• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.255-263
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• 2011

Introduction: Maxillomandibular fixation (MMF) is essential before surgery under general anesthesia in maxillofacial trauma patients. MMF is used basically to reconstruct the occlusion and occlusal stability to recover the facial shape and oral functions. The arch bar and wire is a traditional method for MMF, but it can not only bring pressure to the periodontal ligaments and teeth but also cause a penetrating injury to the surgeons. Materials and Methods: In this study, 198 patients with an open reduction using a manual reduction without MMF from September 2005 to May 2010 in Dankook University Dental Hospital were subjected to a follow-up evaluation during the postoperative 4 months periods. This study evaluated the incidence of complications according to the condition of the patient (gender, age), the state of bony union of the fracture sites and a numeric rating scale evaluation for postoperative pain scoring. Results: 1. The complications were classified into major and minor according to the seriousness, and the major complication rate was as low as 2.02%. Only 2 cases of re-operations (1.01%) were encountered. In the classification according to the fracture line, plate fracture was observed in both cases of mandibular symphysis fracture, and angle fractures and loosening of two screws were noted in the case of mandibular angle fracture. 2. The complication rate was similar regardless of gender and age. 3. The degree of bony union was satisfactory, and the complication rate was reduced as the bony union improved. 4. More patients complained of pain as the operation time was increased. Conclusion: The use of MMF is not always necessary if a skilled assistant is provided to help manually reduce the fracture site. Compared to other studies of mandibular fracture surgery using MMF, the complication rate was similar using only manual reduction and the patients' discomfort was reduced without MMF.

• 대한두개안면성형외과학회지
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• 제13권2호
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• pp.119-124
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• 2012

Purpose: Closed reduction and nasal packings for 3-7 days is usual procedures in managing nasal bone fracture. Most patients experience several discomfort owing to lack of nasal breathing. There are many reports concerning how to reduce patient's discomforts or complications. But it is obvious that the duration of nasal packing is 3-7 days. The aim of this study is evaluate the effect of half day nasal packing in results of nasal bone fracture. Methods: The study was performed on 97 nasal bone fracture patients who had simple nasal bone fractures from January to June 2012. The incidence, cause, patient's discomfort and satisfaction with half day nasal packing are analyzed according to patient's medical records and questionnaire at each nasal packing removal, postoperative 4 weeks. Results: Young male patients, especially the teenagers and the twenties were the common age group, and physical violence was most common cause of injury. A total of 78 out of 97 patients were male. In 92 cases, closed reduction were applied. Approximately, 87% of the patients were satisfied with the outcomes. Conclusion: Half day nasal packing is considered as an effective method to minimize patient's discomfort owing to prolonged absence of nasal breathing with maintenance of stability.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.6.1-6.6
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• 2020

Background: Various types of miniplates have been developed and used for the reduction of facial bone fractures. We introduced Yang's Keyhole (YK) plate, and reported on its short-term stability. The purpose of this study was to evaluate the long-term stability of the YK plate, as a follow-up study, by examining the patients who had used the YK plate among the patients with the reduction of mandible fractures and who visited for plate removal. Methods: We reviewed the medical records of 16 patients who underwent mandibular fracture fixation using a YK plate (group I) and 17 patients who underwent mandibular fracture fixation using a conventional plate (group II). Assessment was then made on malunion, occlusal stability, discomfort during the application, and clinical symptoms. Results: From January 2015 to December 2017, a total of 36 patients underwent mandibular fracture surgery using a YK plate. A total of 16 patients received plate removal. Among them, 15 were male and 1 female. The average age was 26 years. The applied surgical sites were the 12 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of YK plate was an average of 335 days. During the same period, 45 people underwent surgery on the conventional plate. A total of 17 patients received plate removal. Among them, 15 were male and 2 females. The average age was 36 years. The applied surgical sites were the 8 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of the conventional plate was an average of 349 days. No malocclusion occurred at the time of removal, and occlusion was stable. No patient complained of joint disease or discomfort. Conclusion: The YK plate system, in which the screw was first inserted and the plate was applied, for clinical convenience did not cause any particular problem and no significant difference from the conventional plate.

• 대한족부족관절학회지
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• 제9권1호
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• pp.99-104
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• 2005

Purpose: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. Materials and Methods: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. Results: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. Conclusion: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.

• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.12-16
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• 2011

Purpose: This study examined the biomechanical stability of four different plating techniques in the experimental model of mandibular subcondyle fracture. Methods: Twenty standardized bovine tibia bone samples ($7{\times}1.5{\times}1.0cm$) were used for this study. Each of the four sets of tibia bone was cut to mimic a perpendicular subcondyle fracture in the center area. The osteotomized tibia bone was fixed using one of four different fixation groups (A,B,C,D). The fixation systems included single 2.0 mm 4 hole mini adaption plate (A), single 2.0 mm 4 hole dynamic compression miniplate (B), double fixation with 2.0 mm 4 hole mini adaption plate (C), double fixation with a 2.0 mm 4 hole mini adaption plate and 2.0 mm 4 hole dynamic compression miniplate (D). A bending force was applied to the experimental model using a pressure machine (858 table top system, $MTS^{(R)}$) until failure occurred. The load for permanent deformation, maximum load of failure were measured in the load displacement curve with the chart recorder. Results: Double fixation with a 2.0 mm 4 hole mini adaption plate and a 2.0 mm 4 hole dynamic compression miniplate (D) applied to the anterior and posterior regions of the subcondyle experimental model showed the highest load to failure. Conclusion: From this study, double fixation with an adaption plate and dynamic compression miniplate fixation technique produced the greatest biomechanical stability. This technique may be considered a useful means of fixation to reduce the postoperative internal maxillary fixation period and achieve early mobility of the jaw.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.129-138
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• 2016

Purpose: Due to recent advances in internal fixation techniques, instrumentation and orthopedic implants there is an increasing number of humeral shaft fracture treated operatively. As a consequence, an increased number nonunion after operative fixation are being referred to our center. The aim of this study is to report the common error during osteosynthesis that may have led to nonunion and present a systematic analytical approach for the management of aseptic humeral shaft nonunion. Methods: In between January 2007 to December 2013, 20 patients with humeral shaft nonunion after operative procedure were treated according to our treatment algorithm. We could analysis x-rays of 12 patients from initial treatment to nonunion. In a subgroup of 12 patients the initial operative procedure were analyzed to determine the error that may have caused nonunion. The following questions were used to examine the cases: 1) Was the fracture biology preserved during the procedure? 2) Does the implant construct have enough stability to allow fracture healing? Results: In 19 out of 20 patients have showed radiographic evidence of union on follow up. One patient has to undergo reoperation because of the technical error with bone graft placement but eventually healed. There were 2 cases wherein the treatment algorithm was not followed. All patients had problems with mechanical stability, and in 13 patients had biologic problems. In the analysis of the initial operative fixation, only one of 12 patients had biologic problems. Conclusion: In our analysis, the common preventable error made during operative fixation of humeral shaft fracture is failure to provide adequate stability for bony union to occur. And with these cases we have demonstrated a systematic analytic management approach that may be used to prevent surgeons from reproducing the same fault and reduce the need for bone grafting.

• 한국기계가공학회지
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• 제9권3호
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• pp.49-55
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• 2010

In this paper, the stability of cracked cantilever T-beams subjected to subtangential follower force is investigated. Also, the effect of subtangential coefficient and crack on the natural frequency of T-beams is presented. Based on the Euler-Bernoulli beam theory, the equation of motion is derived by the energy expressions using extended Hamilton's Principle. The crack is assumed to be in the first mode of fracture and to be always opened during the vibrations. The values of critical follower force and the stability maps of cantilever T-beams are obtained according to the subtangential coefficient and crack severity. The results of this study will contribute to the safety testing and the stability estimation of cracked T-beams subjected to follower force.

• Structural Engineering and Mechanics
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• 제58권1호
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• pp.103-119
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• 2016

Multi-storey frame structures are frequently exposed to static and dynamic forces. Therefore analyses of static (buckling) and dynamic stability come into prominence for these structures. In this study, the effects of number of storey, static and dynamic load parameters, crack depth and crack location on the in-plane static and dynamic stability of cracked multi-storey frame structures subjected to periodic loading have been investigated numerically by using the Finite Element Method. A crack element based on the Euler beam theory is developed by using the principles of fracture mechanics. The equation of motion for the cracked multi-storey frame subjected to periodic loading is achieved by Lagrange's equation. The results obtained from the stability analysis are presented in three dimensional graphs and tables.

• 한국소음진동공학회논문집
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• 제17권10호
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• pp.1002-1009
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• 2007

In this paper, the dynamic stability of a cracked simply supported pipe conveying fluid with an attached mass is investigated. Also, the effect of attached mass on the dynamic stability of a simply supported pipe conveying fluid is presented for the different positions and depth of the crack. Based on the Euler-Bernouli beam theory, the equation of motion can be constructed by the energy expressions using extended Hamilton's principle. The crack section is represented by a local flexibility matrix connecting two undamaged pipe segments. The crack is assumed to be in the first mode of a fracture and to be always opened during the vibrations. Finally, the critical flow velocities and stability maps of the pipe conveying fluid are obtained by changing the attached mass and crack severity.

• 한국정밀공학회지
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• 제25권5호
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• pp.121-131
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• 2008

In this paper, the dynamic stability of a cracked simply supported pipe conveying fluid with an attached mass is investigated. Also, the effect of attached masses on the dynamic stability of a simply supported pipe conveying fluid is presented for the different positions and depth of the crack. Based on the Euler-Bernoulli beam theory, the equation of motion can be constructed by the energy expressions using extended Hamilton's principle. The crack section is represented by a local flexibility matrix connecting two undamaged pipe segments. The crack is assumed to be in the first mode of a fracture and to be always opened during the vibrations. Finally, the critical flow velocities and stability maps of the pipe conveying fluid are obtained by changing the attached masses and crack severity. As attached masses are increased, the region of re-stabilization of the system is decreased but the region of divergence is increased.