures due to traffic accidents in Medellin (Colombia)].

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    Agudelo-Suárez, Andrés A; Duque-Serna, Francisco Levi; Restrepo-Molina, Lucas; Martínez-Herrera, Eliana

    2015-09-01

    To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers' knowledge and practices. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. To evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures: A prospective study.

    Science.gov (United States)

    Bali, Rishi K; Sharma, Parveen; Jindal, Shalu; Gaba, Shivani

    2013-07-01

    The present study was undertaken to evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures and to study the morbidity associated with the use of biodegradable plates and screws. This prospective study consisted of 10 patients with maxillofacial fractures requiring open reduction and internal fixation. Fractures with infection, comminuted and pathological fractures were excluded. All were plated with biodegradable system (Inion CPS) using standard plating principles and observed for a total period of 24 weeks. Characteristics of the fractures, ease of use of bioresorbable plate/screw system and post operative complications were assessed. Of total 10 patients, eight patients were of midface fracture and two pediatric patients with mandibular fracture, with nine male and one female. The mean age was 32.8 years. Out of 20 plates and 68 screws applied to the 10 fractures sites; there were three incidences of screw breakage with no other intraoperative difficulties. Paresthesia of the infraorbital nerve was present in two patients, and recovered completely in four weeks after surgery. Fracture reduction was considered to be satisfactory in all cases. One patient developed postsurgical infection and was managed with oral antibiotics and analgesics. Favorable healing can be observed through the use of biodegradable plates and screws to stabilize selected midface fractures in patients of all ages, as well as mandible fractures in early childhood, however further studies with more sample size are required.

  19. Relative Frequency of Maxillofacial Fracture in CT-Scan Radiographs in Shahid Sadoghi and Shahid Rahnemoun Emergency Departments in Yazd from 2007 Till 2010

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    Ezoddini Ardakan

    2012-02-01

    Full Text Available Introduction: Technologic improvement and increased production of car and motorcycle have led to the increased incidence of maxillofacial trauma all around the world. Injuries of maxillofacial region include fractures of mandible, maxilla, zygoma, orbit and nasal bone, which is due to different etiologic factors such as motor vehicle accidents, quarreling, fall, and sport-related and work- related accidents. The Purpose of this study was to evaluate the frequency of maxillofacial fracture in CT-scan radiographs in Shahid Sadoghi and Shahid Rahnemon emergency departments in Yazd from 2007 till 2010. Methods: In this retrospective study we assessed the medical files of all patients with maxillofacial traumawho were admitted at Shahid Sadoughi and Shahid Rahnemoun hospitals in ENT and surgery wards during a 4-year period. The information from patients' medical file and CT scan radiographs were recorded. At last 372 patients were evaluated. Results: In this study the age of patients showed to be between 20 and 29. Eighty six and fourteen percent of patients were males and females, respectively. Among all fractures, mandible fracture was the most frequent one (50.8%. The most frequent etiologic factor was accident (59% and the most frequent outcome was partial recovery (46.4% and death was observed in 0.8% of individuals. Conclusion: Results of this study showed that the most frequent etiologic factor of trauma to maxillofacial region is motor vehicle accident similar to other developing countries.

  20. Frequency and types of fractures in maxillofacial traumas. Assessment using MDCT with multiplanar and 3D reconstructions

    International Nuclear Information System (INIS)

    Tomich, G.; Baigorria, P.; Orlando, N.; Mejico, M.; Costamagna, C.; Villavicencio, R.

    2011-01-01

    Introduction: Maxillofacial trauma (MFT) is a common reason for attendance at Emergency Departments. The complex anatomy of the facial bones requires multiplanar imaging techniques for a proper evaluation. Objectives. To describe frequency and types of fractures in a series of patients with MFT evaluated by multi-slice computed tomography (MDCT) with multiplanar and 3D reconstructions. Materials and Methods: Facial bone CTs ordered for MFT by the Emergency Department from June 2008 to December 2009 were retrospectively reviewed. The following data were obtained: age, gender, cause of trauma, presence and type of fractures. Patients were evaluated with an 8-channel MDCT. Multiplanar reconstructions were performed in all cases using high resolution bone window and soft tissue window, as well as 3D reconstructions. Results: One-hundred and thirty-seven CTs were performed for MFT: 78 (57%) showed 131 fractures. Of these 78 patients, 52 (66%) were males and 26 (34%) were females; mean age 33 years old (range: 14-90 yrs.). Causes: 58 % were injuries from traffic accidents; 24% were injuries from fights; 13% were sport injuries; and 7% were due to miscellaneous etiologies. Type and frequency of fractures: 18.3% were orbital floor fractures, 16% were maxillary sinus fractures, 15.3% were nasal fractures, 13% were jaw fractures, 9.2% were orbital fractures, and 12.3% were fractures of the zygomatic-malar complex; two cases of Le Fort II-III fractures were also observed. Conclusions: Fractures were more common in males, in the age range from 15 to 35 years old. Most fractures, and the most complex ones, were caused by traffic accidents. The most common fracture, either isolated or associated with other fractures, was the orbital floor fracture. (authors)

  1. Delayed Foreign Body Reaction Caused by Bioabsorbable Plates Used for Maxillofacial Fractures

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    Hong Bae Jeon

    2016-01-01

    Full Text Available BackgroundBioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws.MethodsA total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA in 61 patients. Their mean age was 35.2 years (range, 15-84 years. Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla.ResultsComplications occurred in eight (3.4% of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction.ConclusionsInadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.

  2. Tibial bone fractures occurring after medioproximal tibial bone grafts for oral and maxillofacial reconstruction.

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    Kim, Il-Kyu; Cho, Hyun-Young; Pae, Sang-Pill; Jung, Bum-Sang; Cho, Hyun-Woo; Seo, Ji-Hoon

    2013-12-01

    Oral and maxillofacial defects often require bone grafts to restore missing tissues. Well-recognized donor sites include the anterior and posterior iliac crest, rib, and intercalvarial diploic bone. The proximal tibia has also been explored as an alternative donor site. The use of the tibia for bone graft has many benefits, such as procedural ease, adequate volume of cancellous and cortical bone, and minimal complications. Although patients rarely complain of pain, swelling, discomfort, or dysfunction, such as gait disturbance, both patients and surgeons should pay close attention to such after effects due to the possibility of tibial fracture. The purpose of this study is to analyze tibial fractures that occurring after osteotomy for a medioproximal tibial graft. An analysis was intended for patients who underwent medioproximal tibial graft between March 2004 and December 2011 in Inha University Hospital. A total of 105 subjects, 30 females and 75 males, ranged in age from 17 to 78 years. We investigated the age, weight, circumstance, and graft timing in relation to tibial fracture. Tibial fractures occurred in four of 105 patients. There were no significant differences in graft region, shape, or scale between the fractured and non-fractured patients. Patients who undergo tibial grafts must be careful of excessive external force after the operation.

  3. An assessment of maxillofacial fractures treated in a sub- urban ...

    African Journals Online (AJOL)

    McRoy

    2014-12-31

    Dec 31, 2014 ... ... which permits unrestricted, non-commercial, share-alike use, distribution, and .... treated resulted in a successful outcome while 12 ... likely to engage in driving and motor bike ... drive and ride motor bikes around the towns.

  4. maxillofacial surgery

    African Journals Online (AJOL)

    The history of maxillofacial and oral injuries, including mandibular fractures, from 1650 BC to the present, is the topic of two publications.1,2 To summarise: the Greek. 'Father of Medicine' Hippocrates was the first to describe fracture treatment – he recommended bandages and single jaw fixation. Celsus, a Roman (30 BC ...

  5. Consensus or controversy? The classification and treatment decision-making by 491 maxillofacial surgeons from around the world in three cases of a unilateral mandibular condyle fracture.

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    Kommers, Sofie C; Boffano, Paolo; Forouzanfar, Tymour

    2015-12-01

    Many studies are available in the literature on both classification and treatment of unilateral mandibular condyle fractures. To date however, controversy regarding the best treatment for unilateral mandibular condyle fractures remains. In this study, an attempt was made to quantify the level of agreement between a sample of maxillofacial surgeons worldwide, on the classification and treatment decisions in three different unilateral mandibular condyle fracture cases. In total, 491 of 3044 participants responded. In all three mandibular condyle fracture cases, a fairly high level of disagreement was found. Only in the case of a subcondylar fracture, assuming dysocclusion was present, more than 81% of surgeons agreed that the best treatment would be open reduction and internal fixation. Based on the study results, there is considerable variation among surgeons worldwide with regard to treatment of unilateral mandibular condyle fracture. 3D imaging in higher fractures tends to lead to more invasive treatment decisions. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. Clinical Features and Treatment Modes of Mandibular Fracture at the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, Japan.

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    Hiroto Tatsumi

    Full Text Available The number of elderly patients with maxillofacial trauma is rapidly increasing due to active lifestyles and longevity. Shimane prefecture has the fastest growing proportion of elderly individuals in Japan. The aim of this study was to reveal the distinctive features and treatment modes of mandibular fracture treatment mode in patients requiring hospitalization at the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, Japan.Patient age, sex, period between injury and first consultation, years since injury, cause of injury, fracture site, treatment, and duration of hospitalization were evaluated. Univariate Poisson regression, relative risk with 95% confidence interval based on the Wald test, Fisher's exact test, and Kruskal-Wallis test were used to explore associations among clinical and demographic variables.In total, 305 patients were diagnosed with and hospitalized for mandibular fracture from 1980 to 2010. Younger age increased the risk for mandibular fracture. Incidence was higher in males than females, particularly in the young, but the male to female ratio decreased with age. The period until first hospital consultation decreased progressively over the study period. Fall was a much more frequent cause in patients aged ≥60 than in those aged <60 years. Mandibular fracture with condyle, symphysis, and angle involvement were most common and were associated with sex, age, and treatment mode. Length of hospitalization has decreased since 1980.In our department, patients aged ≥60 years accounted for a greater proportion of mandibular fracture cases than in many previous studies, reflecting the greater proportion of elderly residents in Shimane prefecture.

  7. University student’s dental and maxillofacial fractures characteristics and epidemiology in sports

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    Ivan Onone Gialain

    2014-10-01

    Full Text Available Current study analyzes the characteristics and epidemiology of oral and nasal fractures and knowledge degree regarding the use of a mouthguard by an amateur university handball team inBrazil.  A cross-sectional study comprised 138 students who practiced the sport. They were interviewed on dental and nasal fractures and on the need of mouthguards in games such as amateur handball. Data were processed by descriptive analysis. Results showed that 19.6% had suffered some type of dental injury during the practice of sports, namely 40 fractured teeth; 12% had fractured nasal bones; 57% underwent head and neck injuries; 32% were unaware of the need to use a mouthguard during sports; 68% had heard of mouthguards, but only 4.5% of the interviewees made use of this protection device. There was a high prevalence of nasal and dental fractures in the group under analysis. The upper central incisors were most susceptible to fracture. Even though most athletes knew a mouthguard was needed during sports activities, only 4.5% actually used one.

  8. [Dynamic magnetotherapy use in comprehensive treatment phlegmons of maxillofacial region and mandible fractures].

    Science.gov (United States)

    Lepilin, A V; Raĭgorodckiĭ, Iu M; Nozdrachev, V G; Erokina, N L

    2007-01-01

    145 patients (60 with phlegmons of submandibular and submental regions, 85--with fractures of mandible) were observed and treated with the use of moving pulse magnetic field (MPMF) produced by special apparatus (AMO-ATOS-E, , Saratov-city), 60 patients with the same pathology were treated by traditional physical methods and served as control. Use of MPMF led to quicker patient recovery: quicker reduction (if compared with traditional physical methods of treatment) of oedema and soft tissue inflammatory infiltration, quicker relief from inflammatory reaction (according to data of cytokinin profile), improvement of tissue blood supply in the region of fractures in patients with mandible fractures. As the result--we had shortening treatment terms of such patients and complication number reduction.

  9. Computed Tomography evaluation of maxillofacial injuries

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    V Natraj Prasad

    2017-01-01

    Full Text Available Background & Objectives: The maxillofacial region, a complex anatomical structure, can be evaluated by conventional (plain films, Tomography, Multidetector Computed Tomography, Three-Dimensional Computed Tomography, Orthopantomogram and Magnetic Resonance Imaging. The study was conducted with objective of describing various forms of maxillofacial injuries, imaging features of different types of maxillofacial fractures and the advantage of using Three- Dimensional Computed Tomography reconstructed image. Materials & Methods: A hospital based cross-sectional study was conducted among 50 patients during April 2014 to September 2016 using Toshiba Aquilion Prime 160 slice Multi Detector Computed Tomography scanner.Results: The maxillofacial fractures were significantly higher in male population (88% than female population (12 %. Road traffic accidents were the most common cause of injury others being physical assault and fall from height. It was most common in 31-40 years (26% and 21-30 (24% years age group. Maxillary sinus was the commonest fracture (36% followed by nasal bone and zygomatic bone (30%, mandible and orbital bones (28%. Soft tissue swelling was the commonest associated finding. Three dimensional images (3 D compared to the axial scans missed some fractures. However, the extension of the complex fracture lines and degree of displacement were more accurately assessed. Complex fractures found were Le fort (6% and naso-orbito-ethmoid (4% fractures.Conclusion: The proper evaluation of complex anatomy of the facial bones requires Multidetector Computed Tomography which offers excellent spatial resolution enabling multiplanar reformations and three dimensional reconstructions for enhanced diagnostic accuracy and surgical planning.

  10. [Cranio-maxillofacial traumatology

    NARCIS (Netherlands)

    Kroon, F.H.; Beek, G.J.; Damme, P.A. van

    2007-01-01

    During the last 50 years, significant developments have taken place in the treatment of cranio-maxillofacial fractures. The aim of treatment is to achieve the most complete possible restoration of facial functions Epidemiologic figures for these fractures are sparsely available in the literature,

  11. Maxillofacial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Larheim, T.A. [Oslo Univ. (Norway). Dept. of Maxillofacial Radiology; Westesson, P.L. [Univ. of Rochester School of Medicine and Dentistry, NY (United States). Div. of Diagnostic and Interventional Radiology

    2006-07-01

    Maxillofacial imaging has evolved dramatically over the past two decades with development of new cross-sectional imaging techniques. Traditional maxillofacial imaging was based on plain films and dental imaging. However, today's advanced imaging techniques with CT and MRI have only been partially implemented for maxillofacial questions. This book bridges the gap between traditional maxillofacial imaging and advanced medical imaging. We have applied CT and MRI to a variety of maxillofacial cases and these are illustrated with high-quality images and multiple planes. A comprehensive chapter on imaging anatomy is also included. This book is useful for oral and maxillofacial radiologists, oral and maxillofacial surgeons, dentists, radiologists, plastic surgeons, head and neck surgeons, and others that work with severe maxillofacial disorders. (orig.)

  12. Trend and Demographic Characteristics of Maxillofacial Fractures in Level I Trauma Center.

    Science.gov (United States)

    Emodi, Omri; Wolff, Amir; Srouji, Hanna; Bahouth, Hany; Noy, Dani; Abu El Naaj, Imad; Rachmiel, Adi

    2018-03-01

    The aim of this study was to analyze the pattern and treatment of craniomaxillofacial injuries in the northern part of Israel, within a Jewish majority and large Arab minority population. A 5-year retrospective study evaluated patients treated for craniomaxillofacial fractures. Fracture cause, type, site, and patient demographics were evaluated. Patient age ranged from 1 to 94 years with an average age of 36.7 years; 52% of the victims were Jews and 48% Arabs. There was male predilection in both sectors (78.3% vs 21.7%). The main site of injury was the zygomatic bone (33.5%) followed by nasal bone, orbital, mandible, frontal sinus, and maxillary fractures. The main etiology of injuries was falls (45.4%) with significantly more falls reported by females (52.1% vs 43.2% in males). Motor vehicle accidents caused injuries more frequent in males. Arabs experienced CMF fractures at a younger age compared to Jews (27.8 and 44.8 average age, respectively). In the elderly, the trend reversed where Jews were more prone to craniomaxillofacial fractures. Compared to their weight in the population, the Arab sector experiences more craniomaxillofacial injuries. The Jewish elderly population tends to reside in nursing homes where they are more susceptible to accidental falls, whereas young Arab males are more exposed to motor vehicle accidents and interpersonal violence. Falls were the main cause of injuries particularly in women. This may reflect the women's fear of reporting domestic violence. We believe that increased government investments in infrastructures and education will lower the incidence of craniomaxillofacial trauma and balance the gap between both sectors and sexes.

  13. Maxillofacial trauma in Tamil Nadu children and adolescents: A retrospective study

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    Ramraj Jayabalan Arvind

    2013-01-01

    Full Text Available Aim: The aim of this retrospective study is to describe the incidence, aetiology, complexity and surgical indications of maxillofacial injuries in children and adolescents population of Tamil Nadu state of india during period of 4 years. Materials and Methods: A retrospective review was conducted among 500 children and adolescents patients of age group 6 years to 16 years suffered or suffering with maxillofacial and skull fractures presenting to ten Level I trauma centers over a 4 year period.The data collected for this study included age, gender, etiology, associated maxillofacial trauma, anatomic site of fracture and treatment. Results and Conclusion: In our study the most common cause of trauma was traffic 35%, followed by falls 24% and sports 22%. Mandible was commenest bone prone to fracture, followed by maxilla and nasal bone. Mandible fractures accounted for 72% of all maxillofacial fractures.

  14. Our Results in Penile Fractures

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    Tufan Süelözgen

    2016-06-01

    Full Text Available Introduction Penile fracture is a urological emergency caused by direct trauma to an erected penis, tearing the tunica albuginea in the corpus cavernosum. The preferred treatment method is draining the hematoma and surgical repair of tunica albuginea tear as soon as possible following diagnosis. Materials and Methods Forty-nine patients who were diagnosed with penile fracture between January 2009 and December 2014 were reviewed. Physical examination was performed to see the extent of penile hematoma, the side of the penile curvature and the presence of blood in the external meatus. Two patients who were diagnosed with urethrorrhagia underwent retrograde urethrogram for urethral injury. In all patients, penile skin was peeled using a circular subcoronal degloving incision and tunica tear was repaired using absorbable suture materials. The patients were then followed for painful erections, penile deformities and erection angles. Results The average age of the 49 patients, who were included in the study, was 36.5 years (21-65. In their etiological questioning, most patients reported the fracture occurring during sexual intercourse. Retrograde urethrography was indicated in 2 patients with blood in the external meatus and were diagnosed with urethral injury. The patients were taken to emergency surgery. Tunica defects varied between 1 and 2 cm. Incomplete urethral injuries were primarily repaired around 18 French Foley catheter. None of the patients reported penile deformity or painful erections. Their erection angles were found to be within the normal range. Conclusion Even though it is a relatively rare condition, penile fractures are so important that might cause serious complications when not treated surgically. A thorough anamnesis and physical examination suffice for diagnosis.

  15. Maxillofacial fractures and craniocerebral injuries - stress propagation from face to neurocranium in a finite element analysis.

    Science.gov (United States)

    Huempfner-Hierl, Heike; Schaller, Andreas; Hierl, Thomas

    2015-04-21

    Severe facial trauma is often associated with intracerebral injuries. So it seemed to be of interest to study stress propagation from face to neurocranium after a fistlike impact on the facial skull in a finite element analysis. A finite element model of the human skull without mandible consisting of nearly 740,000 tetrahedrons was built. Fistlike impacts on the infraorbital rim, the nasoorbitoethmoid region, and the supraorbital arch were simulated and stress propagations were depicted in a time-dependent display. Finite element simulation revealed von Mises stresses beyond the yield criterion of facial bone at the site of impacts and propagation of stresses in considerable amount towards skull base in the scenario of the fistlike impact on the infraorbital rim and on the nasoorbitoethmoid region. When impact was given on the supraorbital arch stresses seemed to be absorbed. As patients presenting with facial fractures have a risk for craniocerebral injuries attention should be paid to this and the indication for a CT-scan should be put widely. Efforts have to be made to generate more precise finite element models for a better comprehension of craniofacial and brain injury.

  16. Comportamiento de las fracturas maxilofaciales atendidas en el Hospital Universitario de Maabar, República de Yemen Behavior of the maxillofacial fractures in the Maabar's University Hospital, Yemen Republic

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    Juan Carlos Quintana Díaz

    2012-03-01

    the results of other studies conducted in Cuba and other countries. Methods: a retrospective, descriptive and statistic study was conducted on the maxillofacial fractures seen by the Cuban professor brigade in this hospital between 2006 and 2009. The study variables were: sex, age, cause of the fracture and involved region, as well as the type of fracture and associated traumata. Results: the male sex was more involved that the female one. The road accidents were the commonest cause (more than the 50 % of cases. The nose fracture was the more frequent and in more than of 150 cases there were associated traumata much of them very severe including skull fracture, of extremities and soft tissue wounds. Conclusions: the results confirm that the male sex is the more involved one and that the road accidents are the leading cause of face fractures. The nose fracture is the more frequent of all that of facial bones (more than 50 % of cases, but others register the mandible or the zygomatic region as the more frequent involved zone. The mandibular fractures were impressive in children, something not frequent in Cuba.

  17. Reconstructive surgery for complex midface trauma using titanium miniplates: Le Fort I fracture of the maxilla, zygomatico-maxillary complex fracture and nasomaxillary complex fracture, resulting from a motor vehicle accident.

    Science.gov (United States)

    Nicholoff, T J; Del Castillo, C B; Velmonte, M X

    Maxillofacial injuries resulting from trauma can be a challenge to the Maxillo-Facial Surgeon. Frequent causes of these injuries are attributed to automobile accidents, physical altercations, gunshot wounds, home accidents, athletic injuries, work injuries and other injuries. Motor vehicle accidents tend to be the primary cause of most midface fractures and lacerations due to the face hitting the dashboard, windshield and steering wheel or the back of the front seat for passengers in the rear. Seatbelts have been shown to drastically reduce the incidence and severity of these injuries. In the United States seatbelt laws have been enacted in several states thus markedly impacting on the reduction of such trauma. In the Philippines rare is the individual who wears seat belts. Metro city traffic, however, has played a major role in reducing daytime MVA related trauma, as usually there is insufficient speed in traffic areas to cause severe impact damage, the same however cannot be said for night driving, or for driving outside of the city proper where it is not uncommon for drivers to zip into the lane of on-coming traffic in order to overtake the car in front ... often at high speeds. Thus, the potential for severe maxillofacial injuries and other trauma related injuries increases in these circumstances. It is however unfortunate that outside of Metro Manila or other major cities there is no ready access to trauma or tertiary care centers, thus these injuries can be catastrophic if not addressed adequately. With the exception of Le Fort II and III craniofacial fractures, most maxillofacial injuries are not life threatening by themselves, and therefore treatment can be delayed until more serious cerebral or visceral, potentially life threatening injuries are addressed first. Our patient was involved in an MVA in Zambales, seen and stabilized in a provincial primary care center initially, then referred to a provincial secondary care center for further stabilization

  18. Diffuse reflectance spectroscopy for optical nerve identification. Preliminary ex vivo results for feedback controlled oral and maxillofacial laser surgery

    Science.gov (United States)

    Stelzle, Florian; Zam, Azhar; Adler, Werner; Douplik, Alexandre; Tangermann-Gerk, Katja; Nkenke, Emeka; Neukam, Friedrich Wilhelm; Schmidt, Michael

    Objective: Laser surgery has many advantages. However, due to a lack of haptic feedback it is accompanied by the risk of iatrogenic nerve damage. The aim of this study was to evaluate the possibilities of optical nerve identification by diffuse reflectance spectroscopy to set the base for a feedback control system to enhance nerve preservation in oral and maxillofacial laser surgery. Materials and Methods: Diffuse reflectance spectra of nerve tissue, skin, mucosa, fat tissue, muscle, cartilage and bone (15120 spectra) of ex vivo pig heads were acquired in the wavelength range of 350-650 nm. Tissue differentiation was performed by principal components analysis (PCA) followed by linear discriminant analysis (LDA). Specificity and sensitivity were calculated by receiver operating characteristic (ROC) analysis and the area under curve (AUC). Results: Nerve tissue could correctly be identified and differed from skin, mucosa, fat tissue, muscle, cartilage and bone in more than 90% of the cases (AUC results) with a specificity of over 78% and a sensitivity of more than 86%. Conclusion: Nerve tissue can be identified by diffuse reflectance spectroscopy with high precision and reliability. The results may set the base for a feedback system to prevent iatrogenic nerve damage performing oral and maxillofacial laser surgery.

  19. Secondary reconstruction of maxillofacial trauma.

    Science.gov (United States)

    Castro-Núñez, Jaime; Van Sickels, Joseph E

    2017-08-01

    Craniomaxillofacial trauma is one of the most complex clinical conditions in contemporary maxillofacial surgery. Vital structures and possible functional and esthetic sequelae are important considerations following this type of trauma and intervention. Despite the best efforts of the primary surgery, there are a group of patients that will have poor outcomes requiring secondary reconstruction to restore form and function. The purpose of this study is to review current concepts on secondary reconstruction to the maxillofacial complex. The evaluation of a posttraumatic patient for a secondary reconstruction must include an assessment of the different subunits of the upper face, middle face, and lower face. Virtual surgical planning and surgical guides represent the most important innovations in secondary reconstruction over the past few years. Intraoperative navigational surgery/computed-assisted navigation is used in complex cases. Facial asymmetry can be corrected or significantly improved by segmentation of the computerized tomography dataset and mirroring of the unaffected side by means of virtual surgical planning. Navigational surgery/computed-assisted navigation allows for a more precise surgical correction when secondary reconstruction involves the replacement of extensive anatomical areas. The use of technology can result in custom-made replacements and prebent plates, which are more stable and resistant to fracture because of metal fatigue. Careful perioperative evaluation is the key to positive outcomes of secondary reconstruction after trauma. The advent of technological tools has played a capital role in helping the surgical team perform a given treatment plan in a more precise and predictable manner.

  20. INCIDENCE OF MAXILLOFACIAL TRAUMA IN SONEPAT (HARYANA, INDIA

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    Malik SUNITA

    2013-03-01

    Full Text Available Background: Maxillofacial injuries represent a therapeutic challenge to oral and maxillofacial surgeons working in emerging countries. This study was carried out to determine the incidence of maxillofacial trauma, clinical management and associated complications. This study highlights the need of oral and maxillofacial surgery along with other disciplines to deliver the emergency services and management to the maxillofacial trauma patients. Patients and Methods: A prospective Medical institute study of maxillofacial injured patients was carried out between September 20122 and December 2012, at the recently founded B.P.S Government Medical College for women, Khanpur kalan, Sonepat, Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed. Results: A total of 462 patients were studied. Males outnumbered females by a ratio of 2.9:1. age range was 9 months to 75 years with the peak incidence occurring in the age group 17-34 years .Most injuries were caused by road traffic accidents (75.8%, followed by assault and falls in 10.6% and 8% respectively. Soft tissue injuries and mandibular fractures were the most common type of injuries. Head/neck (53.1% and limb injuries (28.1% were the most prevalent associated injuries. Surgical debridement and soft tissue suturing (95.1% were the most common surgical procedures. Closed reduction of maxillofacial fractures was employed in 56% of patients, Open reduction and internal fixation was performed in 35% of cases and 9% were managed conservatively. Complications occurred in 3.4% of patients, mainly due to infection and malocclusion. The mean duration of hospital stay was 10.12 ± 6.24 days. Conclusion: This study highlights the importance of Dental surgery department alongwith other disciplinaes in the management of maxillofacial injuries. Moreover there is a need to reinforce legislation aimed to

  1. Radiologic assessment of maxillofacial, mandibular, and skull base trauma

    International Nuclear Information System (INIS)

    Schuknecht, Bernhard; Graetz, Klaus

    2005-01-01

    Cranio-maxillofacial injuries affect a significant proportion of trauma patients either in isolation or concurring with other serious injuries. Contrary to maxillofacial injuries that result from a direct impact, central skull base and lateral skull base (petrous bone) fractures usually are caused by a lateral or sagittal directed force to the skull and therefore are indirect fractures. The traditional strong role of conventional images in patients with isolated trauma to the viscerocranium is decreasing. Spiral multislice CT is progressively replacing the panoramic radiograph, Waters view, and axial films for maxillofacial trauma, and is increasingly being performed in addition to conventional films to detail and classify trauma to the mandible as well. Imaging thus contributes to accurately categorizing mandibular fractures based on location, into alveolar, mandibular proper, and condylar fractures - the last are subdivided into intracapsular and extracapsular fractures. In the midface, CT facilitates attribution of trauma to the categories central, lateral, or combined centrolateral fractures. The last frequently encompass orbital trauma as well. CT is the imaging technique of choice to display the multiplicity of fragments, the degree of dislocation and rotation, or skull base involvement. Transsphenoid skull base fractures are classified into transverse and oblique types; lateral base (temporal bone) trauma is subdivided into longitudinal and transverse fractures. Supplementary MR examinations are required when a cranial nerve palsy occurs in order to recognize neural compression. Early and late complications of trauma related to the orbit, anterior cranial fossa, or lateral skull base due to infection, brain concussion, or herniation require CT to visualize the osseous prerequisites of complications, and MR to define the adjacent brain and soft tissue involvement. (orig.)

  2. MAXILLOFACIAL SOFT TISSUE INJURIES IN NAIROBI, KENYA

    African Journals Online (AJOL)

    2012-09-09

    Sep 9, 2012 ... Conclusion: The leading causes of MF-STIs apparently differ from those of skeletal fractures. INTRODUCTION. Maxillofacial (MF) soft tissue injuries (STIs) are often overlooked in clinical surveys compared to fractures, yet these injuries negatively impact both on function and esthetics. Previous surveys on ...

  3. Isolated tympanic plate fracture frequency and its relationship to mandibular trauma.

    Science.gov (United States)

    Altay, Canan; Erdoğan, Nezahat; Batkı, Ozan; Eren, Erdem; Altay, Sedat; Karasu, Sebnem; Mete, Berna; Uluç, Engin

    2014-11-01

    This study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT). We retrospectively evaluated the maxillofacial CT of 1590 patients who presented to our emergency department with maxillofacial trauma between December 2010 and December 2012. Maxillofacial CT was used as the criterion standard for evaluating patients with maxillofacial fractures. The CT images were evaluated by using an electronic picture archiving and communications system and interpreted independently by 2 radiologists. The maxillofacial CT images revealed mandibular fractures in 167 of the patients and isolated tympanic plate fractures in 35 of these 167 patients. Four patients (11%) had a bilateral tympanic plate fracture, and 31 patients (89%) had unilateral tympanic plate fracture. Of all the tympanic plate fractures, 19 (54%) were on the right side and 16 (46%) were on the left side (P > .05). In our results, a significant correlation between the presence of a right-sided tympanic plate fracture and fracture of the ipsilateral condylar process was found (P = .036). However, a statistically significant difference between the presence of a tympanic plate fracture and other mandible fractures, additional soft-tissue findings, or the number of fractures was not determined (P > .05). Sex had no impact on the presence of tympanic plate fracture (P > .05). The frequency of isolated tympanic plate fractures in maxillofacial trauma is low, but it is an important anatomic location. Condyle fractures are significantly associated with isolated tympanic plate fractures. The presence of these injuries should raise suspicion of a concomitant isolated tympanic plate fracture. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  4. Epidemiological study of facial fractures at the Oral and Maxillofacial Surgery Service, Santa Casa de Misericordia Hospital Complex, Porto Alegre - RS - Brazil

    OpenAIRE

    Zamboni, Rodrigo Andrighetti; Wagner, João Carlos Birnfeld; Volkweis, Maurício Roth; Gerhardt, Eduardo Luis; Buchmann, Elissa Muller; Bavaresco, Caren Serra

    2017-01-01

    ABSTRACT Objectives: to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. Methods: we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. Results: the male gender was the most affected (86.6%) and the incidence was higher in the age group from 21 to 30 yea...

  5. Evaluation results of using sole Ilizarov fixator in Pilon fractures

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    Ahmad Reza Mirbolook

    2014-02-01

    Conclusion: According to the results obtained and comparing them with the results of other treatments ,one can claim that this treating approach is better than the others for pilon fractures,particularly for type 3c pilon fractures.

  6. Four years prospective study of the maxillofacial trauma at a tertiary center in Western Nepal

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    Rajib Khadka

    2014-01-01

    Full Text Available Purpose: This study was conducted to find the epidemiological characteristics of maxillofacial trauma in the Western region of Nepal. Materials and Methods: All the trauma patients attending the Department of Oral and Maxillofacial surgery in 4 years period at a tertiary center in Western Nepal were included in the study. The incidence, prevalence, age and sex distribution, etiologies and types as well as seasonal and daily variation of maxillofacial trauma were studied. Results: Maxillofacial trauma with male (71.55% predominance was seen. Road traffic accidents (RTA, 46.5% were the most common cause, and 41.65% of fracture cases due to RTA were under the influence of alcohol. Accidents were more common on the rural roads (38.9%, and majorities (43.3% were due to motorcycle accidents. They were more common on Friday (36.7% and in winter seasons (51.2%. The mandible fractures (65.85% were more common than midface fractures (53.58% and 19.44% of the fractures were combined fractures. Parasymphysis in mandible (32.16% and zygoma (39.09% in midface were the most common type of fracture. Conclusion: The increased incidence of maxillofacial trauma following RTA under the influence of alcohol noted in this study reveals the need for formulating preventive measures in the Western region of Nepal. Need to aware people to avoid drink and drive proper traffic management, prevention of carrying excessive passengers, especially on the rooftop of vehicles on the highway and disposal of out of date vehicles and timely maintenance of faulty roads is a must.

  7. Treatment results in isolated humerus majus fractures

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    Hakan Serhat Yanık

    2012-09-01

    Full Text Available Introduction: The aim of this study is to evaluate the resultsof patients with the isolated greater tubercul fractures(GTF of humerus who conservatively or surgicallytreated.Materials and methods: 23 patients were admitted (11women, 12 men with GTF (54% dominant side of 24shoulder between 2008 and 2011. All of patient wereevaluated with MRI as preoperatively soft tissue injury.There was supraspinatus muscle tear together with GTFin 3 case and their shoulder were arthroscopically assistedrotator cuff repair. Osteosynthesis was performed in 3case with screw and fixation in 2 case with suture. GTF of16 shoulder were conservatively treated. Shoulder functionafter treatment were evaluated according to Constantscore (CS, Quick-DASH score (QDS and VAS score.Results: Three patients with screw fixation had CS 68,6points, QDS 12,8 points, VAS score 1,66. Two patientswith suture fixation had 67,5 CS points, 5,1 QDS pointsp,and 2 VAS score. Three patients with rotator cuff tear repairhad 82,6 CS points, 16,6 QDS points, and 2,33 VASscore. In patients with conservatively treated mean CSwas 63,9 points, QDS 26,1 points, VAS 2,96 points.Conclusions: In this study, conservative and surgicaltreatment results were satisfactory. In terms of pain theresults were excellent. In conclusion, GTFs are rare buttrouble-free with a good observation and sufficient rehabilitation.J Clin Exp Invest 2012; 3 (3: 378-382Key words: Humerus, fracture, greater, tubercul

  8. Epidemiological study of facial fractures at the Oral and Maxillofacial Surgery Service, Santa Casa de Misericordia Hospital Complex, Porto Alegre - RS - Brazil

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    Rodrigo Andrighetti Zamboni

    Full Text Available ABSTRACT Objectives: to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. Methods: we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. Results: the male gender was the most affected (86.6% and the incidence was higher in the age group from 21 to 30 years. The main etiology was assault (38.8%, followed by motor vehicle accidents (14.2%, motorcycle accidents (13.4%, falls (9%, road accidents (6.7%, sports accidents (5.2%, work accidents (5.2%, firearm injuries (4.5% and cycling accidents (3%. The most frequent fractures were those of the zygomatic complex (44.5%, followed by fractures of the mandible (42.5%, maxillary bone (5.2%, nasal bones (4.5% and zygomatic arch (3.3%. Conclusion: the fractures of the zygomatic complex and the mandible were the ones with the highest incidence in the facial traumas, having physical assaults as their main cause.

  9. Epidemiologic analysis and evaluation of complications in 1266 cases with maxillofacial trauma

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    Cenk Demirdover

    2018-01-01

    Full Text Available Introduction: Patients with maxillofacial trauma represent a major group of patients in plastic surgery practice. These traumas are often caused by in-car and noncar road accidents and can result in permanent damages. This study aims at providing an epidemiologic analysis of such cases together with their diagnostic procedures, treatment methods, and postoperative complications. Materials and Methods: A total of 1266 maxillofacial trauma cases that were operated on between 2003 and 2017 were studied, and analyzed for fractured bones, etiology, diagnosis and treatment principles, and complications. Results: The major etiologic factor causing maxillofacial trauma in our study is noncar road accidents (25.5%. Mandible fractures were seen to be the most common type of bone fracture (52.2%. Together with physical examination, computerized tomography and orthopantomography are the diagnostic procedures we effectively use in our clinic. Rigid and semi-rigid fixation with plate and screws are the most frequently used treatment methods, and complication rates are seen to be lower (by 6.6% than those reported in the literature. Conclusion: Careful and meticulous processes, as well as effective follow-up of the patient are required to achieve optimal esthetic and functional results in maxillofacial trauma cases. Such approach can help to reduce the possibility of complications and allow for their early identification, hence early intervention.

  10. A CURRENT 4-YEARS RETROSPECTIVE SURVEY OF 64 SURGICALLY TREATED ZYGOMA COMPLEX FRACTURES IN DEPARTMENT OF MAXILLO-FACIAL SURGERY, UNIVERSITY HOSPITAL ‘ST. ANNA’, SOFIA, BULGARIA.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-04-01

    Full Text Available Purpose: The goal of this material was to be an example of the complications that can occur in cases of zygoma fractures and to draw the attention of the clinicians to the need of accurate diagnose and early treatment of the associated with zygoma fractures traumas. Materials and methods: Medical records of 276 patients with different traumas in face and neck area treated in our department ware reviewed. Of those 64 suffered from zygoma fractures and they ware classified according to age, sex, cause of trauma, presence or absence of associated trauma, etc.Results: As other studies also show, we determined that the most common cause of injury was assault and road accidents, fallowed by sport, industrial, etc. Males between 20 and 40 years old ware the biggest group of patients, often after alcohol consumption.Associated traumas occurred more frequently in cases of motor vehicle accident than in other cases and ware presented by closed head trauma, ophthalmologic problems, extremities fractures, etc.Conclusion: Delayed treatment of zygoma injuries is feasible and yields in good results when the severity of trauma needs it, but early repair of such injuries prevent late complications and should be preferred when possible.

  11. Patterns, Severity, and Management of Maxillofacial Injuries in a ...

    African Journals Online (AJOL)

    exposure.[3]. The changing etiological factors and patterns of maxillofacial injuries reported .... Ivy and Curtis[13] system while maxillary fractures were classified .... diligence and compliance to keep a good oral hygiene and prevent infection.

  12. First Rib Fracture Resulting in Horner's Syndrome.

    Science.gov (United States)

    Lin, You-Cheng; Chuang, Ming-Tsung; Hsu, Chin-Hao; Tailor, Al-Rahim Abbasali; Lee, Jung-Shun

    2015-12-01

    First rib fractures and traumatic Horner's syndrome are both quite rare, which can make it difficult to properly diagnose the combination of these 2 conditions in the emergency department. These conditions may be associated with severe medical emergencies, such as ongoing carotid dissection. We present the case of a 33-year-old man who sustained fractures to his right second, third, and fourth ribs and a delay in the diagnosis of left Horner's syndrome after he was involved in a traffic accident. Left Horner's syndrome was caused by a left transverse fracture of the first rib. This fracture was not detected on chest radiographs and required a 3-dimensional reconstructed neck computed tomography scan for detection. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In the diagnosis of carotid artery dissection, conventional angiography is the criterion standard but is considered invasive. CTA is less invasive, time-saving, and can show more anatomic structures in the neck in addition to the carotid arteries. It is a good screening diagnostic modality in the traumatology department. Although the treatments for Horner's syndrome and first rib fracture are conservative, the early diagnosis of both conditions can resolve the anxiety and uncertainty experienced by both doctors and patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Update of patient-specific maxillofacial implant.

    Science.gov (United States)

    Owusu, James A; Boahene, Kofi

    2015-08-01

    Patient-specific implant (PSI) is a personalized approach to reconstructive and esthetic surgery. This is particularly useful in maxillofacial surgery in which restoring the complex three-dimensional (3D) contour can be quite challenging. In certain situations, the best results can only be achieved with implants custom-made to fit a particular need. Significant progress has been made over the past decade in the design and manufacture of maxillofacial PSIs. Computer-aided design (CAD)/computer-aided manufacturing (CAM) technology is rapidly advancing and has provided new options for fabrication of PSIs with better precision. Maxillofacial PSIs can now be designed using preoperative imaging data as input into CAD software. The designed implant is then fabricated using a CAM technique such as 3D printing. This approach increases precision and decreases or completely eliminates the need for intraoperative modification of implants. The use of CAD/CAM-produced PSIs for maxillofacial reconstruction and augmentation can significantly improve contour outcomes and decrease operating time. CAD/CAM technology allows timely and precise fabrication of maxillofacial PSIs. This approach is gaining increasing popularity in maxillofacial reconstructive surgery. Continued advances in CAD technology and 3D printing are bound to improve the cost-effectiveness and decrease the production time of maxillofacial PSIs.

  14. Early results and future challenges of the Danish Fracture Database

    DEFF Research Database (Denmark)

    Gromov, Kirill; Brix, Michael; Kallemose, Thomas

    2014-01-01

    INTRODUCTION: The Danish Fracture Database (DFDB) was established in 2011 to establish nationwide prospective quality assessment of all fracture-related surgery. In this paper, we describe the DFDB's setup, present preliminary data from the first annual report and discuss its future potential...... are registered. Indication for reoperation is also recorded. The reoperation rate and the one-year mortality are the primary indicators of quality. RESULTS: Approximately 10,000 fracture-related surgical procedures were registered in the database at the time of presentation of the first annual DFDB report...... of osteosynthesis were the three most common indications for reoperation and accounted for 34%, 14% and 13%, respectively. CONCLUSION: The DFDB is an online database for registration of fracture-related surgery that allows for basic quality assessment of surgical fracture treatment and large-scale observational...

  15. Approach to the fracture hydrology at Stripa: preliminary results

    International Nuclear Information System (INIS)

    Gale, J.E.; Witherspoon, P.A.

    1979-05-01

    There are two main problems associated with the concept of geologic storage of radioactive waste in fractured crystalline rock: (1) the thermo-mechanical effects of the heat generated by the waste, and (2) the potential for transport of radioactive materials by the groundwater system. In both problems, fractures play a dominant role. An assessment of the hydraulic and mechanical characteristics of fractued rock requires a careful series of laboratory and field investigations. The complexity of the problem is illustrated by the field studies in a fractured granite that are currently underway in an abandoned iron-ore mine at Stripa, Sweden. Much information is being gathered from an extensive series of boreholes and fracture maps. The approach being taken to integrate these data into an analysis of the fracture hydrology is reviewed and preliminary results from the hydrology program are presented. 13 figures

  16. Maxillofacial trauma: managing potentially dangerous and disfiguring complex injuries [digest].

    Science.gov (United States)

    Das, Devjani; Salazar, Lea; Zaurova, Milana

    2017-04-22

    Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face. In addition to an overall review of maxillofacial trauma pathophysiology, associated injuries, and physical examination, this review will also discuss relevant imaging, treatment, and disposition plans. [Points & Pearls is a digest of Emergency Medicine Practice].

  17. Consensus or controversy? The classification and treatment decision-making by 491 maxillofacial surgeons from around the world in three cases of a unilateral mandibular condyle fracture

    NARCIS (Netherlands)

    Kommers, S.C.; Boffano, P.; Forouzanfar, T.

    2015-01-01

    Purpose Many studies are available in the literature on both classification and treatment of unilateral mandibular condyle fractures. To date however, controversy regarding the best treatment for unilateral mandibular condyle fractures remains. Material and methods In this study, an attempt was made

  18. Prevalence and patterns of combat sport related maxillofacial injuries

    Directory of Open Access Journals (Sweden)

    Shirani Gholamreza

    2010-01-01

    Full Text Available Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc., site of facial injury (jaw, nose, malar bone, teeth, etc., dental injuries (tooth fracture, displacement, luxation, and avulsion, causative sport (boxing, taekwondo, kickboxing, and Muay Thai as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and c2 , ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Results: Of 120 subjects, 95 male subjects (79.2%, aged 18-25 years (avg. 20 years, had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma, dental injuries (displacement, luxation, fracture, and avulsion, and mandibular dislocation which were recorded in 83 (69.2%, 55 (45.1%, 53 (44.2%, and 8 (6.7% cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7% were the most common dental injuries, and the nose (84.7% was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%. Injuries were significantly greater in professional rather

  19. Smartphone photography in oral and maxillofacial surgery.

    Science.gov (United States)

    Jamil, F

    2016-01-01

    An increasing number of staff in oral and maxillofacial surgery (OMFS) departments take clinical photographs with their personal phones. We report the results of a survey on the use of smartphone photography in OMFS departments in the United Kingdom, and highlight the guidelines that govern their use and the associated ethical and medicolegal implications. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Negative Pressure Wound Therapy in Maxillofacial Applications

    Directory of Open Access Journals (Sweden)

    Adam J. Mellott

    2016-09-01

    Full Text Available Negative pressure wound therapy has greatly advanced the field of wound healing for nearly two decades, by providing a robust surgical adjunct technique for accelerating wound closure in acute and chronic wounds. However, the application of negative pressure wound therapy in maxillofacial applications has been relatively under utilized as a result of the physical articulations and contours of the head and neck that make it challenging to obtain an airtight seal for different negative pressure wound therapy systems. Adapting negative pressure wound therapies for maxillofacial applications could yield significant enhancement of wound closure in maxillofacial applications. The current review summarizes the basic science underlying negative pressure wound therapy, as well as specific maxillofacial procedures that could benefit from negative pressure wound therapy.

  1. Maxillofacial trauma due to work-related accidents.

    Science.gov (United States)

    Hächl, O; Tuli, T; Schwabegger, A; Gassner, R

    2002-02-01

    Even though numerous reports on maxillofacial trauma exist, only a few give detailed information about work-related maxillofacial injuries. The purpose of this study was to reveal the significance of maxillofacial injuries related to accidents occurring at work by evaluating a large number of patients with maxillofacial injuries over a 9-year period. Out of the 8704 trauma patients treated between 1991 and 1999 in the Department of Oral and Maxillofacial Surgery at the University of Innsbruck, Austria, 463 (5.4%) were injured at work. All charts were reviewed and analyzed according to age, gender, cause of accident, occupation, type of injury, location and frequency of fractures. The highest incidence of maxillofacial injury was found among construction workers (a total of 124 patients, 26.8%), followed by craftsmen (102 patients, 22.0%) and office employees (69 patients, 14.9%). The sex distribution showed an overall male-to-female ratio of 11.8:1 and those in the age group most affected were between 20 and 29 years of age. The most frequent cause of injury was a blow in 48.4%, followed by falls and falls over obstacles, accounting for 27.9% and 7.1%, respectively. Of all trauma, 45.4% (210 persons) sustained 423 maxillofacial fractures, 31.7% (147 patients) suffered 232 dento-alveolar injuries, and 21.2% (98 people) showed 430 soft-tissue injuries. One-fifth (20.7%) of all patients displayed concomitant injuries with cerebral and cranial trauma being the most common. The probability of sustaining maxillofacial trauma at work is correlated to the nature of the occupation. Individuals (mostly men) using tools or machines at work are exposed to a much higher risk of work-related maxillofacial trauma.

  2. Epidemiological study of facial fractures at the Oral and Maxillofacial Surgery Service, Santa Casa de Misericordia Hospital Complex, Porto Alegre - RS - Brazil.

    Science.gov (United States)

    Zamboni, Rodrigo Andrighetti; Wagner, João Carlos Birnfeld; Volkweis, Maurício Roth; Gerhardt, Eduardo Luis; Buchmann, Elissa Muller; Bavaresco, Caren Serra

    2017-01-01

    to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. the male gender was the most affected (86.6%) and the incidence was higher in the age group from 21 to 30 years. The main etiology was assault (38.8%), followed by motor vehicle accidents (14.2%), motorcycle accidents (13.4%), falls (9%), road accidents (6.7%), sports accidents (5.2%), work accidents (5.2%), firearm injuries (4.5%) and cycling accidents (3%). The most frequent fractures were those of the zygomatic complex (44.5%), followed by fractures of the mandible (42.5%), maxillary bone (5.2%), nasal bones (4.5%) and zygomatic arch (3.3%). the fractures of the zygomatic complex and the mandible were the ones with the highest incidence in the facial traumas, having physical assaults as their main cause.

  3. Fracture/matrix flow experiments results

    International Nuclear Information System (INIS)

    Constantino, M S; Wildenschild, D; Roberts, J J; Kneafsey, T J; Lin, W

    1998-01-01

    The impact of vapor diffusion and its potential enhancement are of concern with respect to the performance of the potential nuclear waste repository at Yucca Mountain. Under non-isothermal conditions, such as those prevailing in the near-field environment, gas-phase diffusion of water vapor (a condensable component) may be enhanced as compared to isothermal conditions. Two main phenomena are responsible for this enhancement (Philip and DeVries 1957, p. 226). Normally, diffusive transport of water vapor is obstructed by the presence of liquid islands in the pore throats, and diffusion is reduced at higher saturations. However, under a thermal gradient, a vapor-pressure gradient develops in the gas phase, causing water to evaporate from one side of the liquid island and to diffuse in the gas phase to a liquid island of lower temperature, where it condenses (Figure 1). Water flows through the liquid island as a result of differences in meniscus curvature between the two sides. This difference is caused by the temperature gradient between the liquid-vapor interfaces on the two ends of the liquid island. The evaporation-condensation process repeats itself on the other side of the liquid island; the result is an enhanced diffusive flux through the medium

  4. Frequency of Maxillofacial Injuries Among Athletes-Members of Various Sports Federations in Iranform 1998-2001

    Directory of Open Access Journals (Sweden)

    H Mahmoud Hasehmi

    2003-02-01

    Full Text Available Nowadays, sport injuries constitute a major part of social accidents. The aim of the presentstudy, was to investigate the frequency of maxillofacial injuries among athletes-members of differentsports federations in Iran from 1998-2001. For this reason files which was related to sport injuries of men and women athletes-members of sports federations were studied in Medical Federation of the Islamic Republic of Iran Sports Organization. The information were received through 26 medical organizations,located in different states of the country. The results showed that maxillofacial injuries constitute the major part of the sports injuries. In male athletes, football was the most important cause for maxillofacial injuries. However, mountain climbing and skiing play the least role in this field. Among female athletes,karate was the cause of the highest rate of maxillofacial sport injuries. Diving, mountain climbing and skiing cause the least number of maxillofacial accidents. Nasal fracture was the most common sport injury among Iraninan male and female athletes.

  5. Occupational Maxillofacial Trauma: Report of a Rare Case

    Directory of Open Access Journals (Sweden)

    Dervisoglou Theodoros

    2015-03-01

    Full Text Available Maxillofacial trauma, any physical trauma in the face, can involve soft tissues (lacerations, avulsions, bruises etc, bone injuries (fractures and dislocation, avulsed or fractured teeth (dental issues and special regions (nerves, eyes, salivary glands etc. As the most exposed part of the human body, the face can be susceptible to injuries in work-related accidents. Occupational accident in the maxillofacial region rates 0.9-5% and, in some cases, can reach 9%. Based on their occupation, patients are classified as farm and forestry workers, construction workers, factory workers, craftsmen, service workers, and office workers.

  6. Conservative orthodontic treatment of mandibular bilateral condyle fracture.

    Science.gov (United States)

    Gašpar, Goran; Brakus, Ivan; Kovačić, Ivan

    2014-09-01

    Maxillofacial trauma is rare in children younger than the age of 5 years (range 0.6%-1.2%), and they can require different clinical treatment strategies compared with fractures in the adult population because of concerns regarding mandibular growth and development of dentition. A 5-year-old girl with a history of falling from a bicycle 7 hours earlier was referred to the department of oral and maxillofacial surgery. Multislice computed tomographic examination demonstrated a bilateral fracture of the mandibular condyle neck associated with minimal fracture of the alveolar ridge of the maxilla. The multislice computed tomographic scan also demonstrated dislocation on the right condyle neck and, on the left side, a medial inclination of approximately 45 degrees associated with greenstick fracture of the right parasymphysis region. In this particular case, orthodontic rubber elastics in combination with fixed orthodontic brackets provided good results in the treatment of bilateral condyle neck fractures associated with greenstick fracture of parasymphysis.

  7. Etiology and pattern of maxillofacial injuries in the armed forces of pakistan

    International Nuclear Information System (INIS)

    Khan, S.U.; Khan, M.; Khan, A.A.; Maqsood, A.; Ibrahim, W.; Wasim, A.

    2007-01-01

    To determine the etiology and pattern of maxillofacial injuries in the Armed Forces of Pakistan in terms of anatomical distribution of injuries. Three hundred consecutive patients of Armed Forces of Pakistan with maxillofacial injuries reporting to AFID and admitted to the hospital or treated as out-patients in the oral surgery clinic, were included in this study. Isolated nasal bone and frontal sinus fractures were excluded from the study. Anatomical distribution, frequency and etiology of fractures, rank at job and occupational as well as personal hobbies were recorded. Descriptive analyses were used to determine mean, standard deviation, percentage and range values. The most frequent bone fractured was the mandible, which accounted for 159 cases (53%). The zygomatic complex was fractured in 51 cases (17%), the maxilla in 12 cases (4 %), and the alveolar process in 21 cases (7%). The most common cause was road traffic accident (168 cases; 56%), followed by accidental fall (69 cases; 23%), gunshot injuries (27 cases; 9%), sports related injuries (15 cases; 5%), and injury associated with a fight (12 cases; 4%); there were only 9 cases of animals related injuries (3%). In this series, mandible was the most commonly fractured facial bone, while road traffic accident was the most common etiological factor. Results could be influenced by the personal and working environment. (author)

  8. Airway management in patients with maxillofacial trauma - A retrospective study of 177 cases

    Directory of Open Access Journals (Sweden)

    Chetan B Raval

    2011-01-01

    Full Text Available Background: Airway management in maxillofacial injuries presents with a unique set of problems. Compromised airway is still a challenge to the anesthesiologist in spite of all modalities available. Maxillofacial injuries are the result of high-velocity trauma arising from road traffic accidents, sport injuries, falls and gunshot wounds. Any flaw in airway management may lead to grave morbidity and mortality in prehospital or hospital settings and as well as for reconstruction of fractures subsequently. Methods: One hundred and seventy-seven patients of maxillofacial injuries, operated over a period of one and half years during July 2008 to December 2009 in Al-Nahdha hospital were reviewed. All patients were reviewed in depth with age related type of injury, etiology and techniques of difficult airway management. Results: The major etiology of injuries were road traffic accidents (67% followed by sport (15% and fall (15%. Majority of patients were young in the age group of 11-30 years (71 %. Fracture mandible (53% was the most common injury, followed by fracture maxilla (21%, fracture zygoma (19% and pan-facial fractures (6%. Maxillofacial injuries compromise mask ventilation and difficult airway due to facial fractures, tissue edema and deranged anatomy. Shared airway with the surgeon needs special attention due to restrictions imposed during surgery. Several methods available for securing the airway, both decision-making and performance, are important in such circumstances. Airway secured by nasal intubation with direct visualization of vocal cords was the most common (57%, followed by oral intubation (17%. Other methods like tracheostomy and blind nasal intubation was avoided by fiberoptic bronchoscopic nasal intubation in 26% of patients. Conclusion: The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the

  9. Results of fracture mechanics tests on PNC SUS 304 plate

    International Nuclear Information System (INIS)

    Mills, W.J.; James, L.A.; Blackburn, L.D.

    1985-08-01

    PNC provided SUS 304 plate to be irradiated in FFTF at about 400 0 C to a target fluence of 5 x 10 21 n/cm 2 (E > 0.1 MeV). The actual irradiation included two basically different exposure levels to assure that information would be available for the exposure of interest. After irradiation, tensile properties, fatigue-crack growth rates and J-integral fracture toughness response were determined. These same properties were also measured for the unirradiated material so radiation damage effects could be characterized. This report presents the results of this program. It is expected that these results would be applicable for detailed fracture analysis of reactor components. Recent advances in elastic-plastic fracture mechanics enable reasonably accurate predictions of failure conditions for flawed stainless steel components. Extensive research has focused on the development of J-integral-based engineering approach for assessing the load carrying capacity of low-strength, high-toughness structural materials. Furthermore, Kanninen, et al., have demonstrated that J-integral concepts can accurately predict the fracture response for full-scale cracked structures manufactured from Type 304 stainless steel

  10. FRACTURES OF THE FIFTH METATARSAL RESULTS OF THE EARLY OPERATIVE TREATMENT OF ACUTE DISPLACED FRACTURES

    Directory of Open Access Journals (Sweden)

    Slaviša Mihaljević

    2004-04-01

    Full Text Available Background. Fracture of the proximal 5th metatarsal bone (MTB reach almost 2% of all fractures of the foot. Conservative treatment is method of choice in almost all cases. Selected cases can benefit from acute surgery especially if the proximal fragment is severe displaced or the excessive articular step off is present.Materials and methods. In a 4 year period 14 patients were operated due to the acute fracture of proximal 5th MTB. All patients were treated in less than 2 weeks after the injury. 10 patients had base avulsion fracture in zone I and 4 had Jones fracture in zone II with dislocation of fragments? 5 mm, articular step off of 2 mm and 30% of articulation surface. We used tension bend wire in 9 cases (64%, partially threaded cancellous screw in 4 cases (28% and bone sutures in 1 case (7%. Postoperatively all patients used crutches with nonweight bearing for 4 weeks and afterwards partial weight bearing till the end of the treatment. All patients were practicing active exercises for ankle, foot and toes. The results were evaluated according to the Maryland Foot Score (MFS at least 20 months after injury.Results. 13 patients (93% were included in follow up. 12 patients were evaluated as excellent and only one as a good. All 13 patients have no or slight pain with no change in ADL or work ability. 9 patients (69% reached full functional result and 4 (31% patients had slight limitation during distance walk. Patients reached full weight bearing in average 7 weeks (5–13.Conclusions. Early operative treatment of selected cases allows fast return to preoperative activity without long term functional sequel. Both operative procedures, screw fixation and tension wire, yielded comparable and excellent end result.

  11. Maxillofacial prostheses challenges in resource constrained regions.

    Science.gov (United States)

    Tetteh, Sophia; Bibb, Richard J; Martin, Simon J

    2017-10-24

    This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities. Implications for Rehabilitation More information and support needs to be provided to maxillofacial defect/injuries patients and to their families or guardians in a culturally sensitive manner by governments. The health needs, economic and psychological needs of the patients need to be taken into account during the rehabilitation process by clinicians and healthcare organizations. The possibility of developing training programs to suit these resource limited countries and not necessarily follow conventional fabrication methods must be looked into further by educational entities.

  12. The IPIRG-1 pipe system fracture tests: Experimental results

    International Nuclear Information System (INIS)

    Scott, P.; Olson, R.J.; Wilkowski, G.M.

    1994-01-01

    As part of the First International Piping Integrity Research Group (IPIRG-1) program, six dynamic pipe system experiments were conducted. The objective of these experiments was to generate experimental data to assess analysis methodologies for characterizing the fracture behavior of circumferentially cracked pipe in a representative piping system subjected to combined inertial and displacement-controlled stresses. A unique experimental facility was designed and constructed. The pipe system evaluated was an expansion loop with over 30 m (100 feet) of 16-inch nominal diameter Schedule 100 pipe. The experimental facility was equipped with special hardware to ensure that system boundary conditions could be appropriately modeled. The test matrix involved one uncracked and five cracked dynamic pipe system experiments. The uncracked-pipe experiment was conducted to evaluate the piping system damping and natural frequency characteristics. The cracked-pipe experiments were conducted to evaluate the fracture behavior, piping system response, and fracture stability characteristics of five different materials. All cracked-pipe experiments were conducted at PWR conditions. Material characterization efforts provided the tensile and fracture toughness properties of the different pipe materials at various strain rates and temperatures. Key results from the six pipe system experiments and material characterization efforts are presented. Detailed analyses will be published in a companion paper

  13. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients

    NARCIS (Netherlands)

    van den Bergh, B.; Karagozoglu, K.H.; Heijmans, M.W.; Forouzanfar, T.

    2012-01-01

    Introduction: The incidence of maxillofacial fractures varies widely between different countries. The large variability in reported incidence and aetiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. This retrospective report presents a

  14. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients

    NARCIS (Netherlands)

    van den Bergh, B.; Karagozoglu, K.H.; Heymans, M.W.; Forouzanfar, T.

    2012-01-01

    Introduction The incidence of maxillofacial fractures varies widely between different countries. The large variability in reported incidence and aetiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. This retrospective report presents a

  15. Tensile and fracture toughness test results of neutron irradiated beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Chaouadi, R.; Moons, F.; Puzzolante, J.L. [Centre d`Etude de l`Energie Nucleaire, Mol (Belgium)

    1998-01-01

    Tensile and fracture toughness test results of four Beryllium grades are reported here. The flow and fracture properties are investigated by using small size tensile and round compact tension specimens. Irradiation was performed at the BR2 material testing reactor which allows various temperature and irradiation conditions. The fast neutron fluence (>1 MeV) ranges between 0.65 and 2.45 10{sup 21} n/cm{sup 2}. In the meantime, un-irradiated specimens were aged at the irradiation temperatures to separate if any the effect of temperature from irradiation damage. Test results are analyzed and discussed, in particular in terms of the effects of material grade, test temperature, thermal ageing and neutron irradiation. (author)

  16. Reasonable application of antibiotic prophylaxis in maxillofacial trauma: Literature review

    Directory of Open Access Journals (Sweden)

    Afshin Yadegari Naeeni

    2016-07-01

    Full Text Available Background and Aims: Despite advances in trauma management, treatment of the consequent infections has remained a major challenge. Antibiotic prophylaxis has been widely applied to reduce such infections. Although bacteria are present in most body parts, severe infections after treatment are less frequent in the head and neck of healthy individuals. The aim of the present study was to review the reasonable application of antibiotic prophylaxis in maxillofacial trauma. Materials and Methods: In this review article, PubMed and Google Scholar databases were searched for studies on antibiotic prophylaxis in maxillofacial trauma published during 2000-2014. Conclusion: Antibiotics were not prescribed for tears and small clean wounds in the face and mouth. However, prophylaxis was applied for extensive mouth injuries which involved the facial skin. In case of maxillofacial fractures, 24-hour administration of antibiotics sufficed for compound fractures of the mandible and other parts of the face. Antibiotics were not required in other types of fractures. Prophylaxis should be applied over short pre- or post-operative periods based on the severity and complexity of maxillofacial fractures and their relations with intra- and extraoral environments. Apparently, more detailed studies are warranted to further clarify the subject.

  17. Current concepts in maxillofacial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Boeddinghaus, Rudolf [Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008 (Australia)], E-mail: rboeddinghaus@perthradclinic.com.au; Whyte, Andy [Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008 (Australia)], E-mail: awhyte@perthradclinic.com.au

    2008-06-15

    A review of state-of-the-art maxillofacial imaging is presented. Current imaging techniques include intra-oral radiographs, dental panoramic tomography, multidetector helical computed tomography, cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI). The commonest conditions encountered in clinical radiological practice are reviewed, including maxillofacial deformities, complicated dental impactions, maxillofacial trauma, jaw lesions (cysts, neoplasms, fibro-osseous lesions (FOLs) and infections), and temporomandibular joint pathology. Pre-operative assessment for dental implant placement is also briefly reviewed.

  18. Dental student perceptions of oral and maxillofacial surgery as a specialty.

    Science.gov (United States)

    Jarosz, Krystian F; Ziccardi, Vincent B; Aziz, Shahid R; Sue-Jiang, Shuying

    2013-05-01

    The specialty of oral and maxillofacial surgery (OMS) encompasses the diagnosis and surgical management of a variety of pathologic, functional, and esthetic conditions of the oral and maxillofacial region. Despite the specialty's prominent role in the field of dentistry, a lack of complete understanding still remains among dental and medical health professionals as to the exact scope and expertise of the oral and maxillofacial surgeon. The present study aimed to analyze a population of dental students' perceptions of OMS as a specialty with respect to treatment rendered, referral patterns, and a general opinion of the specialty as a whole. A survey consisting of 10 multiple-choice questions was compiled and distributed to dental students through an on-line polling service (SurveyMonkey). A total of 5 dental student classes at a single dental school were polled using school-based electronic mail, including the graduating seniors. All answers were kept confidential, and no individual students were identified. The students were not able to retake the survey once completed. The final tallies of the survey results were compiled and submitted for statistical analysis. Statistically significant associations between the year of dental education and student perceptions of OMS were determined. As dental students progress through their undergraduate studies, their perceptions change with regard to the referral of dental implants. Periodontists were found to have statistically significantly greater rates of referral than oral and maxillofacial surgeons from dental students in the fourth year and recent graduates compared with younger dental students from the first, second, and third years for placement of dental implants. Statistically insignificant in terms of a changing dental student perception was the finding that third molar removal was within the domain of the oral and maxillofacial surgeon, as well as the management of cleft lip and palate deformities and mandibular

  19. Review of Maxillofacial Hardware Complications and Indications for Salvage

    OpenAIRE

    Hernandez Rosa, Jonatan; Villanueva, Nathaniel L.; Sanati-Mehrizy, Paymon; Factor, Stephanie H.; Taub, Peter J.

    2015-01-01

    From 2002 to 2006, more than 117,000 facial fractures were recorded in the U.S. National Trauma Database. These fractures are commonly treated with open reduction and internal fixation. While in place, the hardware facilitates successful bony union. However, when postoperative complications occur, the plates may require removal before bony union. Indications for salvage versus removal of the maxillofacial hardware are not well defined. A literature review was performed to identify instances w...

  20. Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study.

    Science.gov (United States)

    Wang, Hongwei; Yu, Hailong; Zhou, Yue; Li, Changqing; Liu, Jun; Ou, Lan; Zhao, Yiwen; Song, Guoli; Han, Jianda; Chen, Yu; Xiang, Liangbi

    2017-09-01

    The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height fractures in total and 92 patients (6.5%) presented with multiple fractures. The most common fracture sites were upper extremity fractures in 814 patients (57.6%) and lower extremity fractures in 383 patients (27.1%), followed by craniofacial fractures in 233 patients (16.5%). A total of 231 (16.4%) patients suffered a nerve injury. The frequencies of early and late complications/associated injuries were 19.5% (n = 275) and 9.2% (n = 130). The frequencies of emergency admission, nerve injury, spinal fracture, lower extremity fractures, craniofacial fracture, sternum and rib fracture, and early complications/ASOIs were significantly larger in high fall than low fall (all P fractures (P fracture (P = .039), lower extremity fractures (P = .048), and craniofacial fracture (P = .041) were significantly larger in female than the male patients. The frequency of upper extremity fractures (P fracture, and craniofacial fracture were significantly larger in patients with nerve injury than other patients without nerve injury (all P fractures were the most common etiologies and sites, respectively. High fall, spinal fracture and craniofacial fracture were risk factors for nerve injury. Therefore, we should focus on patients who were caused by high fall and presented with spinal and craniofacial fracture to determine the presence of a nerve injury so that we can provide early, timely diagnosis and targeted treatment to children.

  1. Results of Scientific and Technical Supervision of Hydraulic Fracturing Operations

    Directory of Open Access Journals (Sweden)

    I.Kh. Makhmutov

    2017-11-01

    Full Text Available The paper presents actual results of the research conducted as part of a field pilot project which consisted in interpretation of minifrac test data and evaluation of the efficiency of the scientific and technical supervision of fracking operations. The research program involved 11 wells targeting Devonian terrigenous reservoirs. Minifrac tests in one perforation interval were performed only in seven wells, that is approximately in 64% of total well count. A reliable fracture closure estimate was obtained only in six wells (55%, beginning of pseudoradial flow was observed only in one well out of 11 wells (9%. Hence, conventional minifrac tests should be supplemented with other diagnostic injection tests. Analysis of the performance of hydraulic fracturing operations conducted according to this pilot project plan indicates that fracture modelling, and scientific and technical supervision of fracking operations performed by Hydrofrac Research Laboratory of Institute TatNIPIneft Tatneft PJSC have yielded beneficial effects, namely 1.44 times increase in oil production rates.

  2. Rib fractures predict incident limb fractures: results from the European prospective osteoporosis study.

    Science.gov (United States)

    Ismail, A A; Silman, A J; Reeve, J; Kaptoge, S; O'Neill, T W

    2006-01-01

    Population studies suggest that rib fractures are associated with a reduction in bone mass. While much is known about the predictive risk of hip, spine and distal forearm fracture on the risk of future fracture, little is known about the impact of rib fracture. The aim of this study was to determine whether a recalled history of rib fracture was associated with an increased risk of future limb fracture. Men and women aged 50 years and over were recruited from population registers in 31 European centres for participation in a screening survey of osteoporosis (European Prospective Osteoporosis Study). Subjects were invited to complete an interviewer-administered questionnaire that included questions about previous fractures including rib fracture, the age of their first fracture and also the level of trauma. Lateral spine radiographs were performed and the presence of vertebral deformity was determined morphometrically. Following the baseline survey, subjects were followed prospectively by annual postal questionnaire to determine the occurrence of clinical fractures. The subjects included 6,344 men, with a mean age of 64.2 years, and 6,788 women, with a mean age of 63.6 years, who were followed for a median of 3 years (range 0.4-5.9 years), of whom 135 men (2.3%) and 101 women (1.6%) reported a previous low trauma rib fracture. In total, 138 men and 391 women sustained a limb fracture during follow-up. In women, after age adjustment, those with a recalled history of low trauma rib fracture had an increased risk of sustaining 'any' limb fracture [relative hazard (RH)=2.3; 95% CI 1.3, 4.0]. When stratified by fracture type the predictive risk was more marked for hip (RH=7.7; 95% CI 2.3, 25.9) and humerus fracture (RH=4.5; 95% CI 1.4, 14.6) than other sites (RH=1.6; 95% CI 0.6, 4.3). Additional adjustment for prevalent vertebral deformity and previous (non-rib) low trauma fractures at other sites slightly reduced the strength of the association between rib fracture and

  3. Mandible Fractures.

    Science.gov (United States)

    Pickrell, Brent B; Serebrakian, Arman T; Maricevich, Renata S

    2017-05-01

    Mandible fractures account for a significant portion of maxillofacial injuries and the evaluation, diagnosis, and management of these fractures remain challenging despite improved imaging technology and fixation techniques. Understanding appropriate surgical management can prevent complications such as malocclusion, pain, and revision procedures. Depending on the type and location of the fractures, various open and closed surgical reduction techniques can be utilized. In this article, the authors review the diagnostic evaluation, treatment options, and common complications of mandible fractures. Special considerations are described for pediatric and atrophic mandibles.

  4. Early results and future challenges of the Danish Fracture Database

    DEFF Research Database (Denmark)

    Gromov, K.; Brix, Michael; Kallemose, T.

    2014-01-01

    INTRODUCTION: The Danish Fracture Database (DFDB) was established in 2011 to establish nationwide prospective quality assessment of all fracture-related surgery. In this paper, we describe the DFDB's setup, present preliminary data from the first annual report and discuss its future potential...... of osteosynthesis were the three most common indications for reoperation and accounted for 34%, 14% and 13%, respectively. CONCLUSION: The DFDB is an online database for registration of fracture-related surgery that allows for basic quality assessment of surgical fracture treatment and large-scale observational...

  5. CT of maxillofacial injury

    International Nuclear Information System (INIS)

    DeLaPaz, R.; Brant-Zawadzki, M.; Rowe, L.D.

    1986-01-01

    Computed tomography has the ability to evaluate maxillofacial trauma quickly. The well-known contrast resolution capabilities of CT play a role in the usefulness of this modality. However, it is the image manipulation capability which is of singular advantage in these cases. The spatial resolution of computed tomography has matched that of conventional pluridirectional tomography in current generation equipment. Since a set of axial CT sections can be obtained with automatic table incrementation within 12 minutes, the information content per time of study ratio is improved over that of conventional tomography, despite the fact that image reformation requires extra time on the part of the radiologist. Radiation savings are significantly in favor of computed tomography as well. In the authors' experience, computed tomography is the primary diagnostic imaging modality used in the evaluation of complex facial trauma, after routine screening films are obtained

  6. Quantitative MR imaging in fracture dating--Initial results.

    Science.gov (United States)

    Baron, Katharina; Neumayer, Bernhard; Widek, Thomas; Schick, Fritz; Scheicher, Sylvia; Hassler, Eva; Scheurer, Eva

    2016-04-01

    For exact age determinations of bone fractures in a forensic context (e.g. in cases of child abuse) improved knowledge of the time course of the healing process and use of non-invasive modern imaging technology is of high importance. To date, fracture dating is based on radiographic methods by determining the callus status and thereby relying on an expert's experience. As a novel approach, this study aims to investigate the applicability of magnetic resonance imaging (MRI) for bone fracture dating by systematically investigating time-resolved changes in quantitative MR characteristics after a fracture event. Prior to investigating fracture healing in children, adults were examined for this study in order to test the methodology for this application. Altogether, 31 MR examinations in 17 subjects (♀: 11 ♂: 6; median age 34 ± 15 y, scanned 1-5 times over a period of up to 200 days after the fracture event) were performed on a clinical 3T MR scanner (TimTrio, Siemens AG, Germany). All subjects were treated conservatively for a fracture in either a long bone or in the collar bone. Both, qualitative and quantitative MR measurements were performed in all subjects. MR sequences for a quantitative measurement of relaxation times T1 and T2 in the fracture gap and musculature were applied. Maps of quantitative MR parameters T1, T2, and magnetisation transfer ratio (MTR) were calculated and evaluated by investigating changes over time in the fractured area by defined ROIs. Additionally, muscle areas were examined as reference regions to validate this approach. Quantitative evaluation of 23 MR data sets (12 test subjects, ♀: 7 ♂: 5) showed an initial peak in T1 values in the fractured area (T1=1895 ± 607 ms), which decreased over time to a value of 1094 ± 182 ms (200 days after the fracture event). T2 values also peaked for early-stage fractures (T2=115 ± 80 ms) and decreased to 73 ± 33 ms within 21 days after the fracture event. After that time point, no

  7. Results of Operative Fixation of Fractures of the Ankle at a Tertiary ...

    African Journals Online (AJOL)

    Background: Operative fixation of ankle fractures is becoming popular in developing countries. The concern however is the outcome of care. The objective was to evaluate the results of open reduction and internal fixation (ORIF) of fractures of the ankle in our hospital. Methods: All cases ORIF of fractures of the ankle at the ...

  8. Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample

    Directory of Open Access Journals (Sweden)

    José Luiz Rodrigues Leles

    2010-02-01

    Full Text Available BACKGROUND: Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries. OBJECTIVE: The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil. MATERIAL AND METHODS: A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76% male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. RESULTS: The main causes of trauma were traffic accidents (45.7% and physical assaults (24.3%, and differences in etiological factors were identified according to gender (p<0.001. The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01, physical assaults (p<0.001, falls (p<0.001 and sport injuries (p<0.01. In the multinomial logistic regression analysis (R² = 0.233; p<0.05, age was associated with injury in traffic accidents and falls (p<0.01, sports-related accidents were associated with males (p<0.05, and alcohol consumption with assaults and traffic accidents (p<0.001. Facial soft tissue lesions were found in 98% of patients and facial fractures in 51%. CONCLUSIONS: The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group.

  9. Freeze dried bone allografts in dental and maxillofacial reconstructive surgery - experience in Malaysia

    International Nuclear Information System (INIS)

    Abd Rani Samsudin; Meor Zaidi Meor Kamal

    1999-01-01

    The utilisation of vascularised and free bone autografts remain the goal standard in maxillofacial reconstructive surgery in Malaysia, but the use of freeze dried bone allograft is still widely practiced in many centres with variable results. This study evaluate the effectiveness and clinical efficacy of using radiation sterilised freeze dried bone allografts in oral and maxillofacial reconstructive surgery. The bone grafts were prepared at the Malaysian National Tissue Bank. Seventy eight patients who had undergone oral and Maxillofacial surgical procedures with reconstruction using bone allografts were included in this study. 50 patients were male and 28 patients were female and their age ranged from 14 to 75 years. Forty two patients underwent enucleation of benign cystic lesions in the jaws, 15 patients underwent repair of orbital floor fractures, 6 patients of jaw fractures with partial loss of bone while 8 patients underwent augmentation of depressed cheek bone. Another 4 patients had partial resection of the mandible because of cancer and 3 patients had facial osteotomies. A follow up period of 12 months up to 4 years was carried out. The patients were assessed both clinically and radiologically throughout their follow up visits. Clinical assessment showed no evidence of rejection of the implanted freeze dried allografts. Bone allografts implanted as inlay grafts demonstrated a better clinical performance than onlay grafts and the poorest results were obtained following bridging bony defects in the jaws. Radiation sterilised freeze dried bone allografts produced at the Malaysian National Tissue Bank are bio-compatible, functional, and provide predictable results when applied to selected areas of the facial skeleton

  10. KNOWLEDGE GAPS IN ORAL AND MAXILLOFACIAL SURGERY

    DEFF Research Database (Denmark)

    Österberg, Marie; Holmlund, Anders; Sunzel, Bo

    2017-01-01

    OBJECTIVES: The aim of this study was to evaluate available knowledge and identify knowledge gaps within the field of oral and maxillofacial surgery, by systematically collecting and evaluating systematic reviews. Twelve specific domains were selected: surgical removal of teeth, antibiotic....... However, in all domains, the search revealed a large number of knowledge gaps. Also of concern was the lack of data regarding health economics and ethics. CONCLUSIONS: In conclusion, there is a need for well-conducted clinical research in the fields of oral and maxillofacial surgery........ RESULTS: In all, 1,778 abstracts were identified, of which 200 met the inclusion criteria. Forty-five systematic reviews were assessed as of high to moderate quality. The results disclosed some existing evidence in a few domains, such as surgical removal of teeth and implant survival after sinus lifts...

  11. Circummandibular Wiring of Symphysis Fracture in a Five-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Krishna Priya Vellore

    2013-01-01

    Full Text Available The treatment of pediatric maxillofacial fractures is unique due to the psychological, physiological, developmental, and anatomical characteristics of children. Method. This case report describes the management of symphysis fracture of mandible in a 5-year-old boy. The fracture was treated by acrylic splint with circummandibular wiring. Results. The splint was removed after 3 weeks. The patient had no complaints, and radiograph revealed a healed fracture. Conclusion. The clinical outcome in the present case indicates the management of mandibular fractures in pediatric patients using acrylic splint with circummandibular wiring.

  12. Quality of life following hip fractures: results from the Norwegian hip fracture register.

    Science.gov (United States)

    Gjertsen, Jan-Erik; Baste, Valborg; Fevang, Jonas M; Furnes, Ove; Engesæter, Lars Birger

    2016-07-07

    Patient-reported health-related quality of life is an important outcome measure when assessing the quality of hip fracture surgery. The frequently used EQ-5D index score has unfortunately important limitations. One alternative can be to assess the distribution of each of the five dimensions of the patients' descriptive health profile. The objective of this paper was to investigate health-related quality of life (HRQoL) after hip fractures. Data from hip fracture operations from 2005 through 2012 were obtained from The Norwegian Hip Fracture Register. Patient reported HRQoL, (EQ-5D-3L) was collected from patients preoperatively and at four and twelve months postoperatively n = 10325. At each follow-up the distribution of the EQ-5D-3L and mean pain VAS was calculated. Generally, a higher proportion of patients reported problems in all 5 dimensions of the EQ-5D-3L at all follow-ups compared to preoperative. Also a high proportion of patients with no preoperative problems reported problems after surgery; At 4 and 12 months follow-ups 71 % and 58 % of the patients reported walking problems, and 65 % and 59 % of the patients reported pain respectively. Patients with femoral neck fractures and the youngest patients (age < 70 years) reported least problems both preoperatively and at all follow-ups. A hip fracture has a dramatic impact on the patients' HRQoL, and the deterioration in HRQoL sustained also one year after the fracture. Separate use of the descriptive profile of the EQ-5D is informative when assessing quality of life after hip fracture surgery.

  13. A retrospective study of oral and maxillofacial injuries in Seremban Hospital, Malaysia.

    Science.gov (United States)

    Ramli, Roszalina; Rahman, Normastura Abdul; Rahman, Roslan Abdul; Hussaini, Haizal Mohd; Hamid, Abdul Latif Abdul

    2011-04-01

    Aetiology of oral and maxillofacial injuries in this country includes motorvehicle accident (MVA), fall, industrial accidents and others. Among these causes, MVA accident is the predominant cause of injury in Malaysia. A retrospective record review was carried out using hospital records of all patients who sustained oral and maxillofacial injury at the Department of Oral Surgery, Seremban Hospital, Negeri Sembilan, Malaysia between 1998 and 2002. Information related to demographics, aetiology of trauma, vehicles involved in collision, location of injuries and treatment modalities were reviewed. Two thousand nine hundred and eighty-six patients sustained oral and maxillofacial injuries. Of these patients, 79.2% were men and the remaining were women. Among all the races, Malays had the highest involvement (50.6%) followed by Indians (24.5%), Chinese (19.6%) and others (5.3%). There were statistically significant results on the association of aetiology and the ethnic groups, in the age group of 30 years or less and male gender (P < 0.001). The most common injury was the soft-tissue injury followed by dental and dentoalveolar injuries and bony fracture. Among all facial fractures, 66.3% were managed conservatively, 13% were treated surgically and 19.7% did not have any intervention. In relation to dental and dentoalveolar injuries, 64.8% had treatment in the form of splinting, restorations or dental extraction. The rest of the patients (35.2%) were referred to their dentists or did not have any active treatment at Seremban Hospital. Most of the dental and facial injuries in Seremban Hospital were caused by MVA and were predominantly managed using conservative methods. © 2011 John Wiley & Sons A/S.

  14. Results of operative fixation of unstable ankle fractures in geriatric patients.

    Science.gov (United States)

    Pagliaro, A J; Michelson, J D; Mizel, M S

    2001-05-01

    It is widely accepted that operative fixation of unstable ankle fractures yields predictably good outcomes in the general population. The current literature, however reports less acceptable results in the geriatric population age 65 years and older. The current study analyzes the outcome of the surgical treatment of unstable ankle fractures in patients at least 65 years old. Twenty three patient over 65 years old were surgically treated after sustaining 21 (91%) closed and 2 (9%) open grade II unstable ankle fractures. Fractures were classified according to the Danis-Weber and Lauge-Hansen schemes. Fracture type was predominantly Weber B (21/23, 91%), or supination external rotation stage IV (21/23, 91%). Fracture union rate was 100%. There were three significant complications including a lateral wound dehiscence with delayed fibular union in an open fracture dislocation, and two below knee amputations, neither of which was directly related to the fracture treatment. There were three minor complications; one superficial wound infection and two cases of prolonged incision drainage, all of which resolved without further surgical intervention. Complications were associated with open fractures and preexisting systemic disease. These results indicate that open reduction and internal fixation of unstable ankle fractures in geriatric patients is an efficacious treatment regime that with results that are comparable to the general population.

  15. Early Management of Open Tibial Fractures in Benin - City - Result ...

    African Journals Online (AJOL)

    Open fractures of the tibia shaft are caused by major musculoskeletal injury, most ... The determinants of a successful treatment outcome are effective infection control, ... 15.4% wounds in type II and III (4 and 2 respectively) treated by delayed ...

  16. Panagraphic study of maxillofacial region

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1973-11-15

    The author has studied maxillo-facial anatomical landmarks using Status X with two methods. The one has performed by application of contrast media on the human dry skull, the other has performed on living human skull as control group. Comparing the panagraphs taken by two methods, the author has drawn following results: 1. The panagraphs revealed the undistorted highly sharp panoramic shadows of each jaw on a film. 2. Diminishing the inserted anode tube to 4 cm (focal incisor distance 3 cm), overlapping-free representation of the in terdental spaces of the premolars and anterior teeth was taken. 3. Alternating the head position of the objects, direction of anode tube and film placing, the shadows of temporomandibular joint and zygomatic arch were taken without overlapping the other bone tissues. 4. In the panagraphs applied various shaped contrast media to each anatomical landmark, a radio-anatomical atlas which is necessary to interpret various bone tissues was taken. 5. In order to interpret panagraphic shadows easily, the author has tried this study by comparing the films of the living human skull with the films of the human dry skull applied contrast media.

  17. Panagraphic study of maxillofacial region

    International Nuclear Information System (INIS)

    You, Dong Soo

    1973-01-01

    The author has studied maxillo-facial anatomical landmarks using Status X with two methods. The one has performed by application of contrast media on the human dry skull, the other has performed on living human skull as control group. Comparing the panagraphs taken by two methods, the author has drawn following results: 1. The panagraphs revealed the undistorted highly sharp panoramic shadows of each jaw on a film. 2. Diminishing the inserted anode tube to 4 cm (focal incisor distance 3 cm), overlapping-free representation of the in terdental spaces of the premolars and anterior teeth was taken. 3. Alternating the head position of the objects, direction of anode tube and film placing, the shadows of temporomandibular joint and zygomatic arch were taken without overlapping the other bone tissues. 4. In the panagraphs applied various shaped contrast media to each anatomical landmark, a radio-anatomical atlas which is necessary to interpret various bone tissues was taken. 5. In order to interpret panagraphic shadows easily, the author has tried this study by comparing the films of the living human skull with the films of the human dry skull applied contrast media.

  18. [Intramedullary stabilisation of displaced midshaft clavicular fractures: does the fracture pattern (simple vs. complex) influence the anatomic and functional result].

    Science.gov (United States)

    Langenhan, R; Reimers, N; Probst, A

    2014-12-01

    Displaced midshaft clavicular fractures are often treated operatively. The most common way of treatment is plating. Elastic stable intramedullary nailing (ESIN) is an alternative, but seldom used. Studies showed comparable or even better results for intramedullary nailing than for plating in simple 2- or 3-fragment midshaft fractures. The indication of ESIN for multifragmentary clavicular fractures is discussed critically in the literature because of reduced primary stability and danger of secondary shortening. Until now only few studies report functional results after fracture healing depending on the fracture type. To the best of our knowledge there is no study showing significantly worse functional scores for ESIN in complex displaced midshaft fractures. The objective of this study was to examine anatomic and functional results of simple (2 or 3 fragments, OTA type 15B1 and 15B2) and complex (multifragmentary, OTA type 15B3) displaced midshaft clavicula fractures after internal fixation. Between 2009 and 2012, 40 patients (female/male 10/30; mean age 33 [16-60] years) with closed displaced midshaft clavicular fractures were treated by open reduction and ESIN (Titanium Elastic Nail [TEN], Synthes, Umkirch, Germany). Thirty-seven patients were retrospectively analysed after a mean of 27 (12-43) months. Twenty patients (group A) had simple fractures (OTA type 15B1 and 15B2), 17 patients (group B) had complex fractures (OTA type 15B3). All shoulder joints were postoperatively treated functionally for six weeks without weight limited to 90° abduction/flexion. Both groups were comparable in gender, age, body mass index, months until metal removal, number of physiotherapy sessions and time until follow-up examination. Joint function (neutral zero method) and strength (standing patient with arm in 90° abduction, holding 1-12 kg for 5 sec) in both shoulders were documented. The distance between the centre of the jugulum and the lateral acromial border was measured for

  19. Traumatic fractures resulting from collisions in children and adolescents: A retrospective observational study.

    Science.gov (United States)

    Wang, Hongwei; Liu, Huan; Zhang, Song; Li, Changqing; Zhou, Yue; Liu, Jun; Ou, Lan; Xiang, Liangbi

    2018-05-01

    To investigate the incidence and pattern of child and adolescent (≤18 years old) traumatic fractures (TFs) as a result of collisions.We retrospectively reviewed 270 child and adolescent patients (228 males and 42 females aged 12.8 ± 5.1 years old) with TFs as a result of collisions admitted to our university-affiliated hospitals from 2001 to 2010. The incidence and patterns were summarized with respect to different age groups, sex, etiology, and whether the patient presented with nerve injury.The most common etiologies were struck by object (105, 38.9%) and wounded by person (74, 27.4%). The most common fracture sites were upper limb fractures (126, 46.7%) and craniofacial fractures (82, 30.4%). A total of 65 (24.1%) patients suffered a nerve injury. The frequency of early and late complications/associated injuries was 35.6% (n = 96) and 8.5% (n = 23), respectively. The mean age (P = .001) and frequency of wounded by person (P = .038) was significantly larger in male than in female patients. The frequency of earthquake injury (P lower limb fractures (P = .002) was significantly larger in females than in male patients. The frequency of upper limb fracture was significantly higher in the wounded by machine group (83.3%) than in the other groups (all P lower limb fractures was significantly higher in the earthquake injury group (64.7%) than in the other groups (all P fracture was significantly higher in the wounded by person group (54.1%) than in the other groups (all P fracture (P limb fractures were the most common etiology and site, respectively. Wounded by person and craniofacial fractures were risk factors for nerve injury. Therefore, we should pay more attention to patients wounded by person, presenting with craniofacial fracture, to find whether there is nerve injury.

  20. A statistical study of the maxillofacial diseases by radiograms

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Yoo Tai; Lee, Sang Chull [College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    1974-11-15

    This report based on 300 cases of serious diseases in maxillofacial region by radiograms seen at the department of dental radiodontics, infirmary school of dentistry, Kyung Hee University from October 1971 to August 1974. The maxillofacial diseases were analysed upon the following items, such as 1) the frequency of dominant diseases, 2) sex-ratio of male to female, 3) predominant region of diseases, 4) comparison with the age, 5) the incidence of diseases in relative to the individual teeth. The results were obtained as follows. 1) Among the total of 300 cases of the patients, the frequency of dominant diseases of patients were fractures of facial bone (44.3 {+-} 2.87%), inflammatory diseases (22.7 {+-} 2.39%), cysts (11.1 {+-} 1.62%), tumors(10.7 {+-} 1.77%), maxillary sinusitis (7.9 {+-} 1.56%), temporomandibular joint disorders(3.3 {+-} 1.05%) in the order. 2) The sex ratio of male to female in occurrence of jaw fractures were 7.3 : 1, temporomandibular joint disorders were 2.1 : 1, inflammatory diseases were 1.8:1, maxillary sinusitis were 1.7 : 1, but tumors were 1: 1, while cysts were 1:1 .2 in sex difference.3) The predominant region of mandibular fractures were symphysis (17.3 {+-} 3.27%), canine region (15.0 {+-} 3.09%), and angle region(14.3 {+-} 3.04%) in the order. Inflammatory diseases were occurred frequently in mandible and it's left side were a little dominant. Odontogenic cysts were observed frequently in maxilla, but regardless of right and left. Carcinomas were involved most frequently in maxilla, while sarcomas and ameloblastomas in mandible. Frequency of the maxillary sinusitis w ere dominant in right side and molar area, also temporomandibular joint disorders were dominant in right side. 4) To study comparing with the age, jaw fractures showed the highest ratio at the 2nd decade (32.3 {+-} 4.06%), and 3rd decade (27.8 {+-} 3.89%), 4th decade (19.6 {+-} 3.44%), 6th decade (9.0 {+-} 2.47%), 5th decade(6.0 {+-} 2.06%), lst decade(5.3 {+-} 1

  1. Rapid prototyping-assisted maxillofacial reconstruction.

    Science.gov (United States)

    Peng, Qian; Tang, Zhangui; Liu, Ousheng; Peng, Zhiwei

    2015-05-01

    Rapid prototyping (RP) technologies have found many uses in dentistry, and especially oral and maxillofacial surgery, due to its ability to promote product development while at the same time reducing cost and depositing a part of any degree of complexity theoretically. This paper provides an overview of RP technologies for maxillofacial reconstruction covering both fundamentals and applications of the technologies. Key fundamentals of RP technologies involving the history, characteristics, and principles are reviewed. A number of RP applications to the main fields of oral and maxillofacial surgery, including restoration of maxillofacial deformities and defects, reduction of functional bone tissues, correction of dento-maxillofacial deformities, and fabrication of maxillofacial prostheses, are discussed. The most remarkable challenges for development of RP-assisted maxillofacial surgery and promising solutions are also elaborated.

  2. frequency of ipsilateral femoral neck fractures in patients

    African Journals Online (AJOL)

    Background: Ipsilateral associated femoral neck and shaft fractures are reported to occur in 2.5-6% of all femoral shaft ... nailing of the shaft fracture, which makes treatment of the neck ... chest, spine), while the other had maxillofacial injuries.

  3. Basic research on maxillofacial implants

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Yoshiro [Showa Univ., Tokyo (Japan). School of Dentistry

    2001-11-01

    Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

  4. Basic research on maxillofacial implants

    International Nuclear Information System (INIS)

    Matsui, Yoshiro

    2001-01-01

    Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

  5. Role of prophylactic antiemetics in oral and maxillofacial surgery

    International Nuclear Information System (INIS)

    Hanif, S.; Warraich, R.A.; Khan, S.R.; Riaz, N.; Mehdi, A.J.

    2014-01-01

    To find out the occurrence of postoperative nausea and vomiting (PONY) in oral and maxillofacial surgery done under general anaesthesia and to evaluate the purpose of using prophylactic antiemetic drugs. Design: Observational study. Place and Duration of the Study: Oral and Maxillofacial Department, KEMU / Mayo Hospital Lahore, from September 20 II to June 2012. Method: The number of patients who were operated in oral and maxillofacial surgery ward irrespective of age and gender for this study were 240. Risk factors related with PONY including gender, anesthetic drug used, surgical procedure, approach' used, total time of surgery and postoperative use of opioids were investigated. A wait and watch scheme was followed in patients with complaint of PONY. Antiemetics to be given in those cases where more than 2 episodes of vomiting took place. Results: It was found out that only II patients experienced from nausea and vomiting in post operative period. A notable relation was seen between PONY and female population, total time of surgery, anesthetic drug, surgery of tumor and temporomandibular joint. The surgical approach and opioids in postoperative period for PONY were found to be insignificant. Conclusion: PONY is not a significant finding in oral and maxillofacial surgery. We find out that there is no logic for the use of prophylactic antiemetic drugs in maxillofacial surgery. (author)

  6. EVALUATION OF RESULTS IN FRACTURES OF BOTH BONES FOREARM TREATED WITH DYNAMIC COMPRESSION PLATING

    Directory of Open Access Journals (Sweden)

    Sindhuja G

    2017-06-01

    Full Text Available BACKGROUND The anatomical alignment of the bones, the length, the radial bow, and axis should be restored for a good functional outcome. Conservative treatment has resulted in malunion, non-union, synostosis and ultimately poor functional outcome. Internal fixation helps in perfect reduction of fracture fragments in anatomical position by rigid fixation and early mobilisation, the normal functions of the hand can be re-achieved at the earliest. This study has been taken up to evaluate the results of open reduction and internal fixation of the fractures of BBFA with DCP in adults and its advantages and complications. In this study, the rate and time taken for union, the complication, the functional results in terms of forearm rotation and wrist and elbow movements are evaluated. MATERIALS AND METHODS This study includes treatment of 20 cases of fracture of both bones of forearm by open reduction and internal fixation with 3.5 mm DCP from August 2013 to August 2015 at Department of Orthopaedics at Konaseema Institute of Medical Sciences, Amalapuram. Follow-up was done up to September 2015. This is a prospective time bound study. Sample size - 20 patients. Inclusion Criteria- 1. Simple fractures. 2. Open fractures-Gustilo and Anderson type I and type II. 3. Age criteria = 15 to 70 years, both males and females. Exclusion Criteria- 1. Age criteria 0 to 14 years & > 70 years. 2. Radiologically proven segmental fractures and isolated forearm bone fractures. 3. Pathological fracture. 4. Gustilo and Anderson type III. 5. Patient not willing for surgery. 6. Patient unfit for surgery. RESULTS The present study consists of 20 cases of fracture both bones of the forearm. All the cases were openly reduced and internally fixed with 3.5 mm DCP. The study period was from August 2013 to September 2015. The age of these patients ranged from 15-70 years with fracture being most common in 3 rd decade and an average age of 31 years. CONCLUSION Use of separate

  7. Characterization of Fractures in the Chicxulub Peak Ring: Preliminary Results from IODP/ICDP Expedition 364

    Science.gov (United States)

    McCall, N.; Gulick, S. P. S.; Morgan, J. V.; Hall, B. J.; Jones, L.; Expedition 364 Science Party, I. I.

    2017-12-01

    During Expedition 364, IODP/ICDP drilled the peak ring of the Chicxulub impact crater at Site M0077, recovering core from 505.7 to 1334.7 mbsf. The core has been imaged via X-ray Computer Tomography (CT) as a noninvasive method to create a 3-dimensional model of the core, providing information on the density and internal structure at a 0.3 mm resolution. Results from the expedition show that from 748 mbsf and deeper the peak ring is largely composed of uplifted and fractured granitic basement rocks originally sourced from approximately 8-10 km depth. Impact crater modeling suggests the peak ring was formed through dynamic collapse of a rebounding central peak within 10 minutes of impact, requiring the target rocks to temporarily behave as a viscous fluid. The newly recovered core provides a rare opportunity to investigate the cratering process, specifically how the granite was weakened, as well as the extent of the hydrothermal system created after the impact. Based on the CT data, we identify four classes of fractures based on their CT facies deforming the granitoids: pervasive fine fractures, discrete fine fractures, discrete filled fractures, and discrete open fractures. Pervasive fine fractures were most commonly found proximal to dikes and impact melt rock. Discrete filled fractures often displayed a cataclastic texture. We present density trends for the different facies and compare these to petrophysical properties (density, NGR, P-wave seismic velocity). Fractured areas have a lower density than the surrounding granite, as do most filled fractures. This reduction suggests that fluid migrating through the peak ring in the wake of the impact either deposited lower density minerals within the fractures and/or altered the original fracture fill. The extent and duration of fluid flow recorded in these fractures will assist in the characterization of the post-impact hydrothermal system. Future work includes combining information from CT images with thin sections

  8. A multi-packer technique for investigating resistance to flow through fractured rock and illustrative results

    International Nuclear Information System (INIS)

    Bourke, P.J.; Rae, J.

    1981-01-01

    A multi-packer technique was used to locate twelve discrete fractures in the lower half of a 200 m deep drill hole in Cornish granite. The resistances to water flows into these fractures both singly and together were measured. Geological explanations of the results obtained were sought by examination of core from the hole. Analysis of the results and the further data needed and now being sought to determine resistance to flow over long distances through the pattern of interconnected fractures are discussed. This information is required for the assessment of the safety of burial of radioactive wastes

  9. Differential fracture healing resulting from fixation stiffness variability. A mouse model

    International Nuclear Information System (INIS)

    Gardner, M.J.; Putnam, S.M.; Wong, A.; Streubel, P.N.; Kotiya, A.; Silva, M.J.

    2011-01-01

    The mechanisms underlying the interaction between the local mechanical environment and fracture healing are not known. We developed a mouse femoral fracture model with implants of different stiffness, and hypothesized that differential fracture healing would result. Femoral shaft fractures were created in 70 mice, and were treated with an intramedullary nail made of either tungsten (Young's modulus=410 GPa) or aluminium (Young's modulus=70 GPa). Mice were then sacrificed at 2 or 5 weeks. Fracture calluses were analyzed using standard microCT, histological, and biomechanical methods. At 2 weeks, callus volume was significantly greater in the aluminium group than in the tungsten group (61.2 vs. 40.5 mm 3 , p=0.016), yet bone volume within the calluses was no different between the groups (13.2 vs. 12.3 mm 3 ). Calluses from the tungsten group were stiffer on mechanical testing (18.7 vs. 9.7 N/mm, p=0.01). The percent cartilage in the callus was 31.6% in the aluminium group and 22.9% in the tungsten group (p=0.40). At 5 weeks, there were no differences between any of the healed femora. In this study, fracture implants of different stiffness led to different fracture healing in this mouse fracture model. Fractures treated with a stiffer implant had more advanced healing at 2 weeks, but still healed by callus formation. Although this concept has been well documented previously, this particular model could be a valuable research tool to study the healing consequences of altered fixation stiffness, which may provide insight into the pathogenesis and ideal treatment of fractures and non-unions. (author)

  10. Short- and long-term results following standing fracture repair in 34 horses.

    Science.gov (United States)

    Payne, R J; Compston, P C

    2012-11-01

    Standing fracture repair in the horse is a recently described surgical procedure and currently there are few follow-up data. This case series contains 2 novel aspects in the standing horse: repair of incomplete sagittal fractures of the proximal phalanx and medial condylar repair from a lateral aspect. To describe outcome in a case series of horses that had lower limb fractures repaired under standing sedation at Rossdales Equine Hospital. Case records for all horses that had a fracture surgically repaired, by one surgeon at Rossdales Equine Hospital, under standing sedation and local anaesthesia up until June 2011, were retrieved. Hospital records, owner/trainer telephone questionnaire and the Racing Post website were used to evaluate follow-up. Thirty-four horses satisfied the inclusion criteria. Fracture sites included the proximal phalanx (incomplete sagittal fracture, n = 14); the third metacarpal bone (lateral condyle, n = 12, and medial condyle, n = 7); and the third metatarsal bone (lateral condyle, n = 1). One horse required euthanasia due to caecal rupture 10 days post operatively. Twenty horses (66.7% of those with available follow-up) have returned to racing. Where available, mean time from operation to return to racing was 226 days (range 143-433 days). Standing fracture repair produced similar results to fracture repair under general anaesthesia in terms of both the number of horses that returned to racing and the time between surgery and race. Repair of lower limb fracture in the horse under standing sedation is a procedure that has the potential for tangible benefits, including avoidance of the inherent risks of general anaesthesia. The preliminary findings in this series of horses are encouraging and informative when discussing options available prior to fracture repair. © 2012 EVJ Ltd.

  11. Airway Management in Maxillofacial Trauma: A Retrospective Review of 127 Cases

    Directory of Open Access Journals (Sweden)

    V Saraswat

    2008-01-01

    Maxillofacial injuries need special attention since it involves difficult airway due to fracture to facial bones, Further the airway is shared with surgeon and restrictions are imposed during surgery. Issues involved are time of surgery, preoperative airway assessment, type of intubation and way to achieve it, alternative methods available and their complications.

  12. Differences in Site-Specific Fracture Risk Among Older Women with Discordant Results for Osteoporosis at Hip and Spine: the Study of Osteoporotic Fractures

    Science.gov (United States)

    Fink, Howard A.; Harrison, Stephanie L.; Taylor, Brent C.; Cummings, Steven R.; Schousboe, John T.; Kuskowski, Michael A.; Stone, Katie L.; Ensrud, Kristine E.

    2009-01-01

    To examine the fracture pattern in older women whose bone mineral density (BMD) T-score criteria for osteoporosis at hip and spine disagree, hip and spine BMD were measured in Study of Osteoporotic Fractures participants using dual energy x-ray absorptiometry (DXA). Hip osteoporosis was defined as T-score ≤-2.5 at femoral neck or total hip, and spine osteoporosis as T-score ≤-2.5 at lumbar spine. Incident clinical fractures were self-reported and centrally adjudicated. Incident radiographic spine fractures were defined morphometrically. Compared to women with osteoporosis at neither hip nor spine, those osteoporotic only at hip had a 3.0-fold age and weight-adjusted increased risk for hip fracture (95%CI 2.4-3.6), and smaller increases in risk of nonhip nonspine (HR=1.6), clinical spine (OR=2.2), and radiographic spine fractures (OR=1.5). Women osteoporotic only at spine had a 2.8-fold increased odds of radiographic spine fracture (95%CI 2.1-3.8), and smaller increases in risk of clinical spine (OR=1.4), nonhip nonspine (HR=1.6), and hip fractures (HR=1.2). Discordant BMD results predict different fracture patterns. DXA fracture risk estimation in these patients should be site-specific. Women osteoporotic only at spine would not have been identified from hip BMD measurement alone, and may have a sufficiently high fracture risk to warrant preventive treatment. PMID:18296090

  13. Ultrasonography - A diagnostic modality for oral and maxillofacial diseases

    Directory of Open Access Journals (Sweden)

    Priya Shirish Joshi

    2014-01-01

    Full Text Available Background: Many diseases present themselves in oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intraoral and panoramic radiography, ultrasonography (USG, computer tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, USG is easy to-use for the detection of non-invasive and soft tissue related diseases in oral and maxillofacial regions. USG plays an important role in analyzing normal and abnormal structures. In particular, in oral and maxillofacial regions, the USG may be clinically applied to evaluate lymph nodes, subcutaneous, and oral cavity-related diseases. Aims: The aim was to correlate the findings of USG and histopathology for the diagnosis of oral and maxillofacial pathology and to evaluate whether USG can be used as an adjunct in diagnosing oral and maxillofacial pathology. Materials and Methods: A total of 10 clinically diagnosed patients with intraoral cancerous growths, swellings in maxillary and neck region were included in this study. Incision biopsy was obtained for confirming provisional clinical diagnosis. The selected cases were advised USG. All patients were then posted either for hemi-glossectomy, hemi-mandibulectomy, and partial maxillectomy with or without radical neck dissection. Statistical Analysis: Student′s t-test and coefficient of correlation was used to statistically analyze significant relationship of both the methods. Result: In all 10 cases, USG correlated well with histopathology findings, it could also delineate tumor extent and measure tumor thickness. Conclusion: USG is an excellent method for the diagnosis of soft tissue lesions and can be used as an adjunct in diagnosing oral and maxillofacial pathology.

  14. Contemporary management of maxillofacial ballistic trauma.

    Science.gov (United States)

    Breeze, J; Tong, D; Gibbons, A

    2017-09-01

    Ballistic maxillofacial trauma in the UK is fortunately relatively rare, and generally involves low velocity handguns and shotguns. Civilian terrorist events have, however, shown that all maxillofacial surgeons need to understand how to treat injuries from improvised explosive devices. Maxillofacial surgeons in the UK have also been responsible for the management of soldiers evacuated from Iraq and Afghanistan, and in this review we describe the newer types of treatment that have evolved from these conflicts, particularly that of damage-control maxillofacial surgery. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  15. Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications.

    Science.gov (United States)

    Vidović, Dinko; Matejčić, Aljoša; Ivica, Mihovil; Jurišić, Darko; Elabjer, Esmat; Bakota, Bore

    2015-11-01

    Distal tibial or pilon fractures are usually the result of combined compressive and shear forces, and may result in instability of the metaphysis, with or without articular depression, and injury to the soft tissue. The complexity of injury, lack of muscle cover and poor vascularity make these fractures difficult to treat. Surgical treatment of distal tibial fractures includes several options: external fixation, IM nailing, ORIF and minimally-invasive plate osteosynthesis (MIPO). Management of distal tibial fractures with MIPO enables preservation of soft tissue and remaining blood supply. This is a report of a series of prospectively studied closed distal tibial and pilon fractures treated with MIPO. A total of 21 patients with closed distal tibial or pilon fractures were enrolled in the study between March 2008 and November 2013 and completed follow-up. Demographic characteristics, mechanism of injury, time required for union, ankle range of motion and complications were recorded. Fractures were classified according to the AO/OTA classification. Nineteen patients were initially managed with an ankle-spanning external fixator. When the status of the soft tissue had improved and swelling had subsided enough, a definitive internal fixation with MIPO was performed. Patients were invited for follow-up examinations at 3 and 6 weeks and then at intervals of 6 to 8 weeks until 12 months. Mean age of the patients was 40.1 years (range 19-67 years). Eighteen cases were the result of high-energy trauma and three were the result of low-energy trauma. According to the AO/OTA classification there were extraarticular and intraarticular fractures, but only simple articular patterns without depression or comminution. The average time for fracture union was 19.7 weeks (range 12-38 weeks). Mean range of motion was 10° of dorsiflexion (range 5-15°) and 28.3° of plantar flexion (range 20-35°). Three cases were metalwork-related complications. Two patients underwent plate removal

  16. Prediction of fracture toughness K/sub Ic/ of steel from Charpy impact test results

    Energy Technology Data Exchange (ETDEWEB)

    Iwadate, Tadao; Tanaka, Yasuhiko; Takemata, Hiroyuki; Terashima, Shuhei

    1986-08-01

    This paper presents a method to predict the fracture toughness K/sub Ic/ and/or K/sub Id/ of steels using their Charpy impact test results and tensile properties. The fracture toughness, Charpy impact and tensile properties of 2 1/4 Cr-1Mo, ASTM A508 Cl.1, A508 Cl.2 A508 Cl.3 and A533 Gr.B Cl.1 steels were measured and analysed on the basis of the excess temperature (test temperature minus FATT) and Rolfe-Novak correlation. The relationship between K/sub Ic//K/sub Ic-us/ and the excess temperature, where K/sub Ic-us/ is the upper-shelf fracture toughness K/sub Ic/ predicted by Rolfe-Novak correlation, discloses that the K/sub Ic/ transition curves of several steels are representable by only one trend curve of K/sub Ic//K/sub Ic-us/ or K/sub Id//K/sub Id-us/ versus excess temperature relation. This curve is denoted as a ''master curve''. By using this curve, the fracture toughness of steel can be predicted using Charpy impact and tensile test results. By taking account of the scattering of both the fracture toughness and Charpy impact test results, the confidence limits of the master curve were also determined. Another approach to develop more general procedure of predicting the fracture toughness K/sub Ic/ is also discussed.

  17. Oral myiasis in a maxillofacial trauma patient

    Directory of Open Access Journals (Sweden)

    Grandim Balarama Gupta Vinit

    2013-01-01

    Full Text Available Myiasis is a rare disease primarily caused by the invasion of tissue by larvae of certain dipteran flies. Oral myiasis is still more "rare" and "unique" owing to the fact that oral cavity rarely provides the necessary habitat conducive for a larval lifecycle. Common predisposing factors are poor oral hygiene, halitosis, trauma, senility, learning disabilities, physically and mentally challenged conditions. Oral myiasis can lead to rapid tissue destruction and disfigurement and requires immediate treatment. Treatment consists of manual removal of maggots from the oral cavity after application of chemical agents. Good sanitation, personal and environmental hygiene and cleanliness and special care for debilitated persons are the best methods to prevent oral myiasis. This case report describes the presentation of oral myiasis caused by musca nebulo (common house fly in a 40-year-old male patient, with recent maxillofacial trauma. The patient was treated by manual removal larvae by topical application of turpentine oil, followed by surgical debridement of the wound and open reduction and internal fixation of the fracture.

  18. Prevalence and patterns of combat sport related maxillofacial injuries.

    Science.gov (United States)

    Shirani, Gholamreza; Kalantar Motamedi, Mohammad Hosein; Ashuri, Alireza; Eshkevari, Pooyan Sadr

    2010-10-01

    This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc.), site of facial injury (jaw, nose, malar bone, teeth, etc.), dental injuries (tooth fracture, displacement, luxation, and avulsion), causative sport (boxing, taekwondo, kickboxing, and Muay Thai) as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and χ(2), ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Of 120 subjects, 95 male subjects (79.2%), aged 18-25 years (avg. 20 years), had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma), dental injuries (displacement, luxation, fracture, and avulsion), and mandibular dislocation which were recorded in 83 (69.2%), 55 (45.1%), 53 (44.2%), and 8 (6.7%) cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7%) were the most common dental injuries, and the nose (84.7%) was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%). Injuries were significantly greater in professional rather than amateur athletes. In this study

  19. Maxillofacial trauma due to road traffic accidents in Benin City ...

    African Journals Online (AJOL)

    Distribution of maxillofacial bone and soft tissue injuries by vehicle type as well as associated injuries were documented. Results: The minibus was the vehicle type most often involved (36.2%) and tyre blowout (21.2%) was identified as the most common contributory factor. Males 117 (37.5%) in the 21 – 30 year- age range ...

  20. Evaluation of the scope and practice of oral and maxillofacial ...

    African Journals Online (AJOL)

    2014-11-27

    Nov 27, 2014 ... that developed as a result of the need to treat servicemen injured in ... for effective organization of training, health care planning .... Similarly McNally found 5% female applicants to oral and ... maxillofacial surgeons in Australia worked in both private .... Glass ceiling, preference, prejudice or cohort effect?

  1. Intra‑Operative Airway Management in Patients with Maxillofacial ...

    African Journals Online (AJOL)

    the surgeon and the anesthetist is naturally a challenge for both specialists. In addition to this, when traumatic maxillofacial injury results in the disruption of the normal anatomy from edema or structural damage to tissues, bleeding, unstable skeletal structures, and foreign bodies that can interfere with instrumentation or ...

  2. Intermaxillary Fixation Screw Morbidity in Treatment of Mandibular Fractures

    DEFF Research Database (Denmark)

    Florescu, Vlad-Andrei; Kofod, Thomas; Pinholt, Else Marie

    2016-01-01

    Purpose The aim of the present retrospective study was to investigate the morbidity of screws used for intermaxillary fixation (IMF) in the treatment of mandibular fractures. A review of the published data was also performed for a comparison of outcomes. Our hypothesis was that the use of screws...... for IMF of mandibular fractures would result in minimal morbidity. Materials and Methods Patients treated for mandibular fractures from 2007 to 2013, using screws for IMF, using the international diagnosis code for mandibular fracture, DS026, were anonymously selected (Department of Oral and Maxillofacial...... Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark). The fracture type, radiographic findings, treatment modality, screw type and number, and root damage were recorded. For the outcome comparison, a review of the published data regarding iatrogenic dental root damage caused...

  3. Biodegradable fixation of mandibular fractures in children: stability and early results.

    Science.gov (United States)

    Yerit, Kaan C; Hainich, Sibylle; Enislidis, Georg; Turhani, Dritan; Klug, Clemens; Wittwer, Gert; Ockher, Michael; Undt, Gerhard; Kermer, Christian; Watzinger, Franz; Ewers, Rolf

    2005-07-01

    The aim of this study was to assess the safety and efficiency of biodegradable self-reinforced (SR-PLDLA) bone plates and screws in open reduction and internal fixation of mandible fractures in children. Thirteen patients (5 female, 8 male; mean age 12 years, range 5-16 years) were operated on various fractures of the mandible (2 symphyseal, 6 parasymphyseal, 4 body, 3 angle, 1 ramus, 2 condylar fractures). The mean follow-up time was 26.4 months (range 10.9-43.4 months). Intermaxillary fixation was applied in cases with concomitant condylar fractures up to 3 weeks. Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operations was not endangered. Adverse tissue reactions to the implants, malocclusion, and growth restrictions did not occur during the observation period. Pediatric patients benefit from the advantages of resorbable materials, especially from faster mobilization and the avoidance of secondary removal operations. Based on these preliminary results, self-reinforced fixation devices are safe and efficient in the treatment of pediatric mandible fractures. However, further clinical investigations are necessary to evaluate the long-term reliability.

  4. Additive manufacturing in maxillofacial reconstruction

    Directory of Open Access Journals (Sweden)

    Dincă Luciana Laura

    2017-01-01

    Full Text Available In this paper the benefits of using additive manufacturing technologies in maxillofacial reconstruction are highlighted. Based on a real clinical case, the paper describes the manufacture of an implant prototype replacing the right zygomatic bone and a part of maxilla using additive manufacturing technologies. The face is the most expressive part of the human body that makes us unique. It was shown that the maxillofacial prostheses help to improve the psychological state of patients affected by, because low self esteem feeling appears commonly to this patients with the facial defects. The aim of this paper is to show how using additive manufacturing technologies methods within this research, the producing a surgical model will help surgeon to improve the pre-operative planning. For this we used additive manufacturing technologies such as Stereolitography to achieve the biomodel and FDM-fused deposition modelling to obtain a prototype model because these technologies make it possible to obtain prosthesis according to the physical and mechanical requirements of the region of implantation.

  5. A case of isolated abducens nerve paralysis in maxillofacial trauma

    Science.gov (United States)

    Keskin, Elif Seda; Keskin, Ekrem; Atik, Bekir; Koçer, Abdülkadir

    2015-01-01

    Nervus abducens is a pure motor nerve located in the pons. It retracts the eyeball laterally by stimulating rectus lateralis muscle. In case of their paralysis, diplopia and restriction in the eye movements while looking sideways, are seen. Since the same signs are seen due to the muscle entrapment in blowout fractures, its differential diagnosis has importance in terms of the treatment protocol and avoiding unnecessary operations. In this article, we present a 22-year-old male patient who was referred to our department due to the prediagnosis of blowout fracture following maxillofacial trauma. However, he was diagnosed with abducens nerve paralysis after the consultations and analysis and his restriction of movement was resolved via systemic steroid treatment instead of unnecessary operation. PMID:26981484

  6. Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative Observational Study1234

    Science.gov (United States)

    Orchard, Tonya S; Larson, Joseph C; Alghothani, Nora; Bout-Tabaku, Sharon; Cauley, Jane A; Chen, Zhao; LaCroix, Andrea Z; Wactawski-Wende, Jean; Jackson, Rebecca D

    2014-01-01

    Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear. Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD). Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants. Results: Baseline hip BMD was 3% higher (P 422.5 compared with magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95% CI: 1.01, 1.32) and 1.23 (95% CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95% CI: 1.06, 1.16); HR for quintile 5: 1.15 (95% CI: 1.10, 1.20); P-trend magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials.gov as NCT00000611. PMID:24500155

  7. Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

    Directory of Open Access Journals (Sweden)

    Hassan BOUSSAKRI

    2015-12-01

    Full Text Available This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the trauma-orthopedic department (B4 of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP, as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%. 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.

  8. Obturator Artery Injury Resulting in Massive Hemorrhage From a Low-Energy Pubic Ramus Fracture.

    Science.gov (United States)

    Solarz, Mark K; Kistler, Justin M; Rehman, Saqib

    2017-05-01

    Pelvic ring fractures are common in the elderly population and are usually a result of low-energy trauma, such as falls from standing. In most cases, low-energy pelvic ring injuries can be treated with appropriate analgesia and early mobilization. Arterial injury resulting in hemodynamic instability from a low-energy pelvic ring injury is rare but, given the poor compliance of vessels in the elderly population, possible. These patients must be carefully monitored after the initial injury. The purpose of this report is to describe an elderly patient who sustained a superior pubic ramus fracture and arterial injury following a low-energy fall from standing that required angiographic intervention. Elderly patients who sustain low-energy or pelvic insufficiency fractures are unlike the younger population with high-energy pelvic fractures and hemodynamic collapse. Elderly patients can have a delayed presentation of arterial injury and require careful physical examination and close monitoring. Additionally, the authors provide a review of the literature for low-energy pelvic fractures. [Orthopedics. 2017; 40(3):e546-e548.]. Copyright 2017, SLACK Incorporated.

  9. Risk factors for fractures in patients with rheumatoid arthritis (preliminary results of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment»

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    Marina Mikhailovna Podvorotova

    2013-01-01

    Full Text Available In patients with rheumatoid arthritis (RA, bone fractures occur 1.5-2 times more frequently than in the population. They often lead to reduced quality of life, to disability and death in the patients. It should be noted that risk factors (RFs for fractures have not been studied on a sufficient sample in Russia; there are no recommendations on the prevention of fractures in this category of patients. Objective: to compare groups of RA patients with and without a history of fractures to further identify possible RFs for fractures. Subjects and methods. The trial included 254 patients aged 18 to 85 years, diagnosed with RA, from the database of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment», who had been followed up in 2010 to 2011. The patients were divided into two groups: 1 101 (39.8% patients with a history of low-trauma fractures and 2 153 (60.2% patients without a history of fractures. In Group 1, the patients were older than in Group 2 (mean age 59.8 and 56.1 years, respectively. Menopause was recorded in 88.1 and 77.8% of cases, respectively. The groups differed in the duration of RA an average of 15.5 and 11.5 years, respectively Results. The fractures in the history were associated with the use of glucocorticoids (GC, their higher cumulative dose and use duration. In Group 1 patients, the bone mineral density (BMD was lower in all study skeleton portions and more frequently corresponded to osteoporosis. RA complications, such as amyloidosis and osteonecrosis, were more common in the patients with a history of fractures. Conclusion. In RA patients, the most likely RFs of fractures are age, the long-term intake of large-dose GC, low BMD, the severe course of RA, and the presence of its complications.

  10. Application of computer-aided three-dimensional skull model with rapid prototyping technique in repair of zygomatico-orbito-maxillary complex fracture.

    Science.gov (United States)

    Li, Wei Zhong; Zhang, Mei Chao; Li, Shao Ping; Zhang, Lei Tao; Huang, Yu

    2009-06-01

    With the advent of CAD/CAM and rapid prototyping (RP), a technical revolution in oral and maxillofacial trauma was promoted to benefit treatment, repair of maxillofacial fractures and reconstruction of maxillofacial defects. For a patient with zygomatico-facial collapse deformity resulting from a zygomatico-orbito-maxillary complex (ZOMC) fracture, CT scan data were processed by using Mimics 10.0 for three-dimensional (3D) reconstruction. The reduction design was aided by 3D virtual imaging and the 3D skull model was reproduced using the RP technique. In line with the design by Mimics, presurgery was performed on the 3D skull model and the semi-coronal incision was taken for reduction of ZOMC fracture, based on the outcome from the presurgery. Postoperative CT and images revealed significantly modified zygomatic collapse and zygomatic arch rise and well-modified facial symmetry. The CAD/CAM and RP technique is a relatively useful tool that can assist surgeons with reconstruction of the maxillofacial skeleton, especially in repairs of ZOMC fracture.

  11. [Application of anaerobic bacteria detection in oral and maxillofacial infection].

    Science.gov (United States)

    Bao, Zhen-ying; Lin, Qin; Meng, Yan-hong; He, Chun; Su, Jia-zeng; Peng, Xin

    2016-02-18

    To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection. Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were identified. The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method. The clinical data and antibacterial agents for the treatment of the 61 cases were collected, and the final outcomes were recorded. The bacteria cultures were isolated from all the specimens, with aerobic bacteria only in 6 cases (9.8%), anaerobic bacteria only in 7 cases (11.5%), and both aerobic and anaerobic bacteria in 48 cases (78.7%). There were 55 infected cases (90.2%) with anaerobic bacteria, and 81 anaerobic bacteria stains were isolated. The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus, Bifidobacterium and Pemphigus propionibacterium. No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphyromonas and Prevotella. No metronidazole, cefoxitin, amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria. In the study, 48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing, and the clinical cure rate was 81.3%. Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofacial infection patients. Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.

  12. Faciomaxillary fractures in a Semi-urban South Indian Teaching Hospital: A retrospective analysis of 638 cases

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    Rajasekhar Gali

    2015-01-01

    Full Text Available Background and Objective: The incidence of maxillofacial trauma is increasing at a very fast pace in developing countries like India and poses a major health burden. Hence, the epidemiological data of maxillofacial trauma during a 6 year period, was analyzed to study the characteristics, factors predisposing, and aid in advocating strict guidelines to prevent the same. Materials and Methods: Data related to 638 cases with maxillofacial trauma, from January 2008 to December 2014 were reviewed retrospectively and the data regarding gender, age, etiology, anatomic location of fracture, alcohol consumption, associated head and other injuries, modality of treatment rendered and associated complications were analyzed with descriptive statistics. Results: A total of 638 patients presenting with 869 maxillofacial fractures were analyzed. Most of them [344 (53.9%] were young adults aged 18-40, whereas, 123 (19.2% were 11 to 17 years, and 97(15.2% adults. Men (79.4% were more affected than women. Road traffic accidents remain the main etiology causing fractures in 470 (73.6%, whereas 397 (62.2% had history of consumption of alcohol. Those with alcohol intoxication had multiple injuries. Mandible was more frequently involved with 360 (41.4% fractures, and condyle being the most common site. A total of 374 (58.6% underwent open reduction with internal fixation under general anesthesia. Prevalence of other injuries was noted in 207 (32.4% and complications of fracture treatment in 41(6.4% cases. Conclusion: Road traffic accidents under alcohol influence were most commonly associated with comminuted facial fractures with head injuries, frequently leading to death. Mandible was the most commonly fractured facial bone followed by zygoma

  13. Diagnosis of alveolar and root fractures: an in vitro study comparing CBCT imaging with periapical radiographs

    Directory of Open Access Journals (Sweden)

    Solange KOBAYASHI-VELASCO

    Full Text Available Abstract Objective To compare periapical radiograph (PR and cone-beam computed tomography (CBCT in the diagnosis of alveolar and root fractures. Material and Methods Sixty incisor teeth (20 higid and 40 with root fracture from dogs were inserted in 60 anterior alveolar sockets (40 higid and 20 with alveolar fracture of 15 macerated canine maxillae. Each fractured socket had a root fractured tooth inserted in it. Afterwards, each maxilla was submitted to PR in two different vertical angulation incidences, and to CBCT imaging with a small field of view (FOV and high-definition protocol. Images were randomized and posteriorly analyzed by two oral and maxillofacial radiologists two times, with a two-week interval between observations. Results Sensitivity and specificity values were good for root fractures for PR and CBCT. For alveolar fractures, sensitivity ranged from 0.10 to 0.90 for PR and from 0.50 to 0.65 for CBCT. Specificity for alveolar fractures showed lower results than for root fractures for PR and CBCT. Areas under the ROC curve showed good results for both PR and CBCT for root fractures. However, results were fair for both PR and CBCT for alveolar fractures. When submitted to repeated measures ANOVA tests, there was a statistically significant difference between PR and CBCT for root fractures. Root fracture intraobserver agreement ranged from 0.90 to 0.93, and alveolar fracture intraobserver agreement ranged from 0.30 to 0.57. Interobserver agreement results were substantial for root fractures and poor/fair for alveolar fractures (0.11 for PR and 0.30 for CBCT. Conclusion Periapical radiograph with two different vertical angulations may be considered an accurate method to detect root fractures. However, PR showed poorer results than CBCT for the diagnosis of alveolar fractures. When no fractures are diagnosed in PR and the patient describes pain symptoms, the subsequent exam of choice is CBCT.

  14. Gamma nail in the treatment of closed trochanteric fractures. Results and indications of 121 cases.

    Science.gov (United States)

    Kempf, I; Grosse, A; Taglang, G; Favreul, E

    2014-02-01

    The Gamma Nail is the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. Its design is based on Küntscher's Y-nail and locking intramedullary (IM) nails. This paper reports the results from the first-ever series of 121 patients operated between 1988 and 1990. They were followed until bone union was achieved. The mean patient age was 75 years. Most patients were in poor general health and had unstable fractures. Anatomical preoperative reduction was achieved in 72% of cases. Fixation was good in 66% of cases and acceptable in 27% of cases. Intra-operative complications consisted of nine fractures without consequences. Of the treated patients, 83.4% resumed weight-bearing during the first week. There was one case of deep infection that resolved with treatment. The mortality rate was 12.3% at three months. We noted 7 alunions in varus, 3 in valgus, 2 in external rotation and 1 in internal rotation. There were no cases of non-union. In six cases, the screw had cut out of the femoral head. The drawbacks associated with surgical treatment methods for trochanteric fractures also apply to the Gamma nail. Nevertheless, one of its primary advantages is the possibility of using a closed procedure. When compared to Ender nailing, knee pain is absent and weight-bearing can be achieved in all patients, no matter the fracture type. Copyright © 2014. Published by Elsevier Masson SAS.

  15. Knowledge and Awareness of Medical Practitioners of Jazan City towards Oral and Maxillofacial Surgery as a Specialty.

    Science.gov (United States)

    Ali, Fareedi Mukram; Al-Iryani, Ghassan M; Namis, Sultan Mohammed; Hezam, Asma Ali; Swaid, Salma Abdu; Alomar, Anas Esam

    2018-03-15

    In many health services communities the scope of oral and maxillofacial surgery (OMFS) as a discipline is frequently not probably understood. Good awareness towards OMFS among different branches of health services providers is essential for better referral strategies and will be for the benefit of the patient. The cross-sectional study was done using a specially prepared questionnaire distributed randomly to 125 general medical practitioners working in Jazan province. In this questionnaire, there were also some close-ended questions to evaluate awareness regarding a variety of conditions treated by the oral and maxillofacial surgeons. Out of 125 participants, 105 (84%) were aware of the oral and maxillofacial surgery as a speciality branch of dentistry. Only 52 (41.6%) participants were aware of the different treatment modalities coming under the scope of oral and maxillofacial surgery. Also in the referral of cases to the oral and maxillofacial surgeon, 50 (40%) participants referred their oral and maxillofacial region cases to OMS. Tooth removal was the only procedure where most of the medical practitioners knew it is a speciality procedure of the oral and maxillofacial surgeon. For facial fractures, 76 medical practitioners believe it comes under the scope of the orthopaedic surgeon. Similarly, for facial abscesses, 81 and 36 practitioners responded that it is a job of a general surgeon and OMS respectively. There is low awareness toward the scope of oral and maxillofacial surgery in the medical community. Knowledge and awareness of the scope of oral and maxillofacial surgery can improve the success and promptness of delivery of health services.

  16. New maxillofacial infrared detection technologies

    Energy Technology Data Exchange (ETDEWEB)

    Reshetnikov, A. P.; Kopylov, M. V.; Nasyrov, M. R., E-mail: marat.1994@me.com; Fisher, E. L.; Chernova, L. V. [Izhevsk State Medical Academy, Izhevsk, Russia (426034, Izhevsk, Kommunarov street, 281) (Russian Federation); Soicher, E. M. [Moscow State University of Medicine and Dentistry named after A.I. Evdokimov of the Ministry of Health of the Russian Federation, Moscow, Russia, (127473, Moscow, Delegatskaya str., 20/1) (Russian Federation)

    2015-11-17

    At the dental clinic the infrared range radiation spectrum of tissues was used to study the dynamics of local temperature and structure of the skin, subcutaneous fat, and other tissues of the maxillofacial area in adult healthy volunteers and patients. In particular, we studied the dynamics of local temperature of mucous membranes of the mouth, teeth, and places in the mouth and dental structures in the norm and in various pathological conditions of the lips, gums, teeth, tongue, palate, and cheeks before, during and after chewing food, drinking water, medication, and inhalation of air. High safety and informational content of infrared thermography are prospective for the development of diagnostics in medicine. We have 3 new methods for infrared detection protected by patents in Russia.

  17. Functional Results of Unstable (Type 2 Distal Clavicle Fractures Treated with Superior Anterior Locking Plate

    Directory of Open Access Journals (Sweden)

    Rajesh Govindasamy

    2017-11-01

    Full Text Available Background: The treatment of distal clavicle fracture is always a challenge, as it is mostly unstable and has higherrate of delayed union, malunion, non-union and associated acromioclavicular arthritis. So the management of thesefractures remains controversial. The purpose of this study is to evaluate the functional results of Type 2 distal endclavicle fractures treated with superior anterior locking plate.Methods: From June 2011 to August 2015 a retrospective study of12 male patients (mean age of 41.3 years 11 withunilateral and 1 with bilateral distal clavicle fractures treated with superior anterior locking plate was done. They wereevaluated at regular intervals with mean follow up of 14 months(12-18 months.Those with minimum one year followup were included in our study. All were evaluated for the functioning of the shoulder joint by both Oxford shoulder scoreand Quick DASH scores, rate of bone union, complications and earliest time for return to work.Results: All fractures union seen within 6-8 weeks (mean time: 7.1 weeks.All had good shoulder range of motion. Theaverage oxford shoulder and Quick DASH score were 46.2 and 6.5.There were no major complications in our studyviz. non-union, plate failure, secondary fracture. But one patient had superficial wound infection. All patients returned towork within 3 months of postoperative period.Conclusion: Displaced distal clavicle fractures treated with superior anterior locking plates achieved excellent resultsin terms of bony union with rarely any complications and demonstrate promising results with this novel technique.

  18. Treatment for proximal humeral fractures with percutaneous plating: our first results.

    Science.gov (United States)

    Imarisio, D; Trecci, A; Sabatini, L; Scagnelli, R

    2013-06-01

    Proximal humeral fractures are common lesions; there is no generally accepted strategy about the treatment for displaced and unstable two- to four-part fractures. We have nowadays many different surgical solutions, ranging from percutaneous pinning to shoulder arthroplasty. Percutaneous plating can be a good solution to treat some of these fractures using a minimally invasive technique and performing stable fixation that can allow early mobilization. Purpose of this paper is to evaluate the results of our first cases of percutaneous plating in proximal humeral fractures in order to assess the theoretical advantages and the incidence of possible complications. From June 2009 to February 2012, we treated 29 proximal humeral fractures with a percutaneous plating (NCB-PH plate) through an anterolateral deltoid split. For each patient, we evaluated the clinical outcome according to Constant score and the radiographic results, paying attention to fracture healing, loss of reduction, hardware complications, and head necrosis. The clinical evaluation gave a mean Constant score value of 79 points. Comparing each value to the unaffected shoulder, we could find these results: 7 excellent, 10 good, 8 fair, and 4 poor. No axillary nerve lesions were clinically detected. The radiographic evaluation showed a complete bone healing in all cases within the first 3 months. No head necrosis was detected, as well as screws loosening. In two cases, the X-ray at 2 months revealed a little loss of reduction in varus. Two patients had an anterior pain; in one of these two cases, the plate was removed. In our series, we had no cases of head necrosis, screws cutout, fracture collapse, hardware mobilization, and we think this could be the real advantage of the percutaneous technique compared to the open one, thanks to the reduced biological damage. We had some poor results, related more to patient's age than to other factors. The safety of the technique for the axillary nerve is

  19. X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures.

    Science.gov (United States)

    Chen, L-J; Zhao, M-C; Pan, X-F; Wei, Y-Q; Wang, D-Y

    2013-09-01

    This study analyses the different parts of the upper airway space and the changes in hyoid position. The results provide a clinical reference for developing timely and effective treatment programmes for patients with mandibular fractures caused by maxillofacial trauma. Standard X-cephalometric measurements of the lateral skull of 210 subjects were taken. The subjects were divided into four fracture groups: condylar, mandibular angle, mandibular body, and parasymphyseal. The radiographs of the mandibular fracture groups were compared with the normal occlusion group to analyse the upper airway space and the changes in hyoid position. Different types of fractures have different effects on the upper airway space. Bilateral mandibular body fracture and the parasymphyseal fracture have a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces, with serious obstructions severely restricting the ventilatory function of patients. Fractures at different parts of the mandibular structure are closely related to the upper airway and hyoid position.

  20. Fracture transmissivity as a function of normal and shear stress: first results in Opalinus Clay

    International Nuclear Information System (INIS)

    Cuss, R.J.; Milodowski, A.; Noy, D.J.; Harrington, J.F.

    2010-01-01

    Document available in extended abstract form only. Rock-mass failure around openings is usually observed in the form of a highly complex fracture network (EDZ), which is heterogeneous in distribution around a circular tunnel opening because of the heterogeneous stress distribution. The orientation of stress with respect to the fracture network is known to be important. The complex heterogeneous stress trajectory and heterogeneous fracture network results in a broad range of stresses and stress directions acting on the open fracture network. During the open stage of a repository, stress will slowly alter as shear movements occur along the fractures, as well as other time-dependent phenomena. As the repository is back filled, the stress field is further altered as the backfill settles and changes volume because of re-saturation. Therefore, a complex and wide ranging stress regime and stress history will result. In a purely mechanical sense, fracture transmissivity is a function of normal stress, shear stress, and fracture aperture. The Selfrac test from Mont Terri showed the change in transmissivity with effective normal stress. This work showed that fracture transmissivity decreased with increasing normal load and that an effective normal stress of 2.5 MPa is sufficient to yield a transmissivity similar to that seen in intact Opalinus clay (OPA). Therefore fracture closure because of normal stresses has been proven to be a quite efficient mechanism in OPA. A new shear rig was designed to investigate the detail of fracture transmissivity in OPA. The experimental configuration uses two prepared blocks that are 60 x 60 mm in size and approximately 20 mm thick. The first test sample had machine ground surfaces in contact with each other, with pore fluid being delivered through the centre of the top block directly to the fracture surface. The experimental programme included two distinct stages. In the first normal load was altered to investigate fracture transmissivity

  1. Red Flags Are Missed in the Prevention of Hip Fractures: Baseline Results of the Zurich Hip Fracture Trial

    Science.gov (United States)

    From January 2005 to December 2007, we recruited 173 patients age 65 and older with acute hip fracture and a Folstein mini mental score of at least 15 into an ongoing double-blind RCT with vitamin D. 69% of hip fracture patients were admitted from home and 31% from institutions, 79% were women. Mean...

  2. Motorcycle accident is the main cause of maxillofacial injuries in the Penang Mainland, Malaysia.

    Science.gov (United States)

    Hashim, Hasnah; Iqbal, Syed

    2011-02-01

    Maxillofacial injuries are among the commonest forms of body injuries. There are three divisions, namely, facial bone fractures, soft tissue injuries, and dentoalveolar injuries. Etiologies include motor vehicle accidents, assaults, falls, and sporting injuries. The aim of this study was to determine the profiles including the causes of maxillofacial injuries seen in an urban government hospital in the mainland of Penang State, Malaysia. This was a cross-sectional study that recruited cases reported within a period of 1 year. The source population was maxillofacial injury patients presenting to the Oral and Maxillofacial Surgery Department of an urban hospital in the Penang Mainland, North Malaysia between May 2007 and May 2008. Cases of patients involved in accidents that occurred outside the reference vicinity were excluded. A case report form was developed and completed by the attending clinicians. Data were analyzed using spss version 12.0. A total of 194 cases were studied, with the mean patient age being 27.8 (SD 15.20) years. The majority of patients were Malay men between 20 and 29 years of age. The main cause of injury was motorcycle accident (53.6%). The commonest injury (in isolation/combination with other injuries) involved the soft tissues (87.2%), dentoalveolar region (33.4%), and facial bones (23.9%). Laceration was the commonest soft tissue injury, and crown fracture was the most frequent dentoalveolar injury. The facial bone that was most highly involved in the injury was the zygoma. Subjects involved in motorcycle accidents had a significantly higher incidence of sustaining facial bone fractures. Motorcycle accidents were the commonest cause of maxillofacial injuries in the Penang Mainland, Malaysia. Most patients were young men. Hence, it is prudent to reinforce appropriate road safety and awareness interventions particularly focusing young male motorcyclists so as to reduce the risk of accidents. © 2011 John Wiley & Sons A/S.

  3. Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases

    NARCIS (Netherlands)

    Borens, Olivier; Kloen, Peter; Richmond, Jeffrey; Roederer, Goetz; Levine, David S.; Helfet, David L.

    2009-01-01

    To determine the results of "biologic fixation" with a minimally invasive plating technique using a newly designed low profile "Scallop" plate in the treatment of pilon fractures. Retrospective case series. A tertiary referral center. Seventeen patients were treated between 1999 and 2001 for a

  4. Maxillofacial injuries due to work-related accidents in the North West of Italy.

    Science.gov (United States)

    Roccia, Fabio; Boffano, Paolo; Bianchi, Francesca Antonella; Gerbino, Giovanni

    2013-09-01

    The aim of this study was to assess the incidence and patterns of work-related maxillofacial injuries, identifying worker categories with a high risk of injury. From a systematic computer-assisted database that has continuously recorded patients hospitalized with maxillofacial fractures, only patients with work-related injuries were considered. Occupation, mechanism of injury, and demographic and clinical data were analyzed. Work-related facial injuries represented the fifth most common cause of injury, with a percentage of 6.3 %. Maxillofacial fractures were most often seen in construction workers (37.9 %). The middle third was involved in 67 % of the cases; the mandible was the most frequently injured site. Work-related maxillofacial trauma is rare, but it is often complex and challenging as Facial Injury Severity Scale values show. In agreement with the few published reports, construction workers, together with farm and forestry workers, are at the highest risk of injuries, mainly because of struck by a thrown, projected, or falling object.

  5. [True/Flex intramedullary nailing for forearm shaft fractures. Long-term results].

    Science.gov (United States)

    Trlica, J; Počepcov, I; Kočí, J; Frank, M; Holeček, T; Dědek, T

    2012-01-01

    Presentation of technical experience and the clinical and functional results of intramedullary fixation of forearm shaft fractures. Between January 1994 and December 2009, a total of 96 patients with 144 radial and/or ulnar fractures (ulna, 33; radius,15; both, 48) were treated by nailing (True/Flex®). According to the AO classification there were 22-A, 22-B and 22-C type fractures in 39 (41%), 44 (46%) and 13 (13%).cases, respectively. Of these, 82 (85%) were closed (types: 0, 48; I, 33; II, 1) and 14 (15%) were open (types: I, 13; II, 1; III, 0) fractures. Seventy-eight patients (81%) were followed up and their functional outcomes were evaluated according to the criteria of Anderson et al. The average interval between the operation and final follow-up was 28 months (15 to 96 months) The average time to surgery was 2.2 days (0 to 25 days). Early complications were recorded in 4% of the patients (1x bursitis olecrani; 1x end cup replacement; 1x bending of nails) and late complications in 15% (5x non-union; 2x delay union; 4x bursitis olecrani; 1x ruptured tendon). Bone healing was achieved in 95% of the cases and took on average 16 weeks (7 to 34 weeks). No infection, refracture or synostosis occurred. Primary loss of reduction was recorded in four cases due to distraction in one, bent nails in two and a wrong size of the implant in one; secondary loss of reduction was found in three cases, with two cases of radius shortening and one 10°malrotation. No primary malrotation was recorded, but secondary loss of alignment was seen in the distal part of the radius and the proximal part of the ulna. Functional results according to the Anderson criteria were excellent and good in 87% of the cases. Intramedullary mailing provides good stability to mid- and distal-third shaft fractures of the ulna and mid- and proximalthird shaft fractures of the radius, particularly in AO type A and type B fractures. The technical aspects of the method are analysed in detail in this paper

  6. Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases.

    Science.gov (United States)

    Borens, Olivier; Kloen, Peter; Richmond, Jeffrey; Roederer, Goetz; Levine, David S; Helfet, David L

    2009-05-01

    To determine the results of "biologic fixation" with a minimally invasive plating technique using a newly designed low profile "Scallop" plate in the treatment of pilon fractures. Retrospective case series. A tertiary referral center. Seventeen patients were treated between 1999 and 2001 for a tibial plafond fracture at the Hospital for Special Surgery with a newly designed low-profile plate. Eleven of the fractures (65%) were high-energy injuries. Two fractures were open. Staged surgical treatment with open reduction and fixation of the fibular fracture and application of an external fixator was performed in 12 cases. As soon as the soft tissues and swelling allowed, i.e. skin wrinkling, the articular surface was reconstructed and simply reduced, if necessary through an small incision, and the articular block was fixed to the diaphysis using a medially placed, percutaneously introduced flat scallop plate. In the remaining five cases the operation was performed in one session. Time to healing and complications including delayed union, non-union, instrument failure, loss of fixation, infection, quality of reduction and number of reoperations were evaluated. Quality of results and outcome were graded using the ankle-hindfoot-scale and a modified rating system. All patients went on to bony union at an average time of 14 weeks. There were no plate failures or loss of fixation/reduction. Two superficial wound-healing problems resolved with local wound care. At an average follow up of 17 months (range 6-29 months) eight patients (47%) had an excellent result; seven (41%) had a fair result whereas two (12%) had a poor result. The average ankle-hindfoot-score was 86.1 (range 61-100). Four patients have had the hardware removed and one of them is awaiting an ankle arthrodesis. Based on these initial results, it appears that a minimally invasive surgical technique including new low profile plate can decrease soft tissue problems while leading to fracture healing and

  7. Channel flow and trichloroethylene treatment in a partly iron-filled fracture: Experimental and model results

    Science.gov (United States)

    Cai, Zuansi; Merly, Corrine; Thomson, Neil R.; Wilson, Ryan D.; Lerner, David N.

    2007-08-01

    Technical developments have now made it possible to emplace granular zero-valent iron (Fe 0) in fractured media to create a Fe 0 fracture reactive barrier (Fe 0 FRB) for the treatment of contaminated groundwater. To evaluate this concept, we conducted a laboratory experiment in which trichloroethylene (TCE) contaminated water was flushed through a single uniform fracture created between two sandstone blocks. This fracture was partly filled with what was intended to be a uniform thickness of iron. Partial treatment of TCE by iron demonstrated that the concept of a Fe 0 FRB is practical, but was less than anticipated for an iron layer of uniform thickness. When the experiment was disassembled, evidence of discrete channelised flow was noted and attributed to imperfect placement of the iron. To evaluate the effect of the channel flow, an explicit Channel Model was developed that simplifies this complex flow regime into a conceptualised set of uniform and parallel channels. The mathematical representation of this conceptualisation directly accounts for (i) flow channels and immobile fluid arising from the non-uniform iron placement, (ii) mass transfer from the open fracture to iron and immobile fluid regions, and (iii) degradation in the iron regions. A favourable comparison between laboratory data and the results from the developed mathematical model suggests that the model is capable of representing TCE degradation in fractures with non-uniform iron placement. In order to apply this Channel Model concept to a Fe 0 FRB system, a simplified, or implicit, Lumped Channel Model was developed where the physical and chemical processes in the iron layer and immobile fluid regions are captured by a first-order lumped rate parameter. The performance of this Lumped Channel Model was compared to laboratory data, and benchmarked against the Channel Model. The advantages of the Lumped Channel Model are that the degradation of TCE in the system is represented by a first

  8. Preliminary results of a coupled fracture-flow test at the 0.5 m scale

    International Nuclear Information System (INIS)

    Blair, S.C.; Costantino, M.S.

    1997-01-01

    Understanding the hydrologic response of fluids present in the proposed repository horizon to the construction of a repository and the subsequent storage of high-level radioactive waste is crucial to the evaluation of Yucca Mountain as a suitable repository location. Moreover, recent analysis of site measurements imply that the rate of infiltration of water into Yucca Mountain is higher than previously thought, and an in-depth review of all data and analyses has so far confirmed the new estimates (Taylor, 1997). It is also known that the potential repository horizon at Yucca Mountain contains a significant number of fractures. This fact, coupled with higher estimates of the infiltration rate, has resulted in a revision of the general hydrologic model for Yucca Mountain; and it is now thought that the significant flow regime at this site is episodic fast flow in fractures. This implies that surface water can travel deep into Yucca Mountain through fractures (Taylor, 1997). Given these recent developments, understanding flow in the fractured rock mass at Yucca Mountain is a critical requirement for viability assessment. Further, it is well known that the stress field in the rock surrounding the drifts will be altered by both the excavation of drifts and the heating of the rock associated with waste emplacement and storage. It also is generally accepted that flow in fractured rock is highly dependent on the stress field and temperature in the rock. This implies that the hydrologic behavior of rock surrounding emplacement drifts in the potential repository is dependent on the mechanical response of the fractured rock mass to excavation and waste emplacement

  9. Body mass index, physical activity, and fracture among young adults: longitudinal results from the Thai cohort study.

    Science.gov (United States)

    Jordan, Susan; Lim, Lynette; Berecki-Gisolf, Janneke; Bain, Chris; Seubsman, Sam-ang; Sleigh, Adrian; Banks, Emily

    2013-01-01

    We investigated risk factors for fracture among young adults, particularly body mass index (BMI) and physical activity, which although associated with fracture in older populations have rarely been investigated in younger people. In 2009, 4 years after initial recruitment, 58 204 Thais aged 19 to 49 years were asked to self-report fractures incident in the preceding 4 years. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% CIs for associations of fracture incidence with baseline BMI and physical activity. Very obese women had a 70% increase in fracture risk (OR = 1.73, 95% CI 1.21-2.46) as compared with women with a normal BMI. Fracture risk increased by 15% with every 5-kg/m(2) increase in BMI. The effects were strongest for fractures of the lower limbs. Frequent purposeful physical activity was also associated with increased fracture risk among women (OR = 1.52, 95% CI 1.12-2.06 for 15 episodes/week vs none). Neither BMI nor physical activity was associated with fracture among men, although fracture risk decreased by 4% with every additional 2 hours of average sitting time per day (OR = 0.96, 95% CI 0.93-0.99). The increase in obesity prevalence will likely increase fracture burden among young women but not young men. While active lifestyles have health benefits, our results highlight the importance of promoting injury prevention practices in conjunction with physical activity recommendations, particularly among women.

  10. Minimally invasive treatment of trochanteric fractures with intramedullary nails. Technique and results.

    Science.gov (United States)

    Todor, Adrian; Pojar, Adina; Lucaciu, Dan

    2013-01-01

    The aim of the study was to evaluate the results of minimally invasive treatment of trochanteric fractures with the use of intramedullary nails. From September 2010 to September 2012 we treated 21 patients with pertrochanteric fractures by a minimally invasive technique using the Gamma 3 (Stryker, Howmedica) nail. There were 13 females and 8 men with a mean age of 74.1 years, ranging from 58 to 88 years. Fractures were classified as being stable (AO type 31-A1) in 5 cases and unstable (AO type 31-A2 and A3) in the rest of 16 cases. Patients were reviewed at 6 weeks and 3 months postoperatively. Mean surgery time was 46.8 minutes and mean hospital stay was 14.9 days. No patients required blood transfusions. During the hospital stay all the patients were mobilized with weight bearing as tolerated. All patients were available for review at 6 weeks, and 2 were lost to the 3 months follow up. 16 patients regained the previous level of activity. This minimally invasive technique using a gamma nail device for pertrochanteric fractures gives reliable good results with excellent preservation of hip function.

  11. Pattern, severity, and management of cranio-maxillofacial soft-tissue injuries in Port Harcourt, Nigeria

    Directory of Open Access Journals (Sweden)

    Akinbami Babatunde Olayemi

    2013-01-01

    Full Text Available Background: The pattern of craniofacial soft-tissue injuries occurring either in isolation or in association with fractures vary in different societies and is multiply influenced. The effects are enormous because of the prominence of the face; therefore, the purpose of this study was to document any changing pattern, severity and management of these craniofacial injuries in our center. Patients and Method: Cranio-maxillofacial region was classified into upper, middle and lower face. The cause, type, and site of the injuries were documented. Gunshot injuries were further categorized as penetrating, perforating or avulsions. Further, classification of injuries into mild, moderate, and severe was carried out based on multiple factors. Result: A total of 126 patients with soft-tissue injuries presented to our hospital out of which 85 (67.5% were males and 41 (32.5 were females. The age range of the patients was between 10 months and 90 years with a mean ± SD of 26.4 ± 15.5 years. Road traffic accident was the most common etiology of which vehicular accidents constituted 50 (54.9% and the motorcycle was 2 (2.2%. Assault contributed 16 (17.6% while cases due to gun shots were 13 (14.3%. A total of 19 (15.1% patients had associated head injuries, 11 (8.7% patients had craniofacial fractures involving any of the bones while 3 (2.4% patients had limb fractures and 2 (1.6% patients had rib fractures. There were 51 (41.8% cases classified as mild injuries, 37 (30.3% cases as moderate injuries and 24 (19.7% cases as severe injuries. Total of 126 cases managed, 121 (96.0% received primary closure of the wounds while 5 (4.0% received delayed closure under general anesthesia.

  12. Development of a novel technique for maxillofacial reconstruction using custom-made bioactive ceramic implants

    Science.gov (United States)

    Kulbakin, D. E.; Choinzonov, E. L.; Kulkov, S. N.; Buyakova, S. P.; Chernov, V. I.; Mukhamedov, M. R.; Buyakov, A. S.

    2017-09-01

    Recently, there has been a trend towards the search for new, safe and effective methods of reconstruction of maxillofacial defects after tumor excision. Among various materials used for bone defect reconstruction, ceramics has attached a great deal of attention. The purpose of our study was to develop a technique for personified approach to the reconstruction of maxillofacial bone defects with bioactive ceramic implants. In our study we used the technique of virtual implant planning for maxillofacial reconstruction using preoperative CT data of the patient's facial skeleton. Bioactive ceramic implant materials meet all the requirements for medical materials used in reconstructive surgery. The technique described in this paper to customize prefabricated bioactive ceramic implants enables surgeons to perform reconstruction of large postoperative defects in the maxillofacial region, thereby making custom implants suitable for any patient. The use of this technique decreases surgical time, reduces time needed for postoperative recovery, lowers overall patient morbidity and optimizes aesthetic and functional results.

  13. Local Inflammation in Fracture Hematoma: Results from a Combined Trauma Model in Pigs

    Directory of Open Access Journals (Sweden)

    K. Horst

    2015-01-01

    Full Text Available Background. Previous studies showed significant interaction between the local and systemic inflammatory response after severe trauma in small animal models. The purpose of this study was to establish a new combined trauma model in pigs to investigate fracture-associated local inflammation and gain information about the early inflammatory stages after polytrauma. Material and Methods. Combined trauma consisted of tibial fracture, lung contusion, liver laceration, and controlled hemorrhage. Animals were mechanically ventilated and under ICU-monitoring for 48 h. Blood and fracture hematoma samples were collected during the time course of the study. Local and systemic levels of serum cytokines and diverse alarmins were measured by ELISA kit. Results. A statistical significant difference in the systemic serum values of IL-6 and HMGB1 was observed when compared to the sham. Moreover, there was a statistical significant difference in the serum values of the fracture hematoma of IL-6, IL-8, IL-10, and HMGB1 when compared to the systemic inflammatory response. However a decrease of local proinflammatory concentrations was observed while anti-inflammatory mediators increased. Conclusion. Our data showed a time-dependent activation of the local and systemic inflammatory response. Indeed it is the first study focusing on the local and systemic inflammatory response to multiple-trauma in a large animal model.

  14. Preliminary test results from the HSST shallow-crack fracture toughness program

    International Nuclear Information System (INIS)

    Theiss, T.J.; Robinson, G.C.; Rolfe, S.T.

    1991-01-01

    The Heavy Section Steel Technology (HSST) Program under sponsorship of the Nuclear Regulatory Commission (NRC) is investigating the influence of crack depth on the fracture toughness of reactor pressure vessel steel. The ultimate goal of the investigation is the generation of a limited data base of elastic-plastic fracture toughness values appropriate for shallow flaws in a reactor pressure vessel and the application of this data to reactor vessel life assessments. It has been shown that shallow-flaws play a dominant role in the probabilistic fracture mechanics analysis of reactor pressure vessels during a pressurized-thermal-shock event. In addition, recent research has shown that the crack initiation toughness measured using specimens with shallow flaws is greater that the toughness determined with conventional, deeply notched specimens at temperatures within the transition region for non-nuclear steels. The influence of crack depth on the elastic-plastic fracture toughness for prototypic reactor material is being investigated. Preliminary results indicate a significant increase in the toughness associated with shallow-flaws which has the potential to significantly impact the conditional probability of vessel failure. 8 refs., 4 figs., 1 tab

  15. Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese cohort: results from the Osteoporotic Fractures in Men (MrOs) Study.

    Science.gov (United States)

    Yu, Ruby; Leung, Jason; Woo, Jean

    2014-08-01

    We examined whether sarcopenia is predictive of incident fractures among older men, whether the inclusion of sarcopenia in models adds any incremental value to bone mineral density (BMD), and whether sarcopenia is associated with a higher risk of fractures in elderly with osteoporosis. A cohort of 2000 community-dwelling men aged ≥65 years were examined for which detailed information regarding demographics, socioeconomic, medical history, clinical, and lifestyle factors were documented. Body composition and BMD were measured using dual energy X-ray absorptiometry. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) algorithm. Incident fractures were documented during the follow-up period from 2001 to 2013, and related to sarcopenia and its component measures using Cox proportional hazard regressions. The contribution of sarcopenia for predicting fracture risk was evaluated by receiver operating characteristic analysis, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). During an average of 11.3 years of follow-up, 226 (11.3%) men sustained at least 1 incident fracture, making the incidence of fractures 1200.6/100,000 person-years. After multivariate adjustments, sarcopenia was associated with increased fracture risk (hazard ratio [HR], 1.87, 95% confidence interval [CI], 1.26-2.79) independent of BMD and other clinical risk factors. The addition of sarcopenia did not significantly increase area under curve or IDI but significantly improved the predictive ability on fracture risk over BMD and other clinical risk factors by 5.12% (P sarcopenia (sarco-osteoporosis) resulted in a significantly increased risk of fractures (HR, 3.49, 95% CI, 1.76-6.90) compared with those with normal BMD and without sarcopenia. This study confirms that sarcopenia is a predictor of fracture risk in this elderly men cohort, establishes that sarcopenia provides incremental predictive value for fractures over the

  16. Neurofibromatosis of the Maxillofacial Region

    International Nuclear Information System (INIS)

    AlRuhaimi, Khalid A.; Sailer, Hermann F.

    1989-01-01

    In this study seventeen patients with neurofibromatosis in the maxillofacial region were presented. There was no great difference in the incidence of the disease between males and females. The patient age range was 1 to 75 years with a mean age of 21.5 years. Family history was positive in 5 cases. The spectrum of the clinical manifestations of this disease, known for its protean characteristics, were evident in all of our 17 patients. 14 (82.4%) patients had cafeau-lait spots; 3 (1 7.6%) had multiple cutaneous nodules; malignant transformation was documented in only one case (5.9%). Psychologic depression was recorded in 2 (11.8%) ceases, and one(5.9%) case had grand-mal epilepsy. A rare location of neurofibromatous nodules, i.e. in eye (iris nodules), was reported in only one (5.9%) case. The most frequently performed procedure in our cases was excision of the tumor mass which was, in most instances, incomplete. However, massive bleeding during surgical intervention was prominent in four cases and was overcome with extensive packing removed after approximately two weeks. An interesting finding in this study was the incidence of radiologic findings which was higher (76.4%) than previously reported. All cases of this study were unilateral and involvement of the mandible (65%) was more than that of the maxillae. (author)

  17. A proposal of a three-dimensional CT measurement method of maxillofacial structure

    International Nuclear Information System (INIS)

    Tanaka, Ray; Hayashi, Takafumi

    2007-01-01

    Three-dimensional CT measurement is put in practice in order to grasp the pathological condition on diseases such as the temporomandibular joint disorder, maxillofacial anomaly, jaw deformity, or fracture which cause the morphologic changes of the maxillofacial bones. On the 3D measurement, the unique system that is obtained by volume rendering 3D images with a simultaneous reference of axial images combined with coronal and sagittal multi-planar reconstruction (MPR) images (we call this MPR referential method), is employed in order to define the measurement points. Our purpose in this report is to indicate the usefulness of this unique method by comparing with the common way to define the measurement points on only 3D reconstruction images without consulting of MPR images. Clinical CT data obtained from a male patient with skeletal malocclusion was used. Contiguous axial images were reconstructed at 4 times magnification, with a reconstruction interval of 0.5 mm, focused on the temporomandibular joint region in his left side. After these images were converted to Digital Imaging and Communications in Medicine (DICOM) format and sent to personal computer (PC), 3D reconstruction image was created using free 3D DICOM medical image viewer. The coordinates of 3 measurement points (the lateral and medial pole of the mandibular condyle, and the left foramen ovale) were defined with MPR images (MPR coordinates) as reference coordinates, and then the coordinates that were defined on only 3D reconstruction image without consulting to MPR images (3D coordinates) were compared to those of MPR coordinates. Three examiners were engaged independently 10 times for every measurement point. In our result, there was no correspondence between 3D coordinates and MPR coordinates, and contribution of 3D coordinates showed a variety in every measurement point and in every observer. We deemed that ''MPR referential method'' is useful to assess the location of the target point of anatomical

  18. Results of ASTM round robin testing for mode 1 interlaminar fracture toughness of composite materials

    Science.gov (United States)

    Obrien, T. Kevin; Martin, Roderick H.

    1992-01-01

    The results are summarized of several interlaboratory 'round robin' test programs for measuring the mode 1 interlaminar fracture toughness of advanced fiber reinforced composite materials. Double Cantilever Beam (DCB) tests were conducted by participants in ASTM committee D30 on High Modulus Fibers and their Composites and by representatives of the European Group on Fracture (EGF) and the Japanese Industrial Standards Group (JIS). DCB tests were performed on three AS4 carbon fiber reinforced composite materials: AS4/3501-6 with a brittle epoxy matrix; AS4/BP907 with a tough epoxy matrix; and AS4/PEEK with a tough thermoplastic matrix. Difficulties encountered in manufacturing panels, as well as conducting the tests are discussed. Critical issues that developed during the course of the testing are highlighted. Results of the round robin testing used to determine the precision of the ASTM DCB test standard are summarized.

  19. Results of Closed Intramedullary Nailing using Talwarkar Square Nail in Adult Forearm Fractures

    Directory of Open Access Journals (Sweden)

    Nadeem A Lil

    2012-07-01

    Full Text Available The aim of the study was to evaluate results of closed intramedullary nailing using Talwarkar square nails in adult forearm fractures. We prospectively evaluated 34 patients with both bone forearm fractures. The average time to union was 12.8 (SD +3.2 weeks with cast support for a mean of 8.2 weeks. Union was achieved in 31 out of 34 patients. Using the Grace and Eversmann rating system, 17 patients were excellent, 10 were good, and 4 had an acceptable result. Three patients had non-unions, 2 for the radius and one for the ulna. There were two cases of superficial infection, one subject had olecranon bursitis, and one case of radio-ulnar synostosis. Complication rates associated with the use of square nails were lower compared to plate osteosynthesis and locked intramedullary nails. To control rotation post- operatively, there is a need for application of an above-elbow cast after nailing.

  20. Results of cemented bipolar hemiarthroplasty for fracture of the femoral neck - 10 year study

    Directory of Open Access Journals (Sweden)

    Maini P

    2006-01-01

    Full Text Available Background : One of the most common treatments of displaced fracture of femoral neck in elderly is bipolar hemiarthroplasty. Method : Two hundred and seventy patients of displaced fracture of femoral neck were treated by bipolar hemiarthroplasty. The Mean age of the patients at the time of surgery was 69.80 years. Results : Follow up ranged between 12 months and 120 months. There were 8 cases each of acetabular erosion and protrusion with 10 cases of femoral stem loosening. Eight cases had post operative dislocation requiring open reduction. Eighteen patients got revision surgery to total hip replacement. The overall incidence of DVT/PE was 9.9% which declined after regular use of low molecular weight heparin. Eleven patients had post operative infection. There were 54.2 % excellent results, 21.0 % good results, 10.7 % fair and 3.7% poor results. Conclusion : Elderly patients with displaced fracture of neck femur are able to ambulate early after Cemented bipolar hemi arthroplasty. The complication rate is low, the component survival long and pre injury functional status is restored in majority of patients.

  1. Computerized detection of vertebral compression fractures on lateral chest radiographs: Preliminary results with a tool for early detection of osteoporosis

    International Nuclear Information System (INIS)

    Kasai, Satoshi; Li Feng; Shiraishi, Junji; Li Qiang; Doi, Kunio

    2006-01-01

    -positive fractures per image. The accuracy of identifying vertebral end plates, marked by radiologists in a morphometric study, was 76.6% (400/522) and 70.9% (420/592) for cases used for training and those for testing, respectively. We prepared 32 additional fracture cases for a validation test, and we examined the detection accuracy of our computerized method. The sensitivity for these cases was 75% (24/32) at 1.03 (33/32) false-positive fractures per image. Our preliminary results show that the automated computerized scheme for detecting vertebral fractures on lateral chest radiographs has the potential to assist radiologists in detecting vertebral fractures

  2. Surgical treatment of acetabular fractures: clinical and radiological results and its complications

    International Nuclear Information System (INIS)

    Martinez, C; Rey, R.

    2011-01-01

    The objective of this work is to analyse a serie of consecutive cases of surigically treated acetabular fractures, evaluating middle-term clinical and radiological results. A retrospective analysis of clinical histories, surgical forms and X-rays was performed for 42 patients who underwent surgery in two centers (Instituto Nacional de Ortopedia y Traumatologia [INOT] and Banco de Protesis), from July 2001 through August 2007

  3. Fracture risk in women with type II diabetes. Results from a historical cohort with fracture follow-up

    DEFF Research Database (Denmark)

    Holm, Jakob Præst; Jensen, Thomas; Hyldstrup, Lars

    2018-01-01

    . Prevalent fractures (43.7 vs. 33.2%, p = 0.0010) and prevalent MOF (26.2 vs. 20.5% p = 0.038) were more common among patients with type II diabetes. The unadjusted incident fracture risk was increased with a higher relative risk of 42%. An elevated MOF hazard ratio was present (HR = 1.726, p = 0.......0006). Adjustment for prevalent osteoporosis and other possible confounders did not change this finding (HR = 1.558, p = 0.0207). CONCLUSIONS: An association between type II diabetes and an increased risk of MOF primarily driven by an increased hip fracture risk was documented. This finding was independent......PURPOSE: To examine the independent association between type II diabetes and fracture risk in a population of predominantly postmenopausal women referred to a specialist clinic for osteoporosis evaluation. METHODS: Type II diabetes associated fracture risk were evaluated among to 229 patients...

  4. A Study of Streptococcus Viridans in the Maxillofacial Region

    Directory of Open Access Journals (Sweden)

    Y. Refoua

    2005-12-01

    Full Text Available Statement of Problem: Streptococcus viridans is one of the most important microorganisms in the establishment of infections leading to dental caries and heart valve damages. Therefore the diagnosis and prevention of these infections is critical in health care.Purpose: The aim of this in-vivo study was to determine the prevalence of viridans streptococci in abscesses occurring in the maxillofacial region.Materials and Methods: The study sample consisted of 39 patients with maxillofacial abscesses, referred to the Department of Oral Surgery Faculty of Dentistry Tehran University of Medical Sciences and Dr. Shariati Hospital, Tehran University of Medical Sciences. Extra-oral incision, drainage and pus collection followed by culture, staining and biochemical and sugar fermentation tests were carried out for all participants.Results: In the present study %53.84 and 46.16% of the patients had negative and positive culture results, respectively. In the positive culture group, %2.5 of the viridans streptococci were streptococcus salivarius, %4.6 streptococcus sanguis and %17.9 were streptococcus mutans.Conclusion: The findings of this study showed that viridans streptococci are an important factor in the development of metastatic and maxillofacial infections which can pose a significant threat to the patient’s life.

  5. [Early results of proximal femoral fractures treated with FENIX modular hemiarthroplasty].

    Science.gov (United States)

    Görski, Radosław; Górecki, Andrzej; Olszewski, Paweł; Biedrzycki, Jerzy; Skowronek, Paweł

    2010-01-01

    The article discusses preliminary clinical results in patients with proximal femoral fractures treated with hemiarthroplasty using a FENIX implant. The study group comprised 41 subjects aged 69 to 97 (median age 82.3 year). The follow-up study provided data on 26 subjects (63.4%), among which 15 attended the check-up, 5 subjects refused to visit at the Department and 6 subjects were reported as deceased. Median follow-up period amounted to 6.8 month (1 to 22 months). General hospitalization-related complications occurred in 8 patients (19.5%). During hospitalization no deaths occurred, in the deceased group 3 patients died within 12 months after surgery, while another 3 died after the twelve-month postoperative period (median of 13.3%). According to Merle d'Aubigne-Postel score favorable long-term results were observed in 9 patients (59.9%), 13 patients regained the level of motor function similar to the functional ability prior to fracture. The need to postpone the surgery due to general health status and impaired pre-operative motor function are significant negative prognostic factors. The results obtained were compared with previous efficacy studies on femoral fracture treatment using an Austin-Moore implant. Functional ability and self-reliance was higher in the FENIX group. FENIX arthroplasty effectively helps patients regain self-reliance and motor function thanks to its modular characteristics and anatmoical construction.

  6. Mid term results of Furlong LOL uncemented hip hemiarthroplasty for fractures of the femoral neck.

    Science.gov (United States)

    Chandran, Prakash; Azzabi, Mohammed; Burton, Dave J C; Andrews, Mark; Bradley, John G

    2006-08-01

    We report the mid-term results of hemiarthroplasty with the Furlong hydroxyapatite coated bipolar prosthesis for displaced (Garden type III and IV) intracapsular hip fracture in 480 patients operated between 1989 and 2000. Three hundred sixty eight (77%) patients were lost to follow-up due to death, dementia or movement away from the area. In the patients followed up there was an 8% reoperation rate for infection, aseptic loosening, periprosthetic fracture and acetabular erosion. One hundred and twelve patients with a mean follow-up of 4 years (3-14) were studied. Eighty eight percent had no or slight pain, 77% could mobilise outdoors and 89% needed either no aid or a single walking stick to mobilise. Radiographic assessment revealed a stable implant with visible osseointegration in 91%. We conclude that hemiarthroplasty with the hydroxyapatite coated bipolar Furlong LOL prosthesis for displaced intracapsular fracture of the neck of the femur gives good mid term results in elderly patients for return to mobility, use of mobility aids and freedom from pain. It avoids the need for cement and provides satisfactory incorporation into the host bone. The use of a modular head makes revision to total hip replacement easier.

  7. Statistical analyses of fracture toughness results for two irradiated high-copper welds

    International Nuclear Information System (INIS)

    Nanstad, R.K.; McCabe, D.E.; Haggag, F.M.; Bowman, K.O.; Downing, D.J.

    1990-01-01

    The objectives of the Heavy-Section Steel Irradiation Program Fifth Irradiation Series were to determine the effects of neutron irradiation on the transition temperature shift and the shape of the K Ic curve described in Sect. 6 of the ASME Boiler and Pressure Vessel Code. Two submerged-arc welds with copper contents of 0.23 and 0.31% were commercially fabricated in 215-mm-thick plates. Charpy V-notch (CVN) impact, tensile, drop-weight, and compact specimens up to 203.2 mm thick [1T, 2T, 4T, 6T, and 8T C(T)] were tested to provide a large data base for unirradiated material. Similar specimens with compacts up to 4T were irradiated at about 288 degrees C to a mean fluence of about 1.5 x 10 19 neutrons/cm 2 (>1 MeV) in the Oak Ridge Research Reactor. Both linear-elastic and elastic-plastic fracture mechanics methods were used to analyze all cleavage fracture results and local cleavage instabilities (pop-ins). Evaluation of the results showed that the cleavage fracture toughness values determined at initial pop-ins fall within the same scatter band as the values from failed specimens; thus, they were included in the data base for analysis (all data are designated K Jc )

  8. Risk of surgical glove perforation in oral and maxillofacial surgery.

    Science.gov (United States)

    Kuroyanagi, N; Nagao, T; Sakuma, H; Miyachi, H; Ochiai, S; Kimura, Y; Fukano, H; Shimozato, K

    2012-08-01

    Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n=1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n=45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3-48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Hip Fracture

    Science.gov (United States)

    ... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...

  10. Elbow dislocation with intra-articular fracture: the results of operative treatment without repair of the medial collateral ligament.

    Science.gov (United States)

    Forthman, Christopher; Henket, Marjolijn; Ring, David C

    2007-10-01

    To determine the effectiveness of a protocol for the treatment of fracture-dislocations of the elbow based on the concept that, if dislocation of the elbow with associated fractures can be made to resemble a simple elbow dislocation by repairing or reconstructing the fractured structures, repair of the medial collateral ligament (MCL) will not be necessary. Over a 5-year period, a single surgeon operated on 34 patients with a posterior dislocation of the elbow associated with one or more intra-articular fractures. The mean age of these 19 men and 15 women was 48 years. Associated fractures included the capitellum, trochlea, and lateral epicondyle in 3 patients; the olecranon in 1 patient; and the radial head in 30 patients (with concomitant fracture of the coronoid process-the so-called "terrible triad" of the elbow-in 22 patients, and concomitant fracture of the coronoid and olecranon in 1 patient). Operative treatment consisted of open reduction internal fixation (ORIF) or prosthetic replacement of all fractures and reattachment of the origin of the lateral collateral ligament (LCL) complex to the lateral epicondyle. The MCL was not repaired. Two patients (1 with a terrible triad injury and 1 with fracture of the capitellum and trochlea) had postoperative instability related to noncompliance, had reconstructive procedures, and were considered failures. An average of 32 months after injury, the remaining 32 patients regained an average of 120 degrees ulnohumeral motion and 142 degrees forearm rotation. Twenty-five of 34 patients (74%) had good or excellent results according to the system of Broberg and Morrey. Patients with terrible triad injuries had an average of 117 degrees ulnohumeral motion and 137 degrees forearm rotation, and 17 of 22 patients (77%) had good or excellent results. MCL repair is unnecessary in the treatment of dislocation of the elbow with associated intra-articular fractures, provided that the articular fractures and the LCL are repaired or

  11. Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

    Directory of Open Access Journals (Sweden)

    Rodrigo Arnold Tisot

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.METHODS: A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.RESULTS: There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047 compared to those surgically treated (p=0.335. The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.CONCLUSION: The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.

  12. Bilateral rapidly destructive arthrosis of the hip joint resulting from subchondral fracture with superimposed secondary osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Takuaki; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan); Schneider, Robert [Hospital for Special Surgery, Department of Radiology, New York (United States); Bullough, Peter G. [Hospital for Special Surgery, Department of Laboratory Medicine, New York, NY (United States)

    2010-02-15

    A 57-year-old woman suffered rapid destruction of both hip joints over a 10 months period. At the first visit, her radiographs demonstrated slight joint space narrowing and acetabular cyst formation in both hips. Five months later, joint space narrowing had further progressed, and intra-articular injection of steroid was given in both hips. However, the hip pain gradually became worse. Five months later, both joint spaces had totally disappeared and both femoral heads had undergone massive collapse. At gross examination, both resected femoral heads showed extensive opaque yellow areas consistent with osteonecrosis. Microscopic examination of these areas revealed evidence of both extensive fracture and callus formation, as well as necrosis throughout, indicating that the osteonecrosis observed in this case was a secondary phenomenon superimposed on pre-existing osteoarthritis and subchondral fracture. There were many pseudogranulomatous lesions in the marrow space and necrotic area, where tiny fragments of bone and articular cartilage, surrounded by histiocytes and giant cells, were embedded, such as are typically seen in rapidly destructive arthrosis. No radiologic or morphologic evidence of primary osteonecrosis was noted. This case indicates that at least some cases of rapidly destructive arthritis are the result of subchondral fracture with superimposed secondary osteonecrosis. (orig.)

  13. Bilateral rapidly destructive arthrosis of the hip joint resulting from subchondral fracture with superimposed secondary osteonecrosis

    International Nuclear Information System (INIS)

    Yamamoto, Takuaki; Iwamoto, Yukihide; Schneider, Robert; Bullough, Peter G.

    2010-01-01

    A 57-year-old woman suffered rapid destruction of both hip joints over a 10 months period. At the first visit, her radiographs demonstrated slight joint space narrowing and acetabular cyst formation in both hips. Five months later, joint space narrowing had further progressed, and intra-articular injection of steroid was given in both hips. However, the hip pain gradually became worse. Five months later, both joint spaces had totally disappeared and both femoral heads had undergone massive collapse. At gross examination, both resected femoral heads showed extensive opaque yellow areas consistent with osteonecrosis. Microscopic examination of these areas revealed evidence of both extensive fracture and callus formation, as well as necrosis throughout, indicating that the osteonecrosis observed in this case was a secondary phenomenon superimposed on pre-existing osteoarthritis and subchondral fracture. There were many pseudogranulomatous lesions in the marrow space and necrotic area, where tiny fragments of bone and articular cartilage, surrounded by histiocytes and giant cells, were embedded, such as are typically seen in rapidly destructive arthrosis. No radiologic or morphologic evidence of primary osteonecrosis was noted. This case indicates that at least some cases of rapidly destructive arthritis are the result of subchondral fracture with superimposed secondary osteonecrosis. (orig.)

  14. Comparison of the results of wide plate tests with the predictions of several fracture concepts

    International Nuclear Information System (INIS)

    Rosezin, H.J.; Dahl, W.

    1985-01-01

    With the results of wide plate tests on center cracked specimens the concept of the plastic limit load, the Burdekin-Dawes-design-concept, the J-design-curve according to Turner, the estimation proceeding according to Shih and Kumar, the Two-Criteria-Approach and the FAD according to Pellini were examined and the limits of their application exhibited. The maximum loads of wide plate specimens can be estimated by the plastic limit load, if no low-stress-fractures occur. Corresponding to the Pellini-concept no low-stress-fractures occured at test temperatures above NDT, if the NDT-temperature of the region of material was used, in which the crack was located. With the concept according to Shih and Kumar an estimation of the instability loads of wide plate specimens is possible, if the fracture behaviour is fully ductile, but not in all cases conservative predictions were made. A prediction of critical stresses and crack sizes is possible with the other concepts examined, if the evaluations are based on the critical values for the onset of stable or unstable crack growth. (orig.) [de

  15. Mid-term results of ankle fractures with and without syndesmotic rupture.

    Science.gov (United States)

    Veen, Egbert J D; Zuurmond, Rutger G

    2015-03-01

    This study investigated the effect of short term removal of syndesmotic screws on the ankle function after 6 years, as there still exists controversy on the duration of screw stabilization. Patients with an ankle fracture who received surgery between 1998 and 2004 were reviewed. One group was composed of patients with an ankle fracture needing a syndesmotic repair with screws. The second was composed of operated patients that did not need syndesmotic repair. The primary scoring used was the Olerud-Molander Ankle Score (OMAS). A total of 59 patients were studied with comparable characteristics, with no significant difference on the OMAS after 6 years between the repair group (81.9) and the non-repair group (90.4). On additional clinical scoring groups remained the same. Joint degeneration was seen in both groups (86.7% vs. 55.5%). Patients with ankle fractures using syndesmotic repair and screw removal after 8 weeks and operated patients without syndesmotic injury have comparable results after 6 years. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  16. Fracture healing using degradable magnesium fixation plates and screws.

    Science.gov (United States)

    Chaya, Amy; Yoshizawa, Sayuri; Verdelis, Kostas; Noorani, Sabrina; Costello, Bernard J; Sfeir, Charles

    2015-02-01

    Internal bone fixation devices made with permanent metals are associated with numerous long-term complications and may require removal. We hypothesized that fixation devices made with degradable magnesium alloys could provide an ideal combination of strength and degradation, facilitating fracture fixation and healing while eliminating the need for implant removal surgery. Fixation plates and screws were machined from 99.9% pure magnesium and compared with titanium devices in a rabbit ulnar fracture model. Magnesium device degradation and the effect on fracture healing and bone formation were assessed after 4 weeks. Fracture healing with magnesium device fixation was compared with that of titanium devices using qualitative histologic analysis and quantitative histomorphometry. Micro-computed tomography showed device degradation after 4 weeks in vivo. In addition, 2-dimensional micro-computed tomography slices and histologic staining showed that magnesium degradation did not inhibit fracture healing or bone formation. Histomorphology showed no difference in bone-bridging fractures fixed with magnesium and titanium devices. Interestingly, abundant new bone was formed around magnesium devices, suggesting a connection between magnesium degradation and bone formation. Our results show potential for magnesium fixation devices in a loaded fracture environment. Furthermore, these results suggest that magnesium fixation devices may enhance fracture healing by encouraging localized new bone formation. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Fracture toughness of irradiated candidate materials for ITER first wall/blanket structures: Preliminary results

    International Nuclear Information System (INIS)

    Alexander, D.J.; Pawel, J.E.; Grossbeck, M.L.; Rowcliffe, A.F.

    1993-01-01

    Candidate materials for first wall/blanket structures in ITER have been irradiated to damage levels of about 3 dpa at temperatures of either 60 or 250 degrees C. Preliminary results have been obtained for several of these materials irradiated at 60 degrees C. The results show that irradiation at this temperature reduces the fracture toughness of austenitic stainless steels, but the toughness remains quite high. The unloading compliance technique developed for the subsize disk compact specimens works quite well, particularly for materials with lower toughness. Specimens of materials with very high toughness deform excessively, and this results in experimental difficulties

  18. Fractures of the growing mandible.

    Science.gov (United States)

    Kushner, George M; Tiwana, Paul S

    2009-03-01

    Oral and maxillofacial surgeons must constantly weigh the risks of surgical intervention for pediatric mandible fractures against the wonderful healing capacity of children. The majority of pediatric mandibular fractures can be managed with closed techniques using short periods of maxillomandibular fixation or training elastics alone. Generally, the use of plate- and screw-type internal fixation is reserved for difficult fractures. This article details general and special considerations for this surgery including: craniofacial growth & development, surgical anatomy, epidemiology evaluation, various fractures, the role rigid internal fixation and the Risdon cable in pediatric maxillofacial trauma. It concludes with suggestions concerning long-term follow-up care in light of the mobility, insurance obstacles, and family dynamics facing the patient population.

  19. Management of oral and maxillofacial radiological images

    International Nuclear Information System (INIS)

    Kim, Eun Kyung

    2002-01-01

    To implement the database system of oral and maxillofacial radiological images using a commercial medical image management software with personally developed classification code. The image database was built using a slightly modified commercial medical image management software, Dr. Image v.2.1 (Bit Computer Co., Korea). The function of wild card '*' was added to the search function of this program. Diagnosis classification codes were written as the number at the first three digits, and radiographic technique classification codes as the alphabet right after the diagnosis code. 449 radiological films of 218 cases from January, 2000 to December, 2000, which had been specially stored for the demonstration and education at Dept. of OMF Radiology of Dankook University Dental Hospital, were scanned with each patient information. Cases could be efficiently accessed and analyzed by using the classification code. Search and statistics results were easily obtained according to sex, age, disease diagnosis and radiographic technique. Efficient image management was possible with this image database system. Application of this system to other departments or personal image management can be made possible by utilizing the appropriate classification code system.

  20. Regenerative nanotechnology in oral and maxillofacial surgery.

    Science.gov (United States)

    Shakib, Kaveh; Tan, Aaron; Soskic, Vukic; Seifalian, Alexander M

    2014-12-01

    Regenerative nanotechnology is at the forefront of medical research, and translational medicine is a challenge to both scientists and clinicians. Although there has been an exponential rise in the volume of research generated about it for both medical and surgical uses, key questions remain about its actual benefits. Nevertheless, some people think that therapeutics based on its principles may form the core of applied research for the future. Here we give an account of its current use in oral and maxillofacial surgery, and implications and challenges for the future. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Obtaining consent to oral and maxillofacial surgery.

    Science.gov (United States)

    Poswillo, D

    1989-09-01

    The question of whether or not a patient has consented to treatment has recently become significant to all who practise oral and maxillofacial surgery. It is often linked to professional negligence when the outcome differs from the patient's perception or expectation of the operation. Consent may be oral or written, applies to referred patients and all those with physical and mental handicap and religious restrictions. Examples of procedure in discussing consent assist the surgeon to inform without creating fear. Knowledge of the benefits of informed consent and current legal opinion assist the oral and maxillofacial surgeon to avoid the pitfalls of failure to inform.

  2. Patient satisfaction with maxillofacial prosthesis. Literature review.

    Science.gov (United States)

    Goiato, Marcelo Coelho; Pesqueira, Aldiéris Alves; Ramos da Silva, Cristina; Gennari Filho, Humberto; Micheline Dos Santos, Daniela

    2009-02-01

    Obturators and facial prostheses are important not only in rehabilitation and aesthetics, but also in patient re-socialisation. The level of reintegration is directly related to the degree of satisfaction with rehabilitation. So, the maxillofacial prosthetics must provide patient satisfaction during treatment. This study aimed to search information in database and conduct a literature review on patient satisfaction with maxillofacial prosthesis. The problems experienced by these patients may decrease when specialists keep the patient on regular inspection. Rehabilitation through alloplasty or prosthetic restoration provides satisfactory conditions in aesthetics and well-being and reinstates individuals in familial and social environment.

  3. Hormonal replacement therapy reduces forearm fracture incidence in recent postmenopausal women - results of the Danish Osteoporosis Prevention Study

    DEFF Research Database (Denmark)

    Mosekilde, Leif; Beck-Nielsen, H.; Sørensen, O.H.

    2000-01-01

    -to-treat analysis (n=2016), overall fracture risk was borderline statistically significantly reduced (RR=0.73, 95% CI: 0.50-1.05), and forearm fracture risk was significantly reduced (RR=0.45, 95% CI: 0.22-0.90) with HRT. Restricting the analysis to women who had adhered to their initial allocation of either HRT (n......OBJECTIVES: To study the fracture reducing potential of hormonal replacement therapy (HRT) in recent postmenopausal women in a primary preventive scenario. METHODS: Prospective controlled comprehensive cohort trial: 2016 healthy women aged 45-58 years, from three to 24 months past last menstrual...... by own choice). First line HRT was oral sequential oestradiol/norethisterone in women with intact uterus and oral continuous oestradiol in hysterectomised women. RESULTS: After five years, a total of 156 fractures were sustained by 140 women. There were 51 forearm fractures in 51 women. By intention...

  4. Long-term results of nonsurgical management of condylar fractures in children

    NARCIS (Netherlands)

    Hovinga, J; Boering, G; Stegenga, B

    1999-01-01

    Twenty-five patients with 28 condylar or subcondylar fractures, sustained during their growth period and treated nonsurgically, have been followed for an average period of 15 years. The fractures were classified as intracapsular, high condylar neck and low condylar neck fractures, In 5 patients, two

  5. An institutional experience in the management of pediatric mandibular fractures: A study of 74 cases.

    Science.gov (United States)

    Andrade, Neelam N; Choradia, Smriti; Sriram S, Ganapathy

    2015-09-01

    In maxillofacial surgery, children represent a special group of patients, as they have significant differences from adults as far as the facial skeleton is concerned. The etiology and epidemiology of pediatric trauma involving the facial skeleton has been reported in a large series of patients. Nevertheless, few of these reports review large numbers of pediatric patients, and little is known about treatment protocols for fractures in children. The aims of this study were to retrospectively analyze the treatment methods and outcomes of pediatric mandibular fractures in children and young adolescents up to the age of 15 years, to discuss the findings, and to propose treatment protocols for maxillofacial fractures in childhood. The present study retrospectively analyzed the treatment methods and outcome of the pediatric mandibular fractures in children and young adolescents' up to the age of 15 years over a period of 5 years. All patients were followed up for an average period of 18 months, with a maximum follow-up of 2 years. A total of 74 patients were treated for mandibular and dentoalveolar fractures in children upto the age of 15 years at the Department of Oral and Maxillofacial Surgery at Nair Hospital Dental College, Mumbai from 2007 to 2012. AND CONCLUSIONS: The treatment methods used at our centre had satisfactory outcomes at the end of a follow-up period of 2 years. Reported complications were minimal. Our results confirm the usefulness of open reduction and plate fixation in older children (>12 years of age) and a conservative approach in younger children (≤12 years of age) in treating mandibular fractures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. Arthritis increases the risk for fractures--results from the Women's Health Initiative.

    Science.gov (United States)

    Wright, Nicole C; Lisse, Jeffrey R; Walitt, Brian T; Eaton, Charles B; Chen, Zhao

    2011-08-01

    To examine the relationship between arthritis and fracture. Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture. After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group. The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA.

  7. Piezosurgery in oral and maxillofacial surgery

    Czech Academy of Sciences Publication Activity Database

    Pavlíková, G.; Foltán, R.; Horká, M.; Hanzelka, T.; Borunská, H.; Šedý, Jiří

    2011-01-01

    Roč. 40, č. 5 (2011), s. 451-457 ISSN 0901-5027 Institutional research plan: CEZ:AV0Z50390703 Keywords : piezosurgery * oral surgery * maxillofacial surgery Subject RIV: FJ - Surgery incl. Transplants; FH - Neurology (UEM-P) Impact factor: 1.506, year: 2011

  8. Recovery of mouth-opening after closed treatment of a fracture of the mandibular condyle: a longitudinal study.

    Science.gov (United States)

    Niezen, E T; Stuive, I; Post, W J; Bos, R R M; Dijkstra, P U

    2015-02-01

    The aim of this retrospective study was to assess recovery of mouth opening after closed treatment of fractures of the mandibular condyle, and analyse which characteristics might influence recovery. We measured mouth opening in 142 patients (mean (SD) age 30 (14) years, 96 of whom were male) during follow-up at 3, 6, 13, 26, and 52 weeks after the injury. Fractures were assessed on radiographs. Data were analysed using a multilevel analysis. Half the fractures were of the low condylar neck (n=71). Thirty-seven patients had bilateral condylar fractures, 29 had dislocated fractures, and in 80 the fracture was displaced. One or more additional mandibular fractures were present in 68. During follow-up mean (SD) mouth opening increased to: 33.6 (9.6) at 3 weeks, 40.1 (10.0) at 6 weeks, 45.1 (9.6) at 13 weeks, 49.8 (9.5) at 26 weeks, and 52.6 (7.5) at 52 weeks. Older age, female sex, displaced fracture, bilateral fractures, additional mandibular fractures, and the interaction between follow-up time and additional mandibular fractures, were predictors of a less favourable recovery of mouth opening. Clinicians can use the results of this study to predict recovery of mouth opening after closed treatment of fractures of the mandibular condyle at first consultation. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Diagnostic ability of panoramic radiography for mandibular fractures

    International Nuclear Information System (INIS)

    Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok

    2010-01-01

    The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

  10. Diagnostic ability of panoramic radiography for mandibular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2010-03-15

    The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

  11. The use of fracture mechanics methodologies for NDT results evaluation and comparison

    International Nuclear Information System (INIS)

    Reale, S.

    1995-01-01

    In the general frame of analysing the interactions amongst the information from non destructive evaluation (NDE) and the methodologies to assess the integrity of a defective structure (such as fracture mechanics), the aim of the paper is to analyse and compare, in terms of indices related to safety margins, NDE results from round robin testing trials to acheive assessments of capabilities and limitations.A structural integrity/fracture mechanics approach for evaluating and comparing results from non destructive techniques is presented. Safety factors can be associated to flaws detected and characterized by inspections (estimated flaws) and to flaws actually present (reference flaws). The mismatch between safety factors associated to estimated flaws and safety factors associated to reference flaws can be used to assess capabilities and limitations of procedures and techniques in use for inspections.As an example, to show how the above procedure is applied and its potential as a method of data evaluation and comparison, the NDE results produced by the PISC (project for the inspection of steel components) activity have been considered. (orig.)

  12. Analysis of Dynamic Fracture Compliance Based on Poroelastic Theory - Part II: Results of Numerical and Experimental Tests

    Science.gov (United States)

    Wang, Ding; Ding, Pin-bo; Ba, Jing

    2018-03-01

    In Part I, a dynamic fracture compliance model (DFCM) was derived based on the poroelastic theory. The normal compliance of fractures is frequency-dependent and closely associated with the connectivity of porous media. In this paper, we first compare the DFCM with previous fractured media theories in the literature in a full frequency range. Furthermore, experimental tests are performed on synthetic rock specimens, and the DFCM is compared with the experimental data in the ultrasonic frequency band. Synthetic rock specimens saturated with water have more realistic mineral compositions and pore structures relative to previous works in comparison with natural reservoir rocks. The fracture/pore geometrical and physical parameters can be controlled to replicate approximately those of natural rocks. P- and S-wave anisotropy characteristics with different fracture and pore properties are calculated and numerical results are compared with experimental data. Although the measurement frequency is relatively high, the results of DFCM are appropriate for explaining the experimental data. The characteristic frequency of fluid pressure equilibration calculated based on the specimen parameters is not substantially less than the measurement frequency. In the dynamic fracture model, the wave-induced fluid flow behavior is an important factor for the fracture-wave interaction process, which differs from the models at the high-frequency limits, for instance, Hudson's un-relaxed model.

  13. Closed Versus Open Supracondylar Fractures of the Humerus in Children: A Comparison of Clinical and Radiographic Presentation and Results.

    Science.gov (United States)

    Lewine, Eliza; Kim, Jaehon M; Miller, Patricia E; Waters, Peter M; Mahan, Susan T; Snyder, Brian; Hedequist, Daniel; Bae, Donald S

    2018-02-01

    The purpose of this investigation was to compare the presentation and postoperative results of children treated for open and closed, completely displaced type III supracondylar humerus fractures (SCFs). Thirty patients with open and 66 patients with closed, completely displaced type III SCFs were evaluated. Open fractures underwent irrigation and debridement, and all patients were treated by open or closed reduction and pin fixation. Medical records were reviewed to obtain demographic information as well as preoperative and postoperative clinical data regarding mechanism of injury, neurovascular status, associated injuries, postoperative range of motion, infections, and pain. Radiographs were evaluated to quantify displacement, Baumann's angle, humeral capitellar angle, position of the anterior humeral line, and adequacy of reduction. Outcomes were assessed using Flynn criteria. Mean clinical follow-up for the open and closed fracture groups was 8.9 and 5.7 months, respectively. Both groups were similar with respect to age, sex distribution, weight and body mass index, laterality of involvement, and mechanism of injury. At presentation, 35% of closed SCFs and 23% of open SCFs presented with abnormal neurovascular status. There was a higher prevalence of diminished/absent pulses or distal limb ischemia in patients with open injuries (27%) compared with closed fractures (18%). Conversely, severely displaced closed fractures were more commonly associated with nerve injury/palsy at presentation (35%) than those with open fractures (23%). Spontaneous nerve recovery was seen in 87% within 3 to 6 months. Postoperative loss of reduction and malunion were more common in the closed fracture group. However, 84% of patients achieved good-to-excellent results by Flynn criteria, with no appreciable difference based upon open versus closed fractures. With timely wound and fracture treatment, the clinical and radiographic results of children treated for open SCFs is similar to

  14. [Injury to the Scapholunate Ligament in Distal Radius Fractures: Peri-Operative Diagnosis and Treatment Results].

    Science.gov (United States)

    Gajdoš, R; Pilný, J; Pokorná, A

    2016-01-01

    PURPOSE OF THE STUDY Injury to the scapholunate ligament is frequently associated with a fracture of the distal radius. At present neither a unified concept of treatment nor a standard method of diagnosis in these concomitant injuries is available. The aim of the study was to evaluate a group of surgically treated patients with distal radius fractures in order to assess a contribution of combined conventional X-ray and intra-operative fluoroscopic examinations to the diagnosis of associated lesions and to compare short-term functional outcomes of sugically treated patients with those of patients treated conservatively. MATERIAL AND METHODS A group of patients undergoiong surgery for distal radius fractures using plate osteosynthesis was evaluated retrospectively. The peri-operative diagnosis of associated injury to the scapholunate ligament was based on pre-operative standard X-ray views and intra-operative fluoroscopy. The latter consisted of images of maximum radial and ulnar deviation as well as an image of the forearm in traction exerted manually along the long axis. All views were in postero-anterior projection. Results were read directly on the monitor of a fluoroscopic device after its calibration or were obtained by comparing the thickness of an attached Kirschner wire with the distance to be measured. Subsequently, pixels were converted to millimetres. When a scapholunate ligament injury was found and confirmed by examination of the contralateral wrist, the finding was verified by open reduction or arthroscopy. Both static and dynamic instabilities were treated together with the distal radius fracture at one-stage surgery. After surgery, the patients without ligament injury had the wrist immobilised for 4 weeks, then rehabilitation followed. In the patients with a damaged ligament, immobilisation in a short brace lasted until transarticular wires were removed. All patients were followed up for a year at least. At follow-up, the injured wrist was examined

  15. Maxillectomy defects - to reconstruct or not? Pilot survey of Nigerian oral and maxillofacial surgeons

    Directory of Open Access Journals (Sweden)

    Abdurrazaq Olanrewaju Taiwo

    2017-01-01

    Full Text Available Background: The choice of reconstruction options for maxillectomy defects varies significantly. Factors affecting it range from the type of defect to the surgeon's expertise. This study aims to evaluate the practice of Nigerian Oral and Maxillofacial surgeons in the reconstruction of post-maxillectomy defects. Materials and Methods: The survey was conducted by use of questionnaires administered at the annual scientific meeting of the oral and maxillofacial surgeons of Nigeria in Ibadan 2012. Results: A response rate of 66.7% was achieved. All of our respondents are consultant oral and maxillofacial surgeons, 80% of whom practice in a teaching hospital. All but one of them perform maxillectomies, however only 25% of them offer surgical reconstruction of the resulting defects to patients. Flaps have been used by 25% of the respondents, while none of them has employed microvascular reconstruction. Prosthetic rehabilitation of patients is pervasive among the respondents. Conclusion: Maxillectomy defects have far-reaching consequences on patients' quality of life and attempts should be made to reconstruct such defects. Although maxillectomy is a commonly performed procedure among oral and maxillofacial surgeons in Nigeria, especially for malignancies of the oral and paranasal sinuses, surgical reconstruction of resulting defects is not so frequently done. Microvascular surgery, which is becoming a frequently utilized option among surgeons in developed nations, is still infrequently used in our environment. There is a need for oral and maxillofacial surgeons in our climes to improve their skills so as to increase the range of reconstructive options offered.

  16. Angular-stable locking plate fixation of tibial plateau fractures-clinical and radiological midterm results in 101 patients

    OpenAIRE

    Sven Mardian; Felix Landmann; Florian Wichlas; Norbert P Haas; Klaus-Dieter Schaser; Philipp Schwabe

    2015-01-01

    Background: Articular reconstruction and stable fixation of tibial plateau fractures and its various subtypes continue to represent a surgical challenge. Only few trials have studied results following angular stable plate fixation. The present study aimed to investigate the clinical, radiological, functional and quality of life results following tibial plateau fractures using angular stable plate fixation. Materials and Methods: 101 patients were retrospectively studied using functional (...

  17. Bioprosthetic Valve Fracture Improves the Hemodynamic Results of Valve-in-Valve Transcatheter Aortic Valve Replacement.

    Science.gov (United States)

    Chhatriwalla, Adnan K; Allen, Keith B; Saxon, John T; Cohen, David J; Aggarwal, Sanjeev; Hart, Anthony J; Baron, Suzanne J; Dvir, Danny; Borkon, A Michael

    2017-07-01

    Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) may be less effective in small surgical valves because of patient/prosthesis mismatch. Bioprosthetic valve fracture (BVF) using a high-pressure balloon can be performed to facilitate VIV TAVR. We report data from 20 consecutive clinical cases in which BVF was successfully performed before or after VIV TAVR by inflation of a high-pressure balloon positioned across the valve ring during rapid ventricular pacing. Hemodynamic measurements and calculation of the valve effective orifice area were performed at baseline, immediately after VIV TAVR, and after BVF. BVF was successfully performed in 20 patients undergoing VIV TAVR with balloon-expandable (n=8) or self-expanding (n=12) transcatheter valves in Mitroflow, Carpentier-Edwards Perimount, Magna and Magna Ease, Biocor Epic and Biocor Epic Supra, and Mosaic surgical valves. Successful fracture was noted fluoroscopically when the waist of the balloon released and by a sudden drop in inflation pressure, often accompanied by an audible snap. BVF resulted in a reduction in the mean transvalvular gradient (from 20.5±7.4 to 6.7±3.7 mm Hg, P valve effective orifice area (from 1.0±0.4 to 1.8±0.6 cm 2 , P valves to facilitate VIV TAVR with either balloon-expandable or self-expanding transcatheter valves and results in reduced residual transvalvular gradients and increased valve effective orifice area. © 2017 American Heart Association, Inc.

  18. Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases

    Directory of Open Access Journals (Sweden)

    M.R. Ramesh Babu

    2013-01-01

    Full Text Available Deep vein thrombosis (DVT is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.

  19. [Epidemiology, treatment and results of proximal humeral fractures: experience of a district hospital in a sports- and tourism area].

    Science.gov (United States)

    Sonderegger, J; Simmen, H-P

    2003-02-01

    The epidemiology, therapy and results of proximal humeral fractures in a touristic area were investigated and our concept for treatment presented. Between 1.1.1999 and 30.04.2000 adult patients with proximal humeral fractures were included, the fractures classified (Codman/Neer and AO) and results determined after an average of 9 months. 62 adults were treated. 59 (95 %) had an accident during leisure time, mainly skiing accidents (52 %). 7 patients (11 %) had an associated luxation of the shoulder. 51 (82 %) were treated conservatively, 11 (18 %) operatively with a T-plate. The conservatively treated had to wear a Gilchrist-cast for an average of 29 (operatively 13) days, started passive movement after 20 (operatively 9) days, and active movement after 44 (operatively 45) days. The 32 employed (52 %) were not able to work for 46 days on average. Overall, 52 patients (84 %) were totally or mostly satisfied with the result. 5 among the 13 patients (38.5 %) with 3- or 4-part-fractures, and 4 among the 11 operated patients (36.4 %) were not satisfied with the result. Proximal humeral fractures are common skiing injuries, they need a long and intensive treatment and are economically expensive. The Codman/Neer and AO-classifications are equal. The results for simple, mainly conservatively treated fractures (Codman/Neer 1, 2A, 2-part) are good. Complex, mainly operatively treated fractures (Codman/Neer 3- and 4-part) have a much poorer prognosis. Diagnostically the computed tomography with 3-D-reconstruction is recommended for a better representation of the fracture and a safer choice of the therapeutical strategy.

  20. Femur ultrasound (FemUS)-first clinical results on hip fracture discrimination and estimation of femoral BMD

    DEFF Research Database (Denmark)

    Barkmann, R; Dencks, S; Laugier, P

    2010-01-01

    has been introduced yet. We developed a QUS scanner for measurements at the femur (Femur Ultrasound Scanner, FemUS) and tested its in vivo performance. METHODS: Using the FemUS device, we obtained femoral QUS and DXA on 32 women with recent hip fractures and 30 controls. Fracture discrimination......A quantitative ultrasound (QUS) device for measurements at the proximal femur was developed and tested in vivo (Femur Ultrasound Scanner, FemUS). Hip fracture discrimination was as good as for DXA, and a high correlation with hip BMD was achieved. Our results show promise for enhanced QUS...... and the correlation with femur bone mineral density (BMD) were assessed. RESULTS: Hip fracture discrimination using the FemUS device was at least as good as with hip DXA and calcaneal QUS. Significant correlations with total hip bone mineral density were found with a correlation coefficient R (2) up to 0...

  1. Assessment of the effective dose in supine, prone, and oblique positions in the maxillofacial region using a novel combined extremity and maxillofacial cone beam computed tomography scanner

    NARCIS (Netherlands)

    Koivisto, J.; Wolff, J.; Järnstedt, J.; Dastidar, P.; Kortesniemi, M.

    2014-01-01

    Objective The objectives of this study were to assess the organ and effective doses (International Commission on Radiological Protection [ICRP] 103 standard) resulting from supine, prone, and oblique phantom positions in the maxillofacial region using a novel cone beam computed tomography (CBCT)

  2. Interpersonal violence, circumstances of aggressions and patterns of maxillofacial injuries in the metropolitan area of Campina Grande, State of Paraíba, Brazil (2008-2011).

    Science.gov (United States)

    Bernardino, Ítalo Macedo; Barbosa, Kevan Guilherme Nóbrega; Nóbrega, Lorena Marques; Cavalcante, Gigliana Maria Sobral; Ferreira, Efigenia Ferreira E; d'Ávila, Sérgio

    2017-09-01

    The aim of this study was to determine the circumstances of aggressions and patterns of maxillofacial injuries among victims of interpersonal violence. This was a cross-sectional and exploratory study conducted from the analysis of 7,132 medical-legal and social records of interpersonal violence victims seen in a Forensic Medicine and Dentistry Center. Descriptive and multivariate statistics were performed using Multiple Correspondence Analysis. Three groups with different victimization profiles were identified. The first group was mainly composed of men of different age groups, victims of community violence that resulted in facial bones or dentoalveolar fracture. The second group was mainly composed of adolescents (10-19 years) of both sexes, victims of interpersonal violence and without specific pattern of injuries. The third group was composed of adult women (≥ 20 years) victims of domestic violence that resulted in injuries of soft tissues of face or other body regions. The results suggest that sociodemographic and circumstantial characteristics are important factors in victimization by maxillofacial injuries and interpersonal violence.

  3. Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures

    Directory of Open Access Journals (Sweden)

    Joao Torres

    2014-01-01

    Full Text Available Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A during the surgical procedure, or fracture fixation alone (Group B. Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS, at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P<0.05. Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures.

  4. Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures

    Science.gov (United States)

    Gutierres, Manuel; Lopes, M. Ascenção; Santos, J. Domingos; Cabral, A. T.; Pinto, R.

    2014-01-01

    Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC) to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A) during the surgical procedure, or fracture fixation alone (Group B). Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS), at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P < 0.05). Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures. PMID:24955356

  5. REVIEW OF 40 CASES OF ISOLATED FRACTURE MANDIBLE

    Directory of Open Access Journals (Sweden)

    Shashikant Kondiram Mhashal

    2016-10-01

    Full Text Available BACKGROUND Mandible fractures are a frequent injury because of the mandible's prominence and relative lack of support. The purpose of this study is to clinically determine the most common sites and the prevalence of isolated fracture mandible in our scenario and determine most common traumatic aetiology factor responsible for fracture mandible. Numerous investigators have reported studies on populations on all continents; fractures of the mandible have been reported to account for 36-70% of all maxillofacial fractures. All reports apparently show a higher frequency in males aged 21-30 yrs. There is an emerging trend towards an increase in the frequency of violent mechanisms of fracture and in the proportion of adolescents and young adults sustaining such injuries. MATERIALS AND METHODS Patients treated at the Otorhinolaryngology Head and Neck Surgery Department of B.D.B.A. Hospital from a period between January 2014 to January2016 were (retrospectively evaluated with respect to age groups, gender, aetiology, localisation, type of fractures and treatment. RESULTS Total number of patients 38, 2 patients had bilateral fracture, males 27 (71.05%, females 11 (28.95%. Anatomical location symphysis and parasymphysis 14 (35%, condylar 12 (30%, body 7 (17.5%, angle 6 (15%, coronoid 1 (2.5%. Aetiological factors road traffic accidents 19 (50%, assault 13 (34.24%, fall 3 (7.89%, work-related trauma 2 (5.26%, sports trauma 1 (2.6%. CONCLUSION This study indicates that most common fracture in adult patient were symphysis and parasymphysis, second most common were condylar followed by body fracture and angle fracture. The most common cause of the injury maybe road traffic accidents, second most common assault followed by work related injuries, fall and sports injuries.

  6. Difficulties encountered in preauricular approach over retromandibular approach in condylar fracture

    Directory of Open Access Journals (Sweden)

    Perumal Jayavelu

    2016-01-01

    Full Text Available Fracture of mandible can be classified according to its anatomical location, in which condylar fracture is the most common one overall and is missed on clinical examination. Due to the unique geometry of the mandible and temporomandibular joint, without treatment the fractures can result in marked pain, dysfunction, and deformity. The condylar fracture may be further classified depending on the sides involved: unilateral/bilateral, depending on the height of fracture: intracapsular (within the head of condyle, extracapsular - head and neck (high condyle fracture, and subcondylar (low condyle fracture, and depending on displacement: nondisplaced, displaced (anteromedially, medially, and lateral, and dislocated. The clinical features include swelling and tenderness over the temporomandibular joint region, restricted mouth opening, and anterior open bite. A 34-year-old male patient reported to the Department of Oral and Maxillofacial Surgery at Madha Dental College and Hospital; suffered fall trauma resulting in bilateral condyle fracture, dentoalveolar fracture in mandible with restricted mouth opening, and anterior open bite.

  7. Evaluation in femoral neck fracture scintimetry: modes of region of interest selection and influence on results

    Energy Technology Data Exchange (ETDEWEB)

    Holmberg, S.; Mesko, L.; Stroemqvist, B.; Thorngren, K.G.

    1985-04-01

    Different sized ROIs within the femoral head and different modes of calculation were used in (/sup 99m/Tc)MDP scintimetry after femoral neck fracture. In preoperative scintimetry, correction for increased trochanteric uptake gave the best discrimination, whereas in postoperative scintimetry the direct ratio fractured/intact femoral head was superior. The change in ROI size had little influence.

  8. Evaluation in femoral neck fracture scintimetry: modes of region of interest selection and influence on results

    International Nuclear Information System (INIS)

    Holmberg, S.; Mesko, L.; Stroemqvist, B.; Thorngren, K.G.

    1985-01-01

    Different sized ROIs within the femoral head and different modes of calculation were used in [/sup 99m/Tc]MDP scintimetry after femoral neck fracture. In preoperative scintimetry, correction for increased trochanteric uptake gave the best discrimination, whereas in postoperative scintimetry the direct ratio fractured/intact femoral head was superior. The change in ROI size had little influence

  9. Fracture-mechanical results of non-destructive testing - function, goals, methods

    International Nuclear Information System (INIS)

    Herter, K.H.; Kockelmann, H.; Schuler, X.; Waidele, H.

    2004-01-01

    Non-destructive testing provides data for fracture-mechanical analyses, e.g. defect size and orientation. On the other hand, fracture-mechanical analyses may help to define criteria for non-destructive testing, e.g. sensitivity, inspection intervals and inspection sites. The criteria applied differ as a function of the safety relevance of a component. (orig.) [de

  10. Concurrent patellar fracture and lateral collateral ligament avulsion as a result of trauma in three horses.

    Science.gov (United States)

    McLellan, Jonathan; Plevin, Sarah; Taylor, Elizabeth

    2012-05-15

    3 horses were evaluated because of lameness and swelling of the stifle joint subsequent to trauma. All horses had characteristic clinical signs of stifle joint pain and effusion. A medial patellar fracture and lateral collateral ligament avulsion fracture were visible ultrasonographically in each. Radiography, including standard as well as flexed lateromedial, cranioproximal-craniodistal oblique (skyline patellar), and laterally stressed caudocranial views, revealed similar findings. Arthroscopic surgery to remove the patellar fracture was attempted in 1 horse with severe desmitis of the lateral collateral ligament; it remained lame afterward. The other 2 horses, with less severe collateral ligament damage, were managed conservatively and returned to athletic use, despite the lack of surgical intervention to repair the patellar fractures. Special radiographic views were necessary for diagnosis of medial patellar fracture and lateral collateral ligament avulsion fracture in the 3 horses. Ultrasonographic findings pertaining to the collateral ligament may be prognostically important in such situations. The severity of a fracture involving ligament avulsion may be the limiting factor in horses with this combined injury, and this factor should be considered prior to attempting surgical correction of patellar fractures.

  11. The Temporalis Muscle Flap in Maxillofacial Reconstruction

    International Nuclear Information System (INIS)

    ElSheikh, M; Zeitoun, I; ElMassry, M A K

    1991-01-01

    The temporalis muscle flap is a very versatile and valuable axial flap, which could be used in various reconstructive procedures in and around the oro-maxillofacial region. The surgical anatomy, vascular pattern and technique of elevation of the flap are described, together with our experience in different reconstructive situations. The advantages and disadvantages of the use of this flap are thoroughly discussed taking into consideration the potentiality of cancer recurrence under cover of the flap. (author)

  12. Fracture risk in hepatitis C virus infected persons: results from the DANVIR cohort study.

    Science.gov (United States)

    Hansen, Ann-Brit Eg; Omland, Lars Haukali; Krarup, Henrik; Obel, Niels

    2014-07-01

    The association between Hepatitis C virus (HCV)-infection and fracture risk is not well characterized. We compared fracture risk between HCV-seropositive (HCV-exposed) patients and the general population and between patients with cleared and chronic HCV-infection. Outcome measures were time to first fracture at any site, time to first low-energy and first non-low-energy (other) fracture in 12,013 HCV-exposed patients from the DANVIR cohort compared with a general population control cohort (n=60,065) matched by sex and age. Within DANVIR, 4500 patients with chronic HCV-infection and 2656 patients with cleared HCV-infection were studied. Compared with population controls, HCV-exposed patients had increased overall risk of fracture [adjusted incidence rate ratio (aIRR) 2.15, 95% Confidence Interval (CI) 2.03-2.28], increased risk of low-energy fracture (aIRR 2.13, 95% CI: 1.93-2.35) and of other fracture (aIRR 2.18, 95% CI: 2.02-2.34). Compared with cleared HCV-infection, chronic HCV-infection was not associated with increased risk of fracture at any site (aIRR 1.08, 95% CI: 0.97-1.20), or other fracture (aIRR 1.04, 95% CI: 0.91-1.19). The aIRR for low-energy fracture was 1.20 (95% CI: 0.99-1.44). HCV-exposed patients had increased risk of all fracture types. In contrast, overall risk of fracture did not differ between patients with chronic vs. cleared HCV-infection, although chronic HCV-infection might be associated with a small excess risk of low-energy fractures. Our study suggests that fracture risk in HCV-infected patients is multi-factorial and mainly determined by lifestyle-related factors associated with HCV-exposure. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  13. Fracture of the supraglenoid tubercle: treatment and results in five horses

    International Nuclear Information System (INIS)

    Pankowski, R.L.; Grant, B.D.; Sande, R.; Nickels, F.A.

    1986-01-01

    Five horses with fractures of the supraglenoid tubercle (tuber scapulae) were presented from 6 weeks to 1 year after injury. Clinical signs included lameness characterized by a shortened cranial phase of the stride and shoulder muscle atrophy. Radiographically, the fractures differed in the degree of cranioventral displacement of the fragment as well as the extent of joint involvement. Three horses were treated by resection of the fractured tubercle, including one using a new grid approach to the area of the fracture. Two of these horses have returned to athletic activity and one was euthanized due to postoperative infection. One horse with minimal displacement and joint involvement was treated with rest and raced successfully. One horse seen with a fracture of 1 year duration also was treated with rest and was a pasture sound broodmare

  14. Clinical and statistical analysis of traumatic injuries of the maxillofacial region and its complications on materials of the Department of Maxillofacial Surgery from 2008 till 2012

    Directory of Open Access Journals (Sweden)

    Lepilin A.V. Bakhteeva G.R.

    2013-09-01

    The ratio of male and female patients during the study period did not change (men 89%, women — 11 %. Single fractures that do not require surgical treatment were dominated. Operating activities during the study period of fracture increased. For 5 years, the number of complications of traumatic injuries remained the same. Conclusion. Statistical analysis of traumatic injuries of the maxillofacial region shows that the average age of the patients decreased by almost 5 years, reduced average hospital stay. Most of the patients were admitted to the profile department in the early period (up to 3 days after preparation, but 21.6% of the patients were received only with the development of complications. The article concludes that there is a need to find new methods of diagnosis, treatment and prevention of complications of traumatic injuries.

  15. Medium term results of total knee arthroplasty as a primary treatment for knee fractures

    Directory of Open Access Journals (Sweden)

    Ebied Ayman

    2018-01-01

    Conclusion: Knee arthroplasty achieves highly successful outcome when performed as a primary treatment for comminuted intra and periarticular knee fractures in elderly patients. Survival of implants and functional range of movement at midterm are excellent.

  16. Corroboration of mechanoregulatory algorithms for tissue differentiation during fracture healing: comparison with in vivo results

    NARCIS (Netherlands)

    Isaksson, H.E.; Donkelaar, van C.C.; Huiskes, R.; Ito, K.

    2006-01-01

    Several mechanoregulation algorithms proposed to control tissue differentiation during bone healing have been shown to accurately predict temporal and spatial tissue distributions during normal fracture healing. As these algorithms are different in nature and biophysical parameters, it raises the

  17. Fractures from trampolines: results from a national database, 2002 to 2011.

    Science.gov (United States)

    Loder, Randall T; Schultz, William; Sabatino, Meagan

    2014-01-01

    No study specifically analyzes trampoline fracture patterns across a large population. The purpose of this study was to determine such patterns. We queried the National Electronic Injury Surveillance System database for trampoline injuries between 2002 and 2011, and the patients were analyzed by age, sex, race, anatomic location of the injury, geographical location of the injury, and disposition from the emergency department (ED). Statistical analyses were performed with SUDAAN 10 software. Estimated expenses were determined using 2010 data. There were an estimated 1,002,735 ED visits for trampoline-related injuries; 288,876 (29.0%) sustained fractures. The average age for those with fractures was 9.5 years; 92.7% were aged 16 years or younger; 51.7% were male, 95.1% occurred at home, and 9.9% were admitted. The fractures were located in the upper extremity (59.9%), lower extremity (35.7%), and axial skeleton (spine, skull/face, rib/sternum) (4.4%-spine 1.0%, skull/face 2.9%, rib/sternum 0.5%). Those in the axial skeleton were older (16.5 y) than the upper extremity (8.7 y) or lower extremity (10.0 y) (Pfractures were more frequently female (54.0%) (Pfractures were most frequently admitted (20.0%). The tibia/fibula (39.5%) and ankle (31.5%) were most common in the lower extremity; femur fractures were most frequently admitted (57.9%). Cervical (36.4%) and lumbar (24.7%) were most common locations in the spine; cervical fractures were the most frequently admitted (75.6%). The total ED expense for all trampoline injuries over this 10-year period was $1.002 billion and $408 million for fractures. Trampoline fractures most frequently involve the upper extremity followed by the lower extremity, >90% occur in children. The financial burden to society is large. Further efforts for prevention are needed.

  18. Percutaneous Screw Fixation of Distal Tibia Fractures – Functional Results in Sixteen Patients

    OpenAIRE

    Kaftandziev, Igor; Trpeski, Simon; Arsovski, Oliver; Spasov, Marko

    2014-01-01

    INTRODUCTION: An important feature of distal tibia fractures is the relevance of the soft tissue coverage. In order to maintain good functional outcome, several operative techniques have been established. Among them, percutaneous screw fixation has the advantage of causing less biological damage of the soft tissues with lower rates of complications. MATERIAL AND METHODS: We reviewed 16 patients with distal tibia fracture. Operative treatment consisted of indirect reduction and percutaneou...

  19. Psychiatric analysis of suicide attempt subjects due to maxillofacial gunshot.

    Science.gov (United States)

    Oztürk, Serdar; Bozkurt, Ali; Durmus, Muzaffer; Deveci, Mustafa; Sengezer, Mustafa

    2006-11-01

    The studies of maxillofacial gunshot injuries mainly focused on evaluating the surgical interventions and physical outcomes of the procedures. In this study we aimed to analyze the pre- and post-injury psychiatric status of the patients with self-inflicted gunshot wounds to the face. This study is based on 12 subjects who attempted suicide resulting in extensive maxillofacial injuries using guns placed beneath their chins. The psychiatric evaluation was conducted by interview and using SCID-I, SCID-II, MMPI, Rosenberg Self-Esteem Scale and Suicide Probability Scale. Two subjects were healthy, 1 had bereavement, 6 had current and 5 had previous MDD (major depressive disorder), 2 had dysthymic disorder, 3 had alcohol abuse, 2 had drug abuse and 4 had antisocial personality disorder. The suicidal group was more socially introverted according to MMPI. According to Rosenberg self-esteem subscale, self esteem, the constancy of self respect and depressive mood subtests were statistically significant in the suicide group compared to the healthy controls (P suicide. The changes in the physical facial appearance after the suicide attempt caused impairment of self-esteem and the constancy of self-respect. Similar to other studies, none of our patients reattempted suicide and all tried to return to their pre-injury lifestyle and appeared to accommodate to the stigma of their physical deformities. Early diagnosis and treatment should be considered as a factor to reduce the risk for suicide attempt.

  20. Practice activity trends among oral and maxillofacial surgeons in Australia

    Directory of Open Access Journals (Sweden)

    Teusner Dana N

    2004-12-01

    Full Text Available Abstract Background The aim of this study was to describe practice activity trends among oral and maxillofacial surgeons in Australia over time. Methods All registered oral and maxillofacial surgeons in Australia were surveyed in 1990 and 2000 using mailed self-complete questionnaires. Results Data were available from 79 surgeons from 1990 (response rate = 73.8% and 116 surgeons from 2000 (response rate = 65.1%. The rate of provision of services per visit changed over time with increased rates observed overall (from 1.43 ± 0.05 services per visit in 1990 to 1.66 ± 0.06 services per visit in 2000, reflecting increases in pathology and reconstructive surgery. No change over time was observed in the provision of services per year (4,521 ± 286 services per year in 1990 and 4,503 ± 367 services per year in 2000. Time devoted to work showed no significant change over time (1,682 ± 75 hours per year in 1990 and 1,681 ± 94 hours per year in 2000, while the number of visits per week declined (70 ± 4 visits per week in 1990 to 58 ± 4 visits per week in 2000. Conclusions The apparent stability in the volume of services provided per year reflected a counterbalancing of increased services provided per visit and a decrease in the number of visits supplied.

  1. Surgical Engineering in Cranio-Maxillofacial Surgery: A Literature Review

    Directory of Open Access Journals (Sweden)

    Raphael Olszewski

    2012-01-01

    Full Text Available A systematic review of the literature concerning surgical engineering in cranio-maxillofacial surgery was performed. APubMed search yielded 1721 papers published between 1999 and 2011. Based on the inclusion/exclusion criteria, 1428 articles were excluded after review of titles and abstracts. Atotal of 292 articles were finally selected covering the following topics: finite element analysis (n = 18, computer-assisted surgery (n = 111, rapid prototyping models (n = 41, preoperative training simulators (n = 4, surgical guides (n = 23, image-guided navigation (n = 58, augmented reality (n = 2, video tracking (n = 1, distraction osteogenesis (n = 19, robotics (n = 8, and minimal invasive surgery (n = 7. The results show that surgical engineering plays a pivotal role in the development and improvement of cranio-maxillofacial surgery. Some technologies, such as computer-assisted surgery, image-guided navigation, and three-dimensional rapid prototyping models, have reached maturity and allow for multiple clinical applications, while augmented reality, robotics, and endoscopy still need to be improved.

  2. [Evaluation of the clinical results of non-surgical treatment for pediatric sagittal fracture of mandibular condyle].

    Science.gov (United States)

    Liu, Chang-kui; Tan, Xin-ying; Xu, Juan; Liu, Hua-wei; Liu, San-xia; Hu, Min

    2013-11-01

    To investigate the clinical results of occlusal splint in the treatment of sagittal fracture of mandibular condyle (SFMC) in children. Thirty-nine patients (48 condyles)aged 3-8 years with sagittal fracture of mandibular condyle were included in this study. All the patients were treated by occlusal splint.Slight open occlusion was maintained by occlusal splint for 3-6 months. Clinical and radiological examination was performed six mouths and every year after treatment. Good mandibular function was observed in 39 patients. Maximal mouth opening over 35 mm was achieved at 6 months. But 11 of the 39 patients presented with deviation on mouth opening at 6 months. The radiology showed an complete remodeling in 32 condyles (28 patients) and partial remodeling in 16 condyles (11 patients). Poor remodelling was not observed in any patients. Good clinical results can be obtained by using occlusal splint in the treatment of pediatric sagittal fracture of mandibular condyle.

  3. Minimally invasive plate osteosynthesis for humeral shaft fractures: are results reproducible?

    Science.gov (United States)

    Concha, Juan M; Sandoval, Alejandro; Streubel, Philipp N

    2010-12-01

    Minimally invasive plate osteosynthesis (MIPO) has been advocated as a safe approach to humeral shaft fracture management. We evaluated the reproducibility of this technique in a regional hospital. Thirty-five patients underwent MIPO of humerus shaft fractures. Fifteen patients had an open fracture, six a preoperative radial nerve palsy, and nine a concomitant thoracic, musculoskeletal or vascular injury. At an average 12-month follow-up, 91% of fractures healed after a mean of 12 weeks (range, 8-16). Two infections occurred. Final alignment averaged 4° of varus (range, 5° of valgus to 20° of varus). Active elbow ROM averaged 114° (range, 60-135°) and was less than 100° in nine elbows. Five of six preoperative radial nerve injuries recovered spontaneously. Healing and infection rates in this study are consistent with those reported in the literature. Lower elbow ROM and higher fracture angulation at healing were nevertheless found. MIPO is technically demanding and requires adequate intraoperative imaging and surgical experience in order to obtain adequate fracture alignment. Brachialis muscle scarring and inadequate postoperative rehabilitation may be involved in limited elbow range of motion.

  4. Bilateral femoral neck fractures resulting from pregnancy-associated osteoporosis showed bone marrow edema on magnetic resonance imaging.

    Science.gov (United States)

    Kasahara, Kyoko; Kita, Nobuyuki; Kawasaki, Taku; Morisaki, Shinsuke; Yomo, Hiroko; Murakami, Takashi

    2017-06-01

    Femoral neck fractures resulting from pregnancy-associated osteoporosis is a rare condition. Herein, we report an undoubted case of pregnancy-associated osteoporosis in a 38-year-old primiparous patient with pre-existing anorexia nervosa who suffered bilateral femoral neck fractures in the third trimester and early post-partum period. Magnetic resonance imaging revealed femoral neck fractures as well as diffuse marrow edema involving both femoral heads, which are considered under ordinary circumstances as characteristic imaging findings of transient osteoporosis of the hip. Based on our experience, we propose that pregnancy-associated osteoporosis might be present in femoral neck fractures attributed to transient osteoporosis of the hip in pregnancy. Conversely, bone status should be carefully and accurately estimated in cases of potential transient osteoporosis of the hip in pregnancy to reduce future fracture risk. © 2017 The Authors Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.

  5. Computer-aided trauma simulation system with haptic feedback is easy and fast for oral-maxillofacial surgeons to learn and use.

    Science.gov (United States)

    Schvartzman, Sara C; Silva, Rebeka; Salisbury, Ken; Gaudilliere, Dyani; Girod, Sabine

    2014-10-01

    Computer-assisted surgical (CAS) planning tools have become widely available in craniomaxillofacial surgery, but are time consuming and often require professional technical assistance to simulate a case. An initial oral and maxillofacial (OM) surgical user experience was evaluated with a newly developed CAS system featuring a bimanual sense of touch (haptic). Three volunteer OM surgeons received a 5-minute verbal introduction to the use of a newly developed haptic-enabled planning system. The surgeons were instructed to simulate mandibular fracture reductions of 3 clinical cases, within a 15-minute time limit and without a time limit, and complete a questionnaire to assess their subjective experience with the system. Standard landmarks and linear and angular measurements between the simulated results and the actual surgical outcome were compared. After the 5-minute instruction, all 3 surgeons were able to use the system independently. The analysis of standardized anatomic measurements showed that the simulation results within a 15-minute time limit were not significantly different from those without a time limit. Mean differences between measurements of surgical and simulated fracture reductions were within current resolution limitations in collision detection, segmentation of computed tomographic scans, and haptic devices. All 3 surgeons reported that the system was easy to learn and use and that they would be comfortable integrating it into their daily clinical practice for trauma cases. A CAS system with a haptic interface that capitalizes on touch and force feedback experience similar to operative procedures is fast and easy for OM surgeons to learn and use. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

  6. Finite element analysis of pedestrian lower limb fractures by direct force: the result of being run over or impact?

    Science.gov (United States)

    Li, Zhengdong; Zou, Donghua; Liu, Ningguo; Zhong, Liangwei; Shao, Yu; Wan, Lei; Huang, Ping; Chen, Yijiu

    2013-06-10

    The elucidation and prediction of the biomechanics of lower limb fractures could serve as a useful tool in forensic practices. Finite element (FE) analysis could potentially help in the understanding of the fracture mechanisms of lower limb fractures frequently caused by car-pedestrian accidents. Our aim was (1) to develop and validate a FE model of the human lower limb, (2) to assess the biomechanics of specific injuries concerning run-over and impact loading conditions, and (3) to reconstruct one real car-pedestrian collision case using the model created in this study. We developed a novel lower limb FE model and simulated three different loading scenarios. The geometry of the model was reconstructed using Mimics 13.0 based on computed tomography (CT) scans from an actual traffic accident. The material properties were based upon a synthesis of data found in published literature. The FE model validation and injury reconstruction were conducted using the LS-DYNA code. The FE model was validated by a comparison of the simulation results of three-point bending, overall lateral impact tests and published postmortem human surrogate (PMHS) results. Simulated loading scenarios of running-over the thigh with a wheel, the impact on the upper leg, and impact on the lower thigh were conducted with velocities of 10 m/s, 20 m/s, and 40 m/s, respectively. We compared the injuries resulting from one actual case with the simulated results in order to explore the possible fracture bio-mechanism. The peak fracture forces, maximum bending moments, and energy lost ratio exhibited no significant differences between the FE simulations and the literature data. Under simulated run-over conditions, the segmental fracture pattern was formed and the femur fracture patterns and mechanisms were consistent with the actual injury features of the case. Our study demonstrated that this simulation method could potentially be effective in identifying forensic cases and exploring of the injury

  7. Orbito-Maxillofacial Cutaneous Anthrax

    African Journals Online (AJOL)

    and development of a black eschar were reviewed. Occupational history, falls and/or contact with animal meat was ... and oral ciprofloxacin (500mg BD for 21 days). The culture results isolated Bacillus anthracis highly ... The clinical evolution of cutaneous anthrax is typical with the initial development of minute red macules.

  8. [3D planning in maxillofacial surgery].

    Science.gov (United States)

    Hoarau, R; Zweifel, D; Lanthemann, E; Zrounba, H; Broome, M

    2014-10-01

    The development of new technologies such as three-dimensional (3D) planning has changed the everyday practice in maxillofacial surgery. Rapid prototyping associated with the 3D planning has also enabled the creation of patient specific surgical tools, such as cutting guides. As with all new technologies, uses, practicalities, cost effectiveness and especially benefits for the patients have to be carefully evaluated. In this paper, several examples of 3D planning that have been used in our institution are presented. The advantages such as the accuracy of the reconstructive surgery and decreased operating time, as well as the difficulties have also been addressed.

  9. [Modern technologies in cranio-maxillofacial surgery].

    Science.gov (United States)

    Lübbers, Heinz-Theo; Matthews, Felix; Kruse, Astrid L

    2014-02-26

    Modern technologies are influencing medicine everyday. The oral and maxillofacial surgery meet the worlds from medicine and dentistry. So technologies from both fields are utilized. This article provides an overview about technologies in clinical use, which are typical for the specialty. Their principles and indications are described as well as benefits and limitations. Based on Cone Beam Computed Tomography image fusion and mirroring techniques are explained as well as patient specific models and implants, template guided and free surgical navigation with and without intraoperative three-dimensional imaging. An overall assessment reveals further need of research regarding indications and patient benefit.

  10. Long-term results of various therapy concepts in severe pilon fractures.

    Science.gov (United States)

    Koulouvaris, Panagiotis; Stafylas, Kosmas; Mitsionis, Gregory; Vekris, Marios; Mavrodontidis, Alexandros; Xenakis, Theodore

    2007-07-01

    Intra-articular fractures of the tibia plafond are among the most challenging of orthopaedic problems. This is a retrospective case-control study of surgically treated pilon fractures which was undertaken to compare the internal fixation with the two external fixation methods. This is a case-control study of 55 patients with 55 pilon fractures. There were 36 type C and 19 type B. Of these fractures, 24 were open and 31 closed. Three surgical protocols were used. In 20 patients, Group A, a half pin external fixator with ankle spanning was performed. The mean age of patients was 42.0 years (22.0-74.0), SD 14.1 and the mean follow-up was 77.7 months (38.0-132.0), SD 25.4. In 22 patients, Group B, a single ankle sparring ring hybrid external fixator under a small arthrotomy was performed. The mean age of patients was 48.4 years (28.0-76.0), SD 12.4 and mean follow-up was 67.9 months (36.0-132.0), SD 27.8. In 13 patients, Group C, a two-staged internal fixation was performed. The mean age was 45.6 years (30.0-66.0), SD 9.7 and the mean follow-up was 78.6 months (55.0-132.0), SD 25.4. We addressed the dissimilarity of the type of fracture in each group performing supplementary stratified analyses within each fracture type group. Group A had union in 6.9 months, group B in 5.6 months and group C in 5.1 months; P = 0.009. Six patients (Group A), two (Group B), and one (Group C) had limitation of ankle motion; P = 0.47. One patient from group C developed infection and the plate was removed. Four patients (Group A), one (Group B), and one (Group C) have developed posttraumatic arthritis (loss of joint space and pain); P = 0.25. Seven patients from Group A have reduced their activities; P = 0.004. In stratified statistical analysis by type of fracture, the associations noted for both fracture groups combined were also noted separately within each fracture group. In this long term follow-up study, the two-staged internal fixation and the hybrid fixation with small arthrotomy

  11. Intraarticular calcaneal fractures. Clinical results and functional analysis of the surgical treatment

    International Nuclear Information System (INIS)

    Calixto B, Luis Fernando; Gomez R, Jairo Fernando; Prieto S, Hernan Augusto

    2004-01-01

    This study evaluated the clinical and functional outcome of open reduction and internal fixation in intraarticular calcaneal fractures 22 patients with 24 intra-articular fractures of calcaneous were treated, 19 with open reduction and internal fixation using a 3.5 mm AO/ASIF calcaneal plate. The fractures were classified according the Sanders tomographic system. The Bohler angle was measured before and after the surgery. All patients were evaluated using the functional ankle-hind foot AOFAS scale (American Orthopaedics Foot and Ankle Society) 6 and 12 months after the surgery. Mean age was 39.8 years. The distribution according the type of fracture was: Sanders II: 41.67% and Sanders III: 58.33%. The mean value of the initial Bohler angle was 11.45% and the final was 24.5 degrees. The functional outcome after 6 months was 70 points and after 12 months was 82 points. There were only two complications (12.5%) a fistula and a wound dehiscence. The displaced and slightly comminuted intra articular fractures have the calcaneus (Sandres II and Sandres III) benefit of ORIF obtaining good functional outcomes 6 and 12 months after surgery. This procedure allows a better articular surface reduction, a satisfactory Bohler angle correction and earlier rehabilitation

  12. Results of the Treatment of Talar Neck Fractures in a West African Hospital

    Directory of Open Access Journals (Sweden)

    AD Kacou

    2011-03-01

    Full Text Available Talar neck fractures (TNFs are complex injuries and treatment is fraught with complications. We retrospectively studied 18 patients with TNFs: 6 Hawkins type-I, 7 type-II, 4 type-III, and 1 type-IV. Five patients with type-I and 2 with type-II fractures were treated conservatively. The remaining 11 patients underwent operative treatment. Open reduction via posterolateral approach was performed in 10 patients while closed reduction was used in one patient. All operatively reduced fractures were stabilized with screws. The following postoperative complications were encountered: wound dehiscence (n=1, avascular necrosis (n=2, and post-traumatic osteoarthritis (n=12. Fifteen patients were available for final evaluation at a mean follow- up period of three years (range 10 months to 6 years. Using the American Orthopaedic Foot and Ankle Society (AOFAS score, the mean for type-I fracture was 96.4 points, 80.2 points for type-II, 68.5 points for type-III and 55 points for type-IV fractures. TNFs remain a devastating injury as the prognosis and outcomes of treatment continued to be hampered by the consequences of injury.

  13. Functional results following fractures of the proximal humerus. A controlled clinical study comparing two periods of immobilization

    DEFF Research Database (Denmark)

    Kristiansen, B; Angermann, P; Larsen, T K

    1989-01-01

    In order to compare 1 and 3 weeks of immobilization following proximal humeral fractures a prospective controlled trial was performed in 85 patients. Clinical follow-up according to the Neer assessment system was done after 1, 3, 6, 12, and 24 months. One week of immobilization resulted in a better...

  14. Results of Patello-Tibial Cerclage Wire Technique for Comminuted Patella Fractures Treated with Partial Patellectomy

    Directory of Open Access Journals (Sweden)

    Ender Alagöz

    2014-12-01

    Full Text Available Aim: Partial patellectomy and patellotibial cerclage technique used in comminuted inferior pole patellar fractures were evaluated and the results were discussed. Methods: Thirteen patients who have undergone partial distal patellar excision were evaluated in the study. In all patients, the inferior pole of the patella was resected, patellar tendon was sutured to the proximal patellar fragment and patellotibial cerclage was performed. At the last visit, the patients were evaluated using measurement of the distance between the superior pole of the patella and the tibial tubercle, the Lysholm knee scoring scale, knee range of motion and thigh circumference measurement. Results: The mean flexion value was 131.10 (±4.6 in normal knees and 117.20 (±8.0 in operated knees. The mean thigh diameter was 49.5 (±3.7 cm and 46.4 (±4.5 cm in normal knees and in operated knees, respectively. The mean Lysholm knee score in the patient group was 84.3 (±17.1 points. The mean distance between the superior pole of the patella and the tibial tubercle was 10.6 (±1.0 cm in normal knees and 10.1 (±1.2 cm in operated knees. The exstensor mechanism was intact in all patients and no revision surgery was performed. Conclusion: Patellotibial cerclage technique performed after partial patellectomy permits early motion and protects patients from harmful effects of immobilization; and good functional results are obtained if patients start early knee motion.

  15. Oral and Maxillofacial Surgery: Why the double degree? | Oji ...

    African Journals Online (AJOL)

    The International Association of oral and maxillofacial Surgeons (IAOMS) is committed to quality patient care. The education of oral and maxillofacial surgeons has, however, been in constant evolution ever since the inception of this speciality; and this state of flux reflects the dynamic expansion of its scope. Oral surgery has ...

  16. Causes of maxillofacial patient mortality in a Nigerian tertiary hospital

    African Journals Online (AJOL)

    a Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bayero University, Kano and Consultant, Oral and Maxillofacial Surgeon,. Aminu Kano Teaching Hospital, Kano, Nigeria ... craniofacial trauma and stage IV malignancies [2, 3, 4]. Intraoperative deaths may also occur from anesthetic and/.

  17. Clinico-histopathologic types of maxillofacial malignancies with ...

    African Journals Online (AJOL)

    Clinico-histopathologic types of maxillofacial malignancies with emphasis on sarcomas: A 10-year review. ... Sarcomas peaked in the third decade with 70% occurring below the age of 40 years. The maxilla and the mandible were the most afflicted sites in the maxillofacial region accounting for 52%. The patients on average

  18. Cost of osteoporosis-related fracture in Italy. Results of the BLOCK study

    Directory of Open Access Journals (Sweden)

    Luca Degli Esposti

    2011-09-01

    Full Text Available The objectives of the present study were to calculate the cost of illness of osteoporosis and to assess drug utilization patterns in postmenopausal women after a fracture-related hospitalization. The study subjects were enrolled from a large population-based administrative database. Female patients (age ≥ 65 years who were hospitalized for a typical osteoporotic fracture between 1/1/2000 and 31/12/2005 were included. Patients were classified as exposed/unexposed to treatment according to the presence/absence of at least one prescription for an osteoporosis-related medication in the 6 months following the discharge date. Treatment adherence was calculated for patients who were exposed to bisphosphonate therapy and was defined as at least 80% of treatment coverage during the follow-up period of 18 months after the discharge date. Hospitalizations, medications, diagnostic tests, laboratory tests and specialist visits during the 18-month follow-up period were collected and classified as osteoporosis-related or non-related to osteoporosis. A total of 12,376 patients were included in the study (mean age ± SD, 79.1 ± 7.5 years, out of which 97.9% (n = 12,110 were hospitalized due to an osteoporosis-related fracture and only 2.1% (n = 266 had general osteoporosis diagnosis. Among the 12,110 women with a fracture, 15.2% (n = 1,845 had a subsequent fracture-related hospitalization (63.8% of the patients had hip fracture. Only 32.3% (n = 4,001 of all included patients was exposed to osteoporosis-related medications and out of those patients exposed to bisphosphonates (n = 860 only 34.2% (n = 294 was adherent to therapy. The average cost per patient was € 4,481, of which € 1,089 was for osteoporosis-related and € 3,392 for non-osteoporosis-related items. The average cost of a matching cohort of patients without hospitalizations for fracture was € 2,339. Among osteoporosis-related costs, 87.0% was due to hospitalizations for subsequent fractures

  19. Nationwide Inpatient Sample and National Surgical Quality Improvement Program give different results in hip fracture studies.

    Science.gov (United States)

    Bohl, Daniel D; Basques, Bryce A; Golinvaux, Nicholas S; Baumgaertner, Michael R; Grauer, Jonathan N

    2014-06-01

    National databases are being used with increasing frequency to conduct orthopaedic research. However, there are important differences in these databases, which could result in different answers to similar questions; this important potential limitation pertaining to database research in orthopaedic surgery has not been adequately explored. The purpose of this study was to explore the interdatabase reliability of two commonly used national databases, the Nationwide Inpatient Sample (NIS) and the National Surgical Quality Improvement Program (NSQIP), in terms of (1) demographics; (2) comorbidities; and (3) adverse events. In addition, using the NSQIP database, we identified (4) adverse events that had a higher prevalence after rather than before discharge, which has important implications for interpretation of studies conducted in the NIS. A retrospective cohort study of patients undergoing operative stabilization of transcervical and intertrochanteric hip fractures during 2009 to 2011 was performed in the NIS and NSQIP. Totals of 122,712 and 5021 patients were included from the NIS and NSQIP, respectively. Age, sex, fracture type, and lengths of stay were compared. Comorbidities common to both databases were compared in terms of more or less than twofold difference between the two databases. Similar comparisons were made for adverse events. Finally, adverse events that had a greater postdischarge prevalence were identified from the NSQIP database. Tests for statistical difference were thought to be of little value given the large sample size and the resulting fact that statistical differences would have been identified even for small, clinically inconsequential differences resulting from the associated high power. Because it is of greater clinical importance to focus on the magnitude of differences, the databases were compared by absolute differences. Demographics and hospital lengths of stay were not different between the two databases. In terms of comorbidities

  20. Nutrient patterns and risk of fracture in older subjects: results from the Three-City Study.

    Science.gov (United States)

    Samieri, C; Ginder Coupez, V; Lorrain, S; Letenneur, L; Allès, B; Féart, C; Paineau, D; Barberger-Gateau, P

    2013-04-01

    We investigated the association between nutrient patterns and risk of fractures in 1,482 older subjects. Patterns associated with higher intakes of Ca, P, vitamin B12, proteins and unsaturated fats, and moderate alcohol intake, provided by diets rich in dairies and charcuteries, were related to a lower risk of wrist and hip fractures. The purpose of this study was to investigate the relationship between patterns of nutrient intake and the risk of fractures in older subjects. Among 1,482 participants from the Bordeaux sample of the Three-City (3C) Study who completed a 24-h dietary recall and a food frequency questionnaire, we examined the association between patterns of nutrient intake derived from principal component analysis and 8-year incidence of self-reported fractures of the hip, the wrist, and the vertebrae. A "nutrient-dense" pattern rich in Ca and P, iron, vitamins B including B12, vitamins C and E, alcohol, proteins, and unsaturated fats, and characterized by a higher consumption of fruits and vegetables, meats and fish, cheese and milk, charcuteries, cereals, rice, pasta, and potatoes, was associated with a 19% (95% CI 2-34%, P=0.03) lower risk of wrist fractures. The same pattern was associated with a 14% (95% CI 2-25%) lower risk of fractures at any site. A "south-western French" pattern rich in Ca, P, vitamins D and B12, retinol, alcohol, proteins, and fats-including unsaturated fats; poor in vitamins C, E, and K, carotenes, folates, and fibers; and related to a higher consumption of cheese, milk, and charcuterie and a lower consumption of fruits and vegetables was related to a 33% lower risk of hip fractures (95% CI 3-39%, P=0.03). Higher intakes of Ca, P, vitamin B12, proteins, and unsaturated fats and moderate alcohol, provided by dietary patterns rich in cheese, milk, and charcuteries, were related to a lower risk of wrist and hip fractures in our cohort.

  1. Fixation of fractures of the condylar head of the mandible with a new magnesium-alloy biodegradable cannulated headless bone screw.

    Science.gov (United States)

    Leonhardt, H; Franke, A; McLeod, N M H; Lauer, G; Nowak, A

    2017-07-01

    It is difficult to fix fractures of the condylar head of the mandible. Several techniques have been described which show satisfactory outcomes, but stability can be questionable, and some can cause irritation of the soft tissues. We describe a technique and first results of treating such fractures with resorbable magnesium-based headless bone screws (Magnezix ® 2.7mm CS; Syntellix AG, Hanover, Germany). Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Dracunculiasis in oral and maxillofacial surgery.

    Science.gov (United States)

    Kim, Soung Min

    2016-04-01

    Dracunculiasis, otherwise known as guinea worm disease (GWD), is caused by infection with the nematode Dracunculus medinensis. This nematode is transmitted to humans exclusively via contaminated drinking water. The transmitting vectors are Cyclops copepods (water fleas), which are tiny free-swimming crustaceans usually found abundantly in freshwater ponds. Humans can acquire GWD by drinking water that contains vectors infected with guinea worm larvae. This disease is prevalent in some of the most deprived areas of the world, and no vaccine or medicine is currently available. International efforts to eradicate dracunculiasis began in the early 1980s. Most dentists and maxillofacial surgeons have neglected this kind of parasite infection. However, when performing charitable work in developing countries near the tropic lines or other regions where GWD is endemic, it is important to consider GWD in cases of swelling or tumors of unknown origin. This paper reviews the pathogenesis, epidemiology, clinical criteria, diagnostic criteria, treatment, and prevention of dracunculiasis. It also summarizes important factors for maxillofacial surgeons to consider.

  3. Investigation of flow distribution in a fracture zone at the Stripa mine, using the radar method, results and interpretation

    International Nuclear Information System (INIS)

    Andersson, P.; Andersson, P.; Gustafsson, E.; Olsson, O.

    1989-12-01

    The objective of the current project was to map the steady state flow distribution in a fracture zone in the Stripa mine when water was injected into the zone from a borehole. The basic idea was to map the flow paths by taking the difference between radar results obtained prior to and after injection of a saline tracer (KBr) into the fracture zone. The radar experiments were combined with a more conventional migration experiment to provide validation and calibration of the radar results. Difference tomography using borehole radar was a valuable and successful tool in mapping groundwater flow paths in fractured rock. The data presented were of good quality and sufficiently consistent throughout the investigated rock volume. The interpreted results verified previous findings in the surveyed granite volume as well as contributed to new and unique information about the transport properties of the rock at the site. The inflow data and the tracer breakthrough data has served as a useful aid in the interpretation of the flow distribution within the investigated zone and also within the surrounding rock mass. From the differential attenuation tomograms the migration of the injected tracer was mapped and presented both in the fracture zone of interest and in the entire investigated granite volume. From the radar tomographic model, the major tracer migration was found to be concentrated to a few major flow paths. Two additional fracture zones originally detected within this project, were found to transport portions of the injected tracer. The radar results combined with the tracer breakthrough data were used to estimate the area with tracer transport as well as flow porosity and the wetted surface. (orig.)

  4. Maxillofacial trauma of pediatric patients in Malaysia: a retrospective study from 1999 to 2001 in three hospitals.

    Science.gov (United States)

    Rahman, Roslan Abdul; Ramli, Roszalina; Rahman, Normastura Abdul; Hussaini, Haizal Mohd; Idrus, Sharifah Munirah Ai; Hamid, Abdul Latif Abdul

    2007-06-01

    Maxillofacial trauma in children is not common worldwide. Domestic injuries are frequently seen in younger children while older children are mostly involved in motor vehicle accidents (MVA). The objective of this study was to analyze the pattern of maxillofacial injuries in pediatric patients referred to three government main hospitals in different areas of West Malaysia. Patients' records of three selected hospitals in Malaysia (National University of Malaysia Hospital, Kajang Hospital and Seremban Hospital) from January 1999 to December 2001 were reviewed. Data associated with demographics, etiology of injury in relation to age group, type of injuries whether soft tissues of hard tissue in relation to age group and treatment modalities were collected. A total of 521 pediatric patients' records were reviewed. Malays made up the majority of patients with maxillofacial injuries in the three hospitals. Males outnumbered females in all the three hospitals. Injuries commonly occur in the 11-16 years old. MVA was the most common etiology followed by fall and assault. Soft tissue injuries were the most common type of injuries in all the hospitals. In relation to fractures, mandible was the most common bone to fracture with condyle being the most common site. Orbital fracture was the most common fracture in the midfacial area. Most of the fractures were managed conservatively especially in the younger age groups. Open reduction with or without internal fixation was more frequently carried out in the 11-16 years old group. Children exhibit different pattern of clinical features depending on the etiology and stage of their bone maturation. A dedicated team, who is competent in trauma and aware of the unique anatomy, physical and psychological characteristics of children, should manage pediatric patient with trauma.

  5. Results of operative treatment of avulsion fractures of the iliac crest apophysis in adolescents.

    Science.gov (United States)

    Li, Xigong; Xu, Sanzhong; Lin, Xiangjin; Wang, Quan; Pan, Jun

    2014-04-01

    Avulsion fracture of the iliac crest apophysis is a rare condition that commonly occurs in adolescent athletes. Conservative treatment for this injury can produce excellent functional outcomes. However, the rehabilitation process requires a rather long immobilisation period. This study aimed to evaluate the use of cannulated screws for fixation of avulsion fractures of iliac crest apophysis. Ten patients with avulsion fractures of iliac crest apophysis were treated by open reduction and internal fixation using cannulated screws. The mean age of patients was 14.6 years (range, 13-15 years). The mean intraoperative blood loss was 14.9 ml (range, 10-25 ml). The mean operative time was 40.3 min (range, 33-52 min). The mean follow-up period was 11.2 months (range, 6-20 months). At the 4-week follow-up, all patients returned to previously normal activity without pain and had no evidence of lower extremity muscle weakness. At the final follow-up, all patients resumed their athletic activity without any complications. Open reduction and internal fixation for the treatment of avulsion fracture of iliac crest apophysis can be recommended for patients requiring rapid rehabilitation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. The creation of an asymmetric hydraulic fracture as a result of driving stress gradients

    Czech Academy of Sciences Publication Activity Database

    Fischer, Tomáš; Hainzl, S.; Dahm, T.

    2009-01-01

    Roč. 179, č. 1 (2009), s. 634-639 ISSN 0956-540X Grant - others:EU(XE) MTKI-CT-2004-517242 Institutional research plan: CEZ:AV0Z30120515 Keywords : downhole methods * fracture and flow * earthquake source observations * geomechanics Subject RIV: DC - Siesmology, Volcanology, Earth Structure Impact factor: 2.435, year: 2009

  7. FIELD-SCALE EFFECTIVE MATRIX DIFFUSION COEFFICIENT FOR FRACTURED ROCK: RESULTS FROM LITERATURE SURVEY

    International Nuclear Information System (INIS)

    Zhou, Q.; Hui-Hai Liu; Molz, F.J.; Zhang, Y.; Bodvarsson, G.S.

    2005-01-01

    Matrix diffusion is an important mechanism for solute transport in fractured rock. We recently conducted a literature survey on the effective matrix diffusion coefficient, D m e , a key parameter for describing matrix diffusion processes at the field scale. Forty field tracer tests at 15 fractured geologic sites were surveyed and selected for the study, based on data availability and quality. Field-scale D m e values were calculated, either directly using data reported in the literature or by reanalyzing the corresponding field tracer tests. Surveyed data indicate that the effective-matrix-diffusion-coefficient factor F D (defined as the ratio of D m e to the lab-scale matrix diffusion coefficient [D m ] of the same tracer) is generally larger than one, indicating that the effective matrix diffusion coefficient in the field is comparatively larger than the matrix diffusion coefficient at the rock-core scale. This larger value can be attributed to the many mass-transfer processes at different scales in naturally heterogeneous, fractured rock systems. Furthermore, we observed a moderate trend toward systematic increase in the F D value with observation scale, indicating that the effective matrix diffusion coefficient is likely to be statistically scale dependent. The F D value ranges from 1 to 10,000 for observation scales from 5 to 2,000 m. At a given scale, the F D value varies by two orders of magnitude, reflecting the influence of differing degrees of fractured rock heterogeneity at different sites. In addition, the surveyed data indicate that field-scale longitudinal dispersivity generally increases with observation scale, which is consistent with previous studies. The scale-dependent field-scale matrix diffusion coefficient (and dispersivity) may have significant implications for assessing long-term, large-scale radionuclide and contaminant transport events in fractured rock, both for nuclear waste disposal and contaminant remediation

  8. Treatment of malreduced pilon fracture: A case report and the result in the long-term follow-up.

    Science.gov (United States)

    Balioğlu, Mehmet Bulent; Akman, Yunus Emre; Bahar, Hakan; Albayrak, Akif

    2016-01-01

    The risk for post-traumatic osteoarthritis (POA) following tibial plafond joint trauma has been reported to be as high as 70-75%. In the treatment of more severe joint pathologies, with incongruity and intra-articular defects, internal or external fixations techniques may be required. We report the orthopedic management of a pilon fracture in a 30-year-old male with malunion and implant failure after initial mal-reduction of the fracture 9-months earlier. Tricortical iliac crest autologous bone grafting (TCG) was used in combination with internal fixation to restore distal tibial articular. The procedure resulted in a pain free ankle, sufficient range of motion for function and patient satisfaction. Early surgical intervention and anatomical reduction with appropriate fixation are recommended for intra-articular tibial pilon fractures. Autogenous bone grafting is a reliable treatment option to augment structural stability, bone defects and bone-healing. Indications for bone grafting include delayed union or nonunion, malunion, arthrodesis, limb salvage, and reconstruction of bone voids or defects. The application of TCG in the management of a malreduced tibial plafond fracture has not been described before. We performed TCG with internal fixation in order to restore stability, congruency and alignment in a young patient in whom a biological restoration was feasible due to good bone quality. In suitable cases, TCG might provide an alternative to arthrodesis or arthroplasty. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Oral and maxillofacial surgery residents have poor understanding of biostatistics.

    Science.gov (United States)

    Best, Al M; Laskin, Daniel M

    2013-01-01

    The purpose of this study was to evaluate residents' understanding of biostatistics and interpretation of research results. A questionnaire previously used in internal medicine residents was modified to include oral and maxillofacial surgery (OMS) examples. The survey included sections to identify demographic and educational characteristics of residents, attitudes and confidence, and the primary outcome-knowledge of biostatistics. In 2009 an invitation to the Internet survey was sent to all 106 program directors in the United States, who were requested to forward it to their residents. One hundred twelve residents responded. The percentage of residents who had taken a course in epidemiology was 53%; biostatistics, 49%; and evidence-based dentistry, 65%. Conversely, 10% of OMS residents had taken none of these classes. Across the 6-item test of knowledge of statistical methods, the mean percentage of correct answers was 38% (SD, 22%). Nearly half of the residents (42%) could not correctly identify continuous, ordinal, or nominal variables. Only 21% correctly identified a case-control study, but 79% correctly identified that the purpose of blinding was to reduce bias. Only 46% correctly interpreted a clinically unimportant and statistically nonsignificant result. None of the demographic or experience factors of OMS residents were related to statistical knowledge. Overall, OMS resident knowledge was below that of internal medicine residents (Pbiostatistics and the interpretation of research and are thus unprepared to interpret the results of published clinical research. Residency programs should include effective biostatistical training in their curricula to prepare residents in evidence-based dentistry. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Acetabular Fracture

    Directory of Open Access Journals (Sweden)

    Chad Correa

    2017-09-01

    ; they will show a sagittally oriented fracture line at the roof of the acetabulum on axial CT. Lastly, wall fractures should be evaluated with axial CT images. This is because wall fractures have an obliquely oriented fracture line on axial CT images at the roof of the acetabulum, as opposed to the coronal and sagittal fracture lines described with column and transverse fractures, respectively.2 Fractures are organized using the Letournel Classification based on whether the fracture site lies in the anterior or posterior walls and columns of bone. After diagnosis, early surgical intervention is critical in achieving good results.3 The majority of acetabular fractures are repaired by open reduction and internal fixation. Patients with significant osteopenia or communition benefit most from total hip arthroplasty. However, due to the complex nature of these fractures, there is potential for poor outcome regardless of the injury pattern due to contributing factors such as imperfect reduction, osteochondral defects in the acetabulum or femoral head, osteoarthritis, avascular necrosis of the femoral head, sciatic nerve injury and infection.4

  11. THE RESULT OF INTRAMEDULLARY NAILING WITH BONE GRAFTING OF TIBIA'S PATHOLOGIC FRACTURE

    Directory of Open Access Journals (Sweden)

    V. M. Shapovalov

    2010-01-01

    Full Text Available The authors give the clinical case of successful surgical treatment of patient with tibia's pathologic fracture by intramedullary nailing with bone grafting. The disadvantages of such patients' treatment by plaster immobilization and by some invasive methods like vascular autografting by Ilizarov's method and bone plating were also discussed. The obvious benefits of proposed surgical treatment technique of observed patient category are shown.

  12. CT virtual reality in the preoperative workup of malunited distal radius fractures: preliminary results

    International Nuclear Information System (INIS)

    Rieger, Michael; Gruber, Hannes; Jaschke, Werner R.; Gabl, Markus; Mallouhi, Ammar

    2005-01-01

    Our objective was to evaluate the usefulness of CT virtual preoperative planning in the surgical repositioning of malunited distal radius fracture. Eleven patients with malunited distal radius fracture underwent multislice CT of both wrists. A preoperative workup was performed in a virtual reality environment created from the CT data sets. Virtual planning comprised three main procedures, carrying out the virtual osteotomy of the radius, prediction of the final position of the distal radius after osteotomy and computer-assisted manufacturing of a repositioning device, which was later placed at the surgical osteotomy site to reposition objectively the distal radius fragment before fixation with the osteosynthesis. All patients tolerated the surgical procedure well. During surgery, the orthopedic surgeons were not required in any of the cases to alter the position of the distal radius that was determined by the repositioning device. At postoperative follow-up, the anatomic relationship of the distal radius was restored (radial inclination, 21.4 ; volar tilt, 10.3 ; ulnar variance, 0.5 mm). Clinically, a significant improvement of pronation (P=0.012), supination (P=0.01), flexion (P=0.001) and extension (P=0.006) was achieved. Pain decreased from 54 to 7 points. CT virtual reality is a valuable adjunct for the preoperative workup and surgical reposition of malunited distal radius fractures. (orig.)

  13. Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention.

    Science.gov (United States)

    Bell, Jack J; Bauer, Judith D; Capra, Sandra; Pulle, Ranjeev Chrys

    2014-12-01

    Malnutrition is highly prevalent and resistant to intervention following hip fracture. This study investigated the impact of individualised versus multidisciplinary nutritional care on nutrition intake and outcomes in patients admitted to a metropolitan hospital acute hip fracture unit. A prospective, controlled before and after comparative interventional study aligning to the CONSORT guidelines for pragmatic clinical trials. Randomly selected patients receiving individualised nutritional care (baseline) were compared with post-interventional patients receiving a new model of nutritional care promoting nutrition as a medicine, multidisciplinary nutritional care, foodservice enhancements, and improved nutrition knowledge and awareness. Malnutrition was diagnosed using the Academy of Nutrition and Dietetics criteria. Fifty-eight weighed food records were available for each group across a total of 82 patients (n = 44, n = 38). Group demographics were not significantly different with predominantly community dwelling (72%), elderly (82.2 years), female (70%), malnourished (51.0%) patients prone to co-morbidities (median 5) receiving early surgical intervention (median D1). Multidisciplinary nutritional care reduced intake barriers and increased total 24-h energy (6224 vs. 2957 kJ; p hip fracture inpatients. Similar pragmatic study designs should be considered in other elderly inpatient populations perceived resistant to nutritional intervention. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. [Midterm follow-up results on Asian femoral intramedullary nail for the treatment of segmental and comminuted femoral fractures].

    Science.gov (United States)

    Li, Lang; Gao, Feng; Huang, Qi; Li, Qiang; Xie, Lin; Zhang, Bin

    2016-06-01

    To investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and comminuted femoral fractures. Between June 2011 and October 2012,16 patients with segmental and comminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them, there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old; the time from injury to operation ranged from 3 to 24 d with an average of 9.1 d. There were 6 cases were type C1,2 cases were type C2 and 8 cases were type C3 according to AO classification. X-ray of femoral segment at 3,6 and 12 months after operation were applied for evaluating fracture healing. Harris score of hip joint and HSS score of knee joint were used to evaluate postoperative function. All patients were followed up from 24 to 36 months with an average of 28.4 months. Operative time was from 88 to 112 min with an average of 90.7 min; blood loss ranged from 150 to 200 ml with an average of 188.75 ml; the time of fracture healing was from 5 to 9 months with an average of 5.4 months. All incision were healed at stage I. No loosening, breakage of internal fixation and displacement of fracture were occurred. There were no significant differences in Harris score of hip joint at 3, 6 and 12 months after operation (F = 0.07, P = 0.893 > 0.05), 10 cases obtained excellent results, 5 good and 1 moderate. There was no obvious meaning in HSS score of knee joint (F = 0.08,P = 0.876 > 0.05), 9 cases obtained excellent results, 6 good and 1 poor. Asian femoral intramedullary nail could treat segmental and comminuted femoral fractures by using variety of less invasive ways,which has advantages of less trauma, quick recovery of function and satisfied midterm following-up results. But long term following-up effects remains to be seen.

  15. Fluoroscopically guided closed reduction and internal fixation of fractures of the lateral portion of the humeral condyle: prospective clinical study of the technique and results in ten dogs.

    Science.gov (United States)

    Cook, J L; Tomlinson, J L; Reed, A L

    1999-01-01

    To report a technique for fluoroscopically guided closed reduction with internal fixation of fractures of the lateral portion of the humeral condyle (FLHC) and determine the long-term results in 10 clinical cases. Prospective clinical case study. Ten dogs with 11 fractures. Fractures of the lateral portion of the humeral condyle were stabilized with transcondylar screws and Kirschner wires. Closed reduction and implant placement were achieved using intraoperative fluoroscopic guidance. After fracture repair, postoperative radiographs were evaluated for articular alignment and implant placement. Dogs were evaluated after surgery by means of lameness scores, elbow range of motion (ROM), radiographic assessment, and owner evaluation of function. Postoperative reduction was considered anatomic in 6 fractures with all other fractures having ROM values between affected and unaffected elbows. All of the dogs in this study regained 90-100% of full function, based on owner assessment. Fluoroscopic guidance for closed reduction and internal fixation of FLHC in dogs is an effective technique.

  16. An insight into the future beckons of maxillofacial prosthodontics: Anaplastology

    Directory of Open Access Journals (Sweden)

    S Padmaja

    2015-01-01

    Full Text Available It is the god given right of every human being to appear human. Few areas of dentistry offer more challenges to the technical skills or greater satisfaction for the successful rehabilitation of function and esthetics in the patient with gross anatomic defects and deformities of the maxillofacial region. Although remarkable advances in the surgical management of oral and facial defects, but cannot be satisfactorily repaired by plastic surgery alone. Hence, the demand for maxillofacial prosthetic devices for the rehabilitation of patients with congenital or acquired defects has intensified in recent years. This paper gives an insight into the latest innovations and improvisations in the field of maxillofacial prosthodontics.

  17. Gunshot (Pellets injury to the maxillofacial complex: a case report

    Directory of Open Access Journals (Sweden)

    Kiran D.N

    2014-06-01

    Full Text Available Gunshot injuries are rather serious but uncommon type of trauma in India. A 45-year-old male was presented with gunshot (pellets embedded in the maxillofacial area for 22 years. There is no consensus in the literature whether to attempt their removal or leave them in situ. Our patient had no long-term sequela like infection, fistula formation, carcinogenesis or metal poisoning to date except for chill feeling on cold days. Management of this patient presented a dilemma in treatment in view of the effects of foreign bodies in the maxillofacial area. Key words: Maxillofacial injuries; Wounds, gunshot; Firearms

  18. A systematic review of functional outcome and quality of life following reconstruction of maxillofacial defects using vascularized free fibula flaps and dental rehabilitation reveals poor data quality

    NARCIS (Netherlands)

    Wijbenga, Johan G.; Schepers, Rutger H.; Werker, Paul M. N.; Witjes, Max J. H.; Dijkstra, Pieter U.

    Background: Reconstruction and oral rehabilitation of segmental maxillofacial defects resulting from ablative surgery is commonly achieved by osteocutaneous vascularized free fibula (VFFF) transplantation combined with implant-supported dental prostheses. We systematically reviewed the literature

  19. Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview

    Directory of Open Access Journals (Sweden)

    Tiren Davut

    2012-01-01

    Full Text Available Abstract Background The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%. Nine patients (32% developed impingement symptoms and in 7 patients (25% subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14% developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11% had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.

  20. Seven-year retrospective clinical study evaluating efficacy of stainless steel mesh in mandibular fractures.

    Science.gov (United States)

    Chakraborty, Sudip; Ghosh, Samiran; Burman, Richi; Ray, Amit

    2011-10-01

    The use of titanium mesh in communited mandibular fractures has been substantially documented. However, the use of stainless steel mesh for routine fixation in mandibular fractures has not been widely reported. The aim of the present study was to evaluate the efficacy of stainless steel mesh for routine osteosynthesis of mandibular fractures. A total of 252 patients who had been diagnosed with 287 single or multiple mandibular fractures at Guru Nanak Institute of Dental Science and Research from 2002 to 2009 were selected for the present study. Those with condylar fractures and other maxillofacial injuries were excluded from the study. The patients were evaluated preoperatively, intraoperatively, and postoperatively at 1 day, 6 weeks, and 3 and 6 months. The local complications, occlusion (for static function), and chewing (for dynamic function) were evaluated postoperatively. The intraoperative time taken for implant fixation (from site exposure to fixation of the last screw) was 32 minutes. Of the 252 patients, 40 (15.8%) had local complications and 24 patients required implant removal. Of the 252 patients, 82% had bilaterally satisfactory occlusion according to the surgeon at 6 months postoperatively. Discomfort in chewing unilaterally or bilaterally was reported by 17% of the patients. The results of our study have shown that stainless steel mesh has acceptable complication rates and the ability to maintain occlusion and chewing postoperatively compared with the present standards of care of mandibular fractures using miniplates. The lower cost and versatile placement of screws were the principal advantages. However, placement near the mental foramen with an extraoral approach for certain sites is the primary disadvantage. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Laryngeal fracture due to blunt trauma presenting with pneumothorax and pneumomediastinum.

    Science.gov (United States)

    Narcı, Adnan; Embleton, Didem Baskın; Ayçiçek, Abdullah; Yücedağ, Fatih; Cetinkurşun, Salih

    2011-01-01

    Injuries due to traffic accidents are frequent in childhood, and they have high mortality and morbidity. Laryngeal injury due to a traffic accident is a rare pathology and might be missed if not suspected. Here we present a laryngeal fracture in a child after a blunt chest trauma during a traffic accident that presented with pneumomediastinum and pneumothorax. A 14-year-old girl was referred for pneumomediastinum. Her physical examination was normal except subcutaneous emphysema, edema and tenderness in the cervical area, hoarseness, facial and extremity abrasions and ecchymoses. Chest tomography revealed pneumothorax and pneumomediastinum, and cranial tomography revealed maxillofacial fractures. Upper airway damage was suspected, flexible endoscopy revealed right vocal cord paralysis and cervical tomography revealed thyroid cartilage fracture. The fracture was repaired and tracheotomy was performed. She was discharged on postoperative day 6. Facial fractures were repaired in another center. Tracheotomy was removed on postoperative day 20. Her hoarseness, although decreased, still persists. Pneumomediastinum is a rare result of a laryngeal fracture and if not suspected, the fracture can easily be missed. It should be kept in mind after blunt cervical trauma with pneumomediastinum and/or pneumothorax. Direct endoscopy and cervical tomography may be necessary for the differential diagnosis. Copyright © 2011 S. Karger AG, Basel.

  2. Thoracolumbar spine fractures in the geriatric fracture center : early ambulation leads to good results on short term and is a successful and safe alternative compared to immobilization in elderly patients with two-column vertebral fractures

    NARCIS (Netherlands)

    Weerink, L B M; Folbert, E C; Kraai, M; Smit, R S; Hegeman, J H; van der Velde, D

    INTRODUCTION: Thoracolumbar spine fractures are common osteoporotic fractures among elderly patients. Several studies suggest that these fractures can be treated successfully with a nonoperative management. The aim of this study is to evaluate the conservative treatment of elderly patients with a

  3. Public priorities for osteoporosis and fracture research: results from a general population survey.

    Science.gov (United States)

    Paskins, Zoe; Jinks, Clare; Mahmood, Waheed; Jayakumar, Prakash; Sangan, Caroline B; Belcher, John; Gwilym, Stephen

    2017-12-01

    This is the first national study of public and patient research priorities in osteoporosis and fracture. We have identified new research areas of importance to members of the public, particularly 'access to information from health professionals'. The findings are being incorporated into the research strategy of the National Osteoporosis Society. This study aimed to prioritise, with patients and public members, research topics for the osteoporosis research agenda. An e-survey to identify topics for research was co-designed with patient representatives. A link to the e-survey was disseminated to supporters of the UK National Osteoporosis Society (NOS) in a monthly e-newsletter. Responders were asked to indicate their top priority for research across four topics (understanding and preventing osteoporosis, living with osteoporosis, treating osteoporosis and treating fractures) and their top three items within each topic. Descriptive statistics were used to describe demographics and item ranking. A latent class analysis was applied to identify a substantive number of clusters with different combinations of binary responses. One thousand one hundred eighty-eight (7.4%) respondents completed the e-survey. The top three items overall were 'Having easy access to advice and information from health professionals' (63.8%), 'Understanding further the safety and benefit of osteoporosis drug treatments' (49.9%) and 'Identifying the condition early by screening' (49.2%). Latent class analysis revealed distinct clusters of responses within each topic including primary care management and self-management. Those without a history of prior fracture or aged under 70 were more likely to rate items within the cluster of self-management as important (21.0 vs 12.9 and 19.8 vs 13.3%, respectively). This is the first study of public research priorities in osteoporosis and has identified new research areas of importance to members of the public including access to information. The findings

  4. Distal radius fractures result in alterations in scapular kinematics: a three-dimensional motion analysis.

    Science.gov (United States)

    Ayhan, Cigdem; Turgut, Elif; Baltaci, Gul

    2015-03-01

    Scapular motion is closely integrated with arm motion. Injury to a distal segment requires compensatory changes in the proximal segments leading to alterations in scapular motion. Since the effects of distal injuries on scapular kinematics remain unknown, in the present study we investigated the influences on scapular motion in patients with distal injuries. Sixteen subjects with a history of distal radius fracture and 20 asymptomatic healthy subjects (controls) participated in the study. Three-dimensional scapular and humeral kinematic data were collected on all 3 planes of shoulder elevation: frontal, sagittal, and scapular. All testing was performed in a single session; therefore, the sensors remained attached to the participants for all testing. The position and orientation data of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation and 120°, 90°, 60°, and 30° lowering were used for statistical comparisons. Independent samples t-test was used to compare the scapular internal/external rotation, upward/downward rotation, and anterior/posterior tilt between the affected side of subjects with a distal radius fracture and the dominant side of asymptomatic subjects at the same stage of humerothoracic elevation. Scapular internal rotation was significantly increased at 30° elevation (P=0.01), 90° elevation (P=0.03), and 30° lowering (P=0.03), and upward rotation was increased at 30° and 60° elevation (Pplane elevation. Scapular upward rotation and anterior tilt were significantly increased during 30° lowering on both the scapular (P=0.002 and 0.02, respectively) and sagittal planes (P=0.01 and 0.02. respectively). Patients with distal radius fractures exhibit altered scapular kinematics, which may further contribute to the development of secondary musculoskeletal pathologies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Injuries as a result of sports and vacation activities: Fractures with concomitant vascular injuries. Diagnosis and treatment concept

    International Nuclear Information System (INIS)

    Schlickewei, W.; Kuner, E.H.; Goetze, B.; Spillner, G.

    1989-01-01

    Extremity fractures with concomitant vascular injuries are surgical emergencies. Especially injuries of the upper extremities require a preoperative angiographic examination for the localization of the vascular lesion. In vascular lesions of the lower extremities a primary angiography is not necessary, if there is an opportunity for an intraoperative radiologic evaluation. In our traumatological department 104 patients were treated over the last 15 years with that combined injury. The concept of immediate stabilization of the fracture with simultaneous or postponed arterial repair has been proved to be appropriate. The fasziotomy as prophylactic procedure of a postischemic compartment syndrome is also a part of our concept during the last years. The late results in our mostly young patients depended on the degree of soft tissue damage and the time of ischemia. The often untreatable nerve lesions contributed to a loss of use of about 30% in the late courses. (orig.) [de

  6. [Kirschner wire osteosynthesis for fractures in childhood: bury wires or not? : Results of a survey on care reality in Germany].

    Science.gov (United States)

    Schneidmueller, D; Kertai, M; Bühren, V; von Rüden, C

    2018-02-20

    Kirschner wire osteosynthesis is considered to be the standard technique for surgical fixation of displaced supracondylar humeral and distal radial fractures in children. The Kirschner wires can be left exposed or buried under the skin. Advantages of the epicutaneous technique are, e. g. the efficiency (cost, effort) and the possibility for wire removal without the necessity of a second anesthesia. On the other hand, there is a concern about higher infection rates as well as traumatization of the children due to externally visible wires. A web-based survey of members of the DGU, DGOU, DGOOC, and the pediatric traumatology section of the DGU (SKT) was performed to evaluate current treatment concepts in Germany. The pros and cons for each technique were recorded and the need for a clinical study was examined. In addition, a cost analysis was performed for both methods. The results from the literature are summarized and discussed. A total of 710 questionnaires were evaluated. The majority of the respondents were trauma surgeons working in a hospital (80%). The buried technique was superior in both fracture groups (supracondylar humeral fractures 73% and distal radius fractures 69%), whereas a relevant difference could be found depending on the profession. The main reason for the subcutaneous technique was anxiety or observed higher infections using the epicutaneous technique. In Germany, the majority of wires are buried under the skin due to a fear of higher infection rates. In addition, other influencing factors such as pain and traditional approaches play a significant role. With respect to the results in the literature as well as a possible improvement of efficiency and avoidance of a second anesthesia, a multicentric clinical study seems necessary in the future to compare both techniques.

  7. Plantar impact causing midfoot fractures result in higher forces in Chopart's joint than in the ankle joint.

    Science.gov (United States)

    Richter, M; Wippermann, B; Thermann, H; Schroeder, G; Otte, D; Troeger, H D; Krettek, C

    2002-03-01

    Force effect (impact, extent of foot compartment deformation) and result (fracture pattern) for midfoot fractures in car occupants is known. An analysis of the processes in the foot was intended to improve car safety. Eleven fresh, unfrozen, unpreserved intact human cadavers (age: 36.8 (16-61) years, gender: male, race: Caucasian) were studied 24-72 h after death. In 3 cadavers (5 feet) the experimental design was established: entire cadaver fixed on a special tray in supine position, pendulum with bar impactor hitting the foot plantar to Lisfranc's joint. A custom-made pressure sensor was inserted in the ankle (A), talonavicular (TN) and calcaneocuboid (CC) joints (resolution: 1 cm2, sampling rate: 500/s). Sixteen feet were measured: midfoot fractures were induced in 11 feet. The maximum pressure amounted to 1.22-2.55 MPa (2.04+/-0.412) at 0.005 0.195 s (0.067+/-0.059) after impact. The maximum pressure occurred in 8 (50%) cases in the ankle, in 7 (44%) of the TN and 1 (6%) of the CC joints. A comparison of the first 200 pressure samples after impact of all sensor fields resulted in higher forces in Chopart's joint than in the ankle (t-test: p < 0.001). These force differences were higher in cases with midfoot fractures (mixed model analysis of variance: p = 0.003). Due to considerable forces in Chopart's joint we recommend a modification of the actual crash test dummy lower extremity model with an additional load cell that detects forces in the longitudinal direction of the foot axis.

  8. Perspectives of stem cell use in reconstructive maxillofacial surgery

    Directory of Open Access Journals (Sweden)

    Mikhail G. Semyonov

    2016-12-01

    Full Text Available The discovery of stem cells is one of the greatest achievements of molecular and cell biology, and associated research has confirmed the possibility of self-renewal and differentiation into specialized tissue stem cells. The use of cellular technologies is an important trend in modern medicine. The aim of this article is to briefly review current findings on the use of stem cells in cardiology, endocrinology, neurology, traumatology, and maxillofacial surgery. All data were retrieved from experimental and clinical studies using various cell technologies. The material is part of ongoing maxillofacial surgery research to investigate the possible use of stem cells in reconstructive maxillofacial surgery for jaw bone pathologies in children. Present tissue engineering methods provide some opportunities for solving difficult clinical problems in oral and maxillofacial surgery. Despite some international achievements of effective application of IC in various diseases, clinical use in reconstructive surgery requires further investigation.

  9. Oral and maxillofacial radiology: The challenge of change

    International Nuclear Information System (INIS)

    Omami, Galal

    2015-01-01

    Oral and maxillofacial radiologists may teach, practice, and/or conduct research with regard to any aspect of radiology. They are also responsible for establishing guidelines for radiographic selection criteria, radiation safety, and quality assurance. Some oral and maxillofacial radiologists have joint appointments in medical radiology. This provides a collaborative working environment with medical radiologists, who generally are not conversant with the diagnostic imaging of the jaws

  10. Our Treatment Approaches in Severe Maxillofacial Injuries Occurring After Failed Suicide Attempts Using Long-Barreled Guns.

    Science.gov (United States)

    Kucuker, Ismail; Şimşek, Tekin; Keles, Musa Kemal; Yosma, Engin; Aksakal, Ibrahim Alper; Demir, Ahmet

    2016-03-01

    Maxillofacial traumas with long-barreled guns may sometimes cause catastrophic results by means of smashing in facial structures. In these patients, reconstruction strategies of both fragmented/lost soft and hard tissues still remain controversial. In their clinic, the authors treated 5 patients with severely injured face after failed suicide attempt between 2008 and 2013. In this study, the authors aimed to present their clinical experiences on these severely injured maxillofacial gunshot traumas and offer a treatment algorithm to gain a result as possible as satisfactory in terms of functionality and appearance.

  11. One-year health and care costs after hip fracture for home-dwelling elderly patients in Norway: Results from the Trondheim Hip Fracture Trial

    OpenAIRE

    Hektoen, Liv Faksvåg; Saltvedt, Ingvild; Sletvold, Olav; Helbostad, Jorunn L.; Lurås, Hilde; Halsteinli, Vidar

    2016-01-01

    Aim: The aim of this study was to estimate the one-year health and care costs related to hip fracture for home-dwelling patients aged 70 years and older in Norway, paying specific attention to the status of the patients at the time of fracture and cost differences due to various patient pathways after fracture. Methods: Data on health and care service provision were extracted from hospital and municipal records and from national registries; data on unit costs were collected from the municipal...

  12. Acquisition and manipulation of computed tomography images of the maxillofacial region for biomedical prototyping

    International Nuclear Information System (INIS)

    Meurer, Maria Ines; Silva, Jorge Vicente Lopes da; Santa Barbara, Ailton; Nobre, Luiz Felipe; Oliveira, Marilia Gerhardt de; Silva, Daniela Nascimento

    2008-01-01

    Biomedical prototyping has resulted from a merger of rapid prototyping and imaging diagnosis technologies. However, this process is complex, considering the necessity of interaction between biomedical sciences and engineering. Good results are highly dependent on the acquisition of computed tomography images and their subsequent manipulation by means of specific software. The present study describes the experience of a multidisciplinary group of researchers in the acquisition and manipulation of computed tomography images of the maxillofacial region aiming at biomedical prototyping for surgical purposes. (author)

  13. Use of customized polyetheretherketone (PEEK) implants in the reconstruction of complex maxillofacial defects.

    Science.gov (United States)

    Kim, Michael M; Boahene, Kofi D O; Byrne, Patrick J

    2009-01-01

    Extensive maxillofacial defects resulting from trauma or oncologic resection present reconstructive challenges. Various autografts and alloplastic materials in conjunction with standard soft-tissue techniques have been used in the reconstruction of these types of defects. Polyetheretherketone (PEEK) is a semicrystalline polyaromatic linear polymer exhibiting an excellent combination of strength, stiffness, durability, and environmental resistance. Recent investigations of PEEK as a biomaterial resulted in the successful treatment of cervical disk disease. We describe a series of 4 patients whose defects were reconstructed using customized PEEK implants. All had excellent postoperative aesthetic and functional results without complications such as infections or extrusions. Because PEEK implants are customizable, easily workable, inert, and nonporous, they represent an ideal alloplastic material for maxillofacial reconstruction.

  14. Fresh frozen bone in oral and maxillofacial surgery

    Directory of Open Access Journals (Sweden)

    Luigi Fabrizio Rodella

    2015-06-01

    Full Text Available The aim of the current study was to review the use of fresh frozen bone (FFB in oral and maxillofacial surgery. We performed a review of the articles published in the literature between 1976 and May 2014 analyzing three medical databases (PubMed, Cochrane Library, and Embase and using specific search terms. Literature analysis on FFB applications in oral and maxillofacial surgery revealed 47 articles between 1976 and May 2014. There are 46 clinical articles and one review. Clinical articles are represented by 22 case reports and case series and 24 retrospective studies. Classifying the scientific production by year of publication, it is evident that especially during the last 6 years there was an increase of FFB graft use in oral and maxillofacial approaches. The literature analysis on FFB's use shows that its application in oral and maxillofacial surgery began slowly in 1992 with Perrott and since 2006 it had a real development. The recent significant increase emphasizes the importance of FFB for bone regeneration in oral and maxillofacial surgery. This review found consistent evidence of FFB's use increase in oral and maxillofacial surgery suggesting a valid instrument for bone regeneration. To date, risks connected to the infections' transmission and to the immunogenic potential are extremely low and could be considered practically absent. So, this is an important alternative in the preimplant reconstructive surgery.

  15. Protective association of milk intake on the risk of hip fracture: results from the Framingham Original Cohort.

    Science.gov (United States)

    Sahni, Shivani; Mangano, Kelsey M; Tucker, Katherine L; Kiel, Douglas P; Casey, Virginia A; Hannan, Marian T

    2014-08-01

    were seen for other dairy foods (p range = 0.117 to 0.746). These results suggest that greater intakes of milk and milk + yogurt may lower risk for hip fracture in older adults through mechanisms that are partially, but not entirely, attributable to effects on bone mineral density. © 2014 American Society for Bone and Mineral Research.

  16. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

    OpenAIRE

    Choi, Kang-Young; Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and de...

  17. A New Method for Surgical Treatment of Subcondylar Fractures: A Case Report

    Directory of Open Access Journals (Sweden)

    Gholamreza Shirani

    2017-12-01

    Full Text Available AbstractSubcondylar fractures are common in the maxillofacial region following direct trauma to the mandibular ramus. The literature is replete with articles written on the treatment of subcondylar fractures, encompassing a plethora of various surgical approaches; however, the best treatment procedure has remained controversial. Such fractures are either treated by open reduction with internal fixation or closed reduction with maxillomandibular fixation. In this article, we describe a new surgical method for treatment of subcondylar fractures.

  18. Fracture Mechanics

    International Nuclear Information System (INIS)

    Jang, Dong Il; Jeong, Gyeong Seop; Han, Min Gu

    1992-08-01

    This book introduces basic theory and analytical solution of fracture mechanics, linear fracture mechanics, non-linear fracture mechanics, dynamic fracture mechanics, environmental fracture and fatigue fracture, application on design fracture mechanics, application on analysis of structural safety, engineering approach method on fracture mechanics, stochastic fracture mechanics, numerical analysis code and fracture toughness test and fracture toughness data. It gives descriptions of fracture mechanics to theory and analysis from application of engineering.

  19. [Anterior Superior and Anterior Interior Iliac Spine Fractures. Comparison of the Results of Conservative and Surgical Treatment].

    Science.gov (United States)

    Stančák, A; Kautzner, J; Havlas, V

    2016-01-01

    Avulsion fractures of the anterior superior iliac spine (ASIS) and anterior inferior iliac spine (AIIS) are rare injuries to the skeleton in children. They are most frequent in adolescent athletes, such as sprinters and long-distance runners, and football players. The authors present a group of patients treated at their department and compare the results of procedures used to manage different pelvic avulsion fractures. Between 2005 and 2012, 38 patients (31 boys and seven girls) with an average age of 15.1 years (range, 4-17 years) were treated. Fourteen patients with minimally displaced fractures were treated conservatively, 24 patients with fractures displaced more than 1 cm underwent surgery. All patients had a standard rehabilitation protocol. Post-operative assessments included: the range of motion in the hip; X-ray at 6 weeks, 3 months and 1 year; duration of bed rest; return to previous activities; occurrence of complications (heterotopic ossification, infection, etc). All patients returned to the pre-injury level of sports activities. Recovery was faster and early rehabilitation was better tolerated in patients treated surgically (p = 0.03), particularly in those with AIIS avulsion fractures. Ambulation with partial weight bearing was possible on average at 7.2 days (range, 2-10 days) in surgically treated patients and at 24.1 days (18-27 days) in conservatively treated patients; the difference was statistically significant (p = 0.02). The range of motion markedly improved in surgically treated patients as early as at 6 weeks while, in conservatively treated patients, the comparable outcome was achieved at 3 months of follow-up (p = 0.02). The time necessary for radiographic evidence of fragment union as well as full recovery was comparable in both patient groups. No deep wound infection was recorded; minor heterotopic ossification was detected in five patients, but no further treatment during follow-up was required. Indications for surgical treatment are

  20. Osteo-odonto-keratoprosthesis - a maxillofacial perspective.

    Science.gov (United States)

    Narayanan, Vinod; Nirvikalpa, Natarajan; Rao, Srinivas K

    2012-12-01

    The OOKP (osteo-odonto-keratoprosthesis) is the treatment of choice for conditions like Stevens-Johnson syndrome, ocular cicatricial pemphigoid, trachoma, multiple failed grafts and chemical burns which are not amenable to penetrating keratoplasty. The OOKP is an autograft which replaces the cornea with a polymethacrylate cylinder mounted on a tooth-bone complex. The aim of this paper was to retrospectively analyze the records in 26 patients undergoing OOKP surgery between 2007 and 2011. The paper describes our experience with the procedure, with emphasis on its oral and maxillofacial aspects and management of associated complications. The aetiology of blindness in 23 patients was Stevens-Johnson's syndrome and chemical burns in three. Twenty-two patients had their maxillary canines, two had mandibular canines and two had maxillary first premolars as the choice of donor tooth. An oroantral fistula developed in four patients. One patient needed to undergo a surgical procedure for closure of the same. Roots of adjacent teeth were exposed in 12 patients. Twenty-four patients underwent both stages of the procedure with 19 being visually rehabilitated successfully. There was no improvement in the vision of four patients. One patient was lost to follow-up. Two patients have yet to undergo Stage 2. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Computer-assisted oral and maxillofacial surgery

    International Nuclear Information System (INIS)

    Hassfeld, S.; Brief, J.; Muehling, J.; Krempien, R.; Mende, U.; Raczkowsky, J.; Muenchenberg, J.; Woern, H.; Giess, H.; Meinzer, H.P.

    2000-01-01

    Background: Methods from the area of virtual reality are used in oral and maxillofacial surgery for the planning and three-dimensional individual simulation of surgeries. Simulation: In order to simulate complex surgeries with the aid of a computer, the diagnostic image data and especially various imaging modalities (CT, MRT, US) must be arranged in relation to each other, thus enabling rapid switching between the various modalities as well as the viewing of mixed images. Segmenting techniques for the reconstruction of three-dimensional representations of soft-tissue and osseous areas are required. We must develop ergonomic and intuitively useable interaction methods for the surgeon, thus allowing for precise and fast entry of the planned surgical intervention in the planning and simulation phase. Surgery: During the surgical phase, instrument navigation tools offer the surgeon interactive support through operation guidance and control of potential dangers. This feature is already available today. Future intraoperative assistance will take the form of such passive tools for the support of intraoperative orientation as well as so-called tracking systems (semi-active systems) which accompany and support the surgeons' work. The final form are robots which execute specific steps completely autonomously. Discussion: The techniques of virtual reality keep gaining in importance for medical applications. Many applications are still being developed or are still in the form of a prototype. However, it is already clear that developments in this area will have a considerable effect on the surgeon's routine work. (orig.) [de

  2. Analysis of the drilling sound component from expert performance in a maxillo-facial surgery

    DEFF Research Database (Denmark)

    Hoffmann, Pablo F.; Gosselin, Florian; Taha, Farid

    2009-01-01

    Auditory displays can have a great potential in surgical simulators that aim at training skills associated to the correct interpretation of auditory information. Here, we present preliminary results in the analysis of the sound produced by the drilling procedure in a maxillo-facial surgery when...... performed by expert surgeons. The motivation of this work is to find relevant acoustic parameters that allow for an efficient synthesis method of auditory displays so that they can effectively convey information on expert surgical drilling....

  3. Rapid prototyping modelling in oral and maxillofacial surgery: a two year retrospective study

    OpenAIRE

    Suomalainen, Anni; Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K.

    2015-01-01

    Background The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination ? multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results In total 114 RP models were fabricated for 102 patients. ...

  4. Comparison of circummandibular wiring with resorbable bone plates in pediatric mandibular fractures.

    Science.gov (United States)

    Saikrishna, D; Gupta, Nimish

    2010-06-01

    Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning as well as in their functional and nutritional needs which are different from that of adult patients. Early literature has advocated conservative closed management of pediatric fractures to prevent complications. However recent advances in maxillofacial surgery has enabled us to use biodegradable plates and screws, which overcomes the limitations of metallic plates. We present a comparison of two cases of parasymphysis fracture treated with circum-mandibular wiring and biodegradable plate fixation their outcome in terms of fracture healing and functional stability.

  5. Evaluation of Depression Associated With Post-Traumatic Stress Disorder After Maxillofacial Injuries-A Prospective Study.

    Science.gov (United States)

    Ranganathan, Vatsala; Panneerselvam, Elavenil; Chellappazham, Saravanan; Balasubramaniam, Sasikala; Raja V B, Krishnakumar

    2018-06-01

    Maxillofacial injuries can result in psychological derangement, leading to post-traumatic stress disorder (PTSD), which is characterized by continual re-experiencing of any traumatic event in addition to numerous systemic complications. The objective of this study was to assess the incidence and severity of "PTSD-related depression" in patients with maxillofacial injuries and to identify the risk factors involved. This prospective study involved 88 patients with maxillofacial trauma who had only cosmetic deficits (group A), only functional deficits (group B), or cosmetic and functional deficits (group C). The psychological status of all patients was assessed before and after surgery using Zung's Self-Rating Depression Scale. Remission time also was analyzed. Data were analyzed with SPSS 22.0 using parametric methods. Comparison of mean values among groups was performed using 1-way analysis of variance followed by Tukey honest significance difference post hoc tests for multiple pairwise comparisons. To compare proportions, the χ 2 test was applied. The number of patients in groups A, B, and C was 11, 34 and 43, respectively. In the immediate post-trauma stage, all patients in group A showed severe depression; the percentages of patients with severe depression in groups B and C were 8.8 and 81.4%, respectively, which was statistically relevant. Depression scores of patients of all groups decreased gradually in the postsurgical phase. Patients with cosmetic defects consistently recorded higher depression scores at all intervals. The time taken for recovery from depression (remission time) was shorter for patients with only functional deficits (group B). Patients with maxillofacial injuries are prone to PTSD-related depression from functional and cosmetic deficits. The objectives of trauma management must be aimed at restoring pre-trauma form and function of the maxillofacial skeleton and the patient's psychological status. Copyright © 2018 American Association of

  6. Epidemiology of Surgically Managed Mandibular Condylar Fractures at a Tertiary Referral Hospital in Urban Southwest China.

    Science.gov (United States)

    Thapa, Swosti; Wang, Jun; Hu, Hong-Tao; Zhang, Fu-Gui; Ji, Ping

    2017-01-01

    Mandibular condylar fracture is one of the commonest maxillofacial fractures treated by maxillofacial surgeons. Demography of the patients, causation, and characteristics of the fracture depends on various socio-economic factors. Hence, maxillofacial surgeons should be familiar with epidemiology of mandibular condylar fracture. This study retrospectively describes the demography, etiology, fracture characteristics, and hospital utilization of surgically treated mandibular condylar fractures in a tertiary referral hospital in urban China in past five years. Data of all patients who underwent surgical management between 2011 and 2015 were collected. This included aetiology, characteristics of fracture, time, age, sex, associated injuries, and hospital utilization of 166 patients with 208 mandibular condylar fractures. These patients had undergone open reduction and internal fixation with either miniplates or lag screws. Among the fracture of head of mandibular condyle, 21.28% of the patients had the fracture segments removed. These data were statistically analyzed to describe the epidemiology of mandibular condylar fracture. Most of the patients had unilateral mandibular condylar fractures (74.7%). Male patients (76.51%) outnumbered female patients (23.49%) in this cohort. The average age of the patients was 37 years. The fractures were mostly caused by fall from height (60.84%) and were located at the condylar neck (53.61%). Most of the patients had other associated maxillofacial injuries (71.08%) which were mostly located at symphysis and parasymphysis (44.59%). It took 12.58 +/- 0.35 days of hospitalization for the treatment. Fall from height was the most prevalent cause of mandibular condylar injury in mountainous urban China. The people at highest risk were middle-aged men. Mandibular condylar fracture was mostly located at the condylar neck and was usually associated with fracture at the symphysis and parasymphysis.

  7. [Guided maxillofacial surgery: Simulation and surgery aided by stereolithographic guides and custom-made miniplates.

    Science.gov (United States)

    Philippe, B

    2013-08-05

    We present a new model of guided surgery, exclusively using computer assistance, from the preoperative planning of osteotomies to the actual surgery with the aid of stereolithographic cutting guides and osteosynthetic miniplates designed and made preoperatively, using custom-made titanium miniplates thanks to direct metal laser sintering. We describe the principles that guide the designing and industrial manufacturing of this new type of osteosynthesis miniplates. The surgical procedure is described step-by-step using several representative cases of dento-maxillofacial dysmorphosis. The encouraging short-term results demonstrate the wide range of application of this new technology for cranio-maxillofacial surgery, whatever the type of osteotomy performed, and for plastic reconstructive surgery. Copyright © 2013. Published by Elsevier Masson SAS.

  8. Comparison of circummandibular wiring with resorbable bone plates in pediatric mandibular fractures

    OpenAIRE

    Saikrishna, D.; Gupta, Nimish

    2010-01-01

    Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning as well as in their functional and nutritional needs which are different from that of adult patients. Early literature has advocated conservative closed management of pediatric fractures to prevent complications. However recent advances in maxillofacial surgery has enabled us to use biodegradable plates and screws, which overcomes the limitations of metallic plates. We present a compar...

  9. A Two-Year Prospective Analysis of Mandibular Fractures in Western Population of Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Ashwinirani Suragimath

    2017-01-01

    Full Text Available Introduction: Trauma to the facial region causes injuries to hard and soft tissues of the face. Injuries to the maxillofacial region are increasing in frequency and severity because of the increased number of road traffic accidents (RTAs and increased number of violence. The purpose of this study was to evaluate age, gender distribution, etiology, and pattern of mandibular fractures in Western part of Maharashtra population. Materials and Methods: The study was conducted in the Department of Oral Medicine and Radiology for a period of two years from June 2013 to June 2015. Clinical examination of all trauma patients was done and diagnosis was made based on signs, clinical features, and confirmed by orthopantomographs. Results: Totally, 193 patients were detected with different types of mandibular fractures. Study group involved 77.2% males and 22.8% females with a male to female ratio of 3.3:1. Majority of patients were in the age group of 21–30 years followed by 31–40 years. Trauma due to RTAs were more common followed by assaults and fall. Parasymphyseal fractures were most common type followed by condylar fracture and fracture of angle of mandible. Conclusion: Males were most commonly affected by trauma than females with a predominant age group of 21–30 years. Majority of trauma were due to RTAs with parasymphyseal as most common type of fracture.

  10. Clinical and radiological outcomes of transoral endoscope-assisted treatment of mandibular condylar fractures.

    Science.gov (United States)

    You, H-J; Moon, K-C; Yoon, E-S; Lee, B-I; Park, S-H

    2016-03-01

    Fractures of the mandibular condyle are one of the most common craniofacial fractures. However, the diagnosis and treatment of these fractures is controversial because of the multiple surgical approaches available. The purposes of this study were to identify surgery-related technical tips for better outcomes and to evaluate the results as well as complications encountered during 7 years of endoscope use to supplement the limited intraoral approach in the treatment of mandibular condylar fractures. Between 2005 and 2012, 50 patients with condylar fractures underwent endoscope-assisted reduction surgery. Postoperative facial bone computed tomography and panoramic radiography demonstrated adequate reduction of the condylar fractures in all patients. No condylar resorption was detected, and most patients displayed a satisfactory functional and structural recovery. There was no facial nerve damage or transitory hypoesthesia, and there were no visible scars after the surgery. Transoral endoscope-assisted treatment is a challenging but reliable method with lower morbidity and a rapid recovery. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Evaluation of the Results of Posterior Decompression, Corpectomy and Instrumentation in Traumatic Unstable Thoraco-Lumbar Burst Fractures

    Directory of Open Access Journals (Sweden)

    Md. Anowarul Islam

    2012-06-01

    Full Text Available Background: Thoraco-lumbar burst fractures occur as a result of axial load which often causes displacement of the middle column into the vertebral canal. Posterior surgery reduces the morbid outcomes of different other approaches. Objective: To evaluate the clinical and radiological success of posterior corpectomy and instrumentation in the management of traumatic unstable thoraco-lumbar burst fractures. Methods: It is a prospective interventional study carried out in Bangabandhu Sheikh Mujib Medical University and different private hospitals in Dhaka from July 2008 to December 2011. Total 18 patients; 13 male and 05 female within an age range of 21-40 years were selected. Total 09 cases involved L1, 05 cases at D12, 02 cases at D11 and at L2 each. Neurological status was assessed by Frankel‘s grading and pain status by Visual Analogue Score (VAS. Paired t-test was used for statistical analysis. Results: All the patients were followed up for minimum 1 year. Eleven out of 12 patients with Frankel grade-B and 04 patients out of 06 with Frankel grade-C recovered fully and could walk without support (p<0.05. Overall 03 patients ended with some degrees of persistant neurological deficit. The mean postoperative pain improvement and kyphotic angle correction was significant  (p<0.05. Conclusion: Decompression through posterior approach by laminectomy, corpectomy and fusion by cage with bone graft and stabilization by pedicle screw and rod significantly improves the clinical and radiological outcome in management of traumatic unstable thoraco-lumbar burst fractures.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10998 BSMMU J 2012; 5(1:35-41 

  12. Percutaneous Stabilization System Osseofix® for Treatment of Osteoporotic Vertebral Compression Fractures - Clinical and Radiological Results after 12 Months.

    Directory of Open Access Journals (Sweden)

    Stephan Albrecht Ender

    Full Text Available A prospective consecutive cohort study (follow-up study.Our study investigated whether implantation of an expandable titanium mesh cage (Osseofix® is a successful and safe minimally invasive therapy for osteoporotic vertebral compression fractures (VCF. Our experiences, clinical and radiological findings after 12 months follow-up are presented. Kypho- and vertebroplasty are well-established minimally invasive procedures for the treatment of osteoporotic VCF. The main complications associated with both procedures are uncontrolled bone cement leakage. Therefore a suitable alternative has been investigated.During June 2010 to May 2011 24 patients were included with 32 osteoporotic VCF (T6 to L4. All of them were stabilized with the Osseofix® system. Preinterventionally we performed X-ray, MRI, and bone density measurements (DXA. Clinical and radiological results were evaluated preop., postop. and after 12 months postop. based on the Oswestry Disability Index (ODI and the Visual Analogue Scale (VAS, X-ray (Beck Index, Cobb-angle and CT.There was a significant improvement in the mean ODI (70,6% to 30,1% as well as a significant reduction in pain intensity (VAS (7,7 to 1,4 after 12 month. The mean kyphotic angle according to Cobb showed significant improvements (11,7° to 10,4° after 12 months. Postinterventional imaging showed only one case of loss of height in a stabilized vertebral body (3.1%. We saw no changes in posterior vertebral wall or adjacent fractures. Except for one pronounced postoperative hematoma we saw no surgical complications including no cement leakage.Stabilization of symptomatic osteoporotic VCF with Osseofix® system is a safe and effective procedure, even in fractures with posterior wall involvement. The clinical mid-term results are good at a very low complication rate. The Osseofix® system is an interesting alternative to the established procedures of cement augmentation.

  13. E-cigarette Blast Injury: Complex Facial Fractures and Pneumocephalus

    Directory of Open Access Journals (Sweden)

    Benjamin Archambeau

    2016-11-01

    Full Text Available Electronic cigarettes (also known as e-cigarettes or e-cigs are becoming a popular method of recreational nicotine use over recent years. The growth of new brands and devices has been outpacing the FDA’s ability to regulate them. As a result, some of these devices fail without warning, most likely from malfunction of the lithium-ion batteries that are in close proximity to volatile compounds within the device. Failures have occurred during both use and storage of the devices or their components. The subsequent injuries from several of these events, including full thickness burns requiring grafting and blast injuries, have been observed at Arrowhead Regional Medical Center, a regional trauma and burn center in southern California. One severe case resulted in several maxillofacial fractures, blurred vision, and pneumocephalus after a device failed catastrophically during use. The patient required close monitoring with serial imaging by neurosurgery in the intensive care unit and multiple procedures by oral maxillofacial surgery to reconstruct his facial bones and soft tissue. Ultimately, the patient recovered with minimal permanent damage, but the potential for further injury or even death was apparent. Cases such as this one are becoming more frequent. It is important to increase awareness of this growing problem for both medical professionals and the general public in order to curb this concerning new trend.

  14. Surgical results of open-door laminoplasty for cervical cord injury without fracture or dislocation

    International Nuclear Information System (INIS)

    Hamada, Kenichiro; Oda, Takenori; Kobashi, Masumi; Yamamura, Mitsuyoshi; Tsukamoto, Yasunori; Suzuki, Shozo; Fujita, Satoru; Mori, Shigeki; Fujiwara, Keiju

    2003-01-01

    The purpose of this study is to evaluate the efficacy of spinal cord decompression surgery for cervical spinal cord injury without fracture or dislocation of the spinal column. Twenty-nine patients treated by expansive open-door laminoplasty are the subjects to this study. Severity of neurological deficit was assessed by the Japanese Orthopaedic Association (JOA) scoring system. Therapeutic outcome was evaluated by the recovery rate of JOA score. Seventeen patients were treated by surgically during the acute phase (within three months after injury), and the remaining 12 were in chronic phase (after 3 months). The recovery rate showed no significant difference between the two groups (46.9% vs. 34.0%). In 16 patients, the lesion responsible for spinal cord damage was recognized as a change of the intramedullary signal intensity on MRI, which was most frequently located at C3/4 level. In 7 out of the 16 patients, the most stenotic level agreed with recognized cord injury on MRI, and in the remaining 9 patients, it did not. The recovery rate showed no significant difference between the two groups (57.3% vs. 31.1%). Even if the neurological dysfunction has been present more than 3 months and spontaneous improvement reaches plateau, or spinal cord injury level recognized as a signal intensity change on MRI is not stenotic, there is still some possibility for improving the neurological function through surgery. (author)

  15. [Problems in the admission to in-hospital oral surgical care from the patient's viewpoint--results of patient interviews in the hospital for dental and maxillo-facial surgery of the Karl Marx University, Leipzig].

    Science.gov (United States)

    Erpenbeck, F; Birnbaum, K; Langanke, B; Niemand, B; Thomzyk, I

    1979-06-01

    The author deals with the results from the interviewing of oral surgery patients on their problems concerning the sending and the admission to the hospital, with special attention to the problems of waiting for admission, the familiarization with the clinical environment and the improvement suggestions of the patients. The conclusions concern tasks arising from the medical and dental care for inpatients as well as for outpatients.

  16. Laser therapy and sclerotherapy in the treatment of oral and maxillofacial hemangioma and vascular malformations

    Science.gov (United States)

    Crişan, Bogdan; BǎciuÅ£, Mihaela; BǎciuÅ£, Grigore; Crişan, Liana; Bran, Simion; Rotar, Horatiu; Moldovan, Iuliu; Vǎcǎraş, Sergiu; Mitre, Ileana; Barbur, Ioan; Magdaş, Andreea; Dinu, Cristian

    2016-03-01

    Hemangioma and vascular malformations in the field of oral and maxillofacial surgery is a pathology more often found in recent years in patients. The aim of this study was to evaluate the efficacy of the laser photocoagulation performed with a diode laser (Ga-Al-As) 980 nm wavelength in the treatment of vascular lesions which are located on the oral and maxillofacial areas, using color Doppler ultrasonography for evaluation of the results. We also made a comparison between laser therapy and sclerotherapy in order to establish treatment protocols and recommendations associated with this pathology. We conducted a controlled study on a group of 92 patients (38 male and 54 female patients, with an average age of 36 years) having low flow hemangioma and vascular malformations. Patients in this trial received one of the methods of treatment for vascular lesions such as hemangioma and vascular malformations: laser therapy or sclerotherapy. After laser therapy we have achieved a reduction in size of hemangioma and vascular malformations treated with such a procedure, and the aesthetic results were favorable. No reperfusion or recanalization of laser treated vascular lesions was observed after an average follow-up of 6 to 12 months. In case of sclerotherapy a reduction in the size of vascular lesions was also obtained. The 980 nm diode laser has been proved to be an effective tool in the treatment of hemangioma and vascular malformations in oral and maxillofacial area. Laser therapy in the treatment of vascular lesions was more effective than the sclerotherapy procedure.

  17. Retrospective Audit: Does Prior Assessment by Oral and Maxillofacial Surgeons Reduce the Risk of Osteonecrosis of The Jaw in Patients Receiving Bone-Targeted Therapies for Metastatic Cancers to the Skeleton?--Part II.

    Science.gov (United States)

    Turner, Bruce; Ali, Sacha; Pati, Jhumur; Nargund, Vinod; Ali, Enamul; Cheng, Leo; Wells, Paula

    2016-01-01

    Men who receive bone-targeted therapy for metastatic prostate cancer are at increased risk of osteonecrosis of the jaw (ONJ). Development of ONJ has been associated with the administration of bone-targeted therapies in association with other risk factors. ONJ can be distressing for a patient because it can cause pain, risk of jaw fracture, body image disturbance, difficultly eating, and difficulty maintaining good oral hygiene. The aim of this article is to report results of an audit of prior assessment by oral and maxillofacial surgeons (OMFS) before initiation of bone-targeted therapies and whether it may reduce the risk of ONJ in patients receiving bone-targeted therapies for advanced cancers.

  18. Characterizing fractured rock for fluid-flow, geomechanical, and paleostress modeling: Methods and preliminary results from Yucca Mountain, Nevada

    International Nuclear Information System (INIS)

    Barton, C.C.; Larsen, E.; Page, W.R.; Howard, T.M.

    1993-01-01

    Fractures have been characterized for fluid-flow, geomechanical, and paleostress modeling at three localities in the vicinity of drill hole USW G-4 at Yucca Mountain in southwestern Nevada. A method for fracture characterization is introduced that integrates mapping fracture-trace networks and quantifying eight fracture parameters: trace length, orientation, connectivity, aperture, roughness, shear offset, trace-length density, and mineralization. A complex network of fractures was exposed on three 214- to 260-m 2 pavements cleared of debris in the upper lithophysal unit of the Tiva Canyon Member of the Miocene Paint-brush Tuff. The pavements are two-dimensional sections through the three-dimensional network of strata-bound fractures. All fractures with trace lengths greater than 0.2 m were mapped and studied

  19. Effect of Random Natural Fractures on Hydraulic Fracture Propagation Geometry in Fractured Carbonate Rocks

    Science.gov (United States)

    Liu, Zhiyuan; Wang, Shijie; Zhao, Haiyang; Wang, Lei; Li, Wei; Geng, Yudi; Tao, Shan; Zhang, Guangqing; Chen, Mian

    2018-02-01

    Natural fractures have a significant influence on the propagation geometry of hydraulic fractures in fractured reservoirs. True triaxial volumetric fracturing experiments, in which random natural fractures are created by placing cement blocks of different dimensions in a cuboid mold and filling the mold with additional cement to create the final test specimen, were used to study the factors that influence the hydraulic fracture propagation geometry. These factors include the presence of natural fractures around the wellbore, the dimension and volumetric density of random natural fractures and the horizontal differential stress. The results show that volumetric fractures preferentially formed when natural fractures occurred around the wellbore, the natural fractures are medium to long and have a volumetric density of 6-9%, and the stress difference is less than 11 MPa. The volumetric fracture geometries are mainly major multi-branch fractures with fracture networks or major multi-branch fractures (2-4 fractures). The angles between the major fractures and the maximum horizontal in situ stress are 30°-45°, and fracture networks are located at the intersections of major multi-branch fractures. Short natural fractures rarely led to the formation of fracture networks. Thus, the interaction between hydraulic fractures and short natural fractures has little engineering significance. The conclusions are important for field applications and for gaining a deeper understanding of the formation process of volumetric fractures.

  20. Gender trends in authorship in oral and maxillofacial surgery literature: A 30-year analysis.

    Science.gov (United States)

    Nkenke, Emeka; Seemann, Rudolf; Vairaktaris, Elefterios; Schaller, Hans-Günter; Rohde, Maximilian; Stelzle, Florian; Knipfer, Christian

    2015-07-01

    The aim of the present study was to perform a bibliometric analysis of the gender distribution of first and senior authorships in important oral and maxillofacial journals over the 30-year period from 1980 to 2010. Articles published in three representative oral and maxillofacial surgery journals were selected. The years 1980, 1990, 2000, and 2010 were chosen as representative points in time for article selection. Original research, case reports, technical notes, and reviews were included in the analysis. Case reports and technical notes were pooled in one group. For each article, the gender of the first author as well as that of the senior author was determined, based on the inspection of their first name. The type of article was determined and the country of origin of the article was documented. A total 1412 articles were subjected to the data analysis. A significant increase in female authorship in oral and maxillofacial surgery could be identified over the chosen 30-year period. However, the number of publications by male authors was still significantly higher at all points of time, exceeding those of female authors by at least 3.8 fold in 2010. As there is a trend towards feminization of medicine and dentistry, the results of the present study may serve as the basis for further analysis of the current situation, and the identification of necessary actions to accelerate the closure of the gender gap in publishing in oral and maxillofacial surgery. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. Interactive learning in oral and maxillofacial radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ramesh, Aruna; Ganguly, Rumpa [Dept. of Diagnostic Sciences, Div. of Oral and Maxillofacial Radiology, Tufts University School of Dental Medicine, Boston (United States)

    2016-09-15

    The use of electronic tools in teaching is growing rapidly in all fields, and there are many options to choose from. We present one such platform, Learning Catalytics (LC) (Pearson, New York, NY, USA), which we utilized in our oral and maxillofacial radiology course for second-year dental students. The aim of our study was to assess the correlation between students' performance on course exams and self-assessment LC quizzes. The performance of 354 predoctoral dental students from 2 consecutive classes on the course exams and LC quizzes was assessed to identify correlations using the Spearman rank correlation test. The first class was given in-class LC quizzes that were graded for accuracy. The second class was given out-of-class quizzes that were treated as online self-assessment exercises. The grading in the self-assessment exercises was for participation only and not accuracy. All quizzes were scheduled 1-2 weeks before the course examinations. A positive but weak correlation was found between the overall quiz scores and exam scores when the two classes were combined (P<0.0001). A positive but weak correlation was likewise found between students' performance on exams and on in-class LC quizzes (class of 2016) (P<0.0001) as well as on exams and online LC quizzes (class of 2017) (P<0.0001). It is not just the introduction of technological tools that impacts learning, but also their use in enabling an interactive learning environment. The LC platform provides an excellent technological tool for enhancing learning by improving bidirectional communication in a learning environment.

  2. Interactive learning in oral and maxillofacial radiology

    International Nuclear Information System (INIS)

    Ramesh, Aruna; Ganguly, Rumpa

    2016-01-01

    The use of electronic tools in teaching is growing rapidly in all fields, and there are many options to choose from. We present one such platform, Learning Catalytics (LC) (Pearson, New York, NY, USA), which we utilized in our oral and maxillofacial radiology course for second-year dental students. The aim of our study was to assess the correlation between students' performance on course exams and self-assessment LC quizzes. The performance of 354 predoctoral dental students from 2 consecutive classes on the course exams and LC quizzes was assessed to identify correlations using the Spearman rank correlation test. The first class was given in-class LC quizzes that were graded for accuracy. The second class was given out-of-class quizzes that were treated as online self-assessment exercises. The grading in the self-assessment exercises was for participation only and not accuracy. All quizzes were scheduled 1-2 weeks before the course examinations. A positive but weak correlation was found between the overall quiz scores and exam scores when the two classes were combined (P<0.0001). A positive but weak correlation was likewise found between students' performance on exams and on in-class LC quizzes (class of 2016) (P<0.0001) as well as on exams and online LC quizzes (class of 2017) (P<0.0001). It is not just the introduction of technological tools that impacts learning, but also their use in enabling an interactive learning environment. The LC platform provides an excellent technological tool for enhancing learning by improving bidirectional communication in a learning environment

  3. Pain management procedures used by dental and maxillofacial surgeons: an investigation with special regard to odontalgia

    Directory of Open Access Journals (Sweden)

    Nadstawek Joachim

    2005-12-01

    Full Text Available Abstract Background Little is known about the procedures used by German dental and maxillofacial surgeons treating patients suffering from chronic orofacial pain (COP. This study aimed to evaluate the ambulatory management of COP. Methods Using a standardized questionnaire we collected data of dental and maxillofacial surgeons treating patients with COP. Therapists described variables as patients' demographics, chronic pain disorders and their aetiologies, own diagnostic and treatment principles during a period of 3 months. Results Although only 13.5% of the 520 addressed therapists returned completely evaluable questionnaires, 985 patients with COP could be identified. An orofacial pain syndrome named atypical odontalgia (17.0 % was frequent. Although those patients revealed signs of chronification, pain therapists were rarely involved (12.5%. For assessing pain the use of Analogue Scales (7% or interventional diagnostics (4.6% was uncommon. Despite the fact that surgical procedures are cofactors of COP therapists preferred further surgery (41.9% and neglected the prescription of analgesics (15.7%. However, most therapists self-evaluated the efficacy of their pain management as good (69.7 %. Conclusion Often ambulatory dental and maxillofacial surgeons do not follow guidelines for COP management despite a high prevalence of severe orofacial pain syndromes.

  4. Middle-term follow-up results of Pipkin type IV femoral head fracture patients treated by reconstruction plate and bioabsorbable screws

    Directory of Open Access Journals (Sweden)

    Shan-Xi Wang

    2018-06-01

    Full Text Available Purpose: To investigate the mid-term curative effects of the treatment of Pipkin type IV femoral head fractures using a reconstruction plate and bioabsorbable screws and provide the evidence for clinical practice. Methods: From February 2010 to September 2014, 21 patients with Pipkin type IV femoral head fractures were treated surgically. There were 13 males and 8 females with an average age of 41.1 years (range, 20–65 years. The causes of the fractures included traffic accidents (13 cases, falls from a height (four cases, heavy lifting injuries (three cases, and sport injury (one case. All patients were followed up with radiography and three-dimensional reconstruction computed tomography and other checks and any complications were actively managed. Closed reduction of fracture-dislocation of the hip was attempted under general anesthesia using the Kocher-Langenbeck approach. Femoral head fractures were treated with internal fixation or excision based on the size of the fracture fragments, whereas acetabular fractures were fixed with a reconstruction plate and screws following anatomic reduction. Results: The incisions healed by primary intention in all patients after surgery, without any infection, deep venous thrombosis, or other complications. All 21 patients were followed up for 36–76 months, with an average follow-up duration of 49 months. Postoperative imaging data showed that all dislocations and fractures were anatomically reduced, and bony union of the fractures was achieved. Heterotopic ossification was found in four patients, post-traumatic osteoarthritis in three, and avascular necrosis of the femoral head in two. At the final follow-up, the assessment of hip joint function according to the Thompson-Epstein scoring scale was excellent in 10 cases, good in six cases, fair in three cases, and poor in two cases. The rate of excellent and good functional outcomes was 76.1%. Conclusion: The mid-term curative effects of a

  5. Overexpression of BMP3 in the developing skeleton alters endochondral bone formation resulting in spontaneous rib fractures.

    Science.gov (United States)

    Gamer, Laura W; Cox, Karen; Carlo, Joelle M; Rosen, Vicki

    2009-09-01

    Bone morphogenetic protein-3 (BMP) has been identified as a negative regulator in the skeleton as mice lacking BMP3 have increased bone mass. To further understand how BMP3 mediates bone formation, we created transgenic mice overexpressing BMP3 using the type I collagen promoter. BMP3 transgenic mice displayed spontaneous rib fractures that were first detected at E17.0. The fractures were due to defects in differentiation of the periosteum and late hypertrophic chondrocytes resulting in thinner cortical bone with decreased mineralization. As BMP3 modulates BMP and activin signaling through ActRIIB, we examined the ribs of ActRIIB receptor knockout mice and found they had defects in late chondrogenesis and mineralization similar to BMP3 transgenic mice. These data suggest that BMP3 exerts its effects in the skeleton by altering signaling through ActRIIB in chondrocytes and the periosteum, and this results in defects in bone collar formation and late hypertrophic chondrocyte maturation leading to decreased mineralization and less bone. 2009 Wiley-Liss, Inc.

  6. Early results for treatment of two- and three-part fractures of the proximal humerus using Contours PHP (proximal humeral plate).

    Science.gov (United States)

    Biazzo, Alessio; Cardile, Carlo; Brunelli, Luca; Ragni, Paolo; Clementi, Daniele

    2017-04-28

    The management of displaced 2- and 3-part fractures of the proximal humerus is controversial, both in younger and in elderly patients. The purpose of this paper is to evaluate the functional results of the Contours Proximal Humerus Plate (OrthofixR, Bussolengo,Verona, Italy), for the treatment of displaced 2- and 3-part fractures of the proximal humerus. We retrospectively reviewed 55 patients with proximal humerus fractures, who underwent osteosynthesis with Contours Proximal Humerus Plate from December 2011 to March 2015. We had 21 patients with 2-part fractures and with an average age of 67.1 years and 34 patients with 3-part fractures, with average age of 63.6 years. The average union time was 3 months. The mean Constant score was 67 for 2-part fracture group and 64.9 for 3-part fracture group. The difference was not statistically significant (p = 0.18). The overall complication rate was 14.5 %. Six patients underwent additional surgery (10.9%). The most frequent major complication was secondary loss of reduction following varus collapse of the fracture (2 cases). In these patients, there was loss of medial hinge integrity due to impaction and osteoporosis. The placement of the main locking screw in the calcar area to provide inferomedial support is the rational of the Contours Proximal Humerus Plate. Osteosynthesis with Contours Proximal Humerus Plate is a safe system for treating displaced 2- and 3-part fractures of the proximal humerus, with good functional results and complication rates comparable to those reported in the literature.

  7. Description and results of tracer tests conducted for a deep fracture zone within granitic rock at the Leuggern borehole

    International Nuclear Information System (INIS)

    Spane, F.A. jr.

    1990-09-01

    A tracer test program was planned at the Leuggern borehole, to provide hydrogeologic information concerning the fracture zone(s) intersected within the depth interval 1,634.9 - 1,688.9 m. The original design of the tracer-dilution test was to: establish a uniform tracer concentration within the test system, and then monitor (at ground surface) the decline of tracer concentration within the circulated test system fluid. Analysis of the tracer concentration decline pattern was expected to provide an estimate of the natural lateral flux and lateral hydraulic gradient for the isolated test interval. A later pump-back test was also designed to recover tracer that had been 'flushed' into the test section, during the previous closed-circulation period. Analysis of the tracer recovery pattern was expected to provide an estimate of the dispersivity within the intersected fracture system. Results obtained from 'arrival-time' information during the Eosin and Naphtionat injection/recovery phases indicate a downward vertical flow of approximately 195-225 ml/min in the isolated interval, from an analysis of the dilution levels of Uranin and Eosin during the injection/recovery periods, and review of field data, the top of the upper inflow zone was determined to be approximately 13 m below the top flow line and the bottom of the outflow zone to be approximately 3 to 5 meters above the bottom flow line. (author) 30 figs., tabs., 42 refs

  8. Oral and maxillofacial surgery with computer-assisted navigation system.

    Science.gov (United States)

    Kawachi, Homare; Kawachi, Yasuyuki; Ikeda, Chihaya; Takagi, Ryo; Katakura, Akira; Shibahara, Takahiko

    2010-01-01

    Intraoperative computer-assisted navigation has gained acceptance in maxillofacial surgery with applications in an increasing number of indications. We adapted a commercially available wireless passive marker system which allows calibration and tracking of virtually every instrument in maxillofacial surgery. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. Continuous observation of the operating field facilitated by computer assistance enables surgical navigation in accordance with the physician's preoperative plans. This case report documents the potential for augmented visualization concepts in surgical resection of tumors in the oral and maxillofacial region. We report a case of T3N2bM0 carcinoma of the maxillary gingival which was surgically resected with the assistance of the Stryker Navigation Cart System. This system was found to be useful in assisting preoperative planning and intraoperative monitoring.

  9. Pisiform fractures

    International Nuclear Information System (INIS)

    Fleege, M.A.; Jebson, P.J.; Renfrew, D.L.; El-Khoury, G.Y.; Steyers, C.M. Jr.

    1991-01-01

    Fractures of the pisiform are often missed due to improper radiographic evaluation and a tendency to focus on other, more obvious injuries. Delayed diagnosis may result in disabling sequelae. A high index of clinical suspicion and appropriate radiographic examination will establish the correct diagnosis. Ten patients with pisiform fracture are presented. The anatomy, mechanism of injury, clinical presentation, radiographic features, and evaluation of this injury are discussed. (orig.)

  10. Roentgenographic study on maxillofacial soft tissue in the mixed dentition

    International Nuclear Information System (INIS)

    Lee, Jai Hei; Ahn, Hyung Kyu

    1977-01-01

    The purpose of this study was to obtain the cephalometric maxillofacial soft tissue measurements and to define the differences that exist between male and female on the soft tissue profile who had normal occlusion in mixed dentitions. For the object of this study, cephalometric radiographs were obtained from the centric occlusion with the relaxed lip position. Copper filter was designed to obtain both hard and soft tissue structure on the same film. The subjects consist of 100 male and 100 female from 8 to 12.4 years with the normal occlusion and acceptable profiles. The author measured facial depth, vertical height from the cephalometric soft tissue profiles in the mixed dentitions. The significant test was performed to compare male with females. The following results were obtained from the study 1. In facial convexity, much more larger female than that of male. 2. Inclination of the lip posture was more larger in maxilla (male) and in female more larger in the mandible. 3. The thickness of soft tissue was thicker in male, the height of nose was more prominent in female. 4. There were no significant differences in both sexes.

  11. Preliminary Results for the Treatment of a Pain-Causing Osteoporotic Vertebral Compression Fracture with a Sky Bone Expander

    International Nuclear Information System (INIS)

    Liu, Jin Bo; Tang, Xue Ming; Xu, Nan Wei; Bao, Hong Tao

    2008-01-01

    Vertebral compression fractures (VCFs) are common complications of osteoporosis. The expansion of VCFs with a Sky Bone Expander is a new procedure which improves kyphotic deformities and decreases pain associated with VCFs. The purpose of this study was to investigate the preliminary results for the treatment of painful osteoporotic VCFs with a Sky Bone Expander. Twenty-six patients with pain-causing VCFs were treated with a Sky Bone Expander. This operation involved the percutaneous insertion of the Sky Bone Expander into a fractured vertebral body transpedicularly. Following the expansion, the Sky Bone Expander was contracted and removed, resulting in a cavity to be filled with bone cement. All fractures were analyzed for improvement in sagittal alignment. Clinical complications, pain relief and ambulation status were evaluated 1 day, 1 week, 1 month, and 3 months after the operation. Twenty-four hours after the operation, all the patients treated experienced some degree of pain relief. In addition, no postoperative neurologic complications were noted. The average operative time was 42.4 ± 15.5 min per vertebra. Moreover, an average cement volume of 3.5 mL (range, 2.5 ± 5.0 mL) was injected per vertebra. The average anterior height was 18.4 ± 5.1 mm preoperatively and 20.5 ± 5.3 mm postoperatively (p < 0.01). Furthermore, the average midline height was 15.5 ± 5.2 mm preoperatively and 18.9 ± 4.0 mm postoperatively (p < 0.01). The Cobb angle improved from 18.5 ± 8.2 degrees preoperatively to 9.2 ± 4.0 degrees postoperatively (p < 0.01). The Visual Anabog Scale scores decreased from 7.7 ± 1.8 points preoperatively to 3.1 ± 2.0, 2.9 ± 1.7, 2.6 ± 1.5 and 2.9 ± 11.3 after 1 day, 1 week, 1 month and 3 months after the operation, respectively. Cement extrusion was observed in four patients without any neurologic symptoms. As a result of this study, we can postulate that the expansion of compressed vetrebra with a Sky Bone Expander is a safe and minimally

  12. Protective association of milk intake on the risk of hip fracture: Results from the Framingham Original Cohort

    OpenAIRE

    Sahni, Shivani; Mangano, Kelsey M.; Tucker, Katherine L.; Kiel, Douglas P.; Casey, Virginia A.; Hannan, Marian T.

    2014-01-01

    Dairy foods are rich in bone beneficial nutrients, yet the role of dairy foods in hip fracture prevention remains controversial. The objective was to evaluate the association of milk, yogurt, cheese, cream and milk+yogurt intakes with incident hip fracture. 830 men and women from the Framingham Original Cohort, a prospective cohort study, completed a food frequency questionnaire (1988–89) and were followed for hip fracture until 2008. In this population-based study, Cox-proportional hazards r...

  13. Results of Non-operative and Operative Management Of Apophyseal Avulsion Fractures of the Hip and Pelvis in Adolescent Athletes

    OpenAIRE

    Heyworth, Benton E.; Bonner, Bryant; Suppan, Catherine A.; Kocher, Mininder S.; Yen, Yi-Meng; Micheli, Lyle J.

    2014-01-01

    Objectives: Apophyseal avulsion fractures of the hip and pelvis occur almost exclusively in the adolescent population, with greater numbers being seen recently as the popularity and intensity of youth sports increases. Limited evidence exists detailing the demographics or distribution of these fractures by injury site. The goal of the current study was to present a comprehensive perspective on 437 of these fractures, including the indications and clinical course of 25 cases that underwent sur...

  14. Submental Intubation in Patients with Complex Maxillofacial Injuries

    Science.gov (United States)

    Cheong, Yuseon; Kang, Seong Sik; Kim, Minsoo; Son, Hee Jeong; Park, Jaewoo; Kim, Jeong-Mo

    2016-01-01

    Airway management in patients with complex maxillofacial injuries is a challenge to anesthesiologists. Submental intubation is a useful technique that is less invasive than tracheostomy in securing the airways where orotracheal and nasotracheal intubation cannot be performed. This procedure avoids the use of tracheostomy and bypasses its associated morbidities. A flexible and kink-resistant reinforced endotracheal tube with detachable universal connector is commonly used for submental intubation. Herein, we report cases involving submental intubation using a reinforced endotracheal tube with a non-detachable universal connector in patients with complex maxillofacial injuries. PMID:27924286

  15. Hypoglossal-facial nerve "side"-to-side neurorrhaphy for facial paralysis resulting from closed temporal bone fractures.

    Science.gov (United States)

    Su, Diya; Li, Dezhi; Wang, Shiwei; Qiao, Hui; Li, Ping; Wang, Binbin; Wan, Hong; Schumacher, Michael; Liu, Song

    2018-06-06

    Closed temporal bone fractures due to cranial trauma often result in facial nerve injury, frequently inducing incomplete facial paralysis. Conventional hypoglossal-facial nerve end-to-end neurorrhaphy may not be suitable for these injuries because sacrifice of the lesioned facial nerve for neurorrhaphy destroys the remnant axons and/or potential spontaneous innervation. we modified the classical method by hypoglossal-facial nerve "side"-to-side neurorrhaphy using an interpositional predegenerated nerve graft to treat these injuries. Five patients who experienced facial paralysis resulting from closed temporal bone fractures due to cranial trauma were treated with the "side"-to-side neurorrhaphy. An additional 4 patients did not receive the neurorrhaphy and served as controls. Before treatment, all patients had suffered House-Brackmann (H-B) grade V or VI facial paralysis for a mean of 5 months. During the 12-30 months of follow-up period, no further detectable deficits were observed, but an improvement in facial nerve function was evidenced over time in the 5 neurorrhaphy-treated patients. At the end of follow-up, the improved facial function reached H-B grade II in 3, grade III in 1 and grade IV in 1 of the 5 patients, consistent with the electrophysiological examinations. In the control group, two patients showed slightly spontaneous innervation with facial function improved from H-B grade VI to V, and the other patients remained unchanged at H-B grade V or VI. We concluded that the hypoglossal-facial nerve "side"-to-side neurorrhaphy can preserve the injured facial nerve and is suitable for treating significant incomplete facial paralysis resulting from closed temporal bone fractures, providing an evident beneficial effect. Moreover, this treatment may be performed earlier after the onset of facial paralysis in order to reduce the unfavorable changes to the injured facial nerve and atrophy of its target muscles due to long-term denervation and allow axonal

  16. Preliminary results on the fracture analysis of multi-site cracking of lap joints in aircraft skins

    Science.gov (United States)

    Beuth, J. L., Jr.; Hutchinson, John W.

    1992-07-01

    Results of a fracture mechanics analysis relevant to fatigue crack growth at rivets in lap joints of aircraft skins are presented. Multi-site damage (MSD) is receiving increased attention within the context of problems of aging aircraft. Fracture analyses previously carried out include small-scale modeling of rivet/skin interactions, larger-scale two-dimensional models of lap joints similar to that developed here, and full scale three-dimensional models of large portions of the aircraft fuselage. Fatigue testing efforts have included flat coupon specimens, two-dimensional lap joint tests, and full scale tests on specimens designed to closely duplicate aircraft sections. Most of this work is documented in the proceedings of previous symposia on the aging aircraft problem. The effect MSD has on the ability of skin stiffeners to arrest the growth of long skin cracks is a particularly important topic that remains to be addressed. One of the most striking features of MSD observed in joints of some test sections and in the joints of some of the older aircraft fuselages is the relative uniformity of the fatigue cracks from rivet to rivet along an extended row of rivets. This regularity suggests that nucleation of the cracks must not be overly difficult. Moreover, it indicates that there is some mechanism which keeps longer cracks from running away from shorter ones, or, equivalently, a mechanism for shorter cracks to catch-up with longer cracks. This basic mechanism has not been identified, and one of the objectives of the work is to see to what extent the mechanism is revealed by a fracture analysis of the MSD cracks. Another related aim is to present accurate stress intensity factor variations with crack length which can be used to estimate fatigue crack growth lifetimes once cracks have been initiated. Results are presented which illustrate the influence of load shedding from rivets with long cracks to neighboring rivets with shorter cracks. Results are also included

  17. Fracture analysis

    International Nuclear Information System (INIS)

    Ueng, Tzoushin; Towse, D.

    1991-01-01

    Fractures are not only the weak planes of a rock mass, but also the easy passages for the fluid flow. Their spacing, orientation, and aperture will affect the deformability, strength, heat transmittal, and fluid transporting properties of the rock mass. To understand the thermomechanical and hydrological behaviors of the rock surrounding the heater emplacement borehole, the location, orientation, and aperture of the fractures of the rock mass should be known. Borehole television and borescope surveys were performed to map the location, orientation, and aperture of the fractures intersecting the boreholes drilled in the Prototype Engineered Barrier System Field Tests (PEBSFT) at G-Tunnel. Core logging was also performed during drilling. However, because the core was not oriented and the depth of the fracture cannot be accurately determined, the results of the core logging were only used as reference and will not be discussed here

  18. Mandibular ramus fractures: a rarity.

    Science.gov (United States)

    Kale, Tejraj Pundalik; Kotrashetti, S M; Louis, Archana; Lingaraj, J B; Sarvesh, B U

    2013-01-01

    To determine the incidence of mandibular ramus fractures in KLE's PK Hospital and to analyze the outcome of open reduction and internal fixation of these fractures. Using a retrospective study design, records of all trauma patients who reported to the Department of Oral and Maxillofacial Surgery, KLE's PK Hospital Belgaum, between the years January 2006 to October 2011 was obtained from the medical records office. The data variables that were analyzed were the name, age, sex, cause of injury, pretreatment occlusion, treatment given, period of MMF and post-treatment occlusion. Total number of mandibular fracture cases was 298. Ramus fractures were 10 in number which accounted for 3.3% of fractures. The age range of these 10 patients was seen to be between 20 to 80 years with the average age being 35.6 years. Of these 10 patients, 9 were male and 1 was female and 7 patients were treated by open reduction and internal fixation and the remaining 3 by closed reduction. The average period of MMF was 3 days for the patients who underwent open reduction and internal fixation. There was improvement in occlusion in all 10 patients post-treatment and there was no complication reported in any of the cases. Ramus fractures accounted for 3.3% of all mandibular fractures. Open reduction and internal fixation of ramus fractures ensures adequate functional and anatomic reduction. This study makes an attempt to throw a light on the increasing incidence of ramus fractures and a successful management of these fractures by open reduction and internal fixation. How to cite this article: Kale TP, Kotrashetti SM, Louis A, Lingaraj JB, Sarvesh BU. Mandibular Ramus Fractures: A Rarity. J Contemp Dent Pract 2013;14(1):39-42. Source of support: Nil Conflict of interest: None declared.

  19. Maxillofacial injuries and dental trauma in patients aged 19-80 years, Recife, Brazil Lesiones maxilofaciales y traumatismo dental en pacientes de 19 a 80 años, Recife, Brasil

    Directory of Open Access Journals (Sweden)

    A. Leite Cavalcanti

    2010-03-01

    Full Text Available Aim: A retrospective study was undertaken to assess causes of maxillofacial trauma in Recife, Pernambuco, Brazil. Method: A review of 186 patients with maxillofacial injuries aged 19 and 83 years old seen and treated at the Hospital da Restauração between January and December 2006 was conducted and were analyzed according to age, sex, etiology, site of fracture, dentoalveolar trauma and alcohol abuse. Analysis was made in Epi Info using the Chi-square and Fisher´s Exact Tests. Results: It was found that maxillofacial injuries were most frequent in males (89.2% and in the 19-28 year age group (46.8%. Traffic accidents/motorcycle (23.7% and physical violence (20.4% were the most common etiological factor. Facial fractures were detected in 90.9% and a statistically significant difference between sex and facial fracture was found (p = 0.000. The most common facial fracture was maxilla (29.1%, followed by the mandible (27.5%. A positive association between the presence of facial fracture and alcohol consumption was observed (p = 0.002. Dentoalveolar trauma was present in 7.5% of patients. Conclusion: The incidence of facial fractures in Brazilian population is similar than previously reported elsewhere. There were most common in male patients, mainly due to traffic accidents/motorcycle and physical violence.Objetivo: Se llevó a cabo un estudio retrospectivo para evaluar las causas de traumatismo maxilofacial en Recife, Pernambuco, Brasil. Método: Se hizo una revisión de 186 pacientes con lesiones maxilofaciales de 19 a 83 años atendidos y tratados en el Hospital da Restauração entre Enero y Diciembre 2006, analizándoles según edad, sexo, etiología, localización de la fractura, traumatismo dentoalveolar y abuso de alcohol. Se llevó a cabo el análisis en Epi Info, utilizando el Chi cuadrado y la prueba exacta de Fisher. Resultados: Resultó que las lesiones maxilofaciales fueron más frecuentes en los hombres (89,2% y en el grupo de edad

  20. High frequency of vertebral fracture and low bone quality in patients with rheumatoid arthritis-Results from TOMORROW study.

    Science.gov (United States)

    Okano, Tadashi; Inui, Kentaro; Tada, Masahiro; Sugioka, Yuko; Mamoto, Kenji; Wakitani, Shigeyuki; Koike, Tatsuya; Nakamura, Hiroaki

    2017-05-01

    Osteoporosis is one of the complications in patients with rheumatoid arthritis (RA). In this study, we researched the morbidity of existing vertebral fractures and the risk factors for vertebral fractures in patients with RA. This study included 413 participants, 208 patients with RA, and 205 age- and sex-matched controls without RA. Clinical data, radiographic assessment of vertebral fracture from T4 to L4 in thoracic and lumber spine, bone mineral density (BMD), and bone metabolic markers (BMM) were analyzed. Vertebral fractures were observed more frequently, severe and multiple in patients with RA. In the logistic regression analysis, age (adjusted odds ratios (OR): 1.07, 95% confidence interval (CI): 1.04-1.09) and RA (adjusted OR: 1.72, 95% CI: 1.04-2.83) were risk factors for existing vertebral fracture. Moreover, two bone matrix-related markers, undercarboxylated osteocalcin (ucOC) (adjusted OR: 1.68, 95% CI: 1.02-2.78), and urinary pentocidine (adjusted OR: 2.51, 95% CI: 1.48-4.24) were associated with existing vertebral fracture. High frequent, multiple, and severe vertebral fractures were found in patients with RA compared to the controls. Low bone quality might be the cause of the frequent prevalence of vertebral fracture in patients with RA.

  1. A novel tool for continuous fracture aftercare - Clinical feasibility and first results of a new telemetric gait analysis insole.

    Science.gov (United States)

    Braun, Benedikt J; Bushuven, Eva; Hell, Rebecca; Veith, Nils T; Buschbaum, Jan; Holstein, Joerg H; Pohlemann, Tim

    2016-02-01

    Weight bearing after lower extremity fractures still remains a highly controversial issue. Even in ankle fractures, the most common lower extremity injury no standard aftercare protocol has been established. Average non weight bearing times range from 0 to 7 weeks, with standardised, radiological healing controls at fixed time intervals. Recent literature calls for patient-adapted aftercare protocols based on individual fracture and load scenarios. We show the clinical feasibility and first results of a new, insole embedded gait analysis tool for continuous monitoring of gait, load and activity. Ten patients were monitored with a new, independent gait analysis insole for up to 3 months postoperatively. Strict 20 kg partial weight bearing was ordered for 6 weeks. Overall activity, load spectrum, ground reaction forces, clinical scoring and general health data were recorded and correlated. Statistical analysis with power analysis, t-test and Spearman correlation was performed. Only one patient completely adhered to the set weight bearing limit. Average time in minutes over the limit was 374 min. Based on the parameters load, activity, gait time over 20 kg weight bearing and maximum ground reaction force high and low performers were defined after 3 weeks. Significant difference in time to painless full weight bearing between high and low performers was shown. Correlation analysis revealed a significant correlation between weight bearing and clinical scoring as well as pain (American Orthopaedic Foot and Ankle Society (AOFAS) Score rs=0.74; Olerud-Molander Score rs=0.93; VAS pain rs=-0.95). Early, continuous gait analysis is able to define aftercare performers with significant differences in time to full painless weight bearing where clinical or radiographic controls could not. Patient compliance to standardised weight bearing limits and protocols is low. Highly individual rehabilitation patterns were seen in all patients. Aftercare protocols should be adjusted to real

  2. Management of Subcondylar Fracture through Intraoral Approach with Rigid Internal Fixation.

    Science.gov (United States)

    Patil, Ravi S; Gudi, Santosh S

    2011-09-01

    In Oral and Maxillofacial Surgery, the majority of the condylar fractures are treated by closed reduction with generally satisfactory long term results. But in such cases of closed reduction, patient will be uncomfortable owing to long term application of inter maxillary fixation (IMF). Where as, Disadvantages of extra oral open reduction and fixation of condylar fracture includes facial nerve damage, facial scars etc. which are surely eliminated by the intraoral reduction and rigid fixation. The present study was conducted to determine the efficacy of reduction and fixation of low sub-condylar fractures through intra-oral approach. In this study, ten patients with low sub-condylar fracture, reported to department of Oral and Maxillofacial Surgery. P.M.N.M. Dental College and Hospital Bagalkot were included. These patients were treated by open reduction and internal fixation through intra-oral approach. All the patients were evaluated postoperatively for mouth opening, occlusion and mandibular deviation with regular radiographic examination for 6 weeks. All operated patients followed for 6 weeks, maximum mouth opening was more than 40 mm in seven patients (range from 40 to 50 mm) and less than 40 mm in three patients. Occlusion was satisfactory in all and none of the patients showed deviation of mandible on mouth opening. Statistical analysis showed that postoperative mouth opening was significant ('t' value = 7.88, 'P' = (0.000) value = 1.96, 'P' value (0.081), 0.05]. For occlusion standard photographs were obtained at sixth week and found minor occlusal corrections in two patients are treated by elastic traction for few days. Open reduction with internal fixation through intraoral approach has proved to be safe for early function and also effective by avoiding the patient discomfort due to long term intermaxillary fixation, psychological effect, facial nerve damage, facial scar and weight loss.

  3. Maxillofacial and mandibular phenotypes in the skulls of red Sokoto ...

    African Journals Online (AJOL)

    This work examined phenotypic expressions in the anatomy of the mandible and maxillofacial region of the Red Sokoto and Sahel goats in Nigeria. The infraorbital foramen was placed above premolar two (PM2) in Red Sokoto but above premolar one (PM1) in Sahel. The Red Sokoto displayed interdigital septa (ruggae) ...

  4. 3D workflows in orthodontics, maxillofacial surgery and prosthodontics

    NARCIS (Netherlands)

    van der Meer, Wicher Jurjen

    2016-01-01

    In this thesis different aspects of digital workflows in Orthodontics, Maxillofacial Surgery and Prosthodontics are discussed and, where possible, placed in a broader perspective thereby attempting to go both broader and deeper into the implications of the introduction of 3D digital technology in

  5. Subsequent publication of oral and maxillofacial surgery meeting abstracts.

    Science.gov (United States)

    Rodriguez, Joseph L; Laskin, Daniel M

    2012-05-01

    Previous studies in various medical specialties have shown that fewer than 50% of abstracts presented at meetings are subsequently published. The purpose of the present study was to determine the publication rate of abstracts presented at the annual meetings of the American Association of Oral and Maxillofacial Surgeons. The titles and authors of the abstracts from all oral abstract session presentations and posters by American contributors were collected from the Final Programs of the American Association of Oral and Maxillofacial Surgeons annual meetings for 2006 to 2009. A PubMed search for published articles through December 2010 was then performed using the authors' names, abstract titles, and key words. A total of 311 abstract presentations were done at the 4 annual meetings. Of these, only 85 (24%) were subsequently published. No difference was found between abstracts from oral or poster presentations. Most of the articles were published in the Journal of Oral and Maxillofacial Surgery. Because of deficiencies that can occur in abstracts and the need to disseminate the information they contain, it is important to take the appropriate measures to ensure that full articles are subsequently published. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Dysocclusion after maxillofacial trauma: a 42 year analysis

    NARCIS (Netherlands)

    Kommers, S.C.; van den Bergh, B.; Boffano, P.; Verweij, K.P.; Forouzanfar, T.

    2014-01-01

    Background The aim of this study was to evaluate the surgical management of posttraumatic dysocclusion in the Department of Oral and Maxillofacial Surgery in the VU Medical Centre in Amsterdam. Patients and methods All patients who underwent surgical correction of a posttraumatic dysocclusion

  7. Oral and maxillofacial surgical conditions in Nigeria. | Adebayo ...

    African Journals Online (AJOL)

    The Niger Delta region comprises 9 of the 36 states in the Federal Republic of Nigeria. ... 2000 and 2004, our center offered specialized maxillofacial surgical services to ... Ratio of male to female patients was 1.7:1 while patients were aged between 9 ... Health promotion activities are needed to improve awareness for early

  8. Haemangiomas of the maxillofacial region in Benin City, Nigeria ...

    African Journals Online (AJOL)

    Twenty-two patients with haemangiomas of the oro-facial region who presented at the department of Oral and Maxillofacial Surgery, UBTH, were studied. There was a preponderance of females (72.7%) over males (27.3%) and most (59.1%) patients were in the 11-31-year age group, with a median age of 25.0 years.

  9. Circummandibular Wires for Treatment of Dentoalveolar Fractures Adjacent to Edentulous Areas: A Report of Two Cases.

    Science.gov (United States)

    Maloney, Karl

    2015-09-01

    In general, dentoalveolar fractures are a common injury seen in emergency departments, dental offices, and oral and maxillofacial surgery practices. These injuries can be the result of direct trauma or indirect trauma. Direct trauma more often causes trauma to the maxillary dentition due to the exposure of the maxillary anterior teeth. Indirect trauma is usually the result of forced occlusion secondary to a blow to the chin or from a whiplash injury. Falls are the most common mechanism of injury seen in the pediatric group. In adolescents, many of these fractures are sustained during sporting activities. However, the use of mouth guards and other protective equipment has decreased this number. Most adult injuries are caused by motor vehicle accidents, contact sports, falls, bicycles, interpersonal violence, medical/dental mishaps, and industrial accidents. Early intervention to reduce and stabilize the fracture is required to establish a bony union and ensure correct function. Most dentoalveolar fractures have bilateral stable adjacent dentition and are treated with a closed technique utilizing an acid-etch/resin splint followed by splint removal at 4 weeks. Other inferior stabilization treatments used are arch bars and other wiring techniques. It is widely accepted that semirigid stabilization techniques, such as an acid-etch/resin splint or wiring procedures, are adequate to treat dentoalveolar fractures. This is in contrast to the treatment of mandible fractures where AO principles of rigid fixation are often followed. Fractures that are unable to be reduced sometimes necessitate an open reduction followed by internal fixation, sometimes using a secondary splint for mobile teeth. In those rare cases when there are not stable adjacent teeth bilaterally other modalities must be considered. In the present report, two cases are presented where circummandibular wires were used to treat fractured mandibular dentoalveolar segments adjacent to edentulous areas.

  10. Environmental aspects of hydraulic fracturing - Main results and recommendations from two studies on behalf of the German Environment Agency

    Science.gov (United States)

    Krischbaum, Bernd; Bertram, Andreas; Böttcher, Christian; Iyimen-Schwarz, Züleyha; Rechenberg, Jörg; Dannwolf, Uwe; Meiners, Georg

    2016-04-01

    The German Environment Agency (UBA) accompanies the debate on fracking for years. Two major reports on risks and environmental impacts regarding the exploration and exploitation of unconventional natural gas, in particular shale gas have been published. On the basis of these studies as well as on scientific evidence UBA considers ecological barriers as a sustainable means to minimize the risks to environment and human health. 1) Recent studies show that the contamination of shallow aquifers by rise of fluids through natural faults or artificially created fractures is extremely unlikely. However, activities on the surface and lack of wellbore integrity pose threats and substantial risks for the quality of shallow aquifers. 2) The need for thorough groundwater monitoring is fully accepted, yet its range and design is subject to discussion. 3) Formerly, analysis and mass balances of flowback and produced water have been insufficient, thus there is a lack of exact information on proportions of frac-fluids, flowback and formation water respectively, as well as data on possible reaction products. 4) Currently, neither on national nor on European level best reference techniques (BREF) for the treatment and disposal of flowback and produced water are available. 5) In addition, land consumption, emission of greenhouse gases, and induced seismicity are major issues. UBA recommends amongst others the implementation of an environmental impact assessment (EIA) for fracking activities, the prohibition of fracking in water protection areas as well as their catchments, and the disclosure of all frac-fluid chemicals within a national chemical registry. To achieve these objectives the German Environment Agency suggests a step-by-step approach. The paper will present the main results from the studies and the recommendations of the German Environment Agency regarding hydraulic fracturing for unconventional gas exploitation.

  11. Transoral versus extraoral approach for mandibular angle fractures: A comparative study

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    Sathya Kumar Devireddy

    2014-01-01

    Full Text Available Introduction: Mandibular fractures represent approximately two-thirds of all the maxillofacial fractures (nearly 70% out of which fractures of mandibular angle represent for 26-35%. Aim of the Study: The aim of this study is to compare the transoral and extraoral (submandibular approaches for fixation of mandibular angle fractures. Objectives of Study: The objectives of the following study are to evaluate ease of accessibility, time taken for the procedure, ease of anatomic reduction and complications. Materials and Methods: A prospective study was carried out in 30 patients reporting to the Department of Oral and Maxillofacial surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh during the period of months from November 2011 to August 2013 who were randomly divided in two groups based on computer generated simple randomization chart. Group I patients underwent transoral reduction and fixation and Group II patients underwent extraoral reduction and fixation. The ease of accessibility was analysed by visual analogue scale by the operating surgeon, time taken from incision to closure with digital clock, difficulty level index of surgeon based on the time taken for the procedure and approach related complications. Results: The ease of accessibility in Group I was good in 53.3% while in Group II patients approached extraorally it was good in 86.7%. Group I patients approached transorally showed a mean of 49.7 min while that of Group II patients approached extraorally showed a mean of 73.4 min. Group I had a minimum difficulty level index in 60%, moderate difficulty level in 33.3% and severe difficulty level in 6.7% while Group II had a minimum and moderate difficulty level in 46.7% and severe difficulty level in 6.7%. There was 1 (6.7% complication reported in each group. Conclusion: The statistical analysis of this study concludes that fracture line starting anterior to mandibular third molar and ending at anteroinferior border of

  12. [Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach].

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    Zeman, P; Zeman, J; Matejka, J; Koudela, K

    2008-12-01

    To report on the surgical treatment of intra-articular calcaneal fractures by open reduction and internal fixation with a calcaneal locking compression plate (LCP) from an extended lateral approach, and to retrospectively analyze the mid-term results in a group of patients treated by this technique. In the period from August 2005 till March 2007, a total of 49 patients with 61 calcaneal fractures were treated. Of these, 11 (18 %) were treated conservatively. Reduction combined with Kirschner-wire fixation was used in four fractures (6.6 %). Open reduction with internal calcaneal LCP fixation (ORIF- calcaneal LCP) from an extended lateral approach was carried out to treat 46 fractures (75.4 %) in 38 patients. The group evaluated here comprised 29 patients with 33 calcaneal fractures treated by ORIF-calcaneal LCP at a follow-up longer than 6 months. The fractures were classified on the basis of computer tomography (CT) findings as Sanders types I to IV. The group had two woman (6.9 %) and 27 men (93.1 %) with an average age of 34.2 years (range, 19-55 years). In 11 fractures (33.3 %), the primary treatment included filling a central cancellous bone defect area. Calcium phosphate bone substitute material (resorbable ChronOS) was used in nine cases (27.3 %), a self-solidifying hydroxyapatite implant was injected in two (6.1 %) cases (X3 Wright and Norian SRS, respectively), and a bone allograft was implanted in one case (3 %). Indicated for surgery were patients with an intra-articular calcaneal fracture, Sanders type II or type III, with articular surface displacement by more than 1 mm. Contraindications included age over sixty years, poor cooperation, smoking habits, peripheral vascular disease or skin infection. Surgery was performed only after oedema had resolved. The aim of our treatment was to achieve anatomical reconstruction of all articular surfaces, to restore the height, length, width and axis of the heel bone, to carry out primary stable osteosynthesis, and

  13. A retrospective study of children and adolescents oral and maxillofacial lesions over a 20-year period in Kerman, Iran

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    Molook Torabi-Parizi

    2017-08-01

    Full Text Available BACKGROUND AND AIM: Oral and maxillofacial lesions vary in different geographic regions based on their clinical features. Until now, few investigations have studied these lesions in children and adolescents in Iran. The aim of this research was to study the clinicopathological manifestations of biopsied oral and maxillofacial lesions among children and adolescents in the south of Iran. METHODS: In this retrospective cross-sectional study, all the cases referred to the Department of Pathology, Kerman faculty of Dentistry, and two treatment centers of Kerman University of Medical Sciences, Kerman, Iran during 1996-2015 were included. All demographic information including age, gender, anatomic location and histopathologic diagnosis of the oral and maxillofacial biopsies in patients under 18 years was extracted from patients’ chart fields. SPSS was used for the data analysis. RESULTS: Of 3196 oral and maxillofacial lesions, 326 cases (10.2% occurred in the age group under 18 years. The most common group was inflammatory/reactive lesions (36.8%. The most common lesions were pyogenic granuloma (9.20%, peripheral giant cell granuloma (8.89%, and dentigerous cyst (8.28%. Gingiva was the main involved area and the female to male ratio was 1.1 to 1. CONCLUSION: Our study revealed that almost 10.2% of oral and maxillofacial lesions occurred in children and adolescents. The majority of lesions were benign, and malignant lesions were rarely observed in the sample. The most prevalent biopsied lesions were inflammatory/reactive lesions. Unlike other studies, lower rates of mucocele were observed in this study. These findings can improve patient’s management among dentists and surgeons.

  14. Open reduction and internal fixation of intra-articular fractures of the mandibular condyle: our first experiences.

    Science.gov (United States)

    Vesnaver, Ales

    2008-10-01

    Treatment of intra-articular fractures of the mandibular condyle head is conservative at most institutions dealing with facial fractures. Recently, reports had been published about benefits of surgical treatment in these fractures. From July 2004 until the end of June 2006, 13 patients with 16 displaced intra-articular fractures of the mandibular condyle were treated with open reduction and internal fixation at the Department of Oral and Maxillofacial Surgery in Ljubljana, Slovenia, using the preauricular approach and the lag screw technique. Twelve of the 13 patients could open their mouths for 40 mm or more, and 10 had a deflection of the chin of less than 2 mm upon maximal opening. None of the patients experienced pain upon rest, palpation, or chewing. Occlusion was not noted as altered in any of the cases, neither subjectively, nor on examination. There were no cases of postoperative weakness of the temporal branch of the facial nerve. Surgical treatment of intra-articular condyle fractures using the preauricular approach achieves a good exposure and enables proper reduction. Stable fixation of fractured bony fragments can be achieved using the lag screw technique. Another benefit of open exposure is revision and repair of TMJ soft tissues. With the appropriate surgical technique, the surgical procedure is safe and leads to good results.

  15. Closed reduction of displaced or dislocated mandibular condyle fractures in children using threaded Kirschner wire and external rubber traction.

    Science.gov (United States)

    Kim, J H; Nam, D H

    2015-10-01

    Most surgeons agree that closed treatment provides the best results for condylar fractures in children. Nevertheless, treatment of the paediatric mandibular condyle fracture that is severely displaced or dislocated is controversial. The purpose of this study was to investigate the long-term clinical and radiological outcomes following the treatment of displaced or dislocated condylar fractures in children using threaded Kirschner wire and external rubber traction. This procedure can strengthen the advantage of closed reduction and make up for the shortcomings of open reduction. From March 1, 2005 to December 25, 2011, 11 children aged between 4 and 12 years with displaced or dislocated mandibular condyle fractures were treated using threaded Kirschner wire and external rubber traction under portable C-arm fluoroscopy. All patients had unilateral displaced or dislocated condylar fractures. The follow-up period ranged from 24 to 42 months (mean 29.3 months). Normal occlusion and pain-free function of the temporomandibular joint, without deviation or limitation of jaw opening, was achieved in all patients. This closed reduction technique in displaced or dislocated condylar fractures in children offers a reliable solution in preventing the unfavourable sequelae of closed treatment and the open technique, such as altered morphology, functional disturbances, and facial nerve damage. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Retention systems for extraoral maxillofacial prosthetic implants: a critical review.

    Science.gov (United States)

    Cobein, M V; Coto, N P; Crivello Junior, O; Lemos, J B D; Vieira, L M; Pimentel, M L; Byrne, H J; Dias, R B

    2017-10-01

    We describe the techniques available for retention of implant-supported prostheses: bar-clips, O-rings, and magnets. We present reported preferences and, although this is limited by the heterogeneity of methods used and patients studied, we hope we have identified the best retention systems for maxillofacial prosthetic implants. If practitioners know the advantages and disadvantages of each system, they can choose the most natural and comfortable prosthesis. We searched the PubMed and Scopus databases, and restricted our search to papers published 2001-13. MeSH terms used were Maxillofacial prosthesis and Craniofacial prosthesis OR Craniofacial prostheses. We found a total of 2630 papers, and after duplicates had been removed we analysed the rest and found 25 papers for review. Of these, 12 were excluded because they were case reports or non-systematic reviews. Of the remaining 13, 10 described group analyses and seemed appropriate to find practitioner's choices, as cited in the abstract (n=1611 prostheses). Three papers did not mention the type of prosthetic connection used, so were excluded. The most popular choices for different conditions were analysed, though the sites and retention systems were not specified in all 10 papers. The bar-clip system was the most used in auricular (6/10 papers) and nasal prostheses (4/10). For the orbital region, 6/10 favoured magnets. Non-osseointegrated mechanical or adhesive retention techniques are the least expensive and have no contraindications. When osseointegrated implants are possible, each facial region has a favoured system. The choice of system is influenced by two factors: standard practice and the abilities of the maxillofacial surgeon and maxillofacial prosthetist. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Application of Additive Manufacturing in Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Farré-Guasch, Elisabet; Wolff, Jan; Helder, Marco N; Schulten, Engelbert A J M; Forouzanfar, Tim; Klein-Nulend, Jenneke

    2015-12-01

    Additive manufacturing is the process of joining materials to create objects from digital 3-dimensional (3D) model data, which is a promising technology in oral and maxillofacial surgery. The management of lost craniofacial tissues owing to congenital abnormalities, trauma, or cancer treatment poses a challenge to oral and maxillofacial surgeons. Many strategies have been proposed for the management of such defects, but autogenous bone grafts remain the gold standard for reconstructive bone surgery. Nevertheless, cell-based treatments using adipose stem cells combined with osteoconductive biomaterials or scaffolds have become a promising alternative to autogenous bone grafts. Such treatment protocols often require customized 3D scaffolds that fulfill functional and esthetic requirements, provide adequate blood supply, and meet the load-bearing requirements of the head. Currently, such customized 3D scaffolds are being manufactured using additive manufacturing technology. In this review, 2 of the current and emerging modalities for reconstruction of oral and maxillofacial bone defects are highlighted and discussed, namely human maxillary sinus floor elevation as a valid model to test bone tissue-engineering approaches enabling the application of 1-step surgical procedures and seeding of Good Manufacturing Practice-level adipose stem cells on computer-aided manufactured scaffolds to reconstruct large bone defects in a 2-step surgical procedure, in which cells are expanded ex vivo and seeded on resorbable scaffolds before implantation. Furthermore, imaging-guided tissue-engineering technologies to predetermine the surgical location and to facilitate the manufacturing of custom-made implants that meet the specific patient's demands are discussed. The potential of tissue-engineered constructs designed for the repair of large oral and maxillofacial bone defects in load-bearing situations in a 1-step surgical procedure combining these 2 innovative approaches is

  18. Atención a pacientes con heridas maxilofaciales producidas por armas de fuego Care of patients presenting with maxillofacial wounds by firearms

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    Juan Carlos Quintana Díaz

    2010-06-01

    Full Text Available INTRODUCCIÓN. Los traumatismos y fracturas maxilofaciales ocasionan deformidades difíciles de ocultar por ser la cara la porción más visible del cuerpo. Este trabajo tuvo como objetivo documentar la atención a un grupo de pacientes con heridas maxilofaciales producidas por arma de fuego, que fueron atendidos por la brigada médica cubana del Hospital Al-Waheda de Maabar (República de Yemen. MÉTODOS. Se analizó un grupo de 9 pacientes con heridas maxilofaciales, atendidos en el Hospital Al-Waheda de Maabar, perteneciente a la Universidad de Thamar (Yemen, entre los años 2006 y 2008. Se recogieron los datos siguientes: nombre y apellidos edad, sexo, lesión principal, lesiones asociadas y tipo de tratamiento, así como la evolución de los pacientes. El método estadístico empleado fue el cálculo porcentual. RESULTADOS. Entre las principales lesiones tratadas se encontraron las fracturas mandibulares, nasales y dentoalveolares, para cuyo tratamiento se siguieron las normas de los protocolos establecidos para la atención de este tipo de afección. Los resultados fueron excelentes en todos los pacientes y hubo una rápida recuperación en todos los casos. Se obtuvieron muy buenos resultados estéticos y funcionales. CONCLUSIONES. Al comparar el estado preoperatorio y posoperatorio de los pacientes, se demostró la importancia de la atención integral del equipo de profesores cubanos.INTRODUCTION. Traumatisms and maxillofacial fractures cause deformities difficult to hide because of the face of the more visible portion of the body. The aim of present paper is to document the care to group of patients presenting with maxillofacial wounds caused by firearms, treated by the Cuban medical brigade of Thamar University Al-Waheda Hospital of Maabar (Republic of Yemen. METHODS. A group of 9 patients presenting with maxillofacial wounds caused by firearms treated in above mentioned hospital between 2006 and 2008. Following data were collected

  19. The lingual splint: an often forgotten method for fixating pediatric mandibular fractures.

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    Binahmed, Abdulaziz; Sansalone, Claudio; Garbedian, Justin; Sándor, George K B

    2007-01-01

    Maxillofacial fractures are uncommon in the pediatric population, and their treatment is unique due to the psychological, physiological, developmental and anatomical characteristics of children. We present the case of a boy who was treated in an outpatient dental clinic using a lingual splint for the reduction, stabilization and fixation of a mandibular body fracture. This technique is a reliable, noninvasive procedure that dentists may consider in selected cases by referral to an oral and maxillofacial surgeon. It also limits the discomfort and morbidity that can be associated with maxillomandibular fixation or open reduction and internal fixation in pediatric patients.

  20. Management of unstable spinal fractures with segmental spinal instrumentation (VSP System : Results at 5 year follow up

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    Sen Dipankar

    2005-01-01

    Full Text Available Background: Pedicle screw instrumentation has been widely used for spinal stabilisation following spinal injury with variable results. The controversial points associated with spinal injury are effects of canal compromise and decompression on neurological status. Methods: Thirty four patients of unstable thoraco-lumbar fracture with or without neuro-deficit were treated by decompression and stabilisation with VSP system and followed up for 22 - 39 months (mean 29 months. The results were evaluated by neurological recovery (ASIA score, pain relief, loss of surgical correction and functional rehabilitation (FIM score. Results: We achieved a mean post-operative correction of the kyphotic deformity by 14 degrees and an average gain of 30.2% in the canal diameter by decompression. However no correlation was established between degree of canal compromise before or after the surgery with the final neurological outcome. Conclusion: Although the infrastructure for spinal injury management in developing countries is inadequate in many aspects, we find that it is still possible to achieve results, which are comparable with standard literature by adequate decompression and stabilisation followed by appropriate rehabilitation according to the social and cultural demands of the patients.

  1. Analysis of tensile and fracture toughness results on irradiated molybdenum alloys, TZM and Mo-5%Re. Analysis of results performed in the frame of the NET task PDS 1.4

    International Nuclear Information System (INIS)

    Scibetta, M.; Chaouadi, R.; Puzzolante, J.L.

    1999-10-01

    Due to their good resistance at high temperature, good thermal conductivity and swelling resistance, molybdenum alloys are considered amongst the candidates for divertor structural materials. However, little is known about their tensile and fracture toughness behaviour, in particular after irradiation. This report aims to investigate the tensile and fracture toughness properties of two molybdenum alloys, namely TZM and Mo-5%Re. Tensile and compact tension specimens were irradiated in the BR2 reactor at 40 and 450 degrees Celsius up to a fast neutron fluence of 3.5 1020 n/cm 2 (0.2 dpa). Fracture toughness tests were performed on both precracked and notched specimens. Results show a drastic decrease of the ductility due to irradiation, but only a slight decrease of the fracture toughness in the lower shelf domain

  2. Analysis of tensile and fracture toughness results on irradiated molybdenum alloys, TZM and Mo-5%Re. Analysis of results performed in the frame of the NET task PDS 1.4

    Energy Technology Data Exchange (ETDEWEB)

    Scibetta, M.; Chaouadi, R.; Puzzolante, J.L

    1999-10-01

    Due to their good resistance at high temperature, good thermal conductivity and swelling resistance, molybdenum alloys are considered amongst the candidates for divertor structural materials. However, little is known about their tensile and fracture toughness behaviour, in particular after irradiation. This report aims to investigate the tensile and fracture toughness properties of two molybdenum alloys, namely TZM and Mo-5%Re. Tensile and compact tension specimens were irradiated in the BR2 reactor at 40 and 450 degrees Celsius up to a fast neutron fluence of 3.5 1020 n/cm{sup 2} (0.2 dpa). Fracture toughness tests were performed on both precracked and notched specimens. Results show a drastic decrease of the ductility due to irradiation, but only a slight decrease of the fracture toughness in the lower shelf domain.

  3. Surgical Navigation: A Systematic Review of Indications, Treatments, and Outcomes in Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R Bryan; Thygesen, Torben

    2017-09-01

    This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indications are discussed. A systematic search in relevant electronic databases, journals, and bibliographies of the included articles was carried out. Clinical studies with 5 or more patients published between 2010 and 2015 were included. Traumatology, orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal were the areas of interests. The search generated 13 articles dealing with traumatology; 5, 6, 2, and 0 studies were found that dealt with the topics of orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal, respectively. The average technical system accuracy and intraoperative precision reported were less than 1 mm and 1 to 2 mm, respectively. In general, SN is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

  4. Infant skull fracture (image)

    Science.gov (United States)

    Skull fractures may occur with head injuries. Although the skull is both tough and resilient and provides excellent ... or blow can result in fracture of the skull and may be accompanied by injury to the ...

  5. Assessment of Outcomes of Treatment of Fractures of Distal Femur with a Locking Plate Taking into Account Factors Influencing the Result.

    Science.gov (United States)

    Pakuła, Grzegorz; Kwiatkowski, Krzysztof; Kuczmera, Piotr; Fudalej, Piotr

    2015-10-01

    The aim of this paper is to evaluate the results of treatment of distal femoral fractures (DFF) fixed with locking plates and analysis of factors that influence the final outcome. The patients were treated at the Department of Traumatology and Orthopedics, Military Medical Institute in Warsaw, and the Department of Orthopedics and Traumatology, 4th Military Research Hospital in Wroclaw. We analysed 39 patients with 42 fractures of the distal femur. Treatment results were analysed using the KOOS and KSS scales. Factors influencing the outcome were also investigated. Statistical analysis was performed using STATISTICA v. 10. Mean KOOS scores indicate a predominance of poor outcomes, while mean KSS scores indicate good outcomes. Treatment outcomes were significantly influenced by pain and limited mobility. 1. Subjective evaluation of treatment of fractures of the distal femur using the KOOS scale per form edworse than a clinical evaluation using the KSS. 2. Post-operative management should emphasise pain relief and restoration of the performance of the treated lower limb to ensure good mobility without crutches. 3. Despite the use of modern operational methods of fracture fixation, treatment of distal femur fractures is still a challenge.

  6. The relationship between clinical findings and therapeutic approach in the treatment of fractured frontal sinus walls

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    Pešić Zoran

    2007-01-01

    Full Text Available Introduction The incidence of fractured frontal sinus walls vary from 6% to 12% of all craniofacial injuries. Objective Estimated relation between clinical findings and performed therapeutic procedures in treating fractured frontal sinus walls. To estimate success in performed therapeutic procedures, according to the incidence of postoperative complications and the integrity of injured regions from the functional and esthetical aspect. Method We analyzed, by retrospective clinical investigation, 19 patients with fractured frontal sinus walls and dislocated fragments, treated at the Department for Maxillofacial Surgery, Clinic of Dentistry in Niš, in the period March 1995 - March 2006. The success of therapy was estimated based on the incidence and type of complications and esthetical results in relation to preoperative findings. Results Predominant etiological factor in fractures of frontal sinus walls is trauma sustained in traffic accidents, which occurred in 52.6% of patients in our investigation. In clinical findings, the impression was the predominant sign, present in 16 patients. In 6 cases soft tissue access through already present lacerations or their extensions was employed, in 4 cases it was done by supraciliary access and in 9 by bicoronal access. As a therapeutic measure, drainage was performed in 5 cases, cranialisation in one, ostheoneogenetic access in 11 cases and a simple reposition of fragments in 2 patients with fractured frontal sinus walls. Infection as a complication was absent. All patients were satisfied with postoperative esthetical appearance of the injured region. Conclusion The infection, the lacerations and the direction of fractured lines are dominant factors in the determination of therapeutic procedures used to treat fractured frontal sinus walls. This will result in the low incidence of infection as a postoperative complication and in patient’s satisfaction with postoperative esthetical result of the injured

  7. Serial Versus Direct Dilation of Small Diameter Stents Results in a More Predictable and Complete Intentional Transcatheter Stent Fracture: A PICES Bench Testing Study.

    Science.gov (United States)

    Crystal, Matthew A; Morgan, Gareth J; Danon, Saar; Gray, Robert G; Gruenstein, Daniel H; Gordon, Brent M; Goldstein, Bryan H

    2018-01-01

    Balloon-expandable stents, implanted in infants and children with congenital heart disease (CHD), often require redilation to match somatic growth. Small diameter stents may eventually require longitudinal surgical transection to prevent iatrogenic vascular stenosis. Intentional transcatheter stent fracture (TSF) is an emerging alternative approach to stent transection, but little is known about the optimal stent substrate and best protocol to improve the likelihood of successful TSF. Bench testing was performed with a stent dilation protocol. After recording baseline characteristics, stents were serially or directly dilated using ultra-high-pressure balloons (UHPB) until fracture occurred or further stent dilation was not possible. Stent characteristics recorded were as follows: cell design, metallurgy, mechanism, and uniformity of fracture. Stents tested included bare-metal coronary stents, premounted small diameter stents, and ePTFE-covered small diameter premounted stents. Ninety-four stents representing 9 distinct models were maximally dilated, with 80 (85%) demonstrating evidence of fracture. Comprehensive fracture details were recorded in 64 stents: linear and complete in 34/64 stents (53.1%), linear and incomplete in 9/64 stents (14.1%), transverse/complex and complete in 6/64 stents (9.4%), and transverse/complex and incomplete in 15/64 stents (23.4%). Stent fracture was not accomplished in some stent models secondary to significant shortening, i.e., "napkin-ring" formation. Serial dilation resulted in evidence of fracture in 62/67 (92.5%) stents compared with 18/27 (66.7%) stents in the direct dilation group (p = 0.003). Intentional TSF is feasible in an ex vivo model. Serial dilation more reliably expanded the stent and allowed for ultimate stent fracture, whereas direct large diameter dilation of stents was more likely to generate a "napkin-ring" configuration, which may be more resistant to fracture. In vivo animal and human testing is necessary to

  8. Fracture Blisters

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    Uebbing, Claire M

    2011-02-01

    Full Text Available Fracture blisters are a relatively uncommon complication of fractures in locations of the body, such as the ankle, wrist elbow and foot, where skin adheres tightly to bone with little subcutaneous fat cushioning. The blister that results resembles that of a second degree burn.These blisters significantly alter treatment, making it difficult to splint or cast and often overlying ideal surgical incision sites. Review of the literature reveals no consensus on management; however, most authors agree on early treatment prior to blister formation or delay until blister resolution before attempting surgical correction or stabilization. [West J Emerg Med. 2011;12(1;131-133.

  9. Endochondral fracture healing with external fixation in the Sost knockout mouse results in earlier fibrocartilage callus removal and increased bone volume fraction and strength.

    Science.gov (United States)

    Morse, A; Yu, N Y C; Peacock, L; Mikulec, K; Kramer, I; Kneissel, M; McDonald, M M; Little, D G

    2015-02-01

    Sclerostin deficiency, via genetic knockout or anti-Sclerostin antibody treatment, has been shown to cause increased bone volume, density and strength of calluses following endochondral bone healing. However, there is limited data on the effect of Sclerostin deficiency on the formative early stage of fibrocartilage (non-bony tissue) formation and removal. In this study we extensively investigate the early fibrocartilage callus. Closed tibial fractures were performed on Sost(-/-) mice and age-matched wild type (C57Bl/6J) controls and assessed at multiple early time points (7, 10 and 14days), as well as at 28days post-fracture after bony union. External fixation was utilized, avoiding internal pinning and minimizing differences in stability stiffness, a variable that has confounded previous research in this area. Normal endochondral ossification progressed in wild type and Sost(-/-) mice with equivalent volumes of fibrocartilage formed at early day 7 and day 10 time points, and bony union in both genotypes by day 28. There were no significant differences in rate of bony union; however there were significant increases in fibrocartilage removal from the Sost(-/-) fracture calluses at day 14 suggesting earlier progression of endochondral healing. Earlier bone formation was seen in Sost(-/-) calluses over wild type with greater bone volume at day 10 (221%, p<0.01). The resultant Sost(-/-) united bony calluses at day 28 had increased bone volume fraction compared to wild type calluses (24%, p<0.05), and the strength of the fractured Sost(-/-) tibiae was greater than that that of wild type fractured tibiae. In summary, bony union was not altered by Sclerostin deficiency in externally-fixed closed tibial fractures, but fibrocartilage removal was enhanced and the resultant united bony calluses had increased bone fraction and increased strength. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  10. Student perception of two different simulation techniques in oral and maxillofacial surgery undergraduate training.

    Science.gov (United States)

    Lund, Bodil; Fors, Uno; Sejersen, Ronny; Sallnäs, Eva-Lotta; Rosén, Annika

    2011-10-12

    Yearly surveys among the undergraduate students in oral and maxillofacial surgery at Karolinska Institutet have conveyed a wish for increased clinical training, and in particular, in surgical removal of mandibular third molars. Due to lack of resources, this kind of clinical supervision has so far not been possible to implement. One possible solution to this problem might be to introduce simulation into the curriculum. The purpose of this study was to investigate undergraduate students' perception of two different simulation methods for practicing clinical reasoning skills and technical skills in oral and maxillofacial surgery. Forty-seven students participating in the oral and maxillofacial surgery course at Karolinska Institutet during their final year were included. Three different oral surgery patient cases were created in a Virtual Patient (VP) Simulation system (Web-SP) and used for training clinical reasoning. A mandibular third molar surgery simulator with tactile feedback, providing hands on training in the bone removal and tooth sectioning in third molar surgery, was also tested. A seminar was performed using the combination of these two simulators where students' perception of the two different simulation methods was assessed by means of a questionnaire. The response rate was 91.5% (43/47). The students were positive to the VP cases, although they rated their possible improvement of clinical reasoning skills as moderate. The students' perception of improved technical skills after training in the mandibular third molar surgery simulator was rated high. The majority of the students agreed that both simulation techniques should be included in the curriculum and strongly agreed that it was a good idea to use the two simulators in concert. The importance of feedback from the senior experts during simulator training was emphasised. The two tested simulation methods were well accepted and most students agreed that the future curriculum would benefit from

  11. Head and Maxillofacial Injuries in Child and Adolescent Victims of Automotive Accidents

    Directory of Open Access Journals (Sweden)

    Alessandro Leite Cavalcanti

    2014-01-01

    Full Text Available Background. Victims of motor vehicle accidents may suffer multiple lesions, including maxillofacial injuries. The aim of this study was to evaluate the prevalence and factors associated with head, facial, and maxillofacial injuries in child and adolescent victims of automobile accidents. A cross-sectional study was carried out with analysis of forensic medical reports from the Legal Medical Institute of Campina Grande, Brazil, between January 2008 and December 2011. Descriptive and inferential statistical analysis was conducted using the chi-square test (α = 0.05. From 1613 medical reports analyzed, the sample is composed 232 (14.4% reports referring to child and adolescent victims of automobile accidents aged 0–19 years of both sexes. Victims were mostly adolescents aged from 15 to 19 years (64.2%, males (73.7%, and motorcyclists (51.3%. More than half of the victims had single lesions (54.3% located in the head (20.7% and face (21.6%. Head injuries occurred more frequently in children aged 0–4 years (53.8%, PR = 5.065, 95% CI = 1.617–5.870 and pedestrians (30.4%, PR = 2.039, 95% CI = 1.024–4.061, while facial and maxillofacial injuries occurred in higher proportion among females (31.1%, PR = 0.489, 95% CI = 0.251–0.954. Our findings suggest that accidents involving motorcyclists are the most prevalent, affecting male adolescents aged from 15 to 19 years, resulting in a high frequency of injuries in the head and face regions.

  12. Effect of chemical disinfectants and accelerated aging on maxillofacial silicone elastomers: An In vitro Study

    Directory of Open Access Journals (Sweden)

    Anna Serene Babu

    2018-01-01

    Full Text Available Context: Maxillofacial prostheses need frequent refabrication due to degradation of color and deterioration of physical properties of the elastomer. Aims: This study attempted to evaluate the change in color stability, Shore A hardness, and surface roughness of two maxillofacial silicones, A-2186 and Cosmesil M511, when submitted to chemical disinfection and accelerated aging. Settings and Design: This was a comparative in vitro study. Subjects and Methods: The materials included two silicone elastomers – A-2186 and Cosmesil M511 (Factor II Incorporated – functional intrinsic red pigment and three disinfectants – Fittydent tablet, chlorhexidine gluconate 4%, and neutral soap. The specimens in each group of elastomer were evaluated initially for color, hardness, and surface roughness, which were further divided into subgroups and subjected to disinfection and accelerated aging. The evaluation of color was performed with the help of an ultraviolet reflectance spectrophotometer. Shore A hardness was evaluated using a durometer and surface roughness, with a digital roughness tester followed by scanning electron microscopy analysis. Statistical Analysis Used: Analysis of variance and Tukey's multiple comparison test were used for statistical analysis. Results: Accelerated aging caused a significant decrease in color, increase in Shore A hardness, and variation in surface roughness in both silicone elastomer groups. Chemical disinfection presented significant changes in color and surface roughness whereas no significant effect on Shore hardness, irrespective of the disinfectant used. Conclusions: The maxillofacial silicone elastomers presented deterioration in color, hardening, and significant variations in surface roughness when subjected to chemical disinfection and accelerated aging, which provides a valid baseline for future research.

  13. Evaluation of Ultrasonography as a Diagnostic Tool in Maxillofacial Space Infections

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    Praveen Kumar Pandey

    2011-11-01

    Full Text Available Objectives: The purpose of the study was to establish the role of ultrasonography in determining the involvement of specific fascial spaces in maxillofacial region and the stage of infection, in indicating the appropriate time for surgical intervention and to compare clinical and ultrasonographic findings.Material and Methods: Twenty five patients with fascial space infection in maxillofacial region were subjected to ultrasonographic examination following a detailed clinical and radiological examination. Ultrasonography guided needle aspiration was performed. Based on the findings, patients diagnosed with abscess were subjected to incision and drainage and those with cellulitis were subjected to medical line of treatment.Results: More than one fascial space was involved in all patients. On clinical examination 64 spaces were involved, of them 34 spaces had abscess formation and 30 spaces were in the stage of cellulitis. On ultrasonography examination, 28 spaces were reported to have abscess formation and 36 spaces were diagnosed to be in the stage of cellulitis. On comparative analysis of both clinical and ultrasonographic findings, ultrasonography was found to be sensitive in 65% of the cases and having specificity of 80%. It was registered statistically significant (P < 0.001 agreement between these two methods of assessment (kappa index = 0.814.Conclusions: Ultrasonography is a quick, widely available, relatively inexpensive, and painless procedure and can be repeated as often as necessary without risk to the patient. Thus ultrasonography is a valuable diagnostic aid to the oral and maxillofacial surgeon for early and accurate diagnosis of fascial space infection, their appropriate treatment and to limit their further spread.

  14. [Percutaneous maxillary nerve block anesthesia in maxillofacial surgery].

    Science.gov (United States)

    Robiony, M; Demitri, V; Costa, F; Politi, M

    1999-01-01

    Personal experience in percutaneous maxillary nerve block anesthesia in association with transmucosal anesthesia of the sphenopalatine ganglion in oral and maxillofacial surgery, is presented. Six Caldwell-Luc, 9 anthrotomies and biopsies of maxillary sinus, 8 removals of extensive odontogenic cysts and 12 surgical maxillary expansions were performed from 1994 to 1996 at our Department. Maxillary transcutaneous nerve block in association with transmucosal anesthesia of the sphenopalatine ganglion were performed. Carbocaine without adrenaline in association with NaCO3 1/10 for maxillary nerve block anesthesia and lidocaineoprilocaine cream (EMLA) for transmucosal anesthesia were employed. Intra- and post-operative pain were evaluated by visual analogue scale in all the patients. Anesthesiological procedures revealed to be effective in all surgical interventions and postoperative analgesia allowed easier pain control. The simplicity of execution, the effective pre- and postoperative anesthesia and the absence of side effects make this procedure particularly indicated in oral and maxillofacial surgery.

  15. Oral, Maxillofacial and Dental Diseases in Captive Cheetahs (Acinonyx jubatus).

    Science.gov (United States)

    Steenkamp, G; Boy, S C; van Staden, P J; Bester, M N

    2018-01-01

    Descriptions of several oral, maxillofacial and dental conditions/diseases exist for a variety of captive large felids, but little is reported on the pathology of free roaming large felids. Apart from focal palatine erosions (FPEs) as initially described by Fitch and Fagan (1982) and some reference to absent incisor teeth, few data exist on diseases affecting the oral, maxillofacial and dental structures of cheetahs (Acinonyx jubatus), regardless of their captivity status. This study reports 18 different conditions affecting the teeth, bone and oral cavity soft tissue of cheetahs, based on initial assessment of 256 animals over 11 years (2002-2012) in South Africa and Namibia. This report excludes oral tumours or FPEs, but includes several acquired and developmental conditions never described before. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Chance Fracture Secondary to a Healed Kyphotic Compression Osteoporotic Fracture

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    Teh KK

    2009-11-01

    Full Text Available Chance fracture is an unstable vertebral fracture, which usually results from a high velocity injury. An elderly lady with a previously healed osteoporotic fracture of the T12 and L1 vertebra which resulted in a severe kyphotic deformity subsequently sustained a Chance fracture of the adjacent L2 vertebrae after a minor fall. The previously fracture left her with a deformity which resulted in significant sagittal imbalance therefore predisposing her to this fracture. This case highlights the importance of aggressive treatment of osteoporotic fractures in order to prevent significant sagittal imbalance from resultant (i.e. kyphotic deformity.

  17. Prevalence and patterns of combat sport related maxillofacial injuries

    OpenAIRE

    Shirani, Gholamreza; Kalantar Motamedi, Mohammad Hosein; Ashuri, Alireza; Eshkevari, Pooyan Sadr

    2010-01-01

    Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referre...

  18. CBCT images of anatomic landmarks in maxillofacial region

    OpenAIRE

    Mayil, Meltem; Keser, Gaye; Namdar Pekiner, Filiz

    2014-01-01

    Conventional radiographic techniques in dental radiology allows only 2D images of 3D structures of head and neck region. CBCT is a recent technology, is also named as dental volumetric tomography, which was developed as an alternative to conventional CT using cone beam-shaped X-ray to provide more rapid acquisition of a data set of entire maxillofacial region. CBCT has remarkable advantages such as shorter exposure time, reduced image distortion due to patient movements, dec...

  19. [Orthognathic surgery, master-piece of maxillo-facial surgery].

    Science.gov (United States)

    Reychler, H

    2001-01-01

    Orthognathic surgery is this field of the maxillofacial surgery which aims to reposition the jaws or some segments of these jaws when masticatory dysfunctions are evident. This tridimensional repositioning in the craniofacial skeleton allows to restore the masticatory function by means of osteotomies, which must be followed either by preoperative simulated bony displacements or by callus bone distraction. Not only are the functional benefits evident on the dental, articular and neuromuscular levels, but also a facial esthetic harmony can almost be obtained.

  20. Basic studies of CT in the maxillofacial areas, 1

    International Nuclear Information System (INIS)

    Suzuki, Shinichiro; Kaneko, Hiroshi; Higashi, Tomomitsu; Takenaka, Eiichi.

    1982-01-01

    As CT values of hard tissues would pose problems in the application of CT to the maxillofacial area, attenuation coefficients of each oral hard tissue were examined based on the existing data, and the linearity in the area of high x-ray attenuation was examined. We thought that a new contrast scale suitable for each area should be established for measurements of CT values of tissues of high x-ray attenuation such as teeth. (Chiba, N.)

  1. The Use of Telemedicine in Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

    2016-04-01

    To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P telemedicine, whereas OMS respondents were more neutral. GPs responded they would refer more patients (4.4) if consultations could be performed by telemedicine. OMSs agreed that more referrals would influence their decision to provide telemedicine consultations (51%). Practitioners had neutral perceptions about the reliability of telemedicine. OMS respondents agreed they would implement telemedicine in their practice if it provided equally good consultations as in-office visits. According to the present findings, telemedicine could be an important step in the right direction for overcoming current issues with patient access to care and increasing health care costs. The benefits of telemedicine technology have been documented and will continue to be seen with wider application of its use in other areas of health care such as oral and maxillofacial surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier

  2. Education of Oral and Maxillofacial Radiology in South Korea

    International Nuclear Information System (INIS)

    Choi, Soon Chul

    2009-01-01

    Although x-ray had been used in Dental Clinic and taught as Roentgenology as a part of other lectures, the independent lecture was established at Seoul National University in 1953. The first independent Department was separated from the Department of Oral Surgery at Seoul National University in 1963. Nowadays, there are 6 national and 5 private dental schools in South Korea. Each dental school has a Department of Oral and Maxillofacial Radiology, which fulfills its role in student education and clinical service. What is specially noteworthy is that 8 of the 11 dental schools have changed or will change from the 2+4 year system to 4+4 year system (postgraduate course). The curriculum has also been or is being amended according to this change. Although the contents of courses for Oral and Maxillofacial Radiology are not much different among dental schools, the methods and structure of education are various. We have to do a systematic and comprehensive analysis of the present educational methods and structure of Oral and Maxillofacial Radiology and need to seek the new and more suitable ones based on competency.

  3. Education of Oral and Maxillofacial Radiology in South Korea

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soon Chul [Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2009-03-15

    Although x-ray had been used in Dental Clinic and taught as Roentgenology as a part of other lectures, the independent lecture was established at Seoul National University in 1953. The first independent Department was separated from the Department of Oral Surgery at Seoul National University in 1963. Nowadays, there are 6 national and 5 private dental schools in South Korea. Each dental school has a Department of Oral and Maxillofacial Radiology, which fulfills its role in student education and clinical service. What is specially noteworthy is that 8 of the 11 dental schools have changed or will change from the 2+4 year system to 4+4 year system (postgraduate course). The curriculum has also been or is being amended according to this change. Although the contents of courses for Oral and Maxillofacial Radiology are not much different among dental schools, the methods and structure of education are various. We have to do a systematic and comprehensive analysis of the present educational methods and structure of Oral and Maxillofacial Radiology and need to seek the new and more suitable ones based on competency.

  4. Treatment of malreduced pilon fracture: A case report and the result in the long-term follow-up

    OpenAIRE

    Balio?lu, Mehmet Bulent; Akman, Yunus Emre; Bahar, Hakan; Albayrak, Akif

    2015-01-01

    Introduction The risk for post-traumatic osteoarthritis (POA) following tibial plafond joint trauma has been reported to be as high as 70?75%. In the treatment of more severe joint pathologies, with incongruity and intra-articular defects, internal or external fixations techniques may be required. Presentation of case We report the orthopedic management of a pilon fracture in a 30-year-old male with malunion and implant failure after initial mal-reduction of the fracture 9-months earlier. Tri...

  5. 2 case reports of the polyostotic fibrous dysplasia on the cranial and maxillofacial bones of the sisters

    International Nuclear Information System (INIS)

    Kim, Han Pyung; Park, Chang Seo

    1979-01-01

    The authors observed 2 cases of fibrous dysplasia on the cranial and maxillofacial bones in 31.28 aged sisters, who had come to the Infirmary of Dental College, Yonsei University. The serial roentgenograms and clinical findings had been taken and the results established as polyostotic fibrous dysplasia according to the findings in their images. To author have obtained the results as follows: 1. Bony expansion of the mandible occurred at 18 years of age and the facial asymmetry appeared due to development of the lesions. 2. The traumatic history were not noted but weak tendency of familial history noted. 3. Endocrine disturbances, hyperpigmentation on the skin and premature puberty in the infancy were not noted. 4. We have concluded these diseases as polyostotic fibrous dysplasia on the cranial and maxillofacial bones with weak familial tendency according to the findings.

  6. THE RESULTS OF THE CLINICAL USE OF A NEW METHOD OF OSTEOSYNTHESIS WITH NON-FREE BONE AUTOPLASTY AT THE MEDIAL FEMORAL NECK FRACTURES

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2013-01-01

    Full Text Available Objective - to improve treatment outcomes in patients with medial fractures of the femoral neck through the development and introduction into clinical practice a new method of fixation with non-free plastic by the autograft from the iliac crest on a permanent muscular-vascular pedicle. Materials and methods. A comparative analysis of short- and long-term results of surgical treatment of 57 patients with medial fractures of the femoral neck, which were divided into primary and control groups. The study group included 24 patients who have undergone an osteosynthesis with cannulated screws with additional autoplasty with vascularized graft from the iliac crest. The control group consisted of 33 patients who underwent fixation with cannulated screws for the traditional method. Results. The use of non-free bone autoplasty in the main group of patients provided the best short- and long-term outcomes: fracture healing occurred in all cases in a period of 6 to 8 months. The long-term results of treatment of 22 patients after 2-6 years after the operation showed comparatively better anatomical functional outcomes. Conclusions. The indications for the clinical use of the fixation with the non-free bone autotransplantation are prognostically unfavorable for the union medial fractures of the femoral neck (II-III types by Pauwels or III-IV types by Garden in patients aged under 60 years with no signs of deforming arthrosis II-III stages.

  7. Modification of elastic stable intramedullary nailing with a 3rd nail in a femoral spiral fracture model - results of biomechanical testing and a prospective clinical study.

    Science.gov (United States)

    Kaiser, Martin M; Stratmann, Christine; Zachert, Gregor; Schulze-Hessing, Maaike; Gros, Nina; Eggert, Rebecca; Rapp, Marion

    2014-01-08

    in this biomechanical model. These results were successfully transmitted into clinical practice. All children, treated by 3CL or 3CM according to the individual character of each fracture, needed no additional stabilization and had no Re-Do operations. As a consequence, at our hospital all children with femoral diaphyseal fractures with open physis are treated with this modified ESIN-technique.

  8. How to improve retromandibular transmasseteric anteroparotid approach for mandibular condylar fractures: our clinical experience.

    Science.gov (United States)

    Salgarelli, A C; Anesi, A; Bellini, P; Pollastri, G; Tanza, D; Barberini, S; Chiarini, L

    2013-04-01

    Fractures of the mandibular condyle are common and account for 25-35% of all mandibular fractures reported in the literature. Even with the development of a consensus on the preference for open reduction and internal fixation of these fractures, the clinician is still faced with a dilemma concerning the optimal approach to the ramus-condyle unit. Limited access and injury to the facial nerve are the most common problems. The most commonly used extraoral approaches are the submandibular, retromandibular and preauricular methods. In this study, we propose a modified cosmetic preauricular incision with a short end in the neck, to improve the transmasseteric anteroparotid (TMAP) approach previously described by Wilson et al. in 2005. We retrospectively analysed 13 patients treated in our department for mandibular condylar fractures. Post-operative complications, occlusal status, interincisal opening and joint tenderness were evaluated at 3 months after surgery. The wider skin incision described here provides a convenient approach for open reduction and rigid internal fixation, and good results were obtained. The follow-up ranged from 6 to 40 months. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Results of triple muscle (sartorius, tensor fascia latae and part of gluteus medius pedicle bone grafting in neglected femoral neck fracture in physiologically active patients

    Directory of Open Access Journals (Sweden)

    Pankaj Kumar Mishra

    2014-01-01

    Full Text Available Background: Femoral neck fractures are notorious for complications like avascular necrosis and nonunion. In developing countries, various factors such as illiteracy, low socioeconomic status, ignorance are responsible for the delay in surgery. Neglected fracture neck femur always poses a formidable challenge. The purpose of this study was to evaluate the results of triple muscle pedicle bone grafting using sartorius, tensor fasciae latae and part of gluteus medius in neglected femoral neck fracture. Materials and Methods: This is a retrospective study with medical record of 50 patients, who were operated by open reduction, internal fixation along with muscle pedicle bone grafting by the anterior approach. After open reduction, two to three cancellous screws (6.5 mm were used for internal fixation in all cases. A bony chunk of the whole anterior superior iliac spine of 1 cm thickness, 1 cm width and 4.5 cm length, taken from the iliac crest comprised of muscle pedicle of sartorius, tensor fascia latae and part of gluteus medius. Then the graft with all three muscles mobilized and put in the trough made over the anterior or anterosuperior aspect of the femoral head. The graft was fixed with one or two 4.5 mm self-tapping cortical screw in anterior to posterior direction. Results: 14 patients were lost to followup. The results were based on 36 patients. We observed that in our series, there was union in 34, out of 36 (94.4% patients. All patients were within the age group of 15-51 years (average 38 years with displaced neglected femoral neck fracture of ≥30 days. Mean time taken for full clinicoradiological union was 14 weeks (range-10-24 weeks. Conclusion: Triple muscle pedicle bone grafting gives satisfactory results for neglected femoral neck fracture in physiologically active patients.

  10. Complex tibial plateau fractures treated by hybrid external fixation system: A correlation of followup computed tomography derived quality of reduction with clinical results

    Directory of Open Access Journals (Sweden)

    Konstantinos Kateros

    2018-01-01

    Full Text Available Background: Tibial plateau fractures are common due to high energy injuries. The principles of treatment include respect for the soft tissues, restoring the congruity of the articular surface and reduction of the anatomic alignment of the lower limb to enable early movement of the knee joint. There are various surgical fixation methods that can achieve these principles of treatment. Recognition of the particular fracture pattern is important, as this guides the surgical approach required in order to adequately stabilize the fracture. This study evaluates the results of the combined treatment of external fixator and limited internal fixation along with the advantages using postoperative computed tomography (CT scan after implant removal. Materials and Methods: 55 patients with a mean age of 42 years (range 17–65 years with tibial plateau fracture, were managed in our institution between October 2010 and September 2013., Twenty fractures were classified as Schatzker VI and 35 as Schatzker V. There were 8 open fractures (2 Gustilo Anderson 3A and 6 Gustilo Anderson 2. All fractures were treated with closed reduction and hybrid external fixation (n = 21/38.2% or with minimal open reduction internal fixation and a hybrid system (n = 34/61.8%. After the removal of the fixators, CT-scan was programmed for all the cases, for correlation with the results. At final followup, the American Knee Society Score (AKSS was administered. Results: All patients were evaluated with a minimum of 12 months (range 12–21 months followup. Average time to union was 15.5 weeks (range 13–19 weeks. The postoperative joint congruity as evaluated in the postoperative CT-scan was 5° in 19 cases (35%. Patients with residual joint depression 4.5 mm displayed a 100% chance of getting poor-fair scores both in AKSS knee and AKSS function score. The association of a postoperative mechanical axis within 5° of the contralateral limb and improved knee scores was statistically

  11. Functional result of the surgical treatment of the fractures opened up in the severely traumatised hind foot

    International Nuclear Information System (INIS)

    Ramos Tovar, William Domingo; Arroyo Sanchez, Carlos Augusto

    2006-01-01

    Present study plans to carry out an evaluation of the functional result of the surgical treatment of the open fractures of the severely traumatised hind foot, in the Hospital Militar Central during 1998 to 2002 for the above-mentioned we plane a descriptive retrospective study type: series of cases. We also think about specific objectives in relation to demographic aspects, aspects of the treatment and of the complications that are presented in these patients. For the functional evaluation we used the AOFAS (American Orthopaedic Foot and Ankle Society Scale) scale for the hind foot. 60 patients were included. 95% was men. The age average was of 26 years. The mechanism in 51% of the cases was trauma due to high-speed firearm (rifle), 27% trauma for mine, 12% fall of height, 7% has an accident of traffic, and 3% of firearm of low speed (gun). The presentation frequency according to the classification of Gustilo was type ll 12%, type lllA 63% and type IIIB 25%. In all the cases the initial care was begin with surgical debridement and take of cultures and I. V. antibiotics. The interval of time between the lesion and the definitive surgery was of 6 months (1 month to 24 months). The initial handling was orthopedic in 23 cases, open reduction and internal fixation in 16 cases, external fixation in 19 cases, and external fixation plus internal fixation in 2 cases. Additional surgeries were required in 48 cases, 8 of these were tibiotalar arthrodesis, 26 subtalar arthrodesis, 5 tibiocalcaneal arthrodesis, 5 panarthrodesis, 4 arthrodesis of the mid foot. The final average score according to the AOFAS scale for the hind foot was 81 points

  12. Statistical analysis of results from the quantitative mapping of fracture minerals in Laxemar. Site descriptive modelling - complementary studies

    Energy Technology Data Exchange (ETDEWEB)

    Loefgren, Martin (Niressa AB, Norsborg (Sweden)); Sidborn, Magnus (Kemakta Konsult AB, Stockholm (Sweden))

    2010-12-15

    Within the Laxemar site investigation campaign, quantitative mapping of different fracture minerals has been performed. This has been done by studying fracture surfaces of drill core sections from many different boreholes at the Laxemar site /Eklund and Mattsson 2008/. The drill core mapping was focused on the rock in the vicinity of flow anomalies detected by the Posiva Flow Log (PFL). The quantitative mapping was performed only on open fractures. The fracture minerals that were mapped are calcite, chlorite, clay minerals (as a group), hematite, and pyrite. In this present report, data from the quantitative mineral mapping campaign are refined, sorted into different data subsets, and analysed by parametric and non-parametric statistical methods. The data subsets are associated with 17 different rock volumes, representing different elevations, rock domains, fracture domains, and groups of deformation zones. In total 1,852 fractures were mapped at the site, and the most frequent mineral was calcite. Its amount could be quantitatively estimated in 51% of the mapped fractures. Of the other minerals, chlorite was quantitatively estimated in 46%, pyrite in 19%, clay minerals in 16%, and hematite in 0.05% of the mapped fractures. For fractures where the averaged fracture mineral thickness, d{sub mean} [mm], and visible coverage, C{sub vis} [%], could be quantitatively estimated, the following arithmetic means were found: calcite = 0.25 mm and 22%, chlorite = 0.29 mm and 41%, pyrite =1.3 mum and 0.2%, and clay minerals = 0.15 mm and 35%. These quantities are based on visual inspection of fracture surfaces and do not include the contribution from non-consolidated fracture fillings. It is shown that there is significant spatial variability of d{sub mean} and C{sub vis} within the examined rock volumes. Furthermore, the non-parametric analyses indicate that there are differences in d{sub mean} and C{sub vis} between the different rock volumes. Even so, the differences are

  13. Statistical analysis of results from the quantitative mapping of fracture minerals in Forsmark. Site descriptive modelling - complementary studies

    Energy Technology Data Exchange (ETDEWEB)

    Loefgren, Martin (Niressa AB, Norsborg (Sweden)); Sidborn, Magnus (Kemakta Konsult AB, Stockholm (Sweden))

    2010-12-15

    Within the Forsmark site investigation campaign, quantitative mapping of different fracture minerals has been performed. This has been done by studying fracture surfaces of drill core sections from many different boreholes at the Forsmark site /Eklund and Mattsson 2009/. The drill core mapping was focused on the rock in the vicinity of flow anomalies detected by the Posiva Flow Log (PFL). The quantitative mapping was performed only on open fractures. The fracture minerals that were mapped are calcite, chlorite, clay minerals (as a group), hematite, and pyrite. In this present report, data from the quantitative mineral mapping campaign are refined, sorted into different data subsets, and analysed by parametric and non-parametric statistical methods. The data subsets are associated with 21 different rock volumes, representing different elevations, rock domains, fracture domains, and groups of deformation zones. In total 2,071 fractures were mapped at the site, and the most frequent mineral was calcite. Its amount could be quantitatively estimated in 32% of the mapped fractures. Of the other minerals, chlorite was quantitatively estimated in 24%, clay minerals in 11%, pyrite in 10%, and hematite in 0.4% of the mapped fractures. For fractures where the averaged fracture mineral thickness, d{sub mean} [mm], and visible coverage, C{sub vis} [%], could be quantitatively estimated, the following arithmetic means were found: calcite = 0.11 mm and 18%, chlorite = 0.22 mm and 38%, clay minerals = 0.14 mm and 40%, pyrite = 2.3 mum and 0.5%, hematite = 19 mum and 14%. These quantities are based on visual inspection of fracture surfaces and do not include the contribution from non-consolidated fracture fillings. It is shown that there is significant spatial variability of d{sub mean} and C{sub vis} within the examined rock volumes. Furthermore, the non-parametric analyses indicate that there are differences in d{sub mean} and C{sub vis} between the different rock volumes. Even

  14. Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS).

    Science.gov (United States)

    Kemmler, W; Bebenek, M; Kohl, M; von Stengel, S

    2015-10-01

    The EFOPS trial clearly established the positive effect of long-term exercise on clinical low-trauma fractures in postmenopausal women at risk. Bearing in mind that the complex anti-fracture exercise protocols also affect a large variety of diseases of increased age, we strongly encourage older adults to perform multipurpose exercise programs. Physical exercise may be an efficient option for autonomous fracture prevention during increasing age. The aim of the study was to evaluate the effect of exercise on clinical overall fracture incidence and bone mineral density (BMD) in elderly subjects at risk. In 1998 initially, 137 early-postmenopausal, osteopenic women living in Erlangen-Nuremberg, Germany, were included in the EFOPS trial. Subjects of the exercise group (EG; n = 86) conducted two supervised group and two home exercise sessions/week while the control group (CG; n = 51) was requested to maintain their physical activity. Primary study endpoints were clinical overall low-trauma fractures determined by questionnaires, structured interviews, and BMD at the lumbar spine and femoral neck assessed by dual-energy X-ray absorptiometry. In 2014, 105 subjects (EG: n = 59 vs. CG: n = 46) representing 1680 participant-years were included in the 16-year follow-up analysis. Risk ratio in the EG for overall low-trauma fractures was 0.51 (95% confidence interval (95% CI) 0.23 to 0.97, p = .046), rate ratio was 0.42 (95% CI 0.20 to 0.86, p = .018). Based on comparable baseline values, lumbar spine (MV -1.5%, 95% CI -0.1 to -2.8 vs. -5.8%, -3.3 to -7.2%) and femoral neck (-6.5%, -5.2 to -7.7 vs. -9.6%, -8.2 to 11.1%) BMD decreased in both groups; however, the reduction was more pronounced in the CG (p ≤ .001). This study clearly evidenced the high anti-fracture efficiency of multipurpose exercise programs. Considering furthermore the favorable effect of exercise on most other risk factors of increasing age, we strongly encourage older adults to perform multipurpose

  15. Tissue differentiation by diffuse reflectance spectroscopy for automated oral and maxillofacial laser surgery: ex vivo pilot study

    Science.gov (United States)

    Zam, Azhar; Stelzle, Florian; Tangermann-Gerk, Katja; Adler, Werner; Nkenke, Emeka; Schmidt, Michael; Douplik, Alexandre

    2010-02-01

    Remote laser surgery lacks of haptic feedback during the laser ablation of tissue. Hence, there is a risk of iatrogenic damage or destruction of anatomical structures like nerves or salivary glands. Diffuse reflectance spectroscopy provides a straightforward and simple approach for optical tissue differentiation. We measured diffuse reflectance from seven various tissue types ex vivo. We applied Linear Discriminant Analysis (LDA) to differentiate the seven tissue types and computed the area under the ROC curve (AUC). Special emphasis was taken on the identification of nerves and salivary glands as the most crucial tissue for maxillofacial surgery. The results show a promise for differentiating tissues as guidance for oral and maxillofacial laser surgery by means of diffuse reflectance.

  16. A possible mechanism of maxillofacial abscess formation: involvement of Porphyromonas endodontalis lipopolysaccharide via the expression of inflammatory cytokines.

    Science.gov (United States)

    Murakami, Y; Hanazawa, S; Tanaka, S; Iwahashi, H; Yamamoto, Y; Fujisawa, S

    2001-12-01

    In a previous study, we developed a specific monoclonal antibody against Porphyromonas endodontalis lipopolysaccharide, and demonstrated that this lipopolysaccharide was detected in bacterially infected root canal fluid. We suggest here that P. endodontalis lipopolysaccharide in the infectious materials plays a stimulatory role in maxillofacial abscess formation via the expression of inflammatory cytokines. Our epidemiological study showed that this lipopolysaccharide was detected in significant levels the infectious material of patients with periapical periodontitis and odontogenic abscesses. Interestingly, infectious material-induced expression of tumor necrosis factor-alpha, interleukin-1beta, or neutrophil chemoattractant KC genes in mouse macrophages, was significantly neutralized by monoclonal antibody against the lipopolysaccharide. In addition, we also detected a significant amount of tumor necrosis factor-alpha in the infectious material. These results suggest that P. endodontalis lipopolysaccharide plays an important role in the pathogenic mechanism of maxillofacial abscess formation via the expression of inflammatory cytokines.

  17. Minimally invasive approach of panfacial fractures

    Directory of Open Access Journals (Sweden)

    Yudi Wijaya

    2017-08-01

    Full Text Available Background. Panfacial fractures involves fractures of several bones of face. They are associated with malocclusion, dish face deformity, enopthalmos, diplopia, cerebrospinal fluid leak and soft tissue injuries. Purpose. The purpose of this paper is to present a case of minimizing surgical wound and morbidity. Case. A 40 year old female presented with severe maxillofacial injuries caused by motor vehicle collisions about 5 days prior to admission. The assessment of the patient is mild head injury, panfacial fractures, lacerated wound at face,  rupture of globe of occular sinistra. An open reduction and internal fixation  (ORIF and enucleation of globe occular sinistra was performed.  Intraoral vestibular incision is made in the upper and lower vestibular region. Mucoperiosteal flap elevation of vestibular will exposure of the anterior maxilla and mandibular fractures. Intermaksilary fixation within 3 week and restore aesthetic with prosthesis fitting eyeball and denture. Discusion. The goal of  treatment of  panfacial fracture is to restore both the functions and pre-injury 3-dimensional facial contours. To achieve this goal two common  sequences of management of Panfacial fractures are proposed, “Bottom up and inside out” or “Top down and outside in”. Other sequences exist but there are variations of these two major approaches. Conclusion. A minimally invasive approach to  the fracture site is an alternative method  to manage panfacial fracture with a simple, effective and lower complication rate.

  18. Evaluation of the results from surgical treatment of fractures of the lateral extremity of the clavicle, using the double ligature technique

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    Alberto Naoki Miyazaki

    2015-04-01

    Full Text Available OBJECTIVE: To evaluate the incidence of consolidation in surgical treatment of fractures of the lateral extremity of the clavicle using the double subcoracoid ligature technique, with nonabsorbable No. 5 thread.METHODS: Between May 1993 and June 2013, the Shoulder and Elbow Group of our service surgically treated 116 patients (116 shoulders with fractures of the lateral extremity of the clavicle. Among these, we were able to reassess 65 cases. The surgical technique used consisted of double subcoracoid ligature with two nonabsorbable threads. In two patients classified as type III, we had to combine this technique with use of an interfragmentary screw for fixation of the intra-articular portion of the acromioclavicular joint.RESULTS: We achieved fracture consolidation in 90%. Fourteen cases (21% evolved with major complications: four cases of pseudarthrosis, five of adhesive capsulitis, two of delayed consolidation and three of loss of reduction. Two cases (3% evolved with minor complications of skin granuloma.CONCLUSION: The double ligature technique for fractures of the lateral extremity of the clavicle promotes the stabilization needed for consolidation to take place, without the need for synthesis using metal components. It avoids reoperation for the synthesis material to be removed. Moreover, it is a low-cost procedure with good reproducibility and preservation of the acromioclavicular joint.

  19. Epidemiología del trauma maxilofacial por accidente ciclístico Epidemiology of the maxillofacial trauma caused by bicycle accident

    Directory of Open Access Journals (Sweden)

    Angel Pérez Rodríguez

    2004-12-01

    Full Text Available Se realizó un estudio descriptivo y transversal sobre aspectos epidemiológicos del trauma maxilofacial por accidentes ciclísticos en 194 pacientes con diagnóstico clínico, radiográfico o ambos, de lesiones en esta región, que fueron recibidos y atendidos en el Servicio de Urgencia de Cirugía Maxilofacial del Hospital Clinicoquirúrgico "Saturnino Lora" de Santiago de Cuba, durante el período comprendido desde el 1 de octubre de 1998 hasta el 31 de diciembre de 1999. Entre los resultados más sobresalientes figuraron el predominio de los adultos jóvenes de 20 a 39 años de edad, sobre todo de los varones, la caída como modalidad de accidente, la colisión como la causante del mayor número de lesionados graves y defunciones. La imprudencia e ingestión de alcohol en conductores laboralmente activos resultaron ser las causas y víctimas que prevalecieron en este tipo de accidente, particularmente en el horario de 4 p.m. a 12 a.m. y en la calle, esta última la vía donde más accidentes y lesionados se produjeron. Las contusiones y laceraciones dentro de los tejidos blandos y las fracturas zigomáticas, nasales y palatoalveolares dentro del tejido duro, resultaron los patrones de lesiones predominantes.A descriptive cross-sectional study on epidemiological aspects of the maxillofacial trauma caused by bicycle accidents was conducted among 194 patients with clinical or radiographic diagnosis, or both, of injuries in this region. They received attention at the Emergency Service of Maxillofacial Surgery of "Saturnino Lora" Clinical and Surgical Hospital, in Santiago de Cuba, from October 1st, 1998 to December 31st, 1999. Some of the most significant results were: the predominance of young adults aged 20-39, mainly males, among the victims, the fall as an accident modality, the collision as the cause of the highest number of severe injures and deaths, and imprudence and alcohol ingestion in working drivers. These were some of the prevailing

  20. Early results of a simple distraction dynamic external fixator in management of comminuted intra-articular fractures of base of middle phalanx.

    Science.gov (United States)

    Mansha, Muhammad; Miranda, Sanjay

    2013-12-01

    Treatment for comminuted fracture dislocations of the proximal interphalangeal joint (pilon injuries) remains a challenge. We present our short term results of twelve pilon fracture dislocations treated by closed reduction and application of a distraction dynamic external fixator. The aim of the study was to assess the clinical outcomes and compare them to the original description by Hynes and Giddins. A cohort of 12 consecutive patients with pilon fracture of the proximal interphalangeal joint (comminuted fracture of the base of middle phalanx, longitudinally unstable with joint subluxation), were treated with this method over the study period. Data was collected by an independent observer at last follow-up appointment in the clinic. The outcome measures recorded were; level of residual pain, arc of motion, X-ray appearance, return to work and satisfaction with the procedure. The study group comprises of 7 male and 5 female patients at a mean age of 38.1 years (range 21-70 years). The average range of movement achieved was 13-87° at a mean follow-up of 16.4 weeks (Range 12-42 weeks). Early return to work, good pain relief and high level of patient satisfaction were achieved. No serious complication was noted during this period. We used the construct with slight modification of the original description and we feel this modification may help to reduce the pin site infection. We found the results reproducible and based on our experience we recommend this technique to treat these complex intra-articular fractures of base of middle phalanx.

  1. To evaluate the efficacy of ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings

    Energy Technology Data Exchange (ETDEWEB)

    Pallagatti, Shambulingappa, E-mail: dr.shambulingappa@gmail.com [Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana (India); Sheikh, Soheyl; Puri, Nidhi; Mittal, Amit; Singh, Balwinder [Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana (India)

    2012-08-15

    Aim: To evaluate the efficacy of Ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. Material and methods: The study was conducted on forty-five patients with maxillofacial swellings. The clinical diagnosis, radiographic diagnosis and ultrasonographic diagnosis were made which was compared to the histopathological diagnosis. The maxillofacial swellings included cystic lesions, benign swellings, malignant swellings, lymphadenopathies and abscesses and space infections. Results: The diagnostic accuracy and contingency coefficient was evaluated considering histopathology as gold standard. The diagnostic accuracy of ultrasound was found to be 92.30% in the diagnosis of cystic lesions, 87.5% in benign tumors, 81.8% in malignant tumors, 100% in lymphadenopathies and 90% in space infections and abscesses. The contingency coefficient of 0.934 was obtained when ultrasonography was compared to the histopathology, which was highly significant. Similar significant results were obtained comparing ultrasonography with clinical diagnosis (0.895) and radiographic diagnosis (0.889). Conclusion: Ultrasonography provides accurate imaging of the head and neck region and provides information about the nature of the lesion, its extent, and relationship with the surrounding structures. As the conventional and digital radiography enable the diagnosis of the presence of the disease, but do not give any indication of its nature. So, together with clinical and histopathological examinations, real time ultrasound imaging works out as a valuable adjunct in the diagnosis of orofacial swellings.

  2. Open Access Publishing: A Study of Current Practice in Oral and Maxillofacial Surgery Research.

    Science.gov (United States)

    Tahim, Arpan; Bansal, Hitesh; Goodson, Alexander M C; Payne, Karl F B; Sabharwal, Sanjeeve

    2016-12-01

    Open access (OA) publication has become an increasingly common route for dissemination of scientific research findings. However, it remains a contentious issue with continued debate as to its impact on the peer-review process and a potential change in the quality of subsequent evidence published. There is little research that looks into OA in oral and maxillofacial surgery. We investigated the OA policy in the 30 relevant journals listed in the Institute for Scientific Information Web of Knowledge journal citation report, comparing bibliometric data and quality of evidence produced in journals offering OA and those with subscription-only policies. 3474 articles were graded for evidence level and the results correlated to journal OA status. 76.7 % of journals offered authors OA services. There was no difference between impact factor, self-citation rate, total citations or quality of evidence between OA and subscription journals. These findings should send clear messages to both clinicians and researchers and should re- assure readers that scientific findings that are disseminated in open access form do not differ in quality to those in subscription-only format. It should reinforce that open access formats are a credible way to display research findings in oral and maxillofacial surgery.

  3. ADAM10 is essential for cranial neural crest-derived maxillofacial bone development

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Yu, E-mail: tanyu2048@163.com; Fu, Runqing, E-mail: furunqing@sjtu.edu.cn; Liu, Jiaqiang, E-mail: liujqmj@163.com; Wu, Yong, E-mail: wyonger@gmail.com; Wang, Bo, E-mail: wb228@126.com; Jiang, Ning, E-mail: 179639060@qq.com; Nie, Ping, E-mail: nieping1011@sina.com; Cao, Haifeng, E-mail: 0412chf@163.com; Yang, Zhi, E-mail: wcums1981@163.com; Fang, Bing, E-mail: fangbing@sjtu.edu.cn

    2016-07-08

    Growth disorders of the craniofacial bones may lead to craniofacial deformities. The majority of maxillofacial bones are derived from cranial neural crest cells via intramembranous bone formation. Any interruption of the craniofacial skeleton development process might lead to craniofacial malformation. A disintegrin and metalloprotease (ADAM)10 plays an essential role in organ development and tissue integrity in different organs. However, little is known about its function in craniofacial bone formation. Therefore, we investigated the role of ADAM10 in the developing craniofacial skeleton, particularly during typical mandibular bone development. First, we showed that ADAM10 was expressed in a specific area of the craniofacial bone and that the expression pattern dynamically changed during normal mouse craniofacial development. Then, we crossed wnt1-cre transgenic mice with adam10-flox mice to generate ADAM10 conditional knockout mice. The stereomicroscopic, radiographic, and von Kossa staining results showed that conditional knockout of ADAM10 in cranial neural crest cells led to embryonic death, craniofacial dysmorphia and bone defects. Furthermore, we demonstrated that impaired mineralization could be triggered by decreased osteoblast differentiation, increased cell death. Overall, these findings show that ADAM10 plays an essential role in craniofacial bone development. -- Highlights: •We firstly reported that ADAM10 was essentially involved in maxillofacial bone development. •ADAM10 cKO mice present craniofacial dysmorphia and bone defects. •Impaired osteoblast differentiation,proliferation and apoptosis underlie the bone deformity.

  4. ADAM10 is essential for cranial neural crest-derived maxillofacial bone development

    International Nuclear Information System (INIS)

    Tan, Yu; Fu, Runqing; Liu, Jiaqiang; Wu, Yong; Wang, Bo; Jiang, Ning; Nie, Ping; Cao, Haifeng; Yang, Zhi; Fang, Bing

    2016-01-01

    Growth disorders of the craniofacial bones may lead to craniofacial deformities. The majority of maxillofacial bones are derived from cranial neural crest cells via intramembranous bone formation. Any interruption of the craniofacial skeleton development process might lead to craniofacial malformation. A disintegrin and metalloprotease (ADAM)10 plays an essential role in organ development and tissue integrity in different organs. However, little is known about its function in craniofacial bone formation. Therefore, we investigated the role of ADAM10 in the developing craniofacial skeleton, particularly during typical mandibular bone development. First, we showed that ADAM10 was expressed in a specific area of the craniofacial bone and that the expression pattern dynamically changed during normal mouse craniofacial development. Then, we crossed wnt1-cre transgenic mice with adam10-flox mice to generate ADAM10 conditional knockout mice. The stereomicroscopic, radiographic, and von Kossa staining results showed that conditional knockout of ADAM10 in cranial neural crest cells led to embryonic death, craniofacial dysmorphia and bone defects. Furthermore, we demonstrated that impaired mineralization could be triggered by decreased osteoblast differentiation, increased cell death. Overall, these findings show that ADAM10 plays an essential role in craniofacial bone development. -- Highlights: •We firstly reported that ADAM10 was essentially involved in maxillofacial bone development. •ADAM10 cKO mice present craniofacial dysmorphia and bone defects. •Impaired osteoblast differentiation,proliferation and apoptosis underlie the bone deformity.

  5. Transcatheter embolization for high blood flow vascular malformations of oral maxillofacial region

    International Nuclear Information System (INIS)

    Sun Zengtao; Liu Zuoqin; Li Jijun; Tang Jun; Shang Jianqiang; Chen Jie

    2007-01-01

    Objective: To explore the treatment and efficiency of high blood flow vascular malformations of oral maxillofacial region with super-selective arterial embolization. Methods: 18 cases underwent angiography of the head and neck before treatment and then followed by super-selective catheterization with microcatheter to embolize the feeding vessels of the vascular malformations with PVA. 8 cases underwent surgical excision within 72 hours after the embolization and the other 10 cases passed through the arterial radical emboliztion treatment. Results: Technical success ratio reached 100% with no complications causing skin necrosis or incorrect arterial embolization else where in the skull. All 8 cases undergone preoperative embolization showed obviously less bleeding, easier removal of the mass and reduction of operation time. 10 cases with radical arterial embolization manifested reduction of swelling and improvement of organ function within 1 to 24 months after the procedure. 5 patients were cured with only once operation, 4 cases with twice operation and 1 with the thrice. Conclusions: Aterial embolization is a safe and effective method in the treatment of high blood flow vascular malformations of oral maxillofacial region. (authors)

  6. Resorbable triangular plate for osteosynthesis of fractures of the condylar neck.

    Science.gov (United States)

    Lauer, Günter; Pradel, Winnie; Leonhardt, Henry; Loukota, Richard; Eckelt, Uwe

    2010-10-01

    We describe a new design of resorbable plate for use in the treatment of fractures of the condylar neck, and report the outcome of initial treatment in two patients. Copyright © 2009 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

  7. Promoting mobility after hip fracture (ProMo: study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people

    Directory of Open Access Journals (Sweden)

    Sipilä Sarianna

    2011-12-01

    Full Text Available Abstract Background To cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture. Methods/Design Population-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women participated in this study and were randomly allocated into control (Standard Care and ProMo intervention groups on average 10 weeks post fracture and 6 weeks after discharged to home. Standard Care included written home exercise program with 5-7 exercises for lower limbs. Of all participants, 12 got a referral to physiotherapy. After discharged to home, only 50% adhered to Standard Care. None of the participants were followed-up for Standard Care or mobility recovery. ProMo-intervention included Standard Care and a year-long program including evaluation/modification of environmental hazards, guidance for safe walking, pain management, progressive home exercise program and physical activity counseling. Measurements included a comprehensive battery of laboratory tests and self-report on mobility limitation, disability, physical functional capacity and health as well as assessments for the key prerequisites for mobility, disability and functional capacity. All assessments were performed blinded at the research laboratory. No significant differences were observed between intervention and control groups in any of the demographic variables. Discussion Ten weeks post hip fracture only half of the participants were compliant to Standard Care. No follow-up for Standard Care or

  8. Concern and risk perception of osteoporosis and fracture among post-menopausal Australian women: results from the Global Longitudinal Study of Osteoporosis in Women (GLOW) cohort.

    Science.gov (United States)

    Barcenilla-Wong, A L; Chen, J S; March, L M

    2013-01-01

    The purpose of this study is to identify factors associated with concern and perception of risks of osteoporosis and osteoporotic fractures and determine whether bone mineral density (BMD) testing influenced concern and risk perception. Study subjects (n = 1,082, age 55-94 years) were female Australian participants of the Global Longitudinal Study of Osteoporosis in Women (GLOW). Self-administered questionnaires were sent annually from 2007 to 2010. Study outcomes included 'concern about osteoporosis', 'perception of getting osteoporosis' and 'perception of fracture risk' compared to similar aged women. The closest post-BMD testing or baseline questionnaires were used for women with and without BMD testing, respectively. Multinomial logistic regression was used for the analysis. BMD testing, prior fracture after age 45, younger age and lower self-reported general health were significantly associated with being 'very' or 'somewhat concerned' about osteoporosis and having a 'much higher' or 'little higher' risk perception of osteoporosis and fractures. A poorer BMD result was associated with higher concern and higher risk perceptions. The presence of comorbidities, having ≥2 falls in the preceding year and maternal osteoporosis were associated with higher concern. Maternal osteoporosis, presence of comorbidities, weight loss of ≥5 kg in the preceding year and low body mass index were associated with higher perceptions of osteoporosis risk. Women's concern and risk perception of osteoporosis and osteoporotic fractures were reasonably well founded. However, increasing age, height loss, smoking and drinking were not associated with concern and perception despite being known osteoporosis risk factors. These factors should be considered in planning for education and awareness raising programmes.

  9. An evaluation of the usefulness of consensus definitions of sarcopenia in older men: results from the observational Osteoporotic Fractures in Men (MrOS) cohort study

    Science.gov (United States)

    Cawthon, Peggy M; Blackwell, Terri L; Cauley, Jane; Kado, Deborah M; Barrett-Connor, Elizabeth; Lee, Christine G; Hoffman, Andrew R; Nevitt, Michael M; Stefanick, Marcia L; Lane, Nancy E; Ensrud, Kristine E; Cummings, Steven R; Orwoll, Eric S

    2016-01-01

    Background Recently, several consensus definitions for sarcopenia have been developed. Objective To evaluate the associations and discriminative ability of definitions of sarcopenia against clinical outcomes. Design Osteoporotic Fractures in Men study Setting Six clinical centers Participants 5,934 community-dwelling men aged ≥65 yrs Measurements Sarcopenia definitions evaluated were: International Working Group (IWG), European Working Group for Sarcopenia in Older Persons (EWGSOP), Foundation for the NIH (FNIH) Sarcopenia, Baumgartner, and Newman. Recurrent falls were defined as ≥2 self-reported falls in the year after baseline (N=694, 11.9%). Incident hip fractures (N=207, 3.5 %) and deaths (N=2003, 34.1%) were confirmed by central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and again 4.6 years later. Logistic regression or proportional hazards models estimated associations between sarcopenia and falls, hip fractures or death. The discriminative ability of the sarcopenia definitions (compared to referent models) for these outcomes was evaluated with areas under the receiver operator curve (AUCs) or C-statistics. Referent models included age alone for falls, function limitations and mortality, and age and BMD for hip fractures. Results The association between sarcopenia by the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with increased mortality risk. However, none of the definitions materially changed discrimination based on AUC and C-statistic when compared to referent models (change ≤1% in all models). Conclusions Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men. PMID:26502831

  10. Results of two years of water training on jump height in postmenopausal women with moderate hip risk fracture

    Directory of Open Access Journals (Sweden)

    María Carrasco Poyatos

    2010-01-01

    Full Text Available The aim of the present study was to investigate the effect of a water-based calisthenics and resistance program on jump height in postmenopausal women with moderate hip risk fracture. 39 women were divided into three groups: swimming group (GN; n = 17, calisthenics and resistance group (GIR; n = 14, and control group (GC; n = 8. Body composition test included body mass index (IMC and waist to hip ratio (ICC. Jump height was assessed by a countermovement jump (CMJ. GN showed a significant (p<0.05 decrease in ICC (5.81%. GIR showed a significant decrease in IMC (3.65% and a significant increase in CMJ (15.5%. Two years of water-based calisthenics and resistance training can offer significant benefits in jump height in postmenopausal women with moderate hip risk fracture. Both exercise programs can also improve body composition.

  11. Digital x-ray radiogrammetry identifies women at risk of osteoporotic fracture: results from a prospective study

    DEFF Research Database (Denmark)

    Bach-Mortensen, Pernille; Hyldstrup, Lars; Appleyard, Merete

    2006-01-01

    affecting DXR bone mineral density (BMD) in this cohort. The study is based on data from a subgroup of women participating in the third Copenhagen City Heart Study and additional data from a questionnaire obtained in 1999. The mean follow-up time was 6.1 years. During the observation period, 245 women...... later osteoporotic fracture and seems to provide meaningful information on bone mass in epidemiological studies, where DXA measurements are not available....

  12. Assessment of online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS): a strategic study.

    Science.gov (United States)

    Abu-Serriah, M; Wong, L; Dhariwal, D; Banks, R J

    2014-02-01

    The Internet is a powerful method of acquiring and sharing information. In marketing and business, online visibility is vital for publicity and the reputation of an organisation. To our knowledge, the importance of such visibility in medicine in general, and in Oral and Maxillofacial Surgery (OMFS) services in the UK, has not previously been investigated. We aimed to provide a better understanding of the way that patients use the Internet by asking 450 patients to complete a questionnaire when they attended outpatient OMFS departments at 2 centres. We also assessed the online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS) and investigated the correlation between the strength of online visibility and professional reputation. Results from the self-administered, anonymous, validated questionnaires showed that 82% of patients agreed that the Internet was a powerful source of information, and two-thirds associated online visibility with a good reputation. However, the perceived online visibility of the BAOMS was poor (2%). This study mirrors findings in business publications, and confirms the link between online visibility and professional reputation. It also shows that there is a gap between patients' perceptions and the level of uptake of professional resources. We propose various strategies to bridge this gap and to promote the online visibility and professional reputation of the BAOMS and of OMFS services in the UK. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. [Treatment of proximal humeral fractures by reverse shoulder arthroplasty: mid-term evaluation of functional results and Notching].

    Science.gov (United States)

    Hernández-Elena, J; de la Red-Gallego, M Á; Garcés-Zarzalejo, C; Pascual-Carra, M A; Pérez-Aguilar, M D; Rodríguez-López, T; Alfonso-Fernández, A; Pérez-Núñez, M I

    2015-01-01

    An analysis was made on relationship between Notching and functional and radiographic parameters after treatment of acute proximal humeral fractures with reverse total shoulder arthroplasty. A retrospective evaluation was performed on 37 patients with acute proximal humeral fracture treated by reversed shoulder arthroplasty. The mean follow-up was 24 months. Range of motion, intraoperative and postoperative complications were recorded. Nerot's classification was used to evaluate Notching. Patient satisfaction was evaluated with the Constant Score (CS). Statistical analysis was performed to evaluate the relationship between Notching and glenosphere position, or functional outcomes. Mean range of elevation, abduction, external and internal rotation were 106.22°, 104.46°, 46.08° and 40.27°, respectively. Mean CS was 63. Notching was present at 12 months in 29% of patients. Statistical analysis showed significance differences between age and CS, age and notching development, and tilt with notching. No statistical significance differences were found between elevation, abduction, internal and external rotation and CS either with scapular or glenosphere-neck angle. Reverse shoulder arthroplasty is a valuable option for acute humeral fractures in patients with osteoporosis and cuff-tear arthropathy. It leads to early pain relief and shoulder motion. Nevertheless, it is not exempt from complications, and long-term studies are needed to determine the importance of notching. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  14. Emergency Closed Reduction of a C4/5 Fracture Dislocation with Complete Paraplegia Resulting in Profound Neurologic Recovery

    Directory of Open Access Journals (Sweden)

    Christian W. Müller

    2013-01-01

    Full Text Available Introduction. Cervical spinal cord injuries due to traumatic fractures are associated with persistent neurological deficits. Although clinical evidence is weak, early decompression, defined as <24–72 h, has been frequently proposed. Animal studies show better outcomes after early decompression within one hour or less, which can hardly ever be achieved in clinical practice. Case Presentation. A 37-year-old patient was hospitalized after being hit by a shying horse. After diagnosis of C4/5 fracture dislocation and complete paraplegia, she was intubated and sedated with deep relaxation. Emergency reduction was performed at approximately 120 minutes after trauma. Subsequently, a standard anterior decompression, discectomy, and fusion were carried out. She was then transferred to a specialized rehabilitation hospital. Her neurologic function improved from AIS grade A on admission to grade B postoperatively and grade D after four months of rehabilitation. One year after the accident, she was ambulatory without walking aids and restarted horse riding. Discussion and Conclusion. Rarely in clinical practice, decompression of the spine canal can be performed as early as in this case. This case highlights the potential benefit of utmost early reduction in cervical fracture dislocations with compression of the spinal cord.

  15. Mechanics of Hydraulic Fractures

    Science.gov (United States)

    Detournay, Emmanuel

    2016-01-01

    Hydraulic fractures represent a particular class of tensile fractures that propagate in solid media under pre-existing compressive stresses as a result of internal pressurization by an injected viscous fluid. The main application of engineered hydraulic fractures is the stimulation of oil and gas wells to increase production. Several physical processes affect the propagation of these fractures, including the flow of viscous fluid, creation of solid surfaces, and leak-off of fracturing fluid. The interplay and the competition between these processes lead to multiple length scales and timescales in the system, which reveal the shifting influence of the far-field stress, viscous dissipation, fracture energy, and leak-off as the fracture propagates.

  16. Mandibular Condyle Fractures and Treatment Modalities

    Directory of Open Access Journals (Sweden)

    Halil ibrahim Kisa

    2014-08-01

    Full Text Available Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction and fixation methods. In the present article, controversial issues related to mandibular condyle fractures were reviewed under the light of current literature. In conclusion, the simplest way that can be done with the least risk of complication should be chosen during treatment planning. In addition, current adjunctive treatment methods accelerating healing of fracture should be considered. [Archives Medical Review Journal 2014; 23(4.000: 658-671

  17. Evaluation of surgical treatment in mandibular condyle fractures.

    Science.gov (United States)

    Vesnaver, Aleš; Ahčan, Uroš; Rozman, Janez

    2012-12-01

    In the past, fractures of the mandibular condylar process were, as a rule, treated conservatively. At the Department of Maxillofacial and Oral Surgery of the University Medical Centre Ljubljana, Slovenia, our doctrine was changed in 2002 on the basis of preliminary results and reports in the literature, and these fractures were started to be treated surgically by open reduction and internal fixation with miniplates and screws, which led to good results and a shorter rehabilitation period. The goal of this study was to determine the safety and efficiency of surgical treatment, as well as to compare long-term results of surgical and conservative treatment, as objectively as possible. Two groups of patients, which had all sustained a unilateral, extra-articular mandibular condyle fracture, were compared. In the test group, there were 42 surgically treated patients, and in the control group, 20 conservatively treated patients. Clinical parameters and X-ray images were assessed in both groups and compared by the two tailed Student t test, and in case of attributive variables by the χ(2) test. Within the surgically treated group, postoperative and intraoperative complications were noted: temporary facial nerve palsy, development of a parotid salivary fistula, disturbance of auricle sensibility due to injury of the greater auricular nerve, miniplate fracture, as well as intraoperative bleeding, postoperative haematoma formation, infection, reoperation due to fragment malposition and other complications. Postoperative scars were also assessed. Statistically significant differences between the surgically and conservatively treated patients were found when comparing clinical parameters as well as X-ray images, the results being better in the surgically treated group. Complications of surgical treatment were also noted, the most important among them temporary paresis of facial nerve branches, which occurred in 10 patients (24%). Plate fractures occurred in five patients (12

  18. Intimate partner violence against women, circumstances of aggressions and oral-maxillofacial traumas: A medical-legal and forensic approach.

    Science.gov (United States)

    de Macedo Bernardino, Ítalo; Santos, Luzia Michelle; Ferreira, Alysson Vinicius Porto; de Almeida Lima, Tomás Lucio Marques; da Nóbrega, Lorena Marques; d'Avila, Sérgio

    2018-03-01

    Intimate partner violence (IPV) is a serious public health problem that frequently results in oral-maxillofacial traumas, generating high social and economic costs. The aim of this study was to describe the profile of women victims of IPV and determine the pattern of oral-maxillofacial traumas, according to a medical-legal and forensic perspective. An exploratory study of 1361 suspected cases of women victims of IPV was carried out based on database of an Institute of Legal Medicine and Forensic Dentistry of Northeastern Brazil during a period of 4 years. Medico-legal and social records of victims were searched for information related to sociodemographic data, circumstances of aggressions and trauma patterns. Descriptive and multivariate statistics and Multiple Correspondence Analysis (MCA) were performed. Almost half of victims exhibited some oral-maxillofacial trauma resulting from IPV (45.8%). Lesions affecting more than one third of the face (41.3%), especially in soft tissues (96.1%) were the most common. Based on the MCA results, two distinct victimization profiles (P1 and P2) have been identified. P1 was mainly characterized by women aged less than 28 years, living in the urban area, with higher education and working. They were assaulted using physical force in community settings perpetrated by former partner or ex-boyfriend during the night and weekends, resulting in oral-maxillofacial traumas. P2 was mainly composed of women aged over 28 years, living in the suburban or rural areas, with low schooling and who did not work. They were assaulted by firearm or weapon in their own home, perpetrated by their partner or boyfriend during the day and weekdays, resulting in trauma to other body parts. Oral and maxillofacial traumas are very common among women victims of IPV who searched for medical-legal service. In this context, forensic dentists can play a key role during the diagnostic process and should always work together with medical, biochemical and

  19. Trends in maxillofacial cone-beam computed tomography usage

    International Nuclear Information System (INIS)

    Arnheiter, C.; Scarfe, W.C.; Farman, A.G.

    2006-01-01

    Cone-beam computed tomography (CBCT) is making inroads into dental practice worldwide, both in terms of adding the third dimension to diagnosis, and also in terms of enabling image-guided treatment strategies. This article reports trends in the early referral pattern of patients to a CBCT facility in the United States. With institutional review board approval, a retrospective study was made of sequential CBCT radiographic reports made by a specialist oral and maxillofacial radiology service from May 2004 through January 2006 (n=329). Demographic and referral data were extracted from the reports. Descriptive statistics identified referral patterns, trends, and indications for CBCT. Comparisons were made with the Rogers' Product Innovation Adoption curve. The mean age of referred patients was 45±21 years, and there was a predominance of women (62%). Oral and maxillofacial surgeons (51%) and periodontology specialists (17%) made most patient referrals. The listed reasons for CBCT referrals were dental implant planning (40%), suspected surgical pathology (24%), and temporomandibular joint analysis (16%). Other uses included planning extraction of impacted teeth and orthodontic assessment. Over the period of the study, the numbers of pathology diagnosis cases remained relatively constant, while adoption of CBCT for dental implant planning followed closely the first three stages of the Rogers' Product Innovation Adoption curve. Alongside this increased CBCT adoption for dental implant planning, there was an associated increased demand for use of Digital Imaging and Communications in Medicine (DICOM) image sets for laser modeling and provision of surgical guides. Diagnosis will probably remain a constant source of referral for CBCT examination by oral and maxillofacial radiologists. Nevertheless, more specialized applications such as laser-guided model fabrication and image-guided surgery are expanding indications for CBCT referrals by dentists and also expanding the

  20. Estudio retrospectivo de causas de trauma maxilofacial en Pasto, Colombia de 2001 a 2006 A retrospective study of maxillofacial trauma causes in Pasto, Colombia from 2001 to 2006

    Directory of Open Access Journals (Sweden)

    Ana Cristina Mafla

    2009-08-01

    Legal y Ciencias Forenses Seccional Nariño - Putumayo" were evaluated. Variables such as year, gender, age, anatomical distribution of fractures were included. Descriptive analyses were used to determine percentages and confidence interval values. Results: The most common causes were violence, which accounted for 350 (49.9%. Motorcycle accidents in 104 (14.8%, car crashes in 93 (13.3 %, and falls in 66 (9.4% cases. There was a substantial increase of violence as a cause in 2003 to 2004. 0 to 6 year-old children were related to falls, whilst 15 to 24 year-old youngsters were related to violence, as well as motorcycle and car accidents. Violence led to nasal fractures, falls to nasal-orbital-ethmoid injuries, and motorcycle and car accidents to politraumatism and panfacial fractures. Conclusions: Since violence, motorcycle, and car accidents were the major causes of maxillofacial injuries in youth, the public policies should be addressed to that Salud UIS 2009; 41: 142-148

  1. Analysis of the drilling sound in maxillo-facial surgery

    DEFF Research Database (Denmark)

    Hoffmann, Pablo F.; Gosselin, Florian; Taha, Farid

    2009-01-01

    Auditory feedback can have a great potential in surgical simulators that aim at training skills associated to the correct interpretation of acoustic information. Here, we present a preliminary analysis of the sound that is produced by the drilling procedure in a maxillo-facial surgery when...... performed by expert surgeons. The motivation of this work is to find relevant acoustic parameters that allow for an efficient synthesis method of the drilling sound and to set the basis of the audio component in the simulator so that expert surgical drilling can effectively be conveyed to users...

  2. Maxillofacial prosthetic rehalibilation of the oral cancer patient

    International Nuclear Information System (INIS)

    Wolfaardt, J.F.; Monteith, B.D.

    1982-01-01

    The victim of orofacial cancer is frequently subjected to severe morphological and functional disturbance: a condition which the maxillofacial prosthetist can do much to alleviate through the use of various prosthetic devices. The successful rehabilitation of these patients, however, is often compromised by the presence of psychosocial and other problems, the solution of which extends beyond the limits of a single clinical discipline. The modern approach to orofacial cancer, therefore, is organised within the context of interdisciplinary co-operation: each phase of patient management being planed and executed according to the co-ordinated efforts of the various members of a head and neck cancer team

  3. Osteoporotic fractures in older adults

    OpenAIRE

    Colón-Emeric, Cathleen S.; Saag, Kenneth G.

    2006-01-01

    Osteoporotic fractures are emerging as a major public health problem in the aging population. Fractures result in increased morbidity, mortality and health expenditures. This article reviews current evidence for the management of common issues following osteoporotic fractures in older adults including: (1) thromboembolism prevention; (2) delirium prevention; (3) pain management; (4) rehabilitation; (5) assessing the cause of fracture; and (6) prevention of subsequent fractures. Areas for prac...

  4. Management of pediatric mandibular fracture using orthodontic vacuum-formed thermoplastic splint: A case report and review of literature.

    Science.gov (United States)

    Sanu, O O; Ayodele, Aos; Akeredolu, M O

    2017-05-01

    Fractures of the mandible are relatively less frequent in children when compared to adults. The anatomic features of children are protected. Children have a higher adaptation to maxillofacial fractures compared to adults. Treatment principles of mandibular fractures in children differ from that of adults due to concerns regarding mandibular growth and the developing dentition. A case of a 6-year-old boy with fractured mandibular symphysis managed by closed reduction using a vacuum formed thermoplastic splint and circummandibular wiring is presented. This article also provides a review of the literature regarding the management of mandibular fracture in young children.

  5. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

    Directory of Open Access Journals (Sweden)

    Serhat Atilgan

    2010-02-01

    Full Text Available OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70% males and 162 (30% females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65% in young patients and traffic accidents (38% in adults. The most common fracture sites were the symphysis (35% and condyle (36% in young patients, and the symphysis in adults (36%. Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67% and adult (39% patients, and 43% of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

  6. Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle.

    Science.gov (United States)

    Aquilina, Peter; Chamoli, Uphar; Parr, William C H; Clausen, Philip D; Wroe, Stephen

    2013-06-01

    The most stable pattern of internal fixation for fractures of the mandibular condyle is a matter for ongoing discussion. In this study we investigated the stability of three commonly used patterns of plate fixation, and constructed finite element models of a simulated mandibular condylar fracture. The completed models were heterogeneous in the distribution of bony material properties, contained about 1.2 million elements, and incorporated simulated jaw-adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. This model was considerably larger and more complex than previous finite element models that have been used to analyse the biomechanical behaviour of differing plating techniques. The use of two parallel 2.0 titanium miniplates gave a more stable configuration with lower mean element stresses and displacements over the use of a single miniplate. In addition, a parallel orientation of two miniplates resulted in lower stresses and displacements than did the use of two miniplates in an offset pattern. The use of two parallel titanium plates resulted in a superior biomechanical result as defined by mean element stresses and relative movement between the fractured fragments in these finite element models. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Low burnout risk and high engagement levels among oral and maxillofacial surgeons

    NARCIS (Netherlands)

    Gorter, R.C.; Jacobs, B.L.T.H.; Allard, R.H.B.

    2012-01-01

    Little is known about the well-being of oral and maxillofacial surgeons. The aim of this study was to measure the levels of burnout risk and the demanding work aspects of Dutch oral and maxillofacial surgeons, as well as the levels of positive work engagement and stimulating aspects of the work

  8. Pattern of Assault-induced Oral and Maxillofacial Injuries in Ado ...

    African Journals Online (AJOL)

    The etiology of maxillofacial injuries varies from one country to another and even within the same country depending on the prevailing socioeconomic, cultural, and environmental factors.[1-4] Road traffic crashes (RTC), assaults, sports, falls occupational hazards are documented causes of oral and maxillofacial injuries.

  9. Accuracy of secondary maxillofacial reconstruction with prefabricated fibula grafts using 3D planning and guided reconstruction

    NARCIS (Netherlands)

    Schepers, Rutger H.; Kraeima, Joep; Vissink, Arjan; Lahoda, Lars U.; Roodenburg, Jan L. N.; Reintsema, Harry; Raghoebar, Gerry M.; Witjes, Max J.

    Background: We compared the pre-operative 3D-surgical plan with the surgical outcome of complex two-stage secondary reconstruction of maxillofacial defects using inserted implants in the prefabricated fibula graft. Methods: Eleven reconstructions of maxillofacial defects with prefabricated fibulas

  10. How evolution of the nailing system improves results and reduces orthopedic complications: more than 2000 cases of trochanteric fractures treated with the Gamma Nail System.

    Science.gov (United States)

    Pascarella, R; Fantasia, R; Maresca, A; Bettuzzi, C; Amendola, L; Violini, S; Cuoghi, F; Sangiovanni, P; Cerbasi, S; Boriani, S; Tigani, D S

    2016-04-01

    The incidence of trochanteric fractures has increased significantly during the last few decades, especially in elderly patients with osteoporosis. The dynamic/sliding hip screw and the cephalomedullary nail are the most commonly used fixation methods to treat trochanteric fractures. The improvements in the Gamma Nail System (GNS) associated with a correct surgical technique reduced the postoperative orthopedic complications. The purpose of this study was to compare the results of the different Gamma Nails. The present study is a retrospective analysis of 2144 patients treated with GNS between January 1997 and December 2011 for trochanteric fractures, classified according to AO classification method. The patients were divided into three groups according to the nailing system: 525 were treated with Standard Gamma Nail (SGN), 422 with Trochanteric Gamma Nail (TGN) and 1197 with Gamma3 Nail. The overall incidence of intra-operative complications was 1.21 %; the incidence of intra-operative complications for each group was 1.71 % for SGN group, 0.47 % for TGN group and 1.25 % for Gamma3 Nail group. The overall incidence of postoperative complications was 5.48 %, and the incidence for each group was 10.73 % for SGN group, 9.92 % for TGN group and 2.92 % for Gamma3 Nail group. The GNS is a safe device with a low rate of intra-operative complications. The evolution of this nail system reduces postoperative complications, thus improving the results at follow-up and confirming that the Gamma3 Nail is a safe and predictable device to fix trochanteric fracture.

  11. Burnout syndrome in oral and maxillofacial surgeons: a critical analysis.

    Science.gov (United States)

    Porto, G G; Carneiro, S C; Vasconcelos, B C; Nascimento, M M; Leal, J L F

    2014-07-01

    The aim of this study was to determine the prevalence of burnout syndrome among Brazilian oral and maxillofacial surgeons and its relationship with socio-demographic, clinical, and habit variables. The sample of this study comprised 116 surgeons. The syndrome was quantified using the Maslach Burnout Inventory (General Survey), which defines burnout as the triad of high emotional exhaustion, high depersonalization, and low personal accomplishment. The criteria of Grunfeld et al. were used to evaluate the presence of the syndrome (17.2%). No significant differences between the surgeons diagnosed with and without the syndrome were observed according to age (P=0.804), sex (P=0.197), marital status (P=0.238), number of children (P=0.336), years of professional experience (P=0.102), patients attended per day (P=0.735), hours worked per week (P=0.350), use of alcohol (P=0.148), sports practice (P=0.243), hobbies (P=0.161), or vacation period per year (P=0.215). Significant differences occurred in the variables sex in the emotional exhaustion subscale (P=0.002) and use or not of alcohol in the personal accomplishment subscale (P=0.035). Burnout syndrome among Brazilian surgeons is average, showing a low personal accomplishment. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Maxillofacial trauma patient: coping with the difficult airway

    Directory of Open Access Journals (Sweden)

    Barak Michal

    2009-05-01

    Full Text Available Abstract Establishing a secure airway in a trauma patient is one of the primary essentials of treatment. Any flaw in airway management may lead to grave morbidity and mortality. Maxillofacial trauma presents a complex problem with regard to the patient's airway. By definition, the injury compromises the patient's airway and it is, therefore, must be protected. In most cases, the patient undergoes surgery for maxillofacial trauma or for other, more severe, life-threatening injuries, and securing the airway is the first step in the introduction of general anaesthesia. In such patients, we anticipate difficult endotracheal intubation and, often, also difficult mask ventilation. In addition, the patient is usually regarded as having a "full stomach" and has not been cleared of a C-spine injury, which may complicate airway management furthermore. The time available to accomplish the task is short and the patient's condition may deteriorate rapidly. Both decision-making and performance are impaired in such circumstances. In this review, we discuss the complexity of the situation and present a treatment approach.

  13. Laser tumor treatment in oral and maxillofacial surgery

    Science.gov (United States)

    Neukam, F. W.; Stelzle, F.

    Cancer treatment is an integral part of oral and maxillofacial surgery. Oral cancer in particular is a highly prevalent neoplasm. Standard treatment for most of the tumors is radical surgery combined with stage-based neo-/adjuvant therapy. Laser surgery has become a reliable treatment option for oral cancer as well as for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. The use of lasers in tumor surgery has several advantages: remote application, precise cutting, hemostasis, low cicatrization, reduced postoperative pain and swelling, can be combined with endoscopic, microscopic and robotic surgery. However, laser surgery has some major drawbacks: In contrast to conventional incisions with scalpels, the surgeon gets no feedback during laser ablation. There is no depth sensation and no tissue specificity with a laser incision, increasing the risk of iatrogenic damage to nerves and major blood vessels. Future prospects may solve these problems by means of an optical feedback mechanism that provides a tissue-specific laser ablation. First attempts have been made to perform remote optical tissue differentiation. Additionally, real time optical tumor detection during laser surgery would allow for a very precise and straight forward cancer resection, enhancing organ preservation and hence the quality of life for patients with cancer in the head and neck region.

  14. The use of optical coherence tomography in maxillofacial surgery

    Science.gov (United States)

    Al-Obaidi, Mohammed; Tandon, Rahul; Tiwana, Paul

    2015-02-01

    The ever-evolving medical field continues to trend toward less invasive approaches to the diagnosis and treatment of pathological conditions. Basic sciences research has allowed for improved technologies that are translated to the clinical sciences. Similarly, advancements in imaging modalities continue to improve and their applications become more varied. As such, surgeons and pathologists are able to depend on smaller samples for tissue diagnosis of pathological disease, where once large sections of tissue were needed. Optical coherence tomography (OCT), a high-resolution imaging technique, has been used extensively in different medical fields to improve diagnostic yield. Its use in dental fields, particularly in oral and maxillofacial surgery, remains limited. Our goal is to assess the use of OCT for improving soft tissue analysis and diagnosis, particularly for its applications in the field of oral and maxillofacial surgery. Optical coherence tomography is a modality that uses an optical signal using safe near-infrared light which is reflected off the sub-surface structures. This allows for high-resolution cross-sectional images of the tissue morphology to be obtained. Ophthalmologists have been using OCT to obtain images of the retina to assess for age-related macular degeneration. More recently, OCT has been used by Interventional Cardiology to image coronary arteries, and assess plaque thickness and morphology. This technology is now being investigated in several medical fields as a form of optical biopsy, providing in situ images with high-resolution morphology of tissues. We are particularly interested in its use on epithelial tissues, and therefore performed a literature review on the use of OCT for assessing epithelium. Evaluation of histologically-diagnosed actinic keratosis, for example, was found to correlate well with the imaging discrepancies found on OCT; and the in vivo assessment of atypical keratinocytes was firmly established. Additionally

  15. Closed treatment of unilateral mandibular condyle fractures in adults: a systematic review.

    Science.gov (United States)

    Rozeboom, A V J; Dubois, L; Bos, R R M; Spijker, R; de Lange, J

    2017-04-01

    Of all mandibular fractures, 25-35% are condylar. Many studies have focused on whether to treat such fractures via open or closed modalities. A uniform protocol for closed treatment is lacking, but such a protocol could ensure good clinical practice. The aims of this systematic review were to provide an overview of the published studies exclusively pertaining to closed treatment and to summarize the existing modalities for closed treatment and their clinical outcomes. Sixteen studies were selected for detailed analysis. The treatments given were highly variable, ranging from doing nothing to applying maxillomandibular fixation with stainless steel wires. The results of the different studies and the treatment modalities used were difficult to interpret; however no clear differences in the outcome measures were seen between the treatment modalities applied. Complications encountered after closed treatment included malocclusion, limited mouth opening, reduced range of motion, and persistent pain. Due to the heterogeneity between groups, high loss-to-follow-up, poor descriptions of the treatments given, and variability in outcome measurement methods, no clear associations between adverse outcomes and the treatments applied could be determined. This review suggests that due to the high level of methodological variability in the relevant studies published to date, there are currently no uniform standards for the closed treatment of condylar fractures that can be expected to yield good clinical results. The establishment of such standards could potentially improve treatment outcomes. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Model of T-Type Fracture in Coal Fracturing and Analysis of Influence Factors of Fracture Morphology

    Directory of Open Access Journals (Sweden)

    Yuwei Li

    2018-05-01

    Full Text Available Special T-type fractures can be formed when coal is hydraulically fractured and there is currently no relevant theoretical model to calculate and describe them. This paper first establishes the height calculation model of vertical fractures in multi-layered formations and deduces the stress intensity factor (SIF at the upper and lower sides of the fracture in the process of vertical fracture extension. Combined with the fracture tip stress analysis method of fracture mechanics theory, the horizontal bedding is taken into account for tensile and shear failure, and the critical mechanical conditions for the formation of horizontal fracture in coal are obtained. Finally, the model of T-type fracture in coal fracturing is established, and it is verified by fracturing simulation experiments. The model calculation result shows that the increase of vertical fracture height facilitates the increase of horizontal fracture length. The fracture toughness of coal has a significant influence on the length of horizontal fracture and there is a threshold. When the fracture toughness is less than the threshold, the length of horizontal fracture remains unchanged, otherwise, the length of horizontal fracture increases rapidly with the increase of fracture toughness. When the shear strength of the interface between the coalbed and the interlayer increases, the length of the horizontal fracture of the T-type fracture rapidly decreases.

  17. Medical Complications Predict Cognitive Decline in Nondemented Hip Fracture Patients-Results of a Prospective Observational Study.

    Science.gov (United States)

    Hack, Juliana; Eschbach, Daphne; Aigner, Rene; Oberkircher, Ludwig; Ruchholtz, Steffen; Bliemel, Christopher; Buecking, Benjamin

    2018-03-01

    The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.

  18. What Surgical Education the Speciality Offers? Perception of Role of Oral and Maxillofacial Surgery by 1200 Healthcare Professionals, Students and the General Public in Hyderabad, India.

    Science.gov (United States)

    Vadepally, Ashwant Kumar; Sinha, Ramen

    2018-06-01

    To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 ( p  oral and maxillofacial surgery was found to be 50.2%. The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.

  19. [Correlations of plasma concentrations of β-amyloid peptide and S-100β with postoperative cognitive dysfunction in patients undergoing oral and maxillofacial cancer surgery].

    Science.gov (United States)

    Liang, Bing; Sun, Yuan-Qing; Jiang, Jue; Xu, Hui

    2016-12-01

    To evaluate the changes of perioperative plasma concentrations of Aβ 1-40 and S-100β to determine the relationship with postoperative cognitive dysfunction in elderly patients undergoing oral and maxillofacial cancer surgeries. One hundred and fifteen patients aged at least 60 years undergoing oral and maxillofacial tumor resection were investigated between May 2014 to December 2014.Neuropsychological tests for detecting postoperative cognitive dysfunction(POCD) were performed one day before surgery and 7 days postoperatively. According to the results of neuropsychological tests on day 7, patients were divided into POCD group and non-POCD group.Plasma values of Aβ 1-40 and S-100β were determined with enzyme linked immunosorbent assay (ELISA) before anesthesia induction, 24 h and 7 days after surgery. The data were analyzed using SPSS 19.0 software package. According to the definition, POCD was present in 37 of 115 (32.3%) patients 1 week after surgery. Compared with pre-anesthesia, S-100β levels in POCD group were significantly increased (Psurgery (Poral and maxillofacial surgeries with general anesthesia. The increasing levels of Aβ 1-40 , S-100β may be associated with the occurence of POCD. Patients with long-lasting operation and high concentrations of Aβ 1-40 and S-100β after surgeries were at a higher risk of POCD. The clinical values of Aβ 1-40 and S-100 as predictive measurements of POCD after oral and maxillofacial cancer surgery appear to be reasonable.

  20. Weight-bearing recommendations after operative fracture treatment-fact or fiction? Gait results with and feasibility of a dynamic, continuous pedobarography insole.

    Science.gov (United States)

    Braun, Benedikt J; Veith, Nils T; Rollmann, Mika; Orth, Marcel; Fritz, Tobias; Herath, Steven C; Holstein, Jörg H; Pohlemann, Tim

    2017-08-01

    Rehabilitation after lower-extremity fractures is based on the physicians' recommendation for non-, partial-, or full weight-bearing. Clinical studies rely on this assumption, but continuous compliance or objective loading rates are unknown. The purpose of this study was to determine the compliance to weight-bearing recommendations by introducing a novel, pedobarography system continuously registering postoperative ground forces into ankle, tibial shaft and proximal femur fracture aftercare and test its feasibility for this purpose. In this prospective, observational study, a continuously measuring pedobarography insole was placed in the patients shoe during the immediate post-operative aftercare after ankle, tibial shaft and intertrochanteric femur fractures. Weight-bearing was ordered as per the institutional standard and controlled by physical therapy. The insole was retrieved after a maximum of six weeks (28 days [range 5-42 days]). Non-compliance was defined as a failure to maintain, or reach the ordered weight-bearing within 30%. Overall 30 patients were included in the study. Fourteen (47%) of the patients were compliant to the weight-bearing recommendations. Within two weeks after surgery patients deviated from the recommendation by over 50%. Sex, age and weight did not influence the performance (p > 0.05). Ankle fracture patients (partial weight-bearing) showed a significantly increased deviation from the recommendation (p = 0.01). Our study results show that, despite physical therapy training, weight-bearing compliance to recommended limits was low. Adherence to the partial weight-bearing task was further decreased over time. Uncontrolled weight-bearing recommendations should thus be viewed with caution and carefully considered as fiction. The presented insole is feasible to determine weight bearing continuously, could immediately help define real-time patient behaviour and establish realistic, individual weight-bearing recommendations.

  1. Automated classification of maxillofacial cysts in cone beam CT images using contourlet transformation and Spherical Harmonics.

    Science.gov (United States)

    Abdolali, Fatemeh; Zoroofi, Reza Aghaeizadeh; Otake, Yoshito; Sato, Yoshinobu

    2017-02-01

    Accurate detection of maxillofacial cysts is an essential step for diagnosis, monitoring and planning therapeutic intervention. Cysts can be of various sizes and shapes and existing detection methods lead to poor results. Customizing automatic detection systems to gain sufficient accuracy in clinical practice is highly challenging. For this purpose, integrating the engineering knowledge in efficient feature extraction is essential. This paper presents a novel framework for maxillofacial cysts detection. A hybrid methodology based on surface and texture information is introduced. The proposed approach consists of three main steps as follows: At first, each cystic lesion is segmented with high accuracy. Then, in the second and third steps, feature extraction and classification are performed. Contourlet and SPHARM coefficients are utilized as texture and shape features which are fed into the classifier. Two different classifiers are used in this study, i.e. support vector machine and sparse discriminant analysis. Generally SPHARM coefficients are estimated by the iterative residual fitting (IRF) algorithm which is based on stepwise regression method. In order to improve the accuracy of IRF estimation, a method based on extra orthogonalization is employed to reduce linear dependency. We have utilized a ground-truth dataset consisting of cone beam CT images of 96 patients, belonging to three maxillofacial cyst categories: radicular cyst, dentigerous cyst and keratocystic odontogenic tumor. Using orthogonalized SPHARM, residual sum of squares is decreased which leads to a more accurate estimation. Analysis of the results based on statistical measures such as specificity, sensitivity, positive predictive value and negative predictive value is reported. The classification rate of 96.48% is achieved using sparse discriminant analysis and orthogonalized SPHARM features. Classification accuracy at least improved by 8.94% with respect to conventional features. This study

  2. Oral Rehabilitation in a Patient with Major Maxillofacial Trauma: A Case Management

    Directory of Open Access Journals (Sweden)

    Elif Bahar Tuna

    2012-01-01

    Full Text Available Traumatic injuries may cause anatomic deficiencies in soft and hard tissues. These defects often result in the loss of attached mucosa and alveolar processes, which might reduce potential prosthesis support and require bone and skin grafting. As a result of major maxillofacial trauma, complete or partial avulsion of the palate may require extensive surgical and prosthodontic rehabilitation. The appropriate treatment for the maxillary defect demands a multidisciplinary approach by a team which consists of various fields of dentistry and medicine. The planning prostheses should replace not only missing teeth but also lost soft tissues and bone, and they should include the hard palate, residual alveolar ridges, and, in some instances, the soft palate. This paper describes the treatment procedures including plastic surgery operation procedures and prosthetic rehabilitation in a 19-year-old woman after her severe bicycle accident.

  3. Anesthetic and Surgical Management of a Bilateral Mandible Fracture in a Patient With Charcot-Marie-Tooth Disease: A Case Report.

    Science.gov (United States)

    Smith, Jeffrey D; Minkin, Patton; Lindsey, Sean; Bovino, Brian

    2015-10-01

    This report describes the case of a 74-year-old man who had been diagnosed with Charcot-Marie-Tooth disease as a child. Because the patient had serious motor and sensory neuropathy associated with his disease, special anesthetic and surgical recommendations had to be considered before he underwent general anesthesia to repair his mandibular fracture. Repair of the mandible was performed under general anesthesia with a nasal endotracheal tube and the use of the nondepolarizing muscle relaxant rocuronium. Open reduction and internal fixation through extraoral approaches were used to fixate the displaced right subcondylar and symphyseal fractures. A closed reduction approach using maxillary fixation screws and a mandibular arch bar with light elastic guidance was used to treat a nondisplaced fracture of the left mandibular ramus. Rigid fixation allowed for avoidance of a period of intermaxillary fixation. General anesthesia and muscle relaxant were administered without complication. Treatment of bilateral mandibular fractures with combined open and closed approaches resulted in restoration of premorbid occlusion and masticatory function. Repair of mandibular fractures under general anesthesia appears to be a safe procedure in patients with Charcot-Marie-Tooth disease when appropriate anesthetic and surgical methods are used. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Scaphoid fractures in children

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2014-01-01

    Full Text Available Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011. The outcome of the treatment of “acute” scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with “acute” fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of “acute” scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.

  5. Site investigation SFR. Fracture mineralogy and geochemistry of borehole sections sampled for groundwater chemistry and Eh. Results from boreholes KFR01, KFR08, KFR10, KFR19, KFR7A and KFR105

    Energy Technology Data Exchange (ETDEWEB)

    Sandstroem, Bjoern (WSP Sverige AB (Sweden)); Tullborg, Eva-Lena (Terralogica AB, Grabo (Sweden))

    2011-01-15

    This report is part of the complementary site investigations for the future expansion of SFR. The report presents the results obtained during a detailed mineralogical and geochemical study of fracture minerals in drill cores from borehole section sampled for groundwater chemistry and where downhole Eh measurements have been performed. The groundwater redox system comprises not only the water, but also the bedrock/fracture mineral system in contact with this water. It is thus important to gain knowledge of the solid phases in contact with the groundwater, i.e. the fracture minerals. The samples studied for mineralogy and geochemistry, here reported, were selected to represent the fracture surfaces in contact with the groundwater in the sampled borehole sections and will give input to the hydrogeochemical model (SFR SDM). The mineralogy was determined using SEM-EDS and XRD and the geochemistry of fracture filling material was analysed by ICP-AES and ICP-QMS. The most common fracture minerals in the samples are mixed layer clay (smectite-illite), illite, chlorite, calcite, quartz, adularia and albite. Other minerals identified in the borehole sections include laumontite, pyrite, barite, chalcopyrite, hematite, Fe-oxyhydroxide, muscovite, REE-carbonate, allanite, biotite, asphaltite, galena, sphalerite, arsenopyrite, uranium phosphate, uranium silicate, Y-Ca silicate, monazite, xenotime, harmotome and fluorite. There are no major differences between the fracture mineralogy of the investigated borehole sections from SFR and the fracture mineralogy of the Forsmark site investigation area. The four fracture mineral generations distinguished within the Forsmark site investigation are also found at SFR. However, some differences have been observed: 1) Barite and uranium minerals are more common in the SFR fractures, 2) clay minerals like mixed layer illite-smectite and illite dominates in contrast to Forsmark where corrensite is by far the most common clay mineral and, 3

  6. Site investigation SFR. Fracture mineralogy and geochemistry of borehole sections sampled for groundwater chemistry and Eh. Results from boreholes KFR01, KFR08, KFR10, KFR19, KFR7A and KFR105

    International Nuclear Information System (INIS)

    Sandstroem, Bjoern; Tullborg, Eva-Lena

    2011-01-01

    This report is part of the complementary site investigations for the future expansion of SFR. The report presents the results obtained during a detailed mineralogical and geochemical study of fracture minerals in drill cores from borehole section sampled for groundwater chemistry and where downhole Eh measurements have been performed. The groundwater redox system comprises not only the water, but also the bedrock/fracture mineral system in contact with this water. It is thus important to gain knowledge of the solid phases in contact with the groundwater, i.e. the fracture minerals. The samples studied for mineralogy and geochemistry, here reported, were selected to represent the fracture surfaces in contact with the groundwater in the sampled borehole sections and will give input to the hydrogeochemical model (SFR SDM). The mineralogy was determined using SEM-EDS and XRD and the geochemistry of fracture filling material was analysed by ICP-AES and ICP-QMS. The most common fracture minerals in the samples are mixed layer clay (smectite-illite), illite, chlorite, calcite, quartz, adularia and albite. Other minerals identified in the borehole sections include laumontite, pyrite, barite, chalcopyrite, hematite, Fe-oxyhydroxide, muscovite, REE-carbonate, allanite, biotite, asphaltite, galena, sphalerite, arsenopyrite, uranium phosphate, uranium silicate, Y-Ca silicate, monazite, xenotime, harmotome and fluorite. There are no major differences between the fracture mineralogy of the investigated borehole sections from SFR and the fracture mineralogy of the Forsmark site investigation area. The four fracture mineral generations distinguished within the Forsmark site investigation are also found at SFR. However, some differences have been observed: 1) Barite and uranium minerals are more common in the SFR fractures, 2) clay minerals like mixed layer illite-smectite and illite dominates in contrast to Forsmark where corrensite is by far the most common clay mineral and, 3

  7. Treatment of trochanteric fractures with the gamma3 nail - methodology and early results of a prospective consecutive monitored clinical case series.

    Science.gov (United States)

    A C, Unger; E, Wilde; B, Kienast; C, Jürgens; A P, Schulz

    2014-01-01

    There is only sparse data on clinical results and complications of the third-generation Gamma nailing system (Gamma3, Stryker). Therefore, we started a large multi-centre case series in 2008. The aim of this paper is to present the study design and early results of a single arm of a prospective, consecutive, monitored, post-market follow-up evaluation of Gamma3 nails. From September 2009 to January 2012, 154 consecutive patients with an average age of 80 ± 1.43 years (50-99 years) and a trochanteric femoral fracture were included in the local arm of the trial. All patients that fulfilled the inclusion criteria were treated with a Gamma3 nail. Preoperative variables included age, gender, fracture classification, walking ability (Merle d'Aubigné score), daily activity level (retrospective Zuckerman score), ASA rating of operative risk, waiting time for operation, use of walker or crutches and body mass index (BMI). Skin-to-skin time, fluoroscopy time, blood loss, intraoperative complications and device information were recorded for each patient. Follow-up postoperative assessment was undertaken at 4, 12 and 24 months. Hip range of motion, pain around the hip and the tight, walking ability (Merle d'Aubigné score, Sahlgrenska mobility score) and management of daily life (Zuckerman score) were used to evaluate the outcome. The descriptive data of age, gender, BMI, ASA classification, fracture type and skin-to-skin time is similar to other studies. Median fluoroscopy time was 62 seconds (range: 4-225 seconds) and significantly shorter in closed reductions. No intraoperative implant-related complication was recorded. A cut-out of the leg-screw during assessment period occurred in 2.6% patients (n = 4). At the 12-month assessment two (1.8%) non-unions were identified and two patients (1.8%) had broken the femoral shaft below the 180 mm nail after a fall. Analysis of the scores showed significantly declined mobility and activity in daily life four months after operation

  8. Computer model for ductile fracture

    International Nuclear Information System (INIS)

    Moran, B.; Reaugh, J. E.

    1979-01-01

    A computer model is described for predicting ductile fracture initiation and propagation. The computer fracture model is calibrated by simple and notched round-bar tension tests and a precracked compact tension test. The model is used to predict fracture initiation and propagation in a Charpy specimen and compare the results with experiments. The calibrated model provides a correlation between Charpy V-notch (CVN) fracture energy and any measure of fracture toughness, such as J/sub Ic/. A second simpler empirical correlation was obtained using the energy to initiate fracture in the Charpy specimen rather than total energy CVN, and compared the results with the empirical correlation of Rolfe and Novak

  9. Preliminary results of hydrologic testing of the Umtanum Basalt Fracture Zone at borehole RRL-2 (3,781 to 3,827 ft)

    International Nuclear Information System (INIS)

    Strait, S.R.; Spane, F.A. Jr.

    1983-02-01

    This report presents preliminary results and description of hydrologic test activities for the Umtanum Basalt Fracture Zone at Borehole RRL-2, within the test interval 3,781 to 3,827 feet. Hydrologic tests conducted include two short-term, constant discharge pumping tests and two slug tests. Preliminary results indicate an observed hydraulic head for the test interval of 406.7 feet above mean sea level. Transmissivity values determined from hydrologic tests performed range between 205 and 881 ft 2 /day. The best estimate of equivalent hydraulic conductivity, based on an effective test thickness of 6 feet, is 147 ft/day. 8 refs., 6 figs., 3 tabs

  10. Perturbation of cobalt 60 radiation doses by metal objects implanted during oral and maxillofacial surgery

    International Nuclear Information System (INIS)

    Tatcher, M.; Kuten, A.; Helman, J.; Laufer, D.

    1984-01-01

    The influence on cobalt 60 dose distributions of typical metal parts used in oral and maxillofacial surgery was studied. Relative doses were determined by exposing x-ray films in a polystyrene phantom set-up containing samples of vitallium, titanium, and stainless steel. Optical densities were converted to doses with the aid of sensitometric curves. The results show that for normal incidence there is a 25% to 40% increase in dose at the entrance side of the metal and a 20% to 25% decrease in dose at the exit side. The enhancement effect falls off rapidly and becomes negligible at about 1 mm from the interface. The reduction effect decreases more gradually and is still evident at distances of a few centimeters. These dose perturbations should be taken into account in the planning of radiation therapy for patients in whom metal objects have been implanted

  11. The development of a comprehensive multidisciplinary care pathway for patients with a hip fracture: design and results of a clinical trial.

    Science.gov (United States)

    Flikweert, Elvira R; Izaks, Gerbrand J; Knobben, Bas A S; Stevens, Martin; Wendt, Klaus

    2014-05-30

    Hip fractures frequently occur in older persons and severely decrease life expectancy and independence. Several care pathways have been developed to lower the risk of negative outcomes but most pathways are limited to only one aspect of care. The aim of this study was therefore to develop a comprehensive care pathway for older persons with a hip fracture and to conduct a preliminary analysis of its effect. A comprehensive multidisciplinary care pathway for patients aged 60 years or older with a hip fracture was developed by a multidisciplinary team. The new care pathway was evaluated in a clinical trial with historical controls. The data of the intervention group were collected prospectively. The intervention group included all patients with a hip fracture who were admitted to University Medical Center Groningen between 1 July 2009 and 1 July 2011. The data of the control group were collected retrospectively. The control group comprised all patients with a hip fracture who were admitted between 1 January 2006 and 1 January 2008. The groups were compared with the independent sample t-test, the Mann-Whitney U-test or the Chi-squared test (Phi test). The effect of the intervention on fasting time and length of stay was adjusted by linear regression analysis for differences between the intervention and control group. The intervention group included 256 persons (women, 68%; mean age (SD), 78 (9) years) and the control group 145 persons (women, 72%; mean age (SD), 80 (10) years). Median preoperative fasting time and median length of hospital stay were significantly lower in the intervention group: 9 vs. 17 hours (p < 0.001), and 7 vs. 11 days (p < 0.001), respectively. A similar result was found after adjustment for age, gender, living condition and American Society of Anesthesiologists (ASA) classification. In-hospital mortality was also lower in the intervention group: 2% vs. 6% (p < 0.05). There were no statistically significant differences in other

  12. Groundwater degassing and two-phase flow in fractured rock: Summary of results and conclusions achieved during the period 1994-2000

    International Nuclear Information System (INIS)

    Jarsjoe, J.; Destouni, G.

    2001-06-01

    drifts, by summarising and systematically interpreting all available laboratory and field investigations that have been conducted within the SKB degassing and two-phase flow programme. Data from various sites in Sweden show that the volumetric percent gas coming out of solution as the pressure of deep groundwater is lowered down to atmospheric pressure is generally less than 5%. Laboratory experiments and an analytical expression showed that conditions often are favourable for trapping and accumulation of gas bubbles in the fracture pore space (once bubbles are formed), implying that local fracture gas saturation degrees may become considerable, even though the evolved percent gas per unit volume flowing water is relatively low. For instance, a saturation degree of 40% was observed in a laboratory fracture for 7% evolved gas. However, degassing effects such as inflow reductions to boreholes and drifts will not be considerable unless the potential degassing zone (where the water pressure is lower than the gas bubble pressure) is sufficiently large in relation to the total length of the fracture. A series of borehole test conducted at Aespoe HRL between 300 and 450 meters depth indicated that degassing only causes considerable flow reductions for gas contents that are well above the normal ones in Swedish granitic bedrock. This field result was reproduced by a predictive degassing model, developed considering independent degassing observations in the laboratory. Since the model predictions were shown to be robust with regard to plausible variable ranges for rock fractures intersecting boreholes at depths between 20 and 600 metres, we conclude more generally that groundwater degassing will not cause considerable inflow reductions in fractures intersecting open boreholes under conditions normal for Swedish granitic bedrock. We also considered the relatively large drift inflow reductions observed in the Stripa simulated drift experiment. These reductions were hypothesised to

  13. Rib Fractures

    Science.gov (United States)

    ... Video) Achilles Tendon Tear Additional Content Medical News Rib Fractures By Thomas G. Weiser, MD, MPH, Associate Professor, ... Tamponade Hemothorax Injury to the Aorta Pulmonary Contusion Rib Fractures Tension Pneumothorax Traumatic Pneumothorax (See also Introduction to ...

  14. Root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios

    2012-01-01

    The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....

  15. Cone beam computed tomography: A boon for maxillofacial imaging

    Directory of Open Access Journals (Sweden)

    Sreenivas Rao Ghali

    2017-01-01

    Full Text Available In day to day practice, the radiographic techniques used individually or in combination suffer from some inherent limits of all planar two-dimensional (2D projections such as magnification, distortion, superimposition, and misrepresentation of anatomic structures. The introduction of cone-beam computed tomography (CBCT, specifically dedicated to imaging the maxillofacial region, heralds a major shift from 2D to three-dimensional (3D approach. It provides a complete 3D view of the maxilla, mandible, teeth, and supporting structures with relatively high resolution allowing a more accurate diagnosis, treatment planning and monitoring, and analysis of outcomes than conventional 2D images, along with low radiation exposure to the patient. CBCT has opened up new vistas for the use of 3D imaging as a diagnostic and treatment planning tool in dentistry. This paper provides an overview of the imaging principles, underlying technology, dental applications, and in particular focuses on the emerging role of CBCT in dentistry.

  16. Polyostotic Fibrous Dysplasia of Cranio-Maxillofacial Area

    Energy Technology Data Exchange (ETDEWEB)

    Han, Jin Woo; Kwon, Hyuk Rok; Lee, Jin Ho; Park, In Woo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kangnung National University, Kangnung (Korea, Republic of)

    2000-06-15

    Fibrous dysplasia is believed to be a hamartomatous developmental lesion of unknown origin. This disease is divided into monostotic and polyostotic fibrous dysplasia. Polyostotic type can be divided into craniofacial type, Lichtenstein-Jaffe type, and McCune-Albright syndrome. In this case, a 31-year-old female presented spontaneous loss of right mandibular teeth before 5 years and has shown continuous expansion of right mandibular alveolus. Through the radiographic view, the coarse pattern of the mixed radiopaque-lucent lesion was seen on the right mandibular body, and there was diffuse pattern of the mixed radiopaque-lucent lesion with ill-defined margin in the left mandibular body. In the right calvarium, the lesion had cotton-wool appearance. Partial excision for contouring, multiple extraction, and alveoloplasty were accomplished under general anesthesia for supportive treatment. Finally we could conclude this case was polyostotic fibrous dysplasia of cranio-maxillofacial area based on the clinical, radiologic finding, and histopathologic examination.

  17. Polyostotic Fibrous Dysplasia of Cranio-Maxillofacial Area

    International Nuclear Information System (INIS)

    Han, Jin Woo; Kwon, Hyuk Rok; Lee, Jin Ho; Park, In Woo

    2000-01-01

    Fibrous dysplasia is believed to be a hamartomatous developmental lesion of unknown origin. This disease is divided into monostotic and polyostotic fibrous dysplasia. Polyostotic type can be divided into craniofacial type, Lichtenstein-Jaffe type, and McCune-Albright syndrome. In this case, a 31-year-old female presented spontaneous loss of right mandibular teeth before 5 years and has shown continuous expansion of right mandibular alveolus. Through the radiographic view, the coarse pattern of the mixed radiopaque-lucent lesion was seen on the right mandibular body, and there was diffuse pattern of the mixed radiopaque-lucent lesion with ill-defined margin in the left mandibular body. In the right calvarium, the lesion had cotton-wool appearance. Partial excision for contouring, multiple extraction, and alveoloplasty were accomplished under general anesthesia for supportive treatment. Finally we could conclude this case was polyostotic fibrous dysplasia of cranio-maxillofacial area based on the clinical, radiologic finding, and histopathologic examination.

  18. [Contribution of botulinum toxin to maxillo-facial surgery].

    Science.gov (United States)

    Batifol, D; de Boutray, M; Goudot, P; Lorenzo, S

    2013-04-01

    Botulinum toxin has a wide range of use in maxillo-facial surgery due to its action on muscles, on the glandular system, and against pain. It already has been given several market authorizations as indicated for: blepharospasm, spasmodic stiff neck, and glabellar lines. Furthermore, several studies are ongoing to prove its effectiveness and usefulness for many other pathologies: treatment of pain following cervical spine surgery; action on salivary glands after trauma, hypertrophy, or hyper-salivation; analgesic action (acknowledged but still being experimented) on neuralgia, articular pain, and keloids scars due to its anti-inflammatory properties. Botulinum toxin injections in the cervico-facial area are more and more used and should be to be correctly assessed. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Preparation of an Adhesive in Emulsion for Maxillofacial Prosthetic

    Directory of Open Access Journals (Sweden)

    Joaquín Palacios-Alquisira

    2010-10-01

    Full Text Available Maxillofacial prostheses is a dental medicine specialty aimed at restoring anatomical facial defects caused by cancer, trauma or congenital malformations through an artificial device, which is commonly attached to the skin with the help of an adhesive. The purpose of our research was to develop a pressure-sensitive adhesive (PSA based on acrylic monomers, characterizing and determining its drying kinetics, that is to say the time it takes to lose 50 to 90% of its moisture. The adhesive synthesis was realized by means of emulsion polymerization; the composition of formulations was: (AA‑MMA‑EA and (AA‑MMA‑2EHA with different molar ratios. The formulation based on (AA‑MMA‑2EHA with 50 w% of solids, presented good adhesive properties such as tack, bond strength, and short drying time. We propose this formulation as a PSA, because it offers an alternative for systemically compromised patients, by less irritation compared to organic solvent-based adhesives.

  20. Oral and cranio-maxillofacial surgery in Byzantium.

    Science.gov (United States)

    Mylonas, Anastassios I; Poulakou-Rebelakou, Eleftheria-Fotini; Androutsos, Georgios I; Seggas, Ioannis; Skouteris, Christos A; Papadopoulou, Evangelia Chr

    2014-03-01

    Byzantine physicians (4th-7th and 8th-12th centuries A.D.), especially those interested in Surgery, developed a number of interesting concepts, views and opinions referring to the field now recognized as Oral and Cranio-maxillofacial Surgery and Pathology. The original texts of Byzantine physicians, written in ancient Greek, and now preserved in the electronic platform Thesaurus Linguae Graecae, at the University of California, Irvine, CA, USA, were investigated in relation to Oral and Cranio-maxillofacial Surgery and Pathology. The most eminent physicians of the Early (4th-7th century A.D.) and Middle (8th-12th century A.D.) Byzantine Period, in particular Oribasius Pergamenus, Aëtius Amidenus, Alexander Trallianus, Theophilus Protospatharius, Paulus Aegineta, Meletius Monachos, and Leo Medicus, in their works deal with topographic and surgical anatomy of the head and neck, and a large list of related topics, including dentoalveolar surgery, oral and cervicofacial infections, trauma of viscerocranium and neurocranium as well as the biomechanics of traumatic brain injuries, temporomandibular joints dysfunction as a consequence of mandibular dislocation, surgical oncology and reconstructive surgery of the head and neck, oral pathology, surgical pathology of salivary glands, therapeutic management of facial nerve dysfunction, preprosthetic surgery, craniofacial surgery, and deformities of the facial skeleton involving anthropologic and craniometric observations. Clinical examination of patients presenting corresponding functional and esthetic problems is considered, using recognizable orthodontic and orthognathic surgical approaches. Finally, specific bandages of the head and neck are described, for treating traumatic injuries of the viscerocranium and neurocranium, diastasis of the cranial sutures, dislocations of the mandible (unilateral and bilateral), as well as inflammatory diseases of the parotids and the neck. Byzantine physicians had been particularly

  1. Release of metal in vivo from stressed and nonstressed maxillofacial fracture plates and screws.

    Science.gov (United States)

    Matthew, I R; Frame, J W

    2000-07-01

    To analyze the release of metal into the adjacent tissues from stressed and nonstressed titanium and stainless steel miniplates and screws. Two miniplates were inserted into the cranial vaults of 12 beagle dogs while they were under general endotracheal anesthesia. One miniplate was shaped to fit the curvature of the skull (control). Another miniplate, made of the same material, was bent in a curve until the midpoint was raised 3 mm above the ends. Screws were inserted and tightened until the plate conformed to the skull curvature, creating stresses in the system. Four animals (2 each, having titanium or stainless steel plates and screws) were killed after 4, 12, and 24 weeks. Metallosis of adjacent soft tissues was assessed qualitatively. Miniplates and screws were removed, and adjacent soft tissue and bone was excised. Titanium, iron, chromium, nickel, and aluminum levels were assayed by ultraviolet/visible light and atomic absorption spectrophotometry. Nonparametric statistical methods were used for data analysis. There was no clear relationship between pigmentation of soft tissue adjacent to the miniplates and screws and the concentrations of metal present. The data did not demonstrate any consistent differences in the concentrations of metallic elements next to stressed and nonstressed (control) miniplates and screws of either material. Stresses arising through poor contouring of miniplates do not appear to influence the extent of release of metal into the adjacent tissues.

  2. Stress Fractures

    Science.gov (United States)

    Stress fractures Overview Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of ...

  3. Management of maxillofacial trauma in emergency: An update of challenges and controversies

    Directory of Open Access Journals (Sweden)

    Anson Jose

    2016-01-01

    Full Text Available Trauma management has evolved significantly in the past few decades thereby reducing mortality in the golden hour. However, challenges remain, and one such area is maxillofacial injuries in a polytrauma patient. Severe injuries to the maxillofacial region can complicate the early management of a trauma patient owing to the regions proximity to the brain, cervical spine, and airway. The usual techniques of airway breathing and circulation (ABC management are often modified or supplemented with other methods in case of maxillofacial injuries. Such modifications have their own challenges and pitfalls in an already difficult situation.

  4. Are You Ready for Emergency Medical Services in Your Oral and Maxillofacial Surgery Office?

    Science.gov (United States)

    Rayner, Clive; Ragan, Michael R

    2018-05-01

    Efficient responses to emergencies in the oral and maxillofacial surgery office require preparation, communication, and thorough documentation of the event and response. The concept of team anesthesia is showcased with these efforts. Emergency medical services training and response times vary greatly. The oral and maxillofacial surgery office should be prepared to manage the patient for at least 15 minutes after making the call to 911. Patient outcomes are optimized when providers work together to manage and transport the patient. Oral and maxillofacial surgery offices should develop and rehearse emergency plans and coordinate these protocols with local Emergency medical services teams. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Attenuation-difference radar tomography: results of a multiple-plane experiment at the U.S. Geological Survey Fractured-Rock Research Site, Mirror Lake, New Hampshire

    Science.gov (United States)

    Lane, J.W.; Day-Lewis, F. D.; Harris, J.M.; Haeni, F.P.; Gorelick, S.M.

    2000-01-01

    Attenuation-difference, borehole-radar tomography was used to monitor a series of sodium chloride tracer injection tests conducted within the FSE, wellfield at the U.S. Geological Survey Fractured-Rock Hydrology Research Site in Grafton County, New Hampshire, USA. Borehole-radar tomography surveys were conducted using the sequential-scanning and injection method in three boreholes that form a triangular prism of adjoining tomographic image planes. Results indicate that time-lapse tomography methods provide high-resolution images of tracer distribution in permeable zones.

  6. Does Self-Citation Influence Quantitative Measures of Research Productivity Among Academic Oral and Maxillofacial Surgeons?

    Science.gov (United States)

    Susarla, Srinivas M; Swanson, Edward W; Lopez, Joseph; Peacock, Zachary S; Dodson, Thomas B

    2015-10-01

    Quantitative measures of research productivity depend on the citation frequency of a publication. Citation-based metrics, such as the h-index (total number of publications h that have at least h citations), can be susceptible to self-citation, resulting in an inflated measure of research productivity. The purpose of the present study was to estimate the effect of self-citation on the h-index among academic oral and maxillofacial surgeons (OMSs). The present study was a cross-sectional study of full-time academic OMSs in the United States. The predictor variable was the frequency of self-citation. The primary outcome of interest was the h-index. Other study variables included demographic factors and citation metrics. Descriptive, bivariate, and regression statistics were computed. The study sample consisted of 325 full-time academic OMSs. Most surgeons were men (88.3%); approximately 40% had medical degrees. The study subjects had an average of 23.5 ± 37.1 publications. The mean number of self-citations was 15 + 56. The sample's mean h-index was 6.6 ± 7.6 and was associated with self-citation (r = 0.71, P citations. After adjusting for PhD degree, total number of publications, and academic rank, an increasing self-citation rate influenced the h-index (r = 0.006, P citations were more likely to have their h-index influenced by self-citation. Self-citation among full-time academic OMSs does not substantially affect the h-index. Surgeons in the top quartile of self-citation rates are more likely to influence their h-index. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Surface Coating of Gypsum-Based Molds for Maxillofacial Prosthetic Silicone Elastomeric Material: The Surface Topography.

    Science.gov (United States)

    Khalaf, Salah; Ariffin, Zaihan; Husein, Adam; Reza, Fazal

    2015-07-01

    This study aimed to compare the surface roughness of maxillofacial silicone elastomers fabricated in noncoated and coated gypsum materials. This study was also conducted to characterize the silicone elastomer specimens after surfaces were modified. A gypsum mold was coated with clear acrylic spray. The coated mold was then used to produce modified silicone experimental specimens (n = 35). The surface roughness of the modified silicone elastomers was compared with that of the control specimens, which were prepared by conventional flasking methods (n = 35). An atomic force microscope (AFM) was used for surface roughness measurement of silicone elastomer (unmodified and modified), and a scanning electron microscope (SEM) was used to evaluate the topographic conditions of coated and noncoated gypsum and silicone elastomer specimens (unmodified and modified) groups. After the gypsum molds were characterized, the fabricated silicone elastomers molded on noncoated and coated gypsum materials were evaluated further. Energy-dispersive X-ray spectroscopy (EDX) analysis of gypsum materials (noncoated and coated) and silicone elastomer specimens (unmodified and modified) was performed to evaluate the elemental changes after coating was conducted. Independent t test was used to analyze the differences in the surface roughness of unmodified and modified silicone at a significance level of p SEM analysis results showed evident differences in surface smoothness. EDX data further revealed the presence of the desired chemical components on the surface layer of unmodified and modified silicone elastomers. Silicone elastomers with lower surface roughness of maxillofacial prostheses can be obtained simply by coating a gypsum mold. © 2014 by the American College of Prosthodontists.

  8. Conductive fracture mapping. A study on the correlation between borehole TV- and radar images and difference flow logging results in borehole KLX02

    International Nuclear Information System (INIS)

    Carlsten, S.; Straahle, A.; Ludvigson, Jan-Erik

    2001-10-01

    This study presents an attempt to correlate images from borehole-TV (BIPS) and borehole radar with interpreted flow anomalies from Difference Flow Meter logging (DIFF). The measurements were performed in the interval 200-400 m in borehole KLX02 at Laxemar. In total, 59 flow anomalies were interpreted by the DIFF-log in this borehole interval. However, 14 flow anomalies were below the rigorous measurement limit for the actual flow meter and are thus regarded as uncertain. In total, 261 features were primarily interpreted by the BIPS-characterization in the borehole interval 200-400 m but only 12 radar reflectors. The low number of interpreted radar reflectors most likely depends on the low frequency of the antenna used in this case which gave a poor depth resolution. The total number of fractures recorded by the core mapping in this interval was 374 (279 in the rock together with 95 fractures in interpreted crush zones). Prior to the correlation analysis it was necessary to adjust the length scales of the BIPS-measurements relative to the length scale of the Difference Flow logging due to non-linear stretching of logging cables etc to achieve the necessary resolution of the depth scale.This adjustment was done by comparing the distances between clearly identified single features in the BIPS-images with the corresponding distances between clearly identified flow anomalies. The BIPS-measurements consist of 5 independent logging sequences in the studied borehole interval, which resulted in 'jumps' when comparing the non-conform length scales of the different sequences. All of the 59 flow anomalies could be correlated (matched) with BIPS-features with varying degree of certainty. A majority of the correlated BIPS-features was classified as open fractures or fractures with cavities. Most of the flow anomalies below the measurement limit were correlated to veins in the rock. In the correlation between borehole radar reflectors and BIPS-features, the calculated angle and

  9. Conductive fracture mapping. A study on the correlation between borehole TV- and radar images and difference flow logging results in borehole KLX02

    Energy Technology Data Exchange (ETDEWEB)

    Carlsten, S.; Straahle, A.; Ludvigson, Jan-Erik [GEOSIGMA AB, Uppsala (Sweden)

    2001-10-01

    This study presents an attempt to correlate images from borehole-TV (BIPS) and borehole radar with interpreted flow anomalies from Difference Flow Meter logging (DIFF). The measurements were performed in the interval 200-400 m in borehole KLX02 at Laxemar. In total, 59 flow anomalies were interpreted by the DIFF-log in this borehole interval. However, 14 flow anomalies were below the rigorous measurement limit for the actual flow meter and are thus regarded as uncertain. In total, 261 features were primarily interpreted by the BIPS-characterization in the borehole interval 200-400 m but only 12 radar reflectors. The low number of interpreted radar reflectors most likely depends on the low frequency of the antenna used in this case which gave a poor depth resolution. The total number of fractures recorded by the core mapping in this interval was 374 (279 in the rock together with 95 fractures in interpreted crush zones). Prior to the correlation analysis it was necessary to adjust the length scales of the BIPS-measurements relative to the length scale of the Difference Flow logging due to non-linear stretching of logging cables etc to achieve the necessary resolution of the depth scale.This adjustment was done by comparing the distances between clearly identified single features in the BIPS-images with the corresponding distances between clearly identified flow anomalies. The BIPS-measurements consist of 5 independent logging sequences in the studied borehole interval, which resulted in 'jumps' when comparing the non-conform length scales of the different sequences. All of the 59 flow anomalies could be correlated (matched) with BIPS-features with varying degree of certainty. A majority of the correlated BIPS-features was classified as open fractures or fractures with cavities. Most of the flow anomalies below the measurement limit were correlated to veins in the rock. In the correlation between borehole radar reflectors and BIPS-features, the calculated

  10. Pathological fractures in children

    Science.gov (United States)

    De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.

    2012-01-01

    Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated. PMID:23610658

  11. Results of bone regenerate study after osteosynthesis with bioinert and calcium phosphate-coated bioactive implants in experimental femoral neck fractures (experimental study

    Directory of Open Access Journals (Sweden)

    K. S. Kazanin

    2015-01-01

    Full Text Available Objective - to analyze the results of X-ray, cytomorphometric and immunohistochemistry experimental studies of bone regenerates after osteosynthesis with bioinert and calcium phosphate-coated bioactive implants. Material and methods. The study was conducted on experimental femoral neck fractures in rabbit males. Reparative osteogenesis processes were studied in groups of bioinert titanium implant osteosynthesis and calcium phosphate-coated bioactive titanium implant osteosynthesis. The animals were clinically followed-up during the postoperative period. X-ray, cytomorphometric and immunohistochemistry studies of samples extracted from femoral bones were conducted over time on days 1, 7, 14, 30 and 60. The animal experiments were kept and treated according to recommendations of international standards, Helsinki Declaration on animal welfare and approved by the local ethics committee. All surgeries were performed under anesthesia, and all efforts were made to minimize the suffering of the animals. Results. In the animal group without femoral neck fracture osteosynthesis, femoral neck pseudoarthrosis was observed at the end of the experiment. The results of cytomorphometric and immunohistochemistry studies conducted on day 60 of the experiment confirmed that the cellular composition of the bone regenerate in the group of calcium phosphate-coated bioactive titanium implants corresponded to a more mature bone tissue than in the group of bioinert titanium implants. Conclusion. The results of the statistical analysis of cytomorphometric and immunohistochemistry data show that the use of calcium phosphate-coated bioactive titanium implants allows to achieve significantly earlier bone tissue regeneration.

  12. Retrospective analysis of two hundred thirty-five pediatric mandibular fracture cases.

    Science.gov (United States)

    Eskitascioglu, Teoman; Ozyazgan, Irfan; Coruh, Atilla; Gunay, Galip K; Yuksel, Esabil

    2009-11-01

    Maxillofacial fractures are encountered less commonly during childhood period due to anatomic, social, cultural, and environmental factors. Although the incidence of all maxillofacial fractures is 1% to 15% among pediatric and adolescent patients, this rate drops to less than 1% in children below 5 years age. Two hundred thirty-five cases (mandibular fracture were evaluated retrospectively. Patients records were examined in terms of age, gender, cause of fracture, fracture localization, number of fractures, fracture pattern, accompanying injuries, applied treatment methods, and complications. Mean age of cases was 9.2 years and 165 cases were male, 70 were female. Traffic accidents as the most common etiologic cause in all ages. Falls is the second most common cause which particularly affects children above age of 2 years. All cases had 333 fractures and the most common fracture localization was parasymphysis region (34%). The other most common fracture localizations were as follows: condyle (19%), corpus (13%), dentoalveolar region (12%), angulus (11%), symphysis region (9%), and ramus (2%). There was only a single fracture line in 145 cases, 40 cases had unilateral multiple and 50 cases had bilateral fracture lines. We applied symptomatic (conservative) treatment in 20 (8%) of our cases; fracture fixation with interdental wires or closed reduction methods were employed in 122 patients. Internal fixation with open reduction (OR) was performed on 51 (22%) patients. Both closed and OR techniques were carried out in 30 (13%) patients. Pediatric mandibular fractures, which are seen less frequently compared with those of adults, require a specific and different treatment. Although mostly less invasive methods are preferred, we believe that ORs should be considered when required.

  13. A Site Characterization Protocol for Evaluating the Potential for Triggered or Induced Seismicity Resulting from Wastewater Injection and Hydraulic Fracturing

    Science.gov (United States)

    Walters, R. J.; Zoback, M. D.; Gupta, A.; Baker, J.; Beroza, G. C.

    2014-12-01

    Regulatory and governmental agencies, individual companies and industry groups and others have recently proposed, or are developing, guidelines aimed at reducing the risk associated with earthquakes triggered by waste water injection or hydraulic fracturing. While there are a number of elements common to the guidelines proposed, not surprisingly, there are also some significant differences among them and, in a number of cases, important considerations that are not addressed. The goal of this work is to develop a comprehensive protocol for site characterization based on a rigorous scientific understanding of the responsible processes. Topics addressed will include the geologic setting (emphasizing faults that might be affected), historical seismicity, hydraulic characterization of injection and adjacent intervals, geomechanical characterization to identify potentially active faults, plans for seismic monitoring and reporting, plans for monitoring and reporting injection (pressure, volumes, and rates), other factors contributing to risk (potentially affected population centers, structures, and facilities), and implementing a modified Probabilistic Seismic Hazard Analysis (PSHA). The guidelines will be risk based and adaptable, rather than prescriptive, for a proposed activity and region of interest. They will be goal oriented and will rely, to the degree possible, on established best practice procedures, referring to existing procedures and recommendations. By developing a risk-based site characterization protocol, we hope to contribute to the development of rational and effective measures for reducing the risk posed by activities that potentially trigger earthquakes.

  14. Quantitative ultrasound parameters as well as bone mineral density are better predictors of trochanteric than cervical hip fractures in elderly women. Results from the EPIDOS study.

    Science.gov (United States)

    Schott, A M; Hans, D; Duboeuf, F; Dargent-Molina, P; Hajri, T; Bréart, G; Meunier, P J

    2005-12-01

    Hip fractures can be separated into cervical and trochanteric fractures. Trochanteric fractures have been associated with up to twice the short-term mortality of cervical fractures in the elderly. There is also evidence suggesting that the mechanisms are different. Evidence from the literature remains limited on the predictive power of bone mineral density (BMD) and quantitative ultrasounds (QUS) for both types of hip fractures. 5703 elderly women aged 75 years or more, who were recruited from the voting lists in the EPIDOS study, and had baseline calcaneal ultrasounds (QUS) and DXA measurements at the hip and the whole body, were analyzed in this paper. Among those, 192 hip fractures occurred during an average follow-up of 4 years, 108 cervical and 84 trochanteric fractures. Femoral neck, trochanteric and whole body BMD were able to predict trochanteric hip fracture (RR's and 95% CI were, respectively, 3.2 (2.4-4.2); 4.8 (3.5-6.6); and 2.8 (2.2-3.6)) more accurately than cervical fractures (respectively, 2.1 (1.7-2.7); 2.3 (1.8-3.0); 1.2 (1.0-1.6)). All ultrasound parameters, SOS, BUA, and stiffness index (SI) were significant predictors of trochanteric (RR's respectively 3.0 (2.2-4.1), 2.5(2.0-3.1), and 3.5(2.6-4.7)) but not cervical fractures. After adjustment for femoral neck or trochanteric BMD ultrasound parameters were still significant predictors of trochanteric fracture, and stiffness tended to be a better predictor of trochanteric fractures than either BUA or SOS with a relative risk of 2.25 (1.6-3.1). A significant decrease of all bone measurements, BMD and QUS, was highly predictive of trochanteric fractures, whereas a decrease of femoral neck and trochanteric BMD were only associated with a slight increase in cervical fracture risk and a low total body BMD or QUS parameters were not significant predictors of cervical fractures. In women who sustained a hip fracture, the decrease of BMD and QUS values increases the risk of trochanteric fracture as

  15. Persistent organochlorine pollutants and risk for skeletal fractures and impaired bone mineral density in humans. Results from the ''COMPARE'' project

    Energy Technology Data Exchange (ETDEWEB)

    Hagmar, L.; Wallin, E.; Joensson, B.A. [Department of Occupational and Environmental Medicine, Lund (Sweden)

    2004-09-15

    Persistent organochlorine pollutants (POP) have, in animal studies, impaired normal bone metabolism and resulted in increased bone fragility. Especially considering the dramatical increase in osteoporotic fractures in western societies during the last decades, it is a pertinent question whether a high dietary intake of POP might pose a risk for deteriorated bone quality in humans. This problem has been assessed as a part of the collaborative project ''COMPARE'', funded by European Commission RD Life Science Program. As a study base we have used cohorts of Swedish fishermen's families. We have earlier shown that fishermen living at the east coast of Sweden, have a high consumption of contaminated fatty fish from the Baltic Sea and consequently relatively high exposure levels for various POPs, also compared with fishermen from the Swedish west coast. Such a discrepancy was also found for fishermen's wives. The aim of the project was to assess in epidemiological studies whether a high dietary intake of POP through fatty fish from the Baltic may result in an increased incidence of osteoporotic fractures or decreased bone mineral density (BMD). We give here an overview of the results.

  16. Estimate of the Costs Caused by Adverse Effects in Hospitalised Patients Due to Hip Fracture: Design of the Study and Preliminary Results

    Directory of Open Access Journals (Sweden)

    David Cuesta-Peredo

    2018-02-01

    Full Text Available Introduction: Hip fracture is a health problem that presents high morbidity and mortality, negatively influencing the patient’s quality of life and generating high costs. Structured analysis of quality indicators can facilitate decision-making, cost minimization, and improvement of the quality of care. Methods: We studied 1571 patients aged 70 years and over with the diagnosis of hip fracture at Hospital Universitario de la Ribera in the period between 1 January 2012 and 31 December 2016. Demographic, clinical, functional, and quality indicator variables were studied. An indirect analysis of the costs associated with adverse events arising during hospital admission was made. A tool based on the “Minimum Basic Data Set (CMBD” was designed to monitor the influence of patient risk factors on the incidence of adverse effects (AE and their associated costs. Results: The average age of the patients analysed was 84.15 years (SD 6.28, with a length of stay of 8.01 days (SD 3.32, a mean preoperative stay of 43.04 h (SD 30.81, and a mortality rate of 4.2%. Likewise, the percentage of patients with AE was 41.44%, and 11.01% of patients changed their cost as a consequence of these AEs suffered during hospital admission. The average cost of patients was €8752 (SD: 1,864 and the average cost increase in patients with adverse events was €2321 (SD: 3,164. Conclusions: Through the analysis of the main clinical characteristics and the indirect estimation of the complexity of the patients, a simple calculation of the average cost of the attention and its adverse events can be designed in patients who are admitted due to hip fracture. Additionally, this tool can fit the welfare quality indicators by severity and cost.

  17. [Latest trends in the surgical management of mandibular condyle fractures in France, 2005-2012].

    Science.gov (United States)

    Trost, O; Péron, J-M

    2013-12-01

    The surgical treatment of mandibular condylar fractures is commonly performed. We had for aim to present the latest trends in the surgical management of condylar fractures in France, between 2005 and 2012. A survey was performed among the 49 members of the French college of oral and maxillofacial surgeons between January and September 2012, with a questionnaire sent by email. We analyzed the therapeutic management, the surgical indications; the techniques used according to the fracture, and the postoperative treatment protocols. The data was compared to that of a similar study performed in 2005. The overall reply rate was 86%. Low subcondylar fractures were operated on in all institutions (100%), compared to 76% in 2005. The most popular technique was the high submandibular approach with intraoral miniplate fixation osteosynthesis. High subcondylar and diacapitular fractures were operated on in respectively 82% and 35% of the cases compared to 29% and 10% in 2005 with various surgical techniques and postoperative management. French maxillofacial surgeons operated on more mandibular condylar fractures in 2012 than in 2005. As observed in 2005, the lower and the more dislocated the fractures were, the more they were operated on. The high submandibular approach has become the most popular approach. The use of miniplates for bone fixation has become common. Diacapitular fractures were usually treated functionally. The postoperative management varied greatly from one team to the other. Copyright © 2013. Published by Elsevier Masson SAS.

  18. Dynamic fracture characterization of material

    International Nuclear Information System (INIS)

    Kobayashi, A.S.; Emery, A.F.; Liaw, B.M.

    1981-01-01

    The influences of a wide range of material properties, i.e. of A533B steel, a silicon nitride ceramic and a Homalite-100 photoelastic polymer, as well as the influences of the specimen sizes on the dynamic fracture response of fracture specimens are presented in this paper. The results of a numerical study show that the dynamic fracture responses of these fracture specimens of proportional dimensions were indistinguishable provided the normalized dynamic fracture toughness versus normalized crack velocity relations of the three materials coincide. The limited results suggest that should the normalized dynamic fracture toughness versus normalized crack velocity relations between prototype and model materials coincide, then dynamic fracture experiments on scaled models can be used to infer the dynamic fracture response of the prototype. (orig./HP)

  19. Comparison of Neck Screw and Conventional Fixation Techniques in Mandibular Condyle Fractures Using 3-Dimensional Finite Element Analysis.

    Science.gov (United States)

    Conci, Ricardo Augusto; Tomazi, Flavio Henrique Silveira; Noritomi, Pedro Yoshito; da Silva, Jorge Vicente Lopes; Fritscher, Guilherme Genehr; Heitz, Claiton

    2015-07-01

    To compare the mechanical stress on the mandibular condyle after the reduction and fixation of mandibular condylar fractures using the neck screw and 2 other conventional techniques according to 3-dimensional finite element analysis. A 3-dimensional finite element model of a mandible was created and graphically simulated on a computer screen. The model was fixed with 3 different techniques: a 2.0-mm plate with 4 screws, 2 plates (1 1.5-mm plate and 1 2.0-mm plate) with 4 screws, and a neck screw. Loads were applied that simulated muscular action, with restrictions of the upper movements of the mandible, differentiation of the cortical and medullary bone, and the virtual "folds" of the plates and screws so that they could adjust to the condylar surface. Afterward, the data were exported for graphic visualization of the results and quantitative analysis was performed. The 2-plate technique exhibited better stability in regard to displacement of fractures, deformity of the synthesis materials, and minimum and maximum tension values. The results with the neck screw were satisfactory and were similar to those found when a miniplate was used. Although the study shows that 2 isolated plates yielded better results compared with the other groups using other fixation systems and methods, the neck screw could be an option for condylar fracture reduction. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Oro-Dental and Maxillofacial Trauma in Epilepsy at a Tertiary ...

    African Journals Online (AJOL)

    Oro-Dental and Maxillofacial Trauma in Epilepsy at a Tertiary Hospital in Lagos. ... Information sought included patient's sociodemographics, type of seizure, ... bones were not so common, all such cases received surgical treatment in hospital.

  1. Isolated Transverse Sacrum Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Cemil Kavalci

    2011-01-01

    Full Text Available Sacral fracture commonly results from high-energy trauma. Most insufficiency fractures of the sacrum are seen in women after the age of 70. Fractures of the sacrum are rare and generally combined with a concomitant pelvic fracture. Transverse sacral fractures are even less frequent which constitute only 3–5% of all sacral fractures. This type of fractures provide a diagnostic challenge. We report a unique case of isolated transverse fracture of sacrum in a young man sustained low-energy trauma. The patient presented to our emergency department after several hours of injury, and diagnosed by clinical features and roentgenogram findings.

  2. Portfolio: A Comprehensive Method of Assessment for Postgraduates in Oral and Maxillofacial Surgery

    OpenAIRE

    Kadagad, Poornima; Kotrashetti, S. M.

    2012-01-01

    Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a...

  3. Dental students’ perceptions of undergraduate clinical training in oral and maxillofacial surgery in an integrated curriculum in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mahmoud Al-Dajani

    2015-09-01

    Full Text Available Purpose: The aim was to understand dental students’ experiences with oral and maxillofacial surgery (OMS teaching, their confidence levels in performing routine dento-alveolar operations, and the relationship between the students’ confidence level and the number of teeth extracted during the clinical practice. Methods: The survey questionnaire was distributed to 32 students at Aljouf University College of Dentistry, Saudi Arabia during their fourth and fifth year in 2015. Respondents were asked to rate 19 items, which represent a student’s confidence in performing routine surgical interventions, using a four-point Likert scale (1=very little confidence, 4=very confident. A multivariate regression was computed between average confidence and the variables: weekly hours devoted to studying oral and maxillofacial surgery, college grade point average, and the total number of teeth extracted. Results: The response rate was 100%. Students revealed the highest level of confidence in giving local anesthesia (96.9%, understanding extraction indications (93.8%, and performing simple extractions (90.6%. Less confidence was shown with handling difficult extractions (50.0%, extracting molars with separation (50.0% or extracting third molars (56.3%. The average confidence in performing surgical procedures was 2.88 (SD=0.55, ranging from 1.79 to 3.89. A given student’s confidence increased with an increase in the total number of teeth extracted (P=0.003. Conclusion: It reveals a significant impact of undergraduate clinical training on students’ confidence in performing oral and maxillofacial surgery clinical procedures: The more clinical experience the students had, the more confidence they reported.

  4. Influence of low-level laser therapy on the healing of human bone maxillofacial defects: A systematic review.

    Science.gov (United States)

    Santinoni, Carolina Dos Santos; Oliveira, Hiskell Francine Fernandes; Batista, Victor Eduardo de Souza; Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos

    2017-04-01

    This systematic review evaluates the effectiveness of low-level laser therapy (LLLT) to enhance maxillofacial area bone repair. A comprehensive search of studies published up to February 2017 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The 15 selected studies evaluated a total of 374 patients (mean age, 28.5years) who were treated with LLLT. Gallium-arsenide (GaAs) and gallium aluminium arsenide (GaAlAs) were the most commonly used devices, and LLLT parameters varied greatly. Wavelengths varied from 500 to 1000nm. Tooth extraction, distraction osteogenesis, maxillary expansion, periodontal defects, orthodontic movement and maxillary cystic defects were evaluated. From the 15 selected studies, six evaluated bone repair (primary outcomes). Of these, four studies showed improvement in bone formation after using LLLT, two demonstrated improved results for only one follow up period, and one showed no additional benefits. The other 9 studies evaluated secondary parameters related to healing (secondary outcomes) in the maxillofacial area after applying LLLT, including anti-inflammatory, analgesic, and healing accelerator effects, and quality of life related to oral health. There were no adverse or negative effects of LLLT reported. Within the limitation of this review, a possible improvement in bone density can be found when LLLT is applied postoperatively in maxillofacial bony defects. LLLT also seems to promote anti-inflammatory and analgesic effects and accelerate healing, as well as enhance quality of life related to oral health. However, LLLT use protocols need to be standardized before more specific conclusions can be drawn about this subject. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. How useful is 3D printing in maxillofacial surgery?

    Science.gov (United States)

    Louvrier, A; Marty, P; Barrabé, A; Euvrard, E; Chatelain, B; Weber, E; Meyer, C

    2017-09-01

    3D printing seems to have more and more applications in maxillofacial surgery (MFS), particularly since the release on the market of general use 3D printers several years ago. The aim of our study was to answer 4 questions: 1. Who uses 3D printing in MFS and is it routine or not? 2. What are the main clinical indications for 3D printing in MFS and what are the kinds of objects that are used? 3. Are these objects printed by an official medical device (MD) manufacturer or made directly within the department or the lab? 4. What are the advantages and drawbacks? Two bibliographic researches were conducted on January the 1st, 2017 in PubMed, without time limitation, using "maxillofacial surgery" AND "3D printing" for the first and for the second "maxillofacial surgery" AND "computer-aided design" AND "computer-aided manufacturing" as keywords. Articles in English or French dealing with human clinical use of 3D printing were selected. Publication date, nationality of the authors, number of patients treated, clinical indication(s), type of printed object(s), type of printing (lab/hospital-made or professional/industry) and advantages/drawbacks were recorded. Two hundred and ninety-seven articles from 35 countries met the criteria. The most represented country was the People's Republic of China (16% of the articles). A total of 2889 patients (10 per article on average) benefited from 3D printed objects. The most frequent clinical indications were dental implant surgery and mandibular reconstruction. The most frequently printed objects were surgical guides and anatomic models. Forty-five percent of the prints were professional. The main advantages were improvement in precision and reduction of surgical time. The main disadvantages were the cost of the objects and the manufacturing period when printed by the industry. The arrival on the market of low-cost printers has increased the use of 3D printing in MFS. Anatomic models are not considered to be MDs and do not have

  6. American Society of Maxillofacial Surgeons 2006 to 2016: Another Decade of Excellence in Education and Research.

    Science.gov (United States)

    Doumit, Gaby; Totonchi, Ali; Wexler, Andy; Gosain, Arun K

    2017-09-01

    Over the past 10 years, the American Society of Maxillofacial Surgeons (ASMS) has continued to advance to meet its mission of being the premier organization to represent maxillofacial and pediatric plastic surgery in the United States. These advances are focused on education of its members, to include the American Society of Maxillofacial Surgeons basic course, the preconference symposium, the annual meeting, two basic maxillofacial courses per year, advanced maxillofacial courses, a boot camp for craniofacial fellows, a cleft course, quarterly webinars, sponsored fellowships, a visiting professorship, and the ASMS journal. In addition, the ASMS has continued to advance as the premier national organization representing maxillofacial and pediatric plastic surgery in the United States, thereby positioning the organization as a primary advocate for these surgical specialties. Outreach of the ASMS has grown over the past decade and now includes representatives to the American Society of Plastic Surgeons/Plastic Surgery Foundation, the American Board of Plastic Surgeons, the American Medical Association, and most recently a seat as a governor with the American College of Surgeons. The ASMS has also initiated an annual Summer Leadership Seminar to explore topics of relevance in a changing health care environment. The present report outlines the major initiatives of the ASMS over the past 10 years.

  7. Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach

    Directory of Open Access Journals (Sweden)

    Michal Barak

    2015-01-01

    Full Text Available According to the Advanced Trauma Life Support recommendations for managing patients with life-threatening injuries, securing the airway is the first task of a primary caregiver. Airway management of patients with maxillofacial trauma is complex and crucial because it can dictate a patient’s survival. Securing the airway of patients with maxillofacial trauma is often extremely difficult because the trauma involves the patient’s airway and their breathing is compromised. In these patients, mask ventilation and endotracheal intubation are anticipated to be difficult. Additionally, some of these patients may not yet have been cleared of a cervical spine injury, and all are regarded as having a full stomach and having an increased risk of regurgitation and pulmonary aspiration. The requirements of the intended maxillofacial operation may often preclude the use of an oral intubation tube, and alternative methods for securing the airway should be considered before the start of the surgery. In order to improve the clinical outcome of patients with maxillofacial trauma, cooperation between maxillofacial surgeons, anesthesiologists, and trauma specialists is needed. In this review, we discuss the complexity and difficulties of securing the airway of patients with maxillofacial trauma and present our approach for airway management of such patients.

  8. Rock fracture processes in chemically reactive environments

    Science.gov (United States)

    Eichhubl, P.

    2015-12-01

    Rock fracture is traditionally viewed as a brittle process involving damage nucleation and growth in a zone ahead of a larger fracture, resulting in fracture propagation once a threshold loading stress is exceeded. It is now increasingly recognized that coupled chemical-mechanical processes influence fracture growth in wide range of subsurface conditions that include igneous, metamorphic, and geothermal systems, and diagenetically reactive sedimentary systems with possible applications to hydrocarbon extraction and CO2 sequestration. Fracture processes aided or driven by chemical change can affect the onset of fracture, fracture shape and branching characteristics, and fracture network geometry, thus influencing mechanical strength and flow properties of rock systems. We are investigating two fundamental modes of chemical-mechanical interactions associated with fracture growth: 1. Fracture propagation may be aided by chemical dissolution or hydration reactions at the fracture tip allowing fracture propagation under subcritical stress loading conditions. We are evaluating effects of environmental conditions on critical (fracture toughness KIc) and subcritical (subcritical index) fracture properties using double torsion fracture mechanics tests on shale and sandstone. Depending on rock composition, the presence of reactive aqueous fluids can increase or decrease KIc and/or subcritical index. 2. Fracture may be concurrent with distributed dissolution-precipitation reactions in the hostrock beyond the immediate vicinity of the fracture tip. Reconstructing the fracture opening history recorded in crack-seal fracture cement of deeply buried sandstone we find that fracture length growth and fracture opening can be decoupled, with a phase of initial length growth followed by a phase of dominant fracture opening. This suggests that mechanical crack-tip failure processes, possibly aided by chemical crack-tip weakening, and distributed solution-precipitation creep in the

  9. Dating fractures in infants

    Energy Technology Data Exchange (ETDEWEB)

    Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Broderick, N J; Somers, J M [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Hawkes, R [Department of Radiology, Paul O' Gorman Building, Bristol (United Kingdom)

    2011-11-15

    Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.

  10. Dating fractures in infants

    International Nuclear Information System (INIS)

    Halliday, K.E.; Broderick, N.J.; Somers, J.M.; Hawkes, R.

    2011-01-01

    Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.

  11. Tibial Plateau Fractures

    DEFF Research Database (Denmark)

    Elsøe, Rasmus

    This PhD thesis reported an incidence of tibial plateau fractures of 10.3/100,000/year in a complete Danish regional population. The results reported that patients treated for a lateral tibial plateau fracture with bone tamp reduction and percutaneous screw fixation achieved a satisfactory level...... with only the subgroup Sport significantly below the age matched reference population. The thesis reports a level of health related quality of life (Eq5d) and disability (KOOS) significantly below established reference populations for patients with bicondylar tibial plateau fracture treated with a ring...... fixator, both during treatment and at 19 months following injury. In general, the thesis demonstrates that the treatment of tibial plateau fractures are challenging and that some disabilities following these fractures must be expected. Moreover, the need for further research in the area, both with regard...

  12. Mandibular condylar fractures and acute atlanto-axial subluxation Part 2 A physiopathological factor for the cervical spine sprain.

    Science.gov (United States)

    Cutilli, T; Corbacelli, A

    2009-05-01

    The aim of this study was to analyze the physiopathology of the acute cervical injure in the event of mandibular condylar fractures. As in the Part 1, 25 non-consecutive cases of condylar mandibular fractures (16 males and 9 females, mean age: 22.96/range 14-36 years) observed and treated in the Maxillofacial Surgery Department of the University of L'Aquila, have been studied. Types of fractures examined included: unilateral: 19 cases (solitary: 12; associated with other mandibular fractures: 7, homolateral: 2); bilateral: 6 cases (equivalent: 2, not equivalent: 4). A control group was constituted of 10 patients, 5 males and 5 females, aged from 19 to 24 years (mean range: 21.6) suffering from acute isolated cervical distorsion (whiplash). The study has been performed by means of the analysis of X-ray and computed tomography (CT)-CT/3D of the mandibular condylar regions, the occipital-atlanto-axial structures and the cervical region. In all the patients the following constant alterations that link up with these fractures have been observed: the rotation of atlas, the atlanto-axial subluxation and the derangement of the occipital-atlanto-epistropheal joint, homolateral to the side of the mandibular condylar fracture. The cervical spine shows the constant loss of physiological lordosis with hinge between C3 and C4. In the whiplash, as the authors have been able to assess in the control group, there are no alterations of occipital-atlanto-axial joint and the kinetic vector is placed on the longitudinal plane. In the mandibular condylar fractures the kinetic mechanism is completely different regarding the whiplash. The point of entry is the chin and the kinetic vector is oriented down-up, sometimes oblique in the opposite side. Subsequently the kinetic force is transmitted throughout the mandibular structure and causes the condylar or bicondylar fracture. The kinetic vector is placed before on the vertical plane, then on the horizontal plane and later on the vertical

  13. Correlation of Hip Fracture with Other Fracture Types: Toward a Rational Composite Hip Fracture Endpoint

    Science.gov (United States)

    Colón-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.

    2016-01-01

    Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123

  14. Effectiveness of hyperbaric oxygen therapy in irradiated maxillofacial dental implant patients: A systematic review with meta-analysis

    Directory of Open Access Journals (Sweden)

    Darshana Nilesh Shah

    2017-01-01

    Full Text Available The significantly higher implant failure rates in maxillofacial patients, undergoing radiotherapy, might be caused by the long-term effects of reduced vascularization compromising the implantation site. An extensive preclinical animal literature and a multitude of clinical reports suggest the use of hyperbaric oxygen (HBO therapy as it can improve the tissue vascularity. Hence, it may increase the implant survival rate by enhancing osseointegration process in such patients. The objective of this systematic review was to investigate the effectiveness of HBO therapy on dental implant survival rate in irradiated maxillofacial patients who require prosthodontic rehabilitation. An electronic search without time restrictions was undertaken in April 2016 using databases: PubMed, Google Scholar, and the Cochrane Oral Health Group Trials Register. We also tried to contact the manufacturers and researchers in the field for necessary details. Clinical human studies, on irradiated maxillofacial dental implant patients, including randomized controlled trials (RCTs, prospective controlled trials, retrospective studies, and preliminary reports were included in the study. Data collection was carried out by two of the authors' independently. The titles and abstracts of all reports were screened for the study design and type of reported intervention; all the duplicates were removed. The data search yielded 62 titles, out of which 14 articles were selected for the study by the article filtration criteria: Title/abstract/full text. Data which were extracted by two authors with any disagreement were resolved by the third author, and a meta-analysis was done using binary random-effect model. The results show decreased implant failure rate in HBO group (9.21% compared to non-HBO group (22.44%. The potential limitations of this study are amount of radiation doses used, period lasting from radiotherapy to the placement of the implants, and follow-up period which varies

  15. Results of screw fixation combined with cortical drilling for treatme