• 대한족부족관절학회지
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• 제14권2호
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• pp.119-122
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• 2010

Purpose: One of the main contributors to proximal fifth metatarsal fracture is ankle inversion and the incidence of recurrence may increase in patients with ankle instability. So, the authors confirmed the patients of proximal fifth metatarsal fracture with ankle instability by checking the history and magnetic resonance imaging (MRI) and assessed the value of MRI as therapeutic prognosis and clinical indicators for prevention of recurrence. Materials and Methods: Patients with proximal fifth metatarsal fractures visited our hospital during recent five years were reviewed. 35 patients with suspected damage by ankle inversion had been identified a history of ankle instability and checked the hindfoot malalignment through hindfoot alignment view and MRI was performed prospectively. The patients was devided to three groups on the location of fracture site and the groups were compared each other. Results: The mean time from injury to checking MRI was 10.7 days. There was no structural abnormality and was no significant difference according to the location of fracture. The patients with history of ankle inversion were 31(88.6%) and the patients with history of chronic or recurrent injury were 22 patients (62.9%). The lesion of MRI related to lateral ankle instability were identified in all patients. Conclusion: This study noted a high incidence of lateral ankle instability that was identified by MRI in the patients of proximal fifth metatarsal fracture. Aggressive treatment for lateral ankle instability should be needed for complications as proximal fifth metatarsal fracture to reduce the recurrence and occurrence.

• The Korean Journal of Pain
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• 제25권4호
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• pp.258-261
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• 2012

Posterior neck pain is a common complaint of patients in the pain clinic. The atlas (C1) burst fracture is known to be a cause of posterior neck pain and instability. Although the atlas burst fracture and instability can be discovered by plain X-rays which show lateral mass displacement or widening of the atlantodental interval, assessment of an atlas burst fracture can be difficult if there is no instability in the imaging study. Here we report a case of a 46-year-old female patient who had complained of sustained posterior neck pain for 6 months. Plain X-rays showed only disc space narrowing at C4/5 and C5/6, without any cervical instability. However, an unrecognized C1 lateral mass fracture was detected by CT and MRI. The patient's pain was then successfully treated after atlantoaxial joint injection with a C2 DRG block.

• Structural Engineering and Mechanics
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• 제71권1호
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• pp.65-75
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• 2019

In this article, the dynamic fracture instability characteristics, including dynamic crack propagation and crack branching, in PMMA brittle solids under dynamic loading are investigated using the discrete element method (DEM) simulations. The microscopic parameters in DEM are first calibrated using the comparison with the previous experimental results not only in the field of qualitative analysis, but also in the field of quantitative analysis. The calibrating process illustrates that the selected microscopic parameters in DEM are suitable to effectively and accurately simulate dynamic fracture process in PMMA brittle solids subjected to dynamic loads. The typical dynamic fracture behaviors of solids under dynamic loading are then reproduced by DEM. Compared with the previous experimental and numerical results, the present numerical results are in good agreement with the existing ones not only in the field of qualitative analysis, but also in the field of quantitative analysis. Furthermore, effects of dynamic loading magnitude, offset distance of the initial crack and initial crack length on dynamic fracture behaviors are numerically discussed.

• Journal of Trauma and Injury
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• 제27권2호
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• pp.29-32
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• 2014

Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

• 한국정밀공학회지
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• 제6권3호
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• pp.78-89
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• 1989

Applicability of tearing modulus based on J-integral proposed by Paris et al is investigated using compact tension specimens of strutural alloy steel (SCM4). Both general fracture test and instability fracture test are performed. The applied tearing modulus, ( $T_{j}$)app estimated from the real load vs. crack growth curve measured from experiments are compared with that estimated from the limit load vs. crack growth curve. The results are : (1) the $T_{j}$parameter could be applied to predict crack growth instability : (2) The use of ( $T_{j}$)app estimated from the load vs. crack growth curve, proposed in this study could be well predicted crack growth instability instead of that estimated form the limit load vs. crack growth curve.e.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1469-1475
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• 2000

Objective : The goal of this study was to evaluate the clinical outcome of the posterior C1-2 transarticular screw fixation without C1-2 sublaminar wiring in atlantoaxial instability. Methods : Between Apr. 1995 and Feb. 2000, we used this technique in treat randomly selected 17 patients (11 men, 6 women) who had atlantoaxial instability. The causes of instability were : type II-A odontoid process fracture(10 cases) ; type II-P odontoid process fracture(1 case) ; Os odontoideum(2 cases) ; transverse ligament laxity due to rheumatoid disease(1 case) ; and, transverse ligament injury without bone fracture(3 cases). All cases were operated with posterior C1-2 transarticular screw fixation with 3.5mm cortical screw and interlaminar iliac graft without sublaminar wire fixation. The mean follow-up period was 28 months(5 to 58 months) and the mean age at the time of operation was 41 years(15 to 68 years). All Patients were allowed to ambulate with Philadelphia neck collar on the first post-operation day. Results : Bony fusion was successfully achieved in all cases demonstrated at 3-month follow-up studies. There was no operative mortality or morbidity. Conclusion : The authors conclude that the posterior transarticular screw fixation without C1-2 sublaminar wiring provide adequate stability with high bony union rate in atlantoaxial instability of various causes.

• 대한토목학회논문집
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• 제31권2A호
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• pp.71-77
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• 2011

본 논문은 고체의 동적 탄소성해석을 수행하기 위해 인장불안정이 제거된 SPH기법을 사용하였다. 인장불안정은 SPH 입자들이 인장력에 의해 서로 떨어져나가는 해석적 오류현상이며, 재료적 특성에 따라 해석결과에 큰 영향을 미치게 된다. 이와 같은 인장불안정을 제어하기 위한 방법으로 본 연구에서는 가상응력의 개념을 적용하였다. 본 연구에서 제시한 SPH에 의해 해석예제를 수행하여 해석법의 효율성을 검증하였으며, 해석예제로 원형 링의 충돌문제와, 절단, 균열과 같은 재료적 파괴문제를 수행하였다.

• 대한기계학회논문집
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• 제17권9호
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• pp.2223-2233
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• 1993

An engineering method is suggested to calculate the applied load versus crack extension in the elastic-plastic fracture. The condition for an increment of crack extension is set by a critical increment of crack-up opening displacement(CTOD). The ratio of the CTOD increment to the incremental crack extention is a critical crack-tip opening angle(CTOA), assumed to be constant for a material of a given thickness. The Dugdale model of crack-tip deformation in an infinite plate is applied to the method, and a complete solution for crack extension and crack instability is obtained. For finite-size specimens of arbitrary geometry in general yielding, an approximate generalization of the Dugdale model is suggested so that the approximation approaches the small-scale yielding solution in a low applied load and the finite-element solution in a large applied load. Maximum load is calculated so that an applied load attains either a limit load on an unbroken ligament or a peak load during crack extension. The proposed method was applied to three-point bend specimens of a carbon steel SM45C in various sizes. Reasonable agreements are found between calculated maximum loads and experimental failure loads. Therefore, the method can be a viable alternative to the J-R curve approach in the elastic-plastic fracture analysis.

• 한국안전학회지
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• 제5권2호
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• pp.58-65
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• 1990

The purpose of this study is to consider the effects of strain rate on the stress-strain behavior of sheet metal at instability. The results and conclusions obtained as follows ： 1. As the strain rate increases, the fracture pressure increases and the polar height at fracture decreases. 2. The effect of strain rate on forming limit diagram produces a general lowering of the diagram with increasing strain rate but changes according to materials and strain paths. 3. The forming limit diagram predicted by swift instability theory is comparatively inconsistent with the experimental result at high strain rates, because there is inevitable gap between them.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.