• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제29권5호
• /
• pp.265-271
• /
• 2003

Skeletal relapse is known as a complication following orthognathic surgery of mandibular prognathism and occurring during intermaxillary fixation period. Therefore relapse of teeth and skeleton during intermaxillary fixation period is considered as a important problem of orthognathic surgery. In this study, cephalolateral radiographs taken at pre-operation, immediate post-operation and after release of intermaxillary fixation were measured for evaluation of dental and skeletal relapse in 30 cases. The cases were classified as screw fixation group and plate fixation group, then we compared magnitude of dental and skeletal changes of each group. The results were as follows 1. The $\underline{1}$ SN angle increased at immediate post-operation with a mean value of $0.12^{\circ}$ and at intermaxillary fixation period with a mean value of $0.43^{\circ}$ (p>0.05). 2. The $\overline{1}$ MP angle decreased with a mean value of $0.14^{\circ} at immediate post-operation and with a mean value of $1.28^{\circ} during intermaxillary fixation period but there were not significant difference(p>0.05). 3. There were not significant difference in magnitude of dental position changes between screw fixation group and plate fixation group(p>0.05). 4. Gonial angle increased with a mean value of $0.62^{\circ} during intermaxillary fixation period. Each group showed changes of gonial angle during intermaxillary fixation period but there were not significant difference(p>0.05).

• PNF and Movement
• /
• 제20권1호
• /
• pp.83-90
• /
• 2022

Purpose: The purpose of this study was to investigate the immediate effects of hip flexor stretching with pelvic fixation on the flexibility of hip extension and gait capacity in subjects with limited hip extension flexibility. Methods: Twenty-six subjects with limited hip extension flexibility were divided into two groups: a hip flexor stretching with pelvic fixation group (n = 13) and a hip flexor stretching without pelvic fixation group (n = 13). The subjects were assessed based on flexibility of hip extension, stride, and gait velocity after applying hip flexor stretching. Results: The hip flexor stretching with pelvic fixation group showed significantly improved flexibility of hip extension, stride, and gait velocity compared with hip flexor stretching without pelvic fixation group (p <0.05). The flexibility of hip extension was significantly improved after application of hip flexor stretching in both groups; however, stride and gait velocity were significantly improved only in the hip flexor stretching with pelvic fixation group. Conclusion: Hip flexor stretching with pelvic fixation is an effective intervention for improving the flexibility of hip extension and gait capacity.

• Clinics in Shoulder and Elbow
• /
• 제12권1호
• /
• pp.61-66
• /
• 2009

목적: 기존의 연구들은 쇄골의 부정 유합 및 불유합에 대한 지연 재건술의 결과가 골절 후 조기 수술적 치료에 필적할 만한 우수한 결과들을 보고하여 왔으나 두 군을 직접적으로 비교한 연구는 드문 실정이다. 저자들은 쇄골 불유합과 부정 유합의 지연 재건술 군과 조기 고정술 군 간의 결과를 비교하였다. 대상 및 방법: 2000년 3월부터 2006년 2월까지 전위성 쇄골 간부 골절에 대해 조기 고정술을 시행한 18예(조기 고정술 군)와 보존적 치료 후 발생한 부정 유합 혹은 불유합에 대해 지연 재건술을 시행한 15예(지연 재건술 군)를 대상으로 하였다. 최종 결과 판정은 Constant 점수에 의한 임상적 결과와 방사선학적 골유합 소견을 비교하였다. 결과: Constant 점수는 지연 재건술 군이 조기 고정술 군에 비해 의미있게 낮았다(p=0.045). 통증 점수와 일상 생활 활동 점수는 두 군간 통계학적으로 유의한 차이를 보였으나(p<0.05) 관절 운동 범위 점수와 근력 점수는 두 군간 통계학적 유의성을 보이지 않았다(p>0.05). 방사선학적 골유합 소견은 조기 고정술 군 평균 8.8주, 지연 재건술 군 평균 9.8주에 관찰되었고 두 군 모두 전례에서 골유합 소견을 보였다. 결론: 지연 재건술 군 또한 임상적, 방사선학적으로 우수한 결과를 보였지만 조기 고정술 군에 비해 Constant 점수와 통증 점수, 일상 생활 활동 점수에서 유의하게 낮은 결과를 보였다. 쇄골 전위성 간부 골절의 초기 치료 선택에 있어 조기 수술과 지연 재건술의 장단점을 환자에게 충분히 설명하고 초기 치료를 결정하는 것이 중요하리라 생각된다.

• Journal of Korean Neurosurgical Society
• /
• 제45권3호
• /
• pp.164-168
• /
• 2009

Objective : Bilateral C1-2 transarticular screw fixation (TAF) with interspinous wiring has been the best treatment for atlantoaxial instability (AAI). However, several factors may disturb satisfactory placement of bilateral screws. This study evaluates the usefulness of unilateral TAF when bilateral TAF is not available. Methods : Between January 2003 and December 2007, TAF was performed in 54 patients with AAI. Preoperative studies including cervical x-ray, three dimensional computed tomogram, CT angiogram, and magnetic resonance image were checked. The atlanto-dental interval (ADI) was measured in preoperative period, immediate postoperatively, and postoperative 1, 3 and 6 months. Results : Unilateral TAF was performed in 27 patients (50%). The causes of unilateral TAF were anomalous course of vertebral artery in 20 patients (74%), severe degenerative arthritis in 3 (11%), fracture of C1 in 2, hemangioblastoma in one, and screw malposition in one. The mean ADI in unilateral group was measured as 2.63 mm in immediate postoperatively, 2.61 mm in 1 month, 2.64 mm in 3 months and 2.61 mm in 6 months postoperatively. The mean ADI of bilateral group was also measured as following; 2.76 mm in immediate postoperative, 2.71 mm in 1 month, 2.73 mm in 3 months, 2.73 mm in 6 months postoperatively. Comparison of ADI measurement showed no significant difference in both groups, and moreover fusion rate was 100% in bilateral and 96.3% in unilateral group (p=0.317). Conclusion : Even though bilateral TAF is best option for AAI in biomechanical perspectives, unilateral screw fixation also can be a useful alternative in otherwise dangerous or infeasible cases through bilateral screw placement.

• Journal of Korean Neurosurgical Society
• /
• 제57권6호
• /
• pp.460-464
• /
• 2015

Objective : Bilateral C1 lateral mass and C2 pedicle screw fixation (C1LM-C2P) is an ideal technique for correcting atlantoaxial instability (AAI). However, the inevitable situation of vertebral artery injury or unfavorable bone structure may necessitate the use of unilateral C1LM-C2P. This study compares the fusion rates of the C1 lateral mass and C2 pedicle screw in the unilateral and bilateral methods. Methods : Over five years, C1LM-C2P was performed in 25 patients with AAI in our institute. Preoperative studies including cervical X-ray, three-dimensional computed tomography (CT), CT angiogram, and magnetic resonance imaging were performed. To evaluate bony fusion, measurements of the atlanto-dental interval (ADI) and CT scans were performed in the preoperative period, immediate postoperative period, and postoperatively at 1, 3, 6, and 12 months. Results : Unilateral C1LM-C2P was performed in 11 patients (44%). The need to perform unilateral C1LM-C2P was due to anomalous course of the vertebral artery in eight patients (73%) and severe degenerative arthritis in three patients (27%). The mean ADI in the bilateral group was 2.09 mm in the immediate postoperative period and 1.75 mm in 12-months postoperatively. The mean ADI in the unilateral group was 1.82 mm in the immediate postoperative period and 1.91 mm in 12-months postoperatively. Comparison of ADI measurements showed no significant differences in either group (p=0.893), and the fusion rate was 100% in both groups. Conclusion : Although bilateral C1LM-C2P is effective for AAI from a biomechanical perspective, unilateral screw fixation is a useful alternative in patients with anatomical variations.

• 대한관절경학회:학술대회논문집
• /
• 대한관절경학회 제21차 추계 학술대회
• /
• pp.153-153
• /
• 2009

The purpose of this study was to evaluate tibial tunnel widening prospectively after anterior cruciate ligament (ACL) reconstruction with hamstring tendon grafts using Rigidfix (DePuy Mitek, Raynham, MA) femoral fixation and Intrafix (DePuy Mitek) tibial fixation. 56 consecutive patients who underwent ACL reconstruction with a minimum of 2 years' postoperative evaluation were reviewed. On the anterior-posterior (AP) and lateral radiographs, the diameter of the tibial tunnel was measured at proximal, middle, and distal positions and the shape of the tibial tunnels were classified. Tunnel widening was defined as widening of greater than 2 mm. Group I was defined as cases with no tunnel widening and group II defined as cases with tunnel widening. Postoperative laxity evaluations were performed using Lachman test, pivot-shift test, and Instrumented laxity testing using the KT-1000 arthrometer. On the AP radiographs, the average diameter of the tibial tunnel increased 8.8% at 6 months and 8.5% at 12 months postoperatively compared to the immediate postoperative day. On the lateral radiographs, the average diameter of the tibial tunnel increased 7.2% at 6 months and 8.1% at 12 months year postoperatively compared to the immediate postoperative day. The tunnel shape evaluation revealed predominantly linear type in 53 patients (95%). Group I was 42 patients (75%) and group II was 14 (25%). The average KT-1000 measurement was 1.0~1.8 mm in group I and 2.1~2.8 mm in group II (p>0.05) The Lachman and pivot-shift showed tests no significant differences between the two groups. In conclusion, hamstring ACL reconstruction using Rigidfix and Intrafix fixation showed less widening of the tibial tunnels than observed in previously published studies.

• Clinics in Shoulder and Elbow
• /
• 제2권1호
• /
• pp.14-20
• /
• 1999

Purpose: Despite of the popular use of the reconstruction plate for the fixation of clavicular shaft fractures, some disadventages have been raised such as long period of immobilization, long skin incision, loosening of plate and screws, and increased chance of nonunion due to severe periosteal injury. Thus, the authors have performed intramedullary multiple Steinmann pins fixation that could reduce the disadvantages of plate fixation in order to compare the treatment results between the two groups. Materials & Methods: From 1994. Jan. to 1997. Dec. the department of orthopaedic surgery of the Kwak's hospital treated operatively for 56 cases of the clavicular shaft fractures in adult. 39 cases of them were treated with the plate fixation and 17 cases with the intramedullary multiple Steinmann pins fixation(SP group). Reconstruction plates(Plate group) were used for 26 out of 39 patients treated with plate fixation. Among the Plate group and SP group, each 15 cases were selected by age and sex and compared each other according to the bone union time, union rate, complication, and functional results. The follow-up period was 12 months at the shortest and 48 months at the longest and the average was 16 months. Results: The Plate group showed that the bone union time was 7 weeks and the bone union rate was 93%. The SP group showed 6.5 weeks and 100% respectively. In complication, the Plate group had 1 case of loosening of plate and screws and delayed union; SP group had 1 case of pin migration. The functional results according to Kang's criteria, 87% of the Plate group and 93% of the SP group showed good or excellent. Conclusion : The SP group showed very comparable results in terms of the bone union time, bone union rate, complication, and functional results comparing to the Plate group. The intramedullary multiple Steinmann pins fixation showed several advantages over the reconstruction plate fixation, which were simple operative technique, easy removal of pins, being able to perform immediate postoperative full range of motion exercise. Therefore, the intramedullary multiple Steinmann pins fixation is thought to be one of the useful operative techniques in treatment of the clavicular shaft fractures in adult.

• 대한치과교정학회지
• /
• 제22권4호
• /
• pp.837-853
• /
• 1992

The purpose of this study was to investigate the positional changes of the mandibular condyles after orthognathic surgery In patients with severe skeletal Class III malocclusion. This study was based on 21 patients who had received bilateral sagittal split osteotomy for mandibular setback. Among them 14 were fixated non - rigidly (W group), and 7 were fixated rigidly (R group). After submental vertex view analysis, each subject was given the T.M.J. Tomogram in both centric occlusion and centric relation immediate before, $4\~6$ weeks after and more than 6 months after surgery. The anteroposterior and vertical changes between each time interval were measured and analyzed statistically. Following results were obtained. 1. There was no significant difference between right and left condyles in their anteroposterior and vertical changes of the condylar position. 2. In anteroposterior changes of condylar position of the wire fixation group, the condyles were moved anteriorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, there was no significant difference in any observation periods of centric occlusion and centric relation. 3. In vertical changes of condylar position of the wire fixation group. the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery in centric occlusion only.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제27권4호
• /
• pp.334-345
• /
• 2005

The purpose of this study was to compare the postoperative stability and relapse according to 2 different fixation methods after bilateral sagittal split ramus osteotomies in mandibular prognathic patients. Tweenty one patients with Class III dental and skeletal malocclusion who were treated with bilateral sagittal split ramus osteotomy were selected for this retrospective study. We classfied the patients into two groups according to the fixation methods of bony segments after osteotomies. Group W (n = 10) had the bone segments fixed with nonrigid wire and Group S (n = 11) had bicortical screws inserted in the gonial area through a transcutaneous approach. Cephalometric radiographs were taken preoperatively, immediate postoperatively and more than six months postoperatively in each patient. After tracing the cephalometric radiographs, various parameters were measured. Before surgery, both groups were balanced with respect to linear and angular measurements of craniofacial morphology. Mean posterior sagittal setback amounts of the mandibular symphysis was 8.6 mm in the wire group and 6.79 mm in the rigid group, Six months postoperatively, the wire group had 33.1% relapse of the mandibular symphysis and 22.8% in the rigid group relapse. Both groups experienced changes in the orientation and configuration of the mandible. It is thought that Rigid screw fixation is a more stable method than nonrigid wire fixation for maintaining mandibular setback after sagittal split ramus osteotomy.

• Hip & pelvis
• /
• 제35권4호
• /
• pp.259-267
• /
• 2023

Purpose: Nondisplaced femoral neck fractures have traditionally been treated with in situ fixation. However, poor surgical and clinical outcomes have been reported for fractures with valgus deformity >15°, and the reduction of valgus impaction has recently been emphasized. In addition, early degenerative osteoarthritis can be caused by cam-type femoroacetabular impingement after healing of femoral neck fractures. This study was designed with the objective of confirming the difference in progression of radiographic osteoarthritis according to the severity of the valgus deformity. Materials and Methods: Patients who underwent internal fixation using multiple cannulateld screws for management of nondisplaced femoral neck fractures were divided into two groups: high valgus group (postoperative valgus angle ≥15°) and low valgus group (postoperative valgus angle <15°). Evaluation of demographic data and changes in the joint space width from the immediate postoperative period to the latest follow-up was performed. Results: A significant decrease in joint space width in both hip joints was observed in the high valgus group when compared with the low valgus group, including cases with an initial valgus angle less than 15° and those corrected to less than 15° of valgus by reduction. No complications requiring surgical treatment were observed in either group; however, two cases of avascular necrosis, one in each group, which developed in the low valgus group after reduction of the fracture, were followed for observation. Conclusion: Performing in situ fixation in cases involving a valgus deformity ≥15° in non-displaced femoral neck fractures may cause accelerated narrowing of the hip joint space.