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The palatal fracture results in deformity of the midface, as well as change in occlusion. However, no report was found on the incidence, treatment and results of palatal fracture in Korea. A retrospective review was done over 6 years and 11 patients(6.5%) with palatal fracture were determind out of 168 patients who had midfacial bone fractures without nasal bone fracture. According to the Hendrickson's classification, the number of patients with specific types of palatal fracture was described as follows; sagittal (2 cases), parasagittal (2 cases), para-alveolar (3 cases), transverse(3 cases) and complex(1 case). Le Fort I (6 cases), Le Fort II (7 cases) and mandible (6 cases) fractures were also associated. Open reduction and internal fixation was applied to all patients. Internal fixation consisted of pyriform or alveolar ridge stabilization and maxillary buttress stabilization. The rigid palatal vault stabilization was applied in one patient with midline split of the palate. The duration of intermaxillary fixation was shortened to less than 3 weeks from 4 to 6 weeks with rigid fixation. The palatal splint was used temporarily before internal fixation. All the patients showed good bony union and satisfactoryocclusion postoperatively. Open reduction and internal fixation showed satisfactory results from the aspects of stability, occlusion, patient convenience and final aesthetics. The following treatment model for palatal fracture according to the fracture type is proposed; 1) Alveolar type - close reduction or open reduction and selective alveolar ridge fixation and selective application of palatal splint, 2) Sagittal type - open reduction and internal fixation of the alveolar ridge, maxillary buttress and palatal vault. 3) Parasagittal type - open reduction and internal fixation of the pyriform aperture and maxillary buttress, as well as selective fixation of the palatal vault. 4) Para-alveolar type - open reduction and internal fixation of the alveolar ridge and maxillary buttress. 5) Complex type - open reduction and internal fixation of the alveolar ridge, maxillary buttress, pyriform aperture and continuous use of a palatal splint to bony union. 6) Transverse type - open reduction and internal fixation of the alveolar ridge and maxillary buttress.
Alveolar Process ; Classification ; Congenital Abnormalities ; Esthetics ; Fractures, Bone ; Humans ; Incidence ; Korea ; Mandible ; Nasal Bone ; Palate ; Retrospective Studies ; Splints

We herein report a case of gout, who was a 45-year-old man and had had multiple various-sized papules or tophi on the helices of ears, hands, elbows, knees, ankles and feet for 10 years. Histopathologic findings of the large tophus of right knee revealed the typical pattern of gout with needle-shaped urate crystal. The phenomenon of iransepidermal elimination was observed in serial sections of histologic speeirnerls, The nsrrow transepidermal channel, lined by pseudoepitheliomstous lips bilaterally, was Eilled with the cellular debris and urate crystal fragments and cornmunicated direotly with the upper dermis. Presumably, transepidermal elirnination in gouty tophus may be the phenomenon whieh could be found rnore commonly than the scarcity of literature.
Ankle ; Dermis ; Ear ; Elbow ; Foot ; Gout ; Hand ; Humans ; Knee ; Lip ; Middle Aged ; Uric Acid