• Title/Summary/Keyword: 연부조직 손상

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Management of an Open Comminuted Fracture of the Metacarpus using Circular External Skeletal Fixation in a Korean Water Deer (Hydropotes inermis argyopus) (고라니에서 발생한 손허리뼈 개방 복합골절의 원형 외부골격고정법 적용)

  • Heo, Su-Young;Jeong, Seongmok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.359-362
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    • 2015
  • A Korean water deer was rescued after being hit by a motor vehicle. Clinical and radiographic examination revealed a grade III open fracture of the right metacarpus with severe soft tissue injury. The water deer underwent closed reduction of the fracture, which was stabilized by the application of the Ilizarov method of 4-ring circular external skeletal fixation (CESF) as a minimally invasive technique. The water deer was successfully released into the wild. CESF was advantageous for the stabilization of open comminuted fracture and the management of a severely contaminated wound in a Korean water deer. CESF can be used successfully in wild deer with good tolerance and minimal complications.

Percutaneous K-wire Fixation of Supracondylar Fracture of Humerus in Children (소아 상완골 과상부 골절의 경피적 K-강선 고정술)

  • Shin, Duk-Seop;Ahn, Jong-Chul;Kim, Se-Dong;Lee, Dong-Woo
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.400-408
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    • 1993
  • During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safety, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an excellent reduction.

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Treatment of Malunion (부정유합의 치료)

  • Kim, Joon-Woo;Park, Kyeong-Hyeon;Oh, Chang-Wug
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.117-124
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    • 2021
  • Although current surgical techniques have reduced the incidence of malunion, it is still observed because of the complexity of the fracture or associated injuries. Osteotomy is needed when the amount of malunion is expected to result in an overload of cartilage and instability of the joint. Preoperative planning is essential when performing an osteotomy for malunion. Inadequate planning can result in serious complications, such as iatrogenic malalignment, intraoperative fracture, postoperative recurrence of deformity, or soft tissue injuries. In addition, a poor functional result can occur secondary to poor patient selection. This review article includes the surgical indications and planning to correct malunion. Various methods of corrective osteotomy are described according to the kinds of plane and fixation implants.

Meniscus Repair using Meniscus Arrow with Anterior Cruciate Ligament Reconstruction (전방 십자 인대 재건술시 동반된 반월상 연골 파열에 대한 meniscus arrow를 이용한 봉합)

  • Cho Sung-Do;Park Tae-Woo;Hwang Su-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.156-160
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    • 2002
  • Purpose : To evaluate the results and usefulness of meniscal repair using meniscal arrows with ACL reconstruction. Material and Methods : Among cases of the simultaneous meniscal arrow fixation and ACL recontruction performed between May, 1997 and September, 2000, 17 cases could be evaluated. The average follow-up were 18.5 months. Twelve cases were medial meniscus, 5 cases, lateral meniscus. All cases were longitudinal tear. Meniscal tear were seen at red-red zone in 13 cases, red-white zone in 5 cases. The results were analyzed by pain, joint line tenderness, locking, McMurray test, the Marshall knee scoring scale and complications. Results : Postoperatively two patients had mild joint line tenderness without pain on joint motion or weight bearing. No patient had locking or positive McMurray test. At last follow-up, 15 cases $(88\%)$ were 'excellent' or 'good' according to the Marshall knee score scale. There were two complications which are soft tissue irritation sign on active knee motion and a femoral chondral injury due to protruded T-shaped head of meniscus arrow. Conclusion : Meniscus arrow can be one of the options in repairing the associated meniscus tear, especially the posterior horn of medial meniscus, during ACL reconstruction. However, surgeons using meniscus arrow should be aware of its potential complications such as pain due to soft tissue irritation and chondral damage of the femoral condyle.

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Efficacy of Arthroscopic Diagnosis and Treatment for Acute Complete Metacarpophalangeal Ulnar Collateral Ligament Tears of the Thumb (무지 중수 수지 관절 척측 측부 인대 급성 완전 파열의 진단 및 치료에 대한 관절경의 유용성)

  • Chun, Churl-Hong;Kim, Dong-Chul;Chin, Byoung-Soo;Kim, Chae-Geun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.49-54
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    • 2005
  • Purpose: Complete rupture of metacarpophalangeal ulnar collateral ligament of thumb needs surgical exploration and repair, owing to the interposition of the adductor aponeurosis (Stener lesion) which interferes in healing process. We performed arthroscopic diagnosis and treatment on ulnar collateral ligament injury of thumb and evaluated it's efficiency. Materials and Methods: Arthroscopy was perfomed on 13 patients of whom injured on complete ruture of metacarpophalangeal ulnar collateral ligament. Follow-up period was over 1 year and mean age was 35.6 years old. Ulnar collateral ligament tears and Stener lesion were diagnosed and treated by arthroscopy procedure. Results were interpreted by joint instability, pinch power, grip power and range of motion on metacarpophalangeal joint of thumb. Results: We found 5 Stener lesions in 13 cases. There was no appreciable postoperative instability. Pinch and grip power were recovered to 92%, 94% of uninjured thumb respectively. Range of motion on metacarpophalangeal joint was mean $52^{\circ}$, almost equal to uninjured thumb. Conclusions: Arthroscopic treatment in metacapophalangeal ulnar collateral ligament injury of thumb is useful method that Stener lesion can be clearly comfirmed and treated. Also soft tissue injuries can be minimized, thereby early functional recovery can be expected.

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Metallic Radial Head Prosthesis in Korea (요골두 금속 치환물의 국내 사용)

  • Han, Sang-Hwan;Moon, Jun-Gyu;Park, Jong-Wong;Jang, Ki-Mo
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.84-91
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    • 2007
  • Purpose: The aim of this study was to report seven cases of metallic radial head prosthesis and present the limit of use in Korea. Materials and Methods: Metallic radial head arthroplasty was performed on 7 patients between April 2006 and December 2006, who had complex elbow injury including comminuted radial head fracture. Indication, operative findings and outcome were assessed. Availability and payment of implant were investigated. Results: All of the patients had more than one associated injury including coronoid fracture, olecranoan fracture, and ligament ruptures. According to Mason classification, there were three type III and four type IV fractures. All radial head fractures were too comminuted to reconstruct. There were two excellent results, four good, and one poor, as graded by Mayo score. There were no patient with instability and implant related complications. Insufficient supply of implant did not enable to do scheduled surgery in 2 cases. Current medical insurance did not cover charge for radial prosthesis, five patients could not help paying for that by themselves. Conclusion: Metallic radial head implants are useful when the radial head cannot be repaired reliably. Preoperative preparing and coverage by medical insurance based on appropriate indication are helpful for decision for a treatment option.

A Study of Fiber-Reinforced Material Models for the Mechanical Characteristics of Human Annulus Fibrosus (인체의 윤상인대의 역학적 특성 모사를 위한 섬유 강화 모델에 관한 연구)

  • Lim, Jun-Taek;Choi, Deok-Kee
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.35 no.6
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    • pp.619-628
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    • 2011
  • Human soft tissues, including muscles, ligaments, skin, and blood vessels, are an interesting subject because damage to them can be observed in everyday life. Besides the lack of available experimental data and the large deformation upon loading, the anisotropic and compressible nature of annulus fibrosus makes it more difficult to find a simple material model. A fiber-reinforced hyperelastic material model is used to determine the stress-strain curves upon uniaxial loading. The energy potential function for annulus fibrosus is composed of three different parts: matrix, fibers, and matrix-fiber interaction, which accounts for the angles between two families of fibers. In this paper, two different types of energy potential function for the matrix are considered, and are inserted into the fiber-reinforced model. The calculated results are compared with the Neo-Hookean model and experimental data, and reasonable agreement is observed overall.

Tibial Fracture Repair in a Black Gibbon (Hylobates concolor) (긴팔원숭이에서 발생한 경골 골절의 외과적 정복 1례)

  • Yoon, Hun-Young;Lee, Bo-Ra;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.644-646
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    • 2009
  • A 5-year-old intact male black gibbon (Hylobates concolor) was referred for evaluation of the right pelvic limb lameness following a fight against other black gibbons. Fractures of the right tibia and fibula were suspected on physical examination and palpation of the right pelvic limb, but no other injuries or abnormalities were detected. While the black gibbon was sedated, pelvic limb radiographs were taken, which revealed diaphyseal oblique fractures of the right tibia and fibula. Open reduction of the fractures was performed. The tibial fracture was repaired by use of an internal fixation technique that included a tubular dynamic compression plate and cortical screws secured along the craniomedial aspect of the tibia. There were no complications during the postoperative rehabilitation period. At 9 weeks, radiographs revealed that bridging callus was well formed over the cortices of the tibial and fibular fracture area. The cast was removed 9 weeks after surgery. The black gibbon exhibited no evidence of lameness and was released back into the group. Presently, there are no published reports of internal fracture fixation in a black gibbon where a tubular dynamic compression plate and cortical screws provided excellent stabilization of the tibia and complete fracture healing allowing normal ambulation.

Treatment of Transverse Patella Fracture with Minimally Invasive Load-Sharing Patellar Tendon Suture and Cannulated Screws (최소 침습 기법 슬개건 부하 분산 봉합술과 유관 나사못을 이용한 슬개골 횡골절의 치료)

  • Lee, Beom-Seok;Park, Byeong-Mun;Yang, Bong-Seok;Kim, Kyu-Wan
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.540-545
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    • 2021
  • A transverse fracture is the most common type of displaced patella fracture requiring surgery. These fractures are commonly fixed with parallel Kirschner wires or screws that cross the fracture line, often with an additional tension band. Nevertheless, conventional fixation methods of patella fractures have prevalent complications caused by the protrusion of wires or pins. These complications necessitate additional surgery for hardware removal, increase medical cost, and can limit the function of the knee joint. This paper reports cases treated with a minimally invasive load-sharing percutaneous suture of the patella tendon. The procedure provides reliable fixation for transverse patella fractures, minimizes soft tissue injuries, preserves blood flow, and reduces postoperative pain. In addition, the procedure also reduces the irritation and pain caused by the internal fixture, thereby reducing the risk of restricted knee joint movement.

Musculoskeletal Injuries by Weapons in Korean Soldiers: Four-Year Follow-Up (총기 및 폭발물에 의한 군인의 근골격계 손상: 최근 4년간 분석)

  • Yang, Hanbual;Hwang, Il-Ung;Song, Daeguen;Moon, Gi Ho;Lee, Na Rae;Kim, Kyoung-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.234-244
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    • 2021
  • Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21-52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion: This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.