• Clinics in Shoulder and Elbow
• /
• 제19권1호
• /
• pp.8-14
• /
• 2016

Background: The purpose of this study was to investigate the difference between two nailing approaches of intramedullary screw fixation, the retrograde nailing versus the anterograde nailing, on the radiological and clinical outcomes in patients with clavicle shaft fractures. Methods: From April 2002 to August 2014, we enrolled a total of 22 patients with clavicle shaft fractures to participate in this study. Twelve patients received retrograde intramedullary nailing and 10 received anterograde nailing. The average duration of follow-up was 12 months. In all the patients, we took follow-up radiographs of the anteroposterior and the axial views to assess the postoperative radiological outcomes. We measured the visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and the range of motion (ROM). Results: Clinically, we did not find a statistically significant difference in the retrograde group and the anterograde group in terms of the duration to bone union, the VAS score the ASES score and the ROMs. Radiologically, we found that the difference in the clavicle shortening of the affected arm and the unaffected arm did not show a statistically significant difference at the immediate postoperative assessment. we found that the difference in the clavicle shortening of the affected arm between the immediate postoperative and the final follow-up value did not show a statistically significant difference. Conclusions: We found that both the retrograde nailing and the anterograde nailing gave a favorable outcome for clavicle shaft fractures. Although we saw evidence of clavicle shortening after intramedullary screw fixation, this was not a factor that influenced clinical outcome.

• 대한두개안면성형외과학회지
• /
• 제10권2호
• /
• pp.76-80
• /
• 2009

Purpose: Zygoma is a major portion of the midfacial skeleton, forms the malar prominence and the three adjacent bony articulations. Zygoma fracture is a very common in facial trauma. Open reduction and rigid fixation of displaced zygoma fractures are necessary to avoid immediate and delayed facial asymmetry and depression. However, it is possible to happen the complications related to the plates and screws. So, we planned to treat the 24 patients of Group II, III, IV zygoma fractures with precise reduction and non-fixation method via intraoral approach. Methods: From August, 2006, to August, 2009, we treated 24 cases of zygoma fracture with reduction and non-fixation methods. Before the surgery, we choose the patients who could be treated with this method among the Group II, III, IV patients. Results: No patients in this study had postoperative complications such as displacement of bony fragments, facial depression and asymmetry, malocclusion, hypoesthesia. Satisfactory aesthetic and functional results can be obtained. Conclusion: In the treatment of the zygoma fracture, it is possible to treat with precise reduction and non-fixation method. The greatest advantage is to decrease the operative time, no need to wide dissection, no complications related to the plates and screws. For the using of this method, it is necessary to choose the adequate patients through the preoperative planning.

• Restorative Dentistry and Endodontics
• /
• 제28권5호
• /
• pp.385-391
• /
• 2003

The purpose of this study is to examine the viability of PDL cells in rat molars by using MTT assay and to verify the MTT assay through the histologic observation. Thirty of Sprague-Dawley white female rats of 4-weeks old with a body weight of about 100 grams were used. Groupings are as follows : Immediate Group : Positive control group(n=10)-after extraction immediately. Dried Group : Negative control group(n=10)-after drying for an hour under warm dry. $ViaSpan^{\circledR}$ Group : 1hour $ViaSpan^{\circledR}$ group(n=10)-after storing in $ViaSpan^{\circledR}{\;}at{\;}4^{\circ}C$ for 1hour. Ten teeth of each group were treated as same as above and replanted to the original socket of experimental animals. After two weeks of replantation. all the experimental animals were sacrificed. And after fixation, extracted maxillary jaw was dimineralized. After it was embedded in paraffin. serial section by $5\mu\textrm{m}$ was carried out and for construction of specimen, hematoxylin-eosin dye was used. The mean MTT measurement of immediate group(positive control) is 2.81 and the mean measurement of dried group(negative control) is 0.98 which is significantt differnt(P<0.05), The mean measurement of $ViaSpan^{\circledR}$ group is 2.65 and there is significant difference between dried group and $ViaSpan^{\circledR}$ group(P<0.05), However, there is no difference between immediate group and $ViaSpan^{\circledR}$ group. The average resorption points of immediate group is 3.03 points. In the dried group, average 6.44 points resorption and 2.68 points showed resorption in the $ViaSpan^{\circledR}$ group. Unlike with MTT assay, there was no significant difference between the immediate group and $ViaSpan^{\circledR}$ group. The usage of MTT assay as a viable cell marker may give us a better indication of the maintenance of periodontal ligament cell vitality.

• Archives of Plastic Surgery
• /
• 제32권2호
• /
• pp.231-236
• /
• 2005

Nowadays breast reconstruction with autologous tissues after radical mastectomy is commonly performed, and a natural inframammary fold in the reconstructed breast is considered to be an essential aspect of symmetrical breast shape and location. Total of 104 patients underwent breast reconstruction with free TRAM flap and formation of inframammary fold with free TRAM breast reconstruction was done in 79 patients. No suture fixation for inframammary fold were done in 19 patients. 27 patients(24.0%) were made of inframammary fold with absorbable suture, 52 patients (50.0%) underwent inframammary fold creation with nonabsorbable suture. There were 4 cases(16.0%) of displacement of reconstructed breast and 2 cases(8.0%) of partial disruption of inframammary fold in the group of no suture. There were 2 cases(7.4%) of displacement of reconstructed breast and 3 cases(11.1%) of partial disruption of inframmamary fold in the fixed group with absorbable suture. There was only 1 case(1.9%) of partial disruption of inframammary fold fixed with nonabsorbable suture group. Therefore, we could speculate that the reinforcement of ligamentous structure for making the definite inframammary fold is necessary, and the area of the inframammary fold should not be undermined in immediate breast reconstruction as much as possible in order to preserve the zone of adherence. If the fold is disrupted during the mastectomy, it should be re-created with the non-absorbable sutures. Nonabsorbable suture fixation seemed to be more stable than absorbable suture. Preoperative marking and design are very important to make the symmetrical shape and location of inframammary fold in both of immediate and delayed reconstruction of breasts.

• 대한족부족관절학회지
• /
• 제19권1호
• /
• pp.11-17
• /
• 2015

Purpose: To report the radiographic and clinical results of 6.5 mm cancellous full threaded buttress screw or Steinmann pin fixation to maintain a reduction of calcaneal posterior facet depression fracture. Materials and Methods: From June 2009 to June 2012, 50 consecutive cases with calcaneal joint depression fracture that underwent open reduction and screw or pin fixation were enrolled in this study. A 6.5 mm cancellous full threaded screw was inserted from the posteroinferior aspect of the calcaneal tuberosity to the posterior facet (group A) or Steinman pin was inserted from the posterosuperior aspect of the calcaneal tuberosity to the calcaneocuboidal joint (group B). Both preoperative and postoperative Bohler and Gissane angles were measured radiographically, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were assessed. Results: The mean age of patients was 44.1 years, and the mean follow-up period was 27.2 months. According to the Sanders classification, 28 cases were type II and 22 cases were type III. In Sanders type II, Bohler and Gissane angles improved significantly from $10.1^{\circ}$ and $126.2^{\circ}$ preoperatively to $27.2^{\circ}$ and $117.1^{\circ}$, respectively, in the immediate postoperative radiograph, and at the final follow-up, $26.6^{\circ}$ and $118.6^{\circ}$, respectively. In Sanders type III, Bohler and Gissane angles improved significantly from $5.0^{\circ}$ and $129.8^{\circ}$ to $29.9^{\circ}$ and $119.3^{\circ}$, respectively, in the immediate postoperative radiograph, and $26.9^{\circ}$ and $120.2^{\circ}$ at the final follow-up. All cases achieved bony union, and the average period until complete union was 13.3 weeks. AOFAS ankle-hindfoot scale was 82.6 in Sanders type II and 77.3 in Sanders type III at the final follow-up. Conclusion: A 6.5 mm cancellous full threaded buttress screw or Steinman pin fixation is a noninvasive treatment method with a merit of being able to maintain the bearing capacity of the posterior facet comparable to plate fixation.

• Imaging Science in Dentistry
• /
• 제54권2호
• /
• pp.181-190
• /
• 2024

Purpose: This study compared sequential changes in skeletal stability and the pharyngeal airway following mandibular setback surgery involving fixation with either a titanium or a bioabsorbable plate and screws. Materials and Methods: Twenty-eight patients with mandibular prognathism undergoing bilateral sagittal split osteotomy by titanium or bioabsorbable fixation were randomly selected in this study. Lateral cephalometric analysis was conducted preoperatively and at 1 week, 3-6 months, and 1 year postoperatively. Mandibular stability was assessed by examining horizontal (BX), vertical (BY), and angular measurements including the sella-nasion to point B angle and the mandibular plane angle (MPA). Pharyngeal airway changes were evaluated by analyzing the nasopharynx, uvula-pharynx, tongue-pharynx, and epiglottis-pharynx (EOP) distances. Mandibular and pharyngeal airway changes were examined sequentially. To evaluate postoperative changes within groups, the Wilcoxon signed-rank test was employed, while the Mann-Whitney U test was used for between-group comparisons. Immediate postoperative changes in the airway were correlated to surgical movements using the Spearman rank test. Results: Significant changes in the MPA were observed in both the titanium and bioabsorbable groups at 3-6 months post-surgery, with significance persisting in the bioabsorbable group at 1 year postoperatively (2.29°±2.28°; P<0.05). The bioabsorbable group also exhibited significant EOP changes (-1.21±1.54 mm; P<0.05) at 3-6 months, which gradually returned to non-significant levels by 1 year postoperatively. Conclusion: Osteofixation using bioabsorbable plates and screws is comparable to that achieved with titanium in long-term skeletal stability and maintaining pharyngeal airway dimensions. However, a tendency for relapse exists, especially regarding the MPA.

• 대한족부족관절학회지
• /
• 제15권2호
• /
• pp.62-67
• /
• 2011

Purpose: The authors evaluated the differences between K-wires and Cannulated screw, plate for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus. Materials and Methods: There were 62 patients (79 feetz) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. We divided the patients into 4 groups, Two K-wire fixed group as A, one cannulated screw fixed group as B. Two cannulated screw fixed group as C, Plate fixed group as D, Group A were patients (26 feet) and Group B were patients z(9 feet), Group C were patients (31 feet) and Group D were patients (13 feet). Preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patient. ANOVA test and Student t-test were done for statistical analysis. Results: Mean follow up period was 43.8 months (range: 12~82 months). Preoperative mean IMA was $16.4{\pm}3.5$, $17.7{\pm}11.3$, $17.3{\pm}5.9$ and $16.6{\pm}2.3$ degrees in respectively group A, B, C, D. Immediate postoperative mean IMA was $5.6{\pm}3.4$, $7.3{\pm}4.4$, $7.6{\pm}4.4$ and $6.7{\pm}2.8$ degrees in respectively group A, B, C, D. The final mean IMA was $8.9{\pm}4.5$, $15.2{\pm}7.5$, $10.3{\pm}4.4$ and D $7.7{\pm}3.5$ degrees in respectively group A, B, C, D. There were significant statistical increase in final mean IMA of group B and C (p<0.05). Conclusion: The IMA was significantly increased in the group which used one or two cannulated screw for fixation on follow up, therefore more caution should be needed when using one or two cannulated screw fixation technique after proximal chevron osteotomy.

• Archives of Hand and Microsurgery
• /
• 제23권4호
• /
• pp.230-238
• /
• 2018

목적: 중수골 골절에서 시행되는 두 가지 수술 방법; 즉, 폐쇄적 정복술 및 평행핀 외고정술, 개방적 정복술 및 플레이트 내고정술 시행 이후 골절각의 변화를 수술 직후 및 추적 관찰하여 비교 분석하였다. 방법: 2008년 4월부터 2018년 1월까지 수부 단일 중수골 골절에 대해 수술적 처치를 받은 46명의 환자를 대상으로 후향적 연구를 진행하였다. 관절 외 중수골 골절에서 폐쇄적 정복술 및 가로 방향 평행 핀 외고정술(그룹 1) 또는 개방적 정복술 및 플레이트 내고정술(그룹 2)을 진행하고, 수술 전후 및 추시 후 수부 방사선 비스듬영상에서 골절각을 측정하여 분석하였다. 결과: 두 그룹 모두 정복술 진행 후 유의한 골절각 교정 결과를 보였다. 그룹 1의 경우 수술 후 3-4주에 능동적 운동을 시작하였으며, 골절각 재발 소견이 다소 나타났다(그룹 1: 수술 직후 골절각 $20^{\circ}{\pm}7^{\circ}$, 추시 후 골절각 $24^{\circ}{\pm}10^{\circ}$, p<0.05). 반면에 그룹 2는 수술 후 2주에 운동 진행 이후에도 정복된 상태를 지속적으로 유지하였다(그룹 2: 수술직후 골절각 $19^{\circ}{\pm}5^{\circ}$, 추시 후 골절각 $18^{\circ}{\pm}6^{\circ}$). 결론: 관절 외 단일 중수골 골절에서 폐쇄적 정복술 및 평행 핀 외고정술과 개방적 정복술 및 플레이트 내고정술 모두 골절에 의한 각형성을 유의하게 교정할 수 있는 유용한 수술 방법이다. 폐쇄적 정복술 및 평행 핀 외고정술 이후 3-4주에 손 운동을 시작할 경우 골절 부위에 과도한 운동 또는 외부 자극에 의한 저항이 가해지면 유합 진행을 악화시킬 수 있으므로 주의 깊은 경과 관찰을 요하며, 골절 상태에 따라 적절한 수술 방법을 계획해야 한다.

• Clinics in Shoulder and Elbow
• /
• 제18권2호
• /
• pp.68-74
• /
• 2015

Background: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. Methods: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. Results: At the final follow-up, the mean Korean Showlder Society score and Constant scores were $88.96{\pm}12.1$ and $86.6{\pm}11.9$, respectively, in group A and $86.21{\pm}11.8$ and $85.3{\pm}11.7$, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was $1.6^{\circ}$ in group A and $4.8^{\circ}$ in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). Conclusions: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.

• Journal of Korean Neurosurgical Society
• /
• 제41권2호
• /
• pp.77-81
• /
• 2007

Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.