• 제목/요약/키워드: Fracture dislocation

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개재골 이식술을 이용한 만성재발성 악관절 탈구의 외과적 처치 (SURGICAL TREATMENT OF CHRONIC RECURRENT TMJ DISLOCATION WITH EMINOPLASTY THROUGH INTERPOSITIONAL BONE GRAFT)

  • 김성곤;최유성
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제21권2호
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    • pp.209-214
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    • 1999
  • Chronic recurrent TMJ dislocation results in difficulty of mastication, speaking, and swallowing due to the limitation of the mandibular movement. Etiologic factors are considered as the looseness of the capsule and ligaments, the decrease of the articular eminence, condylar morphologic change, muscular disharmony near by TMJ, and the decrease of the vertical length of the mandibular ramus. Treatment approach has been suggested that surgical methods are selected for the correction of the etiologic factors when conservative treatments are not effective. Many surgical methods have been reported such as eminectomy, eminence augmentation, condylotomy, and zygomatic arch down fracture technique. We performed the eminence augmentation through interpositional bone graft in chronic recurrent TMJ dislocation. This method leads to favorable postoperative result without recurrence and complication, so we report the case with related references.

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Chronic Dislocation of the Distal Interphalangeal Joints

  • Shiota, Junki;Kawamura, Daisuke;Iwasaki, Norimasa
    • Journal of Trauma and Injury
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    • 제32권1호
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    • pp.47-50
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    • 2019
  • Irreducible dislocation of the distal interphalangeal (DIP) joint is a rare traumatic condition commonly seen in sports injuries. Herein, we present a case with chronic dislocation of the DIP joint caused by high energy trauma accompanied by a fracture of the ipsilateral clavicle. The local deformity resulting from the dislocation can be trivial. Therefore, obtaining radiographs of all the interphalangeal joint injuries, regardless of the findings on inspection, is crucial for accurate diagnosis in the case of high energy trauma. The good functional improvement was obtained by open reduction and temporary wire fixation for 4 weeks.

거골 골절 및 탈구의 임상적 고찰 (Clinical Observation and Treatment of Fracture-Dislocation of Talus)

  • 이동철;김세동;정해훈
    • Journal of Yeungnam Medical Science
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    • 제9권2호
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    • pp.302-311
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    • 1992
  • 1984년 부터 1991년까지 영남대학 병원에서 치료한 거골 골절 및 탈구 환자에서 최장 8년에서 최단 1년간 원격 추시하여 다음과 같은 결론을 얻었다. 1. 평균 30세 나이로 활동기 연령군이였으며, 전부 남자이었다. 2. 손상원인은 추락사고가 대부분이었으며, 교통사고, 스포츠손상 순이었다. 3. 거골 골절 및 탈구는 Marti-Weber 방법으로 분류하였으며, Type I 1례, Type II 1례, Type III 4례, Type IV 5례이였다. 4. 치료는 관혈적 정복술 및 내고정술을 6례에서 시행하였고, 나머지 5례는 도수정북솔로 치료하였다. 5. 치료 결과에 대한 평가는 Hawkins 등급 점수표를 이용하여 약 64%의 만족도를 얻을 수 있었으나, Type IV에서 결과가 좋지 않았다. 6. 합병증으로는 무혈성 괴사가 3례, 퇴행성 관절염이 8례, 불유합이 1례로 퇴행성 관절염의 빈도가 약 70%를 차지하였고, 거골하 관절에서 대부분 발생하였다. 7. 관절의 운동범위에서 건측에 비교하여, 족관절은 약 74%에서 유지되었으며, 거골하 관절은 건측에 비해 약 43%로 감소되었다. 이상에서 거골 골절 및 탈구시에는 빠른 관혈적 정복 및 내고정을 실시하고, 술후 적극적인 재활 치료를 하여 무혈성 괴사증이나, 퇴행성 관절염의 합병증을 줄이면 이차적인 수술을 하지 않을 수 있으며, 족관절의 기능도 가능한 유지할 수 있을 것으로 사료된다.

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주관절의 전방 단순 탈구 - 증례보고 (Simple Anterior Dislocation of the Elbow - Case Report)

  • 이봉진;이성락;김성태
    • Clinics in Shoulder and Elbow
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    • 제8권2호
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    • pp.181-186
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    • 2005
  • An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.

60세 이상 환자에서 발생한 외상성 견관절 전방 탈구 (Traumatic Anterior Shoulder Dislocation in Patients Older than 60 Years of Age)

  • 하종경;유재두;박성필;신상진
    • Clinics in Shoulder and Elbow
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    • 제9권1호
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    • pp.42-49
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    • 2006
  • Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.

주관절 주위 외상후 합병증 (Complications after Trauma Around the Elbow Joint)

  • 전인호;김주은;김풍택
    • Clinics in Shoulder and Elbow
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    • 제12권2호
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    • pp.264-270
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    • 2009
  • 목적: 주관절은 인체에서 가장 안정적인 관절 중 하나지만, 견관절 다음으로 탈구와 골절이 흔히 발생한다. 이러한 손상은 발생 당시 기전과 환자의 나이 그리고 충격에 따라 다양하게 나타나는데 적절한 치료에도 불구하고 여러 가지 합병증들이 발생 가능하다. 이에 저자들은 외상후 합병증을 고찰하고자 한다. 대상 및 방법: 저자들은 일반적인 주관절 탈구의 합병증인 관절 운동제한, 불안정성, 그리고 관절 주위 이소성 골형성의 원인과 치료 등에 대해 기술하였다. 결과 및 결론: 주관절 주위 골절 이후 발생 가능한 합병증 중 부정유합, 불유합, 외상성 관절염 등에 대한 그 기전과 치료에 대해 기술하고자 한다.

Effect of Crystallographic Orientation on Fracture Mechanism of Ni-Base Superalloy

  • Han, Chang-Suk;Lim, Sang-Yeon
    • 한국재료학회지
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    • 제25권11호
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    • pp.630-635
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    • 2015
  • The fatigue strength of a nickel-base superalloy was studied. Stress-controlled fatigue tests were carried out at $700^{\circ}C$ and 5 Hz using triangular wave forms. In this study, two kinds of testing procedures were adopted. One is the conventional tension-zero fatigue test(R = 0). The other was a procedure in which the maximum stress was held at 1000 MPa and the minimum stress was diverse from zero to 1000 MPa at 24 and $700^{\circ}C$. The results of the fatigue tests at $700^{\circ}C$ indicate that the fracture mechanism changed according to both the mean stress and the stress range. At a higher stress range, ${\gamma}^{\prime}$ precipitates are sheared by a/2<110> dislocation pairs coupled by APB. Therefore, in a large stress range, the deformation occurred by shearing of ${\gamma}^{\prime}$ by a/2<110> dislocations, which brought about crystallographic shear fracture. As the stress range was decreased, the fracture mode gradually changed from crystallographic shear fracture to gradual growth of fatigue cracks. At an intermediate stress range, as it became more difficult for a/2<110> dislocation pairs to shear ${\gamma}^{\prime}$ particles, cracks started to propagate in the matrix, avoiding the harder ${\gamma}^{\prime}$ particles. High mean stress induced creep deformation, that is, ${\gamma}^{\prime}$ particles were sheared by {111}<112> slip systems, which led to the formation of stacking faults in the precipitates. Thus, the change in fracture mechanism brought about the inversion of the S-N curves.

리스프랑 관절 골절 및 탈구: 나사와 Kirschner 강선을 이용한 치료 (Fracture and Dislocation of Lisfranc Joint: Treatment with Screw and Kirschner Wire)

  • 하동준;김전교;곽희철;장의찬
    • 대한족부족관절학회지
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    • 제19권4호
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    • pp.181-187
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    • 2015
  • Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.