• Title/Summary/Keyword: Fracture of long bone

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A Preliminary Study on Fatigue Strength of High Toughness Thermoplastic Composite Material AS4/PEEK (고인성 열가소성 복합재료 AS4/PEEK의 피로강도에 관한 기초적 검토)

  • Song, Ji-Ho;Gang, Jae-Yun
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.24 no.4 s.175
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    • pp.1055-1064
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    • 2000
  • First, various specimen geometries, namely, coupon type, waisted type and dog-bone type, were examined to determine appropriate fatigue specimen of thermoplastic composite material AS4/PEEK and the n, fatigue strength of smooth and notched specimens of AS4/PEEK [-45/0/+45/90]2s was investigated. Fatigue tests were performed under load controlled condition at a stress ratio of 0. 1 at a frequency of 5Hz. Stiffness degradation of specimens with fatigue cycling was monitored using an automated unloading compliance technique. The waisted type specimen is found appropriate for smooth fatigue specimen geometry of AS4/PEEK. As for the effect of stress concentration, it is found that fatigue strength is higher for a 2mm-diameter hole notched specimen than a 5mm-diameter one. Fatigue notch factor decreases with the increase of fatigue life. These results are far different from the trend of fatigue strength of metallic materials. The stiffness variation of smooth specimen was only 4% at maximum until final fracture. On the other hand, the stiffness of hole notched specimen was reduced by 45% at maximum. Notched fatigue strength was compared between thermoplastic composite AS4/PEEK and thermosetting composite Graphite/Epoxy. In long-life fatigue (>104), the AS4/PEEK composite shows superior fatigue strength, but in short-life fatigue, the fatigue strength of the Graphite/Epoxy composite is nearly equal or somewhat higher than that of the AS4/PEEK composite.

Therapeutic Effects of Kyphoplasty on Osteoporotic Vertebral Fractures (골다공성 척추체 골절에서 척추 후만변형 복원술의 치료효과)

  • Park, Chun-Kun;Kim, Dong-Hyun;Ryu, Kyung-Sik;Son, Byung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.116-123
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    • 2005
  • Objective: Percutaneous kyphoplasty using a balloon-catheter is an widely accepted method which achieves the restoration of vertebral height and the correction of kyphotic deformity with little complication in osteoporotic vertebral compression fractures. The authors assess the results of 59 patients who underwent kyphoplasty, and analyze the factors that could affect the prognosis. Methods: From December 2001 to May 2003, fifty-nine patients underwent kyphoplasty. The patients included 49 women and 10 men aged 52-85 years. Average t-score on bone marrow density was -3.58. About 7cc of polymethylmethacrylate(PMMA) was injected into the fractured vertebral body using $Kyphon^{(R)}$ under local anesthesia. The vertical height of all fractured vertebrae was measured both before and after surgery. Outcome data were obtained by comparing pre- and post-operative VAS score and by assessing postoperative satisfaction, drug dependency and activity. Various clinical factors were analyzed to assess the relationship with the outcome. Results: The VAS score improved significantly, and the mean percentage of restored vertebral height was 53%. The mean improvement in kyphosis was $3.6^{\circ}$. Eighty-nine percent of the patients gained excellent or good results. Any of the clinical factors including the interval between fracture and operation, the degree of height loss, the degree of the vertebral height restoration or the correction rate of kyphosis did not affect the clinical results. Conclusion: Kyphoplasty is associated with a statistically significant improvement in pain and function with little complication. The clinical results are not affected by any clinical parameters. Further follow-up study is needed to determine whether the restoration affects the long-term clinical results.

The Effect of a Shock-Absorbable Polymer(Chitosan) on the Initial Stability and Dynamic Behavior of Dental Implant (충격흡수용 고분자재료의 이용이 Implant 초기안정성과 동적거동에 미치는 영향)

  • Joo, W.;Choi, K.;Kwon, I.C.;Choi, J.B.;Moon, H.J.;Shin, J.W.;Lee, Y.C.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.11
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    • pp.337-342
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    • 1997
  • Dental implant has been increasingly used to recover the masticatory unction of tooth. It has been well known that the success of dental implant is heavily dependent on initial stability and long-term osseointegration due to optimal stress distribution in the surrounding bones. The role of periodontal ligament, removed during operation, is to absorb impact force and to distribute them to alveolar bone. or this reason, the study for artificial periodontal ligament has become an important issue in this field. In this study, chitosan was coated on dental implant or the purpose of replacing the role of intact periodontal ligament. The results by experiment and FEM analysis showed : I) Initial stability of dental implant was significantly increased(35%) when the implant was coated with chitosan. II) The coated implant showed higher impact absorption, more even stress distribution and lower stress magnitude under impact force than uncoated implant. Accordingly, the micro-fracture of the surrounding bones due to impact force would be lessened by chitosan coating on dental implant.

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Versatile midfacial degloving approach in oral and maxillofacial surgery

  • Anunay, Pangarikar;Umamaheswari, G.;Prachi, Parab;Suresh, Kumar;Devarathnamma, M.V.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.4
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    • pp.192-198
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    • 2019
  • Objectives: Oral and maxillofacial surgeons must gain mastery of various approaches to the midface due to the increasing incidence, complexity, and severity of presenting midfacial fractures. Unlike in the case of other body parts, the need to preserve facial aesthetics makes it more difficult for the surgeon to select an approach for managing the facial injuries. The midfacial degloving (MFD) approach is a combination of intraoral and intranasal incisions made to access the midface without any external incision. The aim of the present study was to evaluate the efficacy of MFD in maxillofacial surgery and to assess its advantages and complications. Materials and Methods: The MFD approach was used in five cases, with three cases treated with open reduction and internal fixation and two cases operated on for posttraumatic deformity. Nasal dorsum augmentation was completed in three cases and nasal osteotomy was performed in one case. The bicoronal flap technique was combined with MFD for frontal bone augmentation in one case. The intraoperative time required for flap completion and the ease of performing the planned procedures were noted. Postoperative evaluation was done for reduction, aesthetics, function, and complications. Results: Access was excellent for performing all planned procedures. Average time spent for flap elevation and exposure of the midface was 63 minutes. Complications like postoperative swelling, infraorbital nerve paresthesia, and intranasal crusting were all transient. No long-term complications like stenosis of the nose, sneer deformity, or weakness of the facial muscles were noticed. Additionally, no complications were noted when MFD was combined with bicoronal flap. Conclusion: Though the MFD approach is technically demanding and takes more time than other facial approaches, it should be learned and applied by maxillofacial surgeons in selective cases, as it provides complete exposure of the midface without facial scarring.

A novel technique for placing titanium mesh with porous polyethylene via the endoscopic transnasal approach into the orbit for medial orbital wall fractures

  • Bae, Seong Hwan;Jeong, Dae Kyun;Go, Ju Young;Park, Heeseung;Kim, Joo Hyoung;Lee, Jae Woo;Kang, Taewoo
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.421-425
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    • 2019
  • Background The endoscopic transnasal approach is widely used for reconstructing the medial orbital wall by filling it with a silicone sheet or Merocel, but this technique has the disadvantage of retaining the packing for a long time. To overcome this drawback, a method of positioning an absorbable plate in the orbit has been introduced, but there is a risk of defect recurrence after the plate is absorbed. Here, the authors report the results of a novel surgical technique of placing a nonabsorbable titanium mesh with porous polyethylene into the orbit through the endoscopic transnasal approach. Methods Fourteen patients underwent surgery using the endoscopic transnasal approach. Preoperative computed tomography (CT) was used to calculate the size of the bone defect due to the fracture, and the titanium mesh was designed to be shorter than the anteroposterior length of the defect and longer than its height. The titanium mesh was inserted into the orbit under an endoscopic view. The authors then confirmed that the titanium mesh supported the orbital contents by pressing the eyeball and finished the operation. Immediately after surgery, CT results were evaluated. Results Postoperative CT scans confirmed that the titanium mesh was well-inserted and in the correct position. All patients were discharged without any complications. Conclusions We obtained satisfactory results by inserting a titanium mesh with porous polyethylene into the orbit via the transnasal approach endoscopically.

Clinicopathologic Features and Prognosis of Osteosarcoma in Turkish Adults

  • Seker, Mehmet Metin;Seker, Ayse;Aksoy, Sercan;Ozdemir, Nuriye;Uncu, Dogan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3537-3540
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    • 2014
  • Background: Osteosarcomas are the most common solid malignancies of bone. In the last two decades there have been no concrete developments in their systemic treatment. In this trial we aimed to present our osteosarcoma patient clinical and demographic outcomes. Materials and Methods: Patients treated and followed up for osteosarcoma in Ankara Numune Education and Research Hospital from 2002 to 2012 were reviewed retrospectively. Results: A total of 21 patients (15 male, 6 female) were diagnosed with osteosarcoma. The disease was located at extremities in 76% and in 14% was metastatic at the time of diagnosis. Median disease free survival (DFS) was 36 months in non-metastatic patients and median progression free survival (PFS) was 2 months in metastatic patients (p<0.0001). Median overall survival (OS) was 80 months and 4 months, respectively (p=0.012). There were no survival differences in terms of presentation with pathological fracture, tumor size, tumor grade, alkaline phosphatase and lactate dehydrogenase level and type of chemotherapy regimen. Conclusions: Tumor site and stages are the most important prognostic factors for osteosarcoma. Extremity primary tumors have beter survival rates than non-extremity tumors. As a result of the use of effective chemotherapy the long term survival rates have improved from 10-20% to 60-70% in the last decades but we need more active agents, especially for metastatic cases.

A Case of Fat Embolism Syndrome of Fat Globules Found in BAL Fluid after Recovery from Acute Respiratory Failure (급성호흡부전 호전 후 기관지폐포세척에서 지방과립구가 확인된 지방색전증후군 1예)

  • Park, Song Ree;Kim, Hyun Soo;Lee, Jae Hyung;Kim, Sang Heon;Kim, Tae Hyung;Yoon, Ho Joo;Park, Sung Soo;Shin, Dong Ho;Park, Chan Kum
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.562-566
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    • 2006
  • Fat embolism syndrome is a rare clinical diagnosis of dyspnea with acute respiratory failure and neurological signs caused by a traumatic long bone fracture. We report a case of fat embolism in a 22 year-old man after a traffic accident. Dyspnea and stuporous mental changes developed on the $1^{st}$ day after the external fixation operation of a left metaphyseal femur fracture. On the following day, he was transferred from a hospital to this one because of acute respiratory failure. After recovery, macrophages with fat droplets were found in the bronchoalveolar lavage fluid 1. It is important to diagnose a fat embolism as the correct cause of acute respiratory failure through the BAL in the acute state of fat embolism syndrome It is believed that clinically apparent or sometimes hidden fat embolism syndrome can be diagnosed from the BAL during the recovery state.

Percutaneous Radiofrequency ablation for the Treatment of Osteoid osteoma (유골골종의 경피적 고주파 열 치료)

  • Seo, Jai-Gon;Jung, Kwang-Hoon;Yang, Il-Soon
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.83-89
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    • 2002
  • Purpose: To analyze the postoperative functional and radiographic follow-up results in patients who underwent percutaneous radiofrequency ablation therapy after the diagnosis of osteoid osteoma. Materials and Methods: Seven patients, who were clinically and radiographically diagnosed with osteoid osteoma from July 1999 to January 2001, and received percutaneous radiofrequency ablation therapy. The average follow-up period was 15.5 months(range, 8~25 months). For the diagnosis and accurate localization of the lesion, simple radiography, computed tomography and magnetic resonance imaging(MRI) were performed preoperatively. Simple radiographs and MRI were taken periodically for the follow-up studies. Results: In all 7 patients, symptoms completely disappeared within 3 days after the operation. The average period of hospitalization was 2.4 days, excluding 1 patient who needed an additional burn treatment. The average postoperative night and day pain scores were 1.8 and 1.3, respectively. The average vocational and recreational activity scores were 1 and 0.6, respectively. Conclusions: Satisfactory functional results were obtained with percutaneous radiofrequency ablation therapy for the elimination of osteoid osteoma. Compared to conventional treatment, the advantages of this therapy were short hospitalization period, no internal fixation and bone graft for preventing fracture, and no limitation of joint motion by long fixation period.

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Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate (잠김 금속판을 이용한 하지의 전이성 병적 골절에 대한 치료)

  • Seo, Chang-Young;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.80-86
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    • 2010
  • Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

The cumulative survival rate of dental implants with micro-threads: a long-term retrospective study

  • Dong-Hui Nam;Pil-Jong Kim;Ki-Tae Koo;Yang-Jo Seol;Yong-Moo Lee;Young Ku;In-Chul Rhyu;Sungtae Kim;Young-Dan Cho
    • Journal of Periodontal and Implant Science
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    • v.54 no.1
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    • pp.53-62
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    • 2024
  • Purpose: This study aimed to evaluate the long-term cumulative survival rate (CSR) of dental implants with micro-threads in the neck over a 10-year follow-up period and to examine the factors influencing the survival rate of dental implants. Methods: This retrospective study was based on radiographic and dental records. In total, 151 patients received 490 Oneplant® dental implants with an implant neck micro-thread design during 2006-2010 in the Department of Periodontology of Seoul National University Dental Hospital. Implant survival was evaluated using Kaplan-Meier analysis. Cox proportional hazard regression analysis was used to identify the factors influencing implant failure. Results: Ten out of 490 implants (2.04%) failed due to fixture fracture. The CSR of the implants was 97.9%, and no significant difference was observed in the CSR between external-and internal-implant types (98.2% and 97.6%, respectively, P=0.670). In Cox regression analysis, 2-stage surgery significantly increased the risk of implant failure (hazard ratio: 4.769, P=0.039). There were no significant differences in influencing factors, including sex, age, implant diameter, length, fixture type, location, surgical procedure, bone grafting, and restoration type. Conclusions: Within the limitations of this retrospective study, the micro-thread design of the implant neck was found to be favorable for implant survival, with stable clinical outcomes.