• Title/Summary/Keyword: Head fracture

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Clinical Study on Monteggia Fracture (Monteggia 골절의 임상적 고찰)

  • Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.131-138
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    • 1987
  • In 1814, Giovanni Battista Monteggia first described two cases of fracture of proximal third of ulna with a dislocation of radial head, and this combined injury is now known as the Monteggia fracture. Despite its rarity, the importance of early recognition of dislocated radial head and correct treatment bas been emphasized. Eight cases of Monteggia fracture were studied from March, 1984 to June, 1987. The results are as follows 1. Male patients were six and female were two. 2. The frequent cause of injury was fall down in four cases. 3. Bado type I accounted for 50%, type II for 12.5% and type III for 37.5%. 4. The level of ulna fracture was above upper one third of ulna in seven. 5. The common direction of dislocated radial head was anterior. 6. Two children and two adults were managed by closed reduction. Four ulna fractures in adult were treated by open reduction and internal fixation using a semitubular plate. 7. The results (by Bruce et al. criteria) were 3 excellent, 2 good, 1 fair and 2 poor.

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Prediction of Joining Torque for Bit Depth of Subminiature Bolt (초소형 볼트의 비트 깊이에 따른 체결 토크 예측)

  • Lee, Hyun-Kyu;Park, Keun;Ra, Seung-Woo;Kim, Jong-Bong
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.38 no.8
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    • pp.917-923
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    • 2014
  • Subminiature joining bolts are required for the electronic parts of gadgets such as mobile phones and watch phones. During the miniaturization of bolt heads, it is difficult to obtain sufficient joining force owing to the risk of shear fracture of the bolt head or severe plastic deformation on the bit region. In this study, the maximum joining torque for the bit depth was predicted using finite element analysis. A shear fracture test was conducted on a wire used in bolt forming. The results of this test were subjected to finite element analysis and a fracture criterion was obtained by comparing the experimental and analysis results. The shear fracture of the bolt head during joining was predicted based on the obtained criterion. Furthermore, the maximum joining torque was predicted for various bit depths. Fracture on the boundary between the bolt head and thread was found to occur in lower joining torque as bit depth increases.

Ulnar Nerve Injury Caused by the Incomplete Insertion of a Screw Head after Internal Fixation with Dual Locking Plates in AO/OTA Type C2 Distal Humerus Fractures

  • Shin, Jae-Hyuk;Kwon, Whan-Jin;Hyun, Yoon-Suk
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.236-239
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    • 2017
  • After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.

Treatments for the Plantar Pain of the First Metatarsal Head (제 1 중족골 두 족저부 동통의 치료)

  • Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Park, Hong-Jun;Yu, Sun-O;Kim, Wan-Hong
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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    • pp.72-78
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    • 2000
  • Purpose: To validate the major bony causes and postoperative results of the first metatarsal head plantar pain. Materials and Methods: We experienced one case of the fracture and non-union of the medial sesamoid treated by autogenous calcaneal bone graft, one case of the fracture and non-union and two cases of the hypoplasia of the medial sesamoid treated by excision of medial sesamoid, one case of the arthrosis between the first metatarsal head and the medial sesamoid treated by plantar 1/2 partial excision of the medial sesamoid, and two cases of the metatarsus primus nexus treated by basal metatarsal closing wedge osteotomy between October 1995 and September 1999. The mean follow-up period was 28 months. We evaluated the results by using of the clinical rating systems for the hallux and the radiographic findings. Results: An excellent results were achieved in all cases except one which was preoperatively diagnosed as metatarsus primus nexus. But, clinically this one case also satisfied with the postoperative result. Radiologically, We did not find the malunion or nonunion of the medial sesamoid treated by bone graft and of the metatarsus primus flex us treated by basal metatarsal closing wedge osteotomy. And also we did not find the postoperative fracture of the medial sesamoid treated by plantar 1/2 partial excision. There were no postoperative complications in all cases. Conclusion: We think that the good results may be achieved from the patients with the plantar pain of the first metatarsal head by the exact diagnosis and aggressive treatments.

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Risk Factors of Intracranial Hemorrhage in Skull Fracture after Pediatric Head Trauma (두부 외상 후 두개골 골절 환아의 두개내 출혈 위험요인)

  • Ji, Myoung-Hee;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.22 no.1
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    • pp.45-52
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    • 2020
  • Purpose: The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. Methods: The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using 𝓍2-test, Fisher's exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. Results: Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage. Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. Conclusion: In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.

Variation in radial head fracture treatment recommendations in terrible triad injuries is not influenced by viewing two-dimensional computed tomography

  • Eric M. Perloff;Tom J. Crijns;Casey M. O'Connor;David Ring;Patrick G. Marinello;Science of Variation Group
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.156-161
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    • 2023
  • Background: We analyzed association between viewing two-dimensional computed tomography (2D CT) images in addition to radiographs with radial head treatment recommendations after accounting for patient and surgeon factors in a survey-based experiment. Methods: One hundred and fifty-four surgeons reviewed 15 patient scenarios with terrible triad fracture dislocations of the elbow. Surgeons were randomized to view either radiographs only or radiographs and 2D CT images. The scenarios randomized patient age, hand dominance, and occupation. For each scenario, surgeons were asked if they would recommend fixation or arthroplasty of the radial head. Multi-level logistic regression analysis identified variables associated with radial head treatment recommendations. Results: Reviewing 2D CT images in addition to radiographs had no statistical association with treatment recommendations. A higher likelihood of recommending prosthetic arthroplasty was associated with older patient age, patient occupation not requiring manual labor, surgeon practice location in the United States, practicing for five years or less, and the subspecialties "trauma" and "shoulder and elbow." Conclusions: The results of this study suggest that in terrible triad injuries, the imaging appearance of radial head fractures has no measurable influence on treatment recommendations. Personal surgeon factors and patient demographic characteristics may have a larger role in surgical decision making. Level of evidence: Level III, therapeutic case-control study.

Development of Evaluation Technology for Press Formability with Hemi-spheroidal Punch (반타원체 펀치에 의한 프레스 가공성 평가 기술 개발)

  • 이승열;주재현
    • Proceedings of the Korean Society for Technology of Plasticity Conference
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    • 1998.06a
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    • pp.164-170
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    • 1998
  • Hemi-spheroidal punch stretching test was developed to evaluate the press formability of sheet materials. In the plane strain stretching tests, our specially designed hemi-spheroidal head punch, hemi-cylindrical head punch(RIST type) and hemi-spherical head punch were used, respectively. In this experiment, the circular sheet blanks with parallel edge sides are uniformly stretched up to fracture by raising these punches to assure plane strain stretching deformation along the longitudinal direction of the specimens. The press formability was evaluated by limit punch height(LPH) and minor strain measurement around the fracture area. Compared with the hemi-spherical punch and the hemi-cylindrical one, our hemi-spheroidal punch was more useful in the experimental reproduction and reliance for press formability test.

Characterization of Fracture Transmissivity for Groundwater Flow Assessment using DFN Modeling (분리단열망개념의 지하수유동해석을 위한 단열투수량계수의 정량화 연구)

  • 배대석;송무영;김천수;김경수;김증렬
    • The Journal of Engineering Geology
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    • v.6 no.1
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    • pp.1-13
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    • 1996
  • The fracture transmissivity($T_f$) is the most important parameter of fracture in assessing groundwater flow in fractured rock masses by using the DFN(Discrete Fracture Network) modeling. $T_f$, the most sensitive parameter m DFN modeling, is dependent upon aperture, size and filling characteristics of each fracture set. In the field test, the accuracy of $T_f$ can be increased with Borehole Acoustic Scanning (Televiewer) and Fixed Interval Length(FIL) test in constant head. $T_f$ values measured from FIL test was modified and estimated by each fracture set on the basis of the Cubic Law and the information of aperture and filling characteristics obtained from Televiewer. The modified $T_f$ results in the increase of confidence and reliability of modeling results including the amount of tunnel inflow.And, this approach would reduce the uncertaintity of the assessment for groundwater flow in fractured rock masses using the DFN modeling.

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Surgical Treatment of Neglected Adult Monteggia Fracture - 2 Cases Report - (성인의 만성 Monteggia 골절의 수술적 치료 - 2예 보고 -)

  • Shon, Hyun-Chul;Kim, Weon-Yoo;Park, Sang-Eun;Kim, Young-Yul;Yoon, Jong-Seoung;Ji, Jong-Hun
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.235-241
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    • 2006
  • Neglected adult Monteggia fracture could induce the pain, instability and malformation of elbow. Especially, compared with the chronic Monteggia fracture of child, that of adult is difficult to treat and could concur with valgus instability and deformity, limitation of range of motion and tardy ulnar nerve palsy. But recently, the chronic Monteggia fracture of adult could be treated by the 3.5 mm compression plate (DCP) or 3.5 mm pelvic reconstruction plate, so that the result improved more and more. The treatment of choice of the chronic Monteggia fracture of adult is the corrective osteotomy and reduction of radial head or resection of radial head. We experienced two patients who had neglected Monteggia fracture over 1 year 6 months and 25 years respectively and we want to report the result of surgical treatment of chronic Monteggia fracture of adult.

Psychosocial Outcome after Head Injury (두부외상후 심리사회적 예후)

  • Park, Ki-Chang;Kim, Hun-Joo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.196-202
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    • 2000
  • Objective : This study was designed to evaluate the relationship between the initial neurosurgical or psychosocial factors and the psychosocial outcome. Patients and Methods : We analyzed 123 head-injured patients who were referred to the department of psychiatry for the evaluation of psychosocial function. We analyzed initial neurosurgical variables such as Glasgow Coma scale(GCS) score, skull fracture, CT finding, and psychosocial outcomes with regards to psychosis, personality change, depression, anxiety and IQ on Intelligence Scale. Results : Patients with mild head injury(GCS score 13-15, N=94, 76.4%) had better recovery rate on Glasgow Outcome Scale(GOS), less personality change than those with moderate or severe head injury. However, depression, anxiety and intelligence were not significantly different between two groups. The skull fracture(N=37, 30.1%) did not influence on the psychosocial outcome with reference to personality change, depression, anxiety and intelligence. The patients with abnormal CT findings(N=64, 52%) had lower recovery rate on GOS, more frequent tendency in psychosis, personality change and severe depression, less frequent in anxiety and mild depression, than patients with normal CT finding. However, levels of intelligence were not different between two groups. The patients with industrial accidents(IA) had lower educational level, milder head injury, more delay for the psychiatric evaluation (longer treatment period) than those with motor vehicular accidents(MVA). The psychosocial outcome with reference to personality change, depression, anxiety, intelligence were not different between two groups. Conclusion : These findings indicate that the more severe initial trauma, the poorer psychosocial outcome. However, it was frequently observed that patients with mild head injury suffered from mild anxiety and depression. Therefore mild head injury appeared to be more complicated by psychosocial stressors. The patients with IA, despite the fact that initial head injury was mild, required longer treatment period than MVA.

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