Neils L. Clark

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In the last 20 years, the management of pan-facial injuries has progressed to the point where immediate treatment using open reduction with rigid fixation is now the standard of care. After discussing the historical progression of treatments, the authors present a plan for treatment of craniofacial injuries based on the use of incisions that expose the four(More)
Le Fort defined the classic weak points of facial fractures. Fractures of the midface and mandible are believed to require management with standard rigid fixation. Recent work has allowed mini- and microplating of multiple fracture fragments into more manageable larger segments for reduction and subsequent plating with rigid fixation to peripheral(More)
Despite evidence indicating dental sealants to be effective in preventing caries on the pit and fissure surfaces of teeth, only 8 percent of school-aged US children had received sealants as of 1986-87. While many rationales have been suggested and scientifically answered for this low level of utilization, issues of cost and cost effectiveness remain(More)
A 17-year experience from 1977 to 1993 with gunshot, shotgun, and high-energy avulsive facial injuries emphasizes the superiority and safety of "ballistic wound" surgical management: (1) immediate stabilization in anatomic position of existing bone, (2) primary closure of existing soft tissue, (3) periodic "second look" serial debridement procedures, and(More)
The patterns of midface fractures were related to postoperative computed tomography scans and clinical results to assess the value of ordering fracture assembly in success of treatment methods. A total of 550 midface fractures were studied for their midface components and the presence of fractures in the adjacent frontal bone or mandible. Preoperative and(More)
The management of nasoethmoidal orbital injuries can be difficult. Clinical recognition and options for correction are diverse. Recently we treated several patients with limited facial injuries in which the nasoethmoidal complex "greensticks." Treatment with limited exposure and rigid fixation allows for adequate reduction. Clinical recognition and an(More)
A classification of palatal fracture types is developed from patterns observed on CT scans, and success with open reduction techniques is correlated with fracture pattern. The six palatal fracture types are as follows: I, anterior and posterolateral alveolar; II, sagittal; III, parasagittal; IV, para-alveolar; V, complex; and VI, transverse. Associated(More)
ii Aknowledgements Harry Partika and Meryl Martin, without whom there would be no data, and Aaron Delwiche, without whom there would be no aspiration. iii Abstract This work begins by providing a comprehensive review of videogame-related literature in fields as diverse as communications, psychology, sociology, and neuroscience; this reading suggested that(More)
The use of an arteriovenous fistula (AVF) to afford vascular access for free tissue transfer is described in 11 consecutive patients from a 1 year period. The leg was the site of pathology in six cases, and a reversed saphenous AVF to the femoral vessels was created. In the remaining five cases, those in the head and neck and arm regions, the recipient(More)
During the past decade, advances in radiographic imaging have made it possible for the surgeon managing orbital fractures to adopt a rational therapeutic strategy based on a knowledge of alterations in surgical anatomy secondary to traumatic injury. To illustrate the value of computed tomography in the surgeon's armamentarium for management of orbital(More)