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Relationship between Locations of Facial Injury and the Use of Bicycle Helmets: A Systematic Review
황건,전윤문,고영성,김연수 대한성형외과학회 2015 Archives of Plastic Surgery Vol.42 No.4
The aim of this study is to review the protective effect of a bicycle helmet on each facial location systematically. PubMed was searched for articles published before December 12, 2014. The data were summarized, and the odds ratio (OR) between the locations of facial injury was calculated. A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre). Bicycle helmets protect the upper and middle face from serious facial injury but do not protect the lower face. Non-wearers had significantly increased risks of upper facial injury (OR, 2.07; P<0.001) and of middle facial injury (OR, 1.97; P<0.001) as compared to helmet users. In the case of lower facial injury, however, only a slightly increased risk (OR, 1.42; 95% confidence interval (CI), 0.67–3.00, P=0.36) was observed. The abovementioned results can be attributed to the fact that a helmet covers the head and forehead but cannot cover the lower face. However, helmets having a chin cap might decrease the risk of lower facial injury.
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요골 원위부 골절에서 외고정장치 후 신연에 따른 수근관절의 기능적 예후
노태훈,전윤문,나엽,이동주 대한수부외과학회 2018 대한수부외과학회지 Vol.23 No.3
Purpose: This study aimed to evaluate the relation between the degree of wrist joint distraction and postoperative restoration of joint function after performed external fixation with distraction of wrist joint in distal radius fracture. Methods: This study was conducted retrospectively on 55 patients who underwent reduction using external fixation for distal intra-articular radius fracture from January 2007 to December 2014. The degree of pre- and post-operative distraction was measured radiographically using the carpal height ratio (CHR). For postoperative functional assessment, range of motion of the wrist, Gartland Werley classification, grip strength, and pinch strength were measured. Results: In the functional assessment based on the Gartland Werley classification, excellent was reported by 31 patients, good; 16 patients, fair; 8 patients, and poor; 0 patients. The mean CHR was 0.519 preoperatively and 0.565 immediately after surgery. The mean postoperative CHR of excellent group was 0.581, demonstrating better clinical outcome in dis-traction than other groups. Eight case of joint stiffness was manifested when CHR value was lower than 0.54 and only 1 case of joint stiffness was manifested when CHR value was higher than 0.54, showing a tendency for lower incidence of joint stiffness when distracted over 0.54 of CHR. Conclusion: External fixation after sufficient distraction of the wrist joint produced an excellent outcome in the functional assessment. The better the prognosis in the Gartland Werley classification, the higher the CHR and the group with a CHR greater than 0.54 immediately after surgery showed less joint stiffness than the lower group. 목적: 요골 원위부 관절 내 골절에서 수근관절 신연 및 외고정술 시행 후, 신연 정도와 수술 후 관절 기능 회복의 연관성에 대해 알아보고자 하였다. 방법: 2007년 1월부터 2014년 12월까지 요골 원위부 골절 환자 중 외고정술을 시행한 55명을 대상으로 후향적 연구를 시행하였다. 신연 정도는 수근 높이 비를 측정하였고, 수근관절 운동 범위, Gartland Werley 분류, 악력, 핀치 강도 등을 조사하였다. 결과: Gartland Werley 평가 결과 우수 31명, 양호 16명, 보통 8명이었다. 수술 전 수근 높이 비 평균은 0.519였으며 수술 직후 0.565로 조사되었다. 우수군의 수술 후 평균 수근 높이 비는 0.581이었고, 양호군 0.553, 보통군 0.529로 임상적 예후가 좋을수록 수근 높이 비가 높았다. 수근 높이 비 0.54 이상인 환자군 중 수근관절 강직을 호소한 경우는 1명, 0.54 이하인 경우는 8명으로, 0.54 이상인 경우 수근관절 강직을 보이는 경우가 적었다. 결론: 요골 원위부 관절 내 골절 시 충분한 신연을 통한 비관혈적 외고정술은 좋은 임상적 결과를 보였으며 예후가 좋을수록 수근 높이 비가 큰 결과를 보였다. 수근 높이 비가 0.54보다 큰 경우가 낮은 경우와 비교하여 수술 후 관절강직이 나타날 확률이 낮은 결과를 보였다.
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