• Title/Summary/Keyword: Fracture dislocation

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Clinical Comparison of Two Types of Hook Plate in Surgical Treatment of Acromioclavicular Dislocation - AO Hook Plate and Wolter Plate - (견봉 쇄골 관절 탈구의 수술적 치료에서 두 가지 갈고리 금속판의 임상적 비교 - AO Hook Plate와 Wolter Plate -)

  • Choi, Jea-Yeol;Kim, Eugene;Jeong, Haw-Jae;Ahn, Jin Whan;Shin, Hun-Kyu;Park, Se-Jin;Lee, Seung-Hee;Lee, Jae-Wook;Choi, Kyu-Bo
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.123-129
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    • 2012
  • Objective: To evaluate if acromial locking in hook plate is necessary for surgical treatment of acromioclavicular dislocation by compare Wolter plate and AO hook plate. Methods: Seventy one patients who have Rockwood type III to V acromioclavicular joint dislocation treated with AO hook plate and Wolter plate were involved. Among them, 39 patients were treated with Wolter hook plate and 32 patients with AO hook plate. The Constant-Murley score and the range of motion of shoulder joint were measured on postoperative 1st ,$3^{rd}$, $6^{th}$ and $12^{th}$ months, and the radiological complications involving plate and bone were investigated. Results: Constant-Murley score of postoperative one year were $83.2{\pm}6.8$ in AO hook plate group and $85.2{\pm}5.3$ in Wolter plate group without statistical difference (p<0.05). Faster recover of forward elevation and external rotation were examined in Wolter plate group at first and third months after surgery than those of AO hook plate group, but there were no significant difference between after six months or later after surgery. Four cases of loosen or broken screws and one case of pull-out of plate were found in Wolter plate group. Seven cases of subacromial bony erosion and one periprosthetic fracture were found in AO hook plate group. Conclusion: Although clinical outcomes of both two methods were same, no matter if acromial locking system was or not. More radiological complication of plate and bone were found in AO hook plate than that of Wolter plate. However also had disadvantage like larger incision during surgery.

Total Elbow Arthroplasty after Failed Surgical Treatment for Elbow Fracture or Dislocation (주관절 골절 혹은 탈구의 실패한 수술적 치료 후 시행한 주관절 전 치환술의 결과)

  • Yi, Jin-Woong;Roh, Jun-Ha;Song, Jong-Hoon;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.190-198
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    • 2007
  • Purpose: The current study reports the clinical results of total elbow arthroplasties (TEA) which were Performed on patients with poor clinical and radiological results after initial surgeries for elbow fractures or dislocations. Materials and Methods: The clinical outcomes of twelve consecutive patients who underwent TEA after failed surgeries for elbow fractures or dislocations from january, 1995 to December, 2005 were evaluated. The initial diagnoses were distal humeral fractures in 8 cases and fracture-dislocations in 4 cases. The Mean period from the initial operations to the TEAs was 12 months. The mean folloow up period after TEA was 43 months. Results: The mean range of motion, in terms of active extension, activeflexion, supination, and pronation, improved from $14.2^{\circ}$, $96.7^{\circ}$, $50.8^{\circ}$ and $53.3^{\circ}$ to $5.4^{\circ}$, $122.1^{\circ}$, $63.3^{\circ}$ and $67.5^{\circ}$, respectively (p<0.05). RAdiolucent lines were found in 3 cases, which were 1 case of type 3, and 2 cases of type 4. All three loosening cases underwent revision TEAs. The mean postoperative Mayo elvow performance score was 79 point. There were 6 cases of excellent, 2 cases of good, and 4 cases in poor. Conclusion: Good clinical results were obtained after TEA performed in failed surgeries for elbow fractures of dislocations.

Elevated Temperature Creep Behavior of Rapidly Solidified Al-9.45wt%Fe-4.45wt%Cr Alloy (급냉응고된 Al-9.45wt%Fe-4.45wt%Cr합금의 고온 크?거동)

  • Rhim, J.K.;Kim, K.H.;Kim, T.S.
    • Journal of the Korean Society of Safety
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    • v.14 no.1
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    • pp.208-215
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    • 1999
  • The creep behavior of a rapidly solidified and consolidated Al-9.45wt%Fe-4.45wt%Cr alloy were investigated in the stress range 40 to 115 MPa and temperature range 300(0.53Tm) to 441$^{\circ}C$(0.66Tm). It is of use to available aerospace and automobile industries for the improved performance of materials used at high temperature. Because Al alloys with improved creep resistance offer the potential for lower weight and reduced costs in aerospace and automobile components (e.g., structural members and engine parts) through the replacement of heavier and more costly materials, the safety in use at high temperature is good. The alloy is characterized by high stress exponents and activation energies for creep, which are greatly dependent on the stress and temperature. Because the creep stress is seen to cause a strongly significant enhancement of coarsening, the coarsening rate of the dispersed particles in all crept specimens is faster than that in isothermally annealed specimens. Dislocations connecting dispersoids are observed more cofrequently in crept specimens with higher stress and lower temperature. The creep strain rates in the power law creep regime were found to be predicted much better by the Shorty and Rosler/Arzt equation with the inclusion of a threshold stress and dislocation detachment mechanism. The dispersoids in this alloy were acting a source of void nucleation that finally leaded to ductile fracture within the grain so called intergranular. Each void was initiated, grown and failed at the dispersoids in the aluminium matrix. Grain boundary accommodation of the slip produced, which result in initiation of the void and then final transgranular fracture. Therefore, it was confirmed that these dispersoids played an important role in the fracture mechanism by the formation of $Al_{13}Fe_4$, $Al_{13}Cr_2$ and $Al_2O_3$.

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Learning Curve of the Direct Anterior Approach for Hip Arthroplasty (직접전방 접근법을 통한 인공 고관절 치환술의 학습곡선)

  • Ham, Dong Hun;Chung, Woo Chull;Choi, Byeong Yeol;Choi, Jong Eun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.143-153
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    • 2020
  • Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion: Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.

The Evaluation of Usefulness New Assistant Device to Observe Posterior Cruciate Ligament Rupture and Patellofemoral Joint Injury in Emergency Patient (응급환자에서 후방십자인대 손상 및 슬대퇴 관절을 관찰하기 위한 보조기구 제작 및 유용성 평가)

  • Seo, Sun-Youl;Han, Man-Seok;Jeon, Min-Chul;Yu, Se-Jong;Kim, Yong-Kyun
    • Journal of radiological science and technology
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    • v.33 no.2
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    • pp.93-96
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    • 2010
  • This study evaluates usefulness of the developed assistant device by taking projection of patellofemoral joint in emergency patients who were doubt posterior cruciate ligament injury in knee joint. The subjects of experiment were patients who visited Eul-Ji University Hospital due to knee injury from January 2006 to December 2006. Seventeen patients, who took the Knee post stress view, Knee merchant view, Knee Seo's view to use assistant device and Knee MRI. To make assistant device of $170{\times}50{\times}70\;cm$, we evaluated its usefulness by measuring posterior dislocation of tibia. Seo's view is more accurate to make judgment of posterior cruciate ligament injury than original knee post stress view. Interval difference of posterior dislocation of original knee post stress view is $6.17{\pm}3.04$ and Seo's view is $8.74{\pm}4.47$. The results show injury of patellofemoral joint, vertical fracture of patella and posterior cruciate ligament injury by taking a projection using Seo's view. Therefore, it is useful to take projection earlier than talometer and MRI in emergency patients who were doubt posterior cruciate ligament injury in knee joint.

Inversion Research on the shortening and Sliding of Drape Zones between Chinese Continent Blocks by GPS Data

  • Zhixing, Du;Fanlin, Yang;Xinzhou, Wang;Xiushan, Lu;Huizhan, Zhang
    • Proceedings of the Korean Institute of Navigation and Port Research Conference
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    • v.1
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    • pp.401-405
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    • 2006
  • A uniform velocity field of crust can be obtained by cumulative multi-year GPS data. Then the shortening and sliding of drape zones between Chinese Continent Blocks can be researched through the velocity field and dynamics meaning is also analyzed. A model of movement and strain is created to extract displacing and rotating information of blocks in this paper. On the basis of it, the shortening vectors and sliding states of drape zones between blocks can be obtained by the model of level center of gravity moving velocity vectors between neighboring blocks. Some result show as follows. India plate jostles greatly toward north, so a complicated movement situation is formed for 14 sub-blocks. And self-deformations of inner tectosomes can be greatly reflected according to the characteristics of drape zones between tectosomes. The extrusion deformation exists between Himalaya and Qiangtang blocks. Its contraction ratio is about 20.1 $mm.a^{-1}$. However, it only is $mm.a^{-1}$ between Tarim and Zhungar. The deformation characteristics and contraction ratio of other drape zones are obviously different with the former. The movement characteristics of contraction, shear, dislocation, etc. are showed in these zones. The average contraction ratio is about 5.0 $mm.a^{-1}$. The whole trend in the west continent has a big movement toward north, and in the east continent has a small movement toward south or southeast. The strain of west continent is far bigger than that of east, and the strain of southwest is bigger than that of the southeast. It is whole showed that India plate jostles toward north-east and the south-north zone has cutting and absorbing phenomena. The total characteristics and present-day trends of deformation of inland drape zones are basically described by the sinistrorse dislocation in south-north zone and Arjin fracture, the sinistrorse shear between south china and north china, etc.

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Alternative Fixation Technique for Bony Bankart Lesion with Using Suture Anchor (봉합나사와 골터널을 이용한 골성 반카르트 병변의 고정)

  • Kim, Byung-Kook;Lee, Ho-Jae;Kim, Go-Tak;Dan, Jinmyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.574-578
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    • 2019
  • For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

Effect of Scrap Impurities on Microstructure and Mechanical Properties of Zr Alloys (스크랩 불순물이 Zr 합금의 미세조직 및 기계적 특성에 미치는 영향)

  • Jeong, Gu Beom;Kim, In Won;Song, Jae Sook;Shin, Pyung Woo;Hong, Sun Ig
    • Journal of Korea Foundry Society
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    • v.36 no.3
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    • pp.81-87
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    • 2016
  • In this study, the effect of scrap ratio on the mechanical properties of Zr alloys was studied. Oxygen content in the ingot cake increased rapidly with increasing fraction of scrap, which can be attributed to the surface oxide of scrap including small pieces of turning, chips, etc. Iron content did not increase much with the increasing addition of scrap, suggesting scrap materials was well reserved in the iron-free container. As-cast structure of Zr alloy with the scrap:sponge ratio displayed plate/or needle ${\alpha}$ phase and no appreciable change of the cast structure was observed with change of scrap fraction. The strength increases with increasing fraction of scrap, which can be attributed to the increase of oxygen content. The ductility decreased slightly with increase of scrap fraction. Dislocation-oxygen interaction is known to increase the strength at the expense of ductility. Ingot cake with intentionally added $Fe_2O_3$ exhibited the drastic decrease of the formability, even exhibited the brittle fracture behavior during rolling. The oxidation resistance, however, increased with the increase of scrap fraction because of high oxygen content, which may prevent more penetration and diffusion of oxygen into matrix.

Needs and Demands Assessment on the First Aid Education of General Teachers in Elementary Schools (초등학교 일반교사의 응급처치 교육 필요도 및 교육 요구도에 관한 연구)

  • Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.139-152
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    • 2007
  • Background and Purpose : Emergencies in the school setting occurs frequently. Therefore, the role of first responders is important. General teachers in elementary schools are expected by first responders in school emergencies. This study attempted to assess needs and demands assessment on the first aid education of general teachers in elementary schools. Method : The subjects of this study were 71 general teachers from 8 elementary schools. Data were collected by the questionnaire during the period from March 19 to April 13, 2007. The data were analyzed through frequency, Cronbach's ${\alpha}$, Independent Two samples t-test, paired T-test, One Way ANOVA, Pearson's Correlation by SPSS win 12.0. Result : 1. It showed that 47.9%(34 persons) of general teachers answerd that they experienced emergencies in elementary school setting. Experienced emergencies were wounds(cut, laceration, abrasion etc.) 79.4%(27 persons), bleeding(including epistaxis) 64.7%(22 person), fracture(including dislocation, sprain) 44.1%(15 person), sting or bite 29.4%(10 persons). 2. It showed that 95.8%(68 persons) of subjects answerd that first aid education are necessary. Also 91.5%(65 persons) of subjects answerd that will be educated first aid if opportunities is given. 3. The total mean showed $2.39{\pm}.40$ in necessities of first aid education and $2.17{\pm}.36$ in needs of first aid education by 3 points Likert scale. Ranking 1 in necessities and needs of first aid education was bleeding control. 4. The total mean in necessities and needs of first aid education showed statistically significant differences(t = 3.453, p = .002). 5. The necessities of first aid education showed significant positive correlations with necessities and needs of first aid education(r = .521, p = .002). Conclusion : These results suggest that education program of first aid on elementary general teachers must be developed through necessities and needs assessment of first aid education and instructors must searched methods to increase needs of first aid.

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Analysis of Ankle Bony Abnormality in the Patients with Chronic Ankle Sprain and Marked Ankle Instability (저명한 불안정성을 가진 만성 족관절 염좌 환자의 족관절 골성 병변에 대한 분석)

  • Jung, Chul-Yong;Eun, Il-Soo;Kim, Byung-Cheol;Choi, Sung-Jong;Yoo, Chong-Il;Kim, Jong-Kyun;Choi, Hyun-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.7-10
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    • 2006
  • Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

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