• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.209-215
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• 2016

Background: The purpose of this study was to identify the clinical and radiological outcomes of hook plate fixation for lateral end fracture of the clavicle and acromioclavicular dislocation. Methods: There were a total of 20 cases with lateral end fracture of the clavicle and 16 cases with acromioclavicular dislocation. All patients were evaluated for range of motion, functional score by using Constant score, and American Shoulder and Elbow Surgeons shoulder index at just before implant removal and at final follow-up. Coracoclavicular distance was measured in acromioclavicular dislocation and bony union was evaluated in the lateral end fracture of the clavicle. Results: The clinical outcomes and range of motion were increased at the final follow-up compared with just before implant removal in both the lateral end fracture of the clavicle and acromioclavicular dislocation. In acromioclavicular dislocation, all cases-except one-showed maintenance of reduction after implant removal. Moreover, in the lateral end fracture of the clavicle, all cases-except one-showed bony union. Conclusions: Hook plate fixation in the lateral end fracture of the clavicle and acromioclavicular dislocation resulted in good clinical and radiological results.

• Clinics in Shoulder and Elbow
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• 제6권2호
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• pp.131-137
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• 2003

Purpose: Unstable Neer type II lateral end fracture of clavicle may be required operation. The purpose of this study is the effectiveness of the use of Hook plate in the management of unstable Neer type II fractures. We preliminary reported the results of Unstable Neer type II lateral end fracture of clavicle using by Hook plate. Material and Methods: From May 1998 to May 2002, we operated 6 cases unstable Neer type II lateral end fracture of clavicle with Hook plate by one surgeon. We checked radiologic evaluation and disappearance of pain per 1 week, and evaluated improvement of range of motion per 2 week. And we followed up at each interval 3 months,6 months, 12 months and after that per 6months interval, at that each time we checked stress radiogram of shoulder and functional evaluation. The shoulder function was evaluated using Modified Shoulder Rating Scale (MSRC) for Distal Clavicle Fracture and UCLA score. Average follow up was on 37.2 (12∼57) months. Results: All 6 patients were regained satisfactory function. Average MSRC for distal clavicle fracture was 17.3 (15∼20) and average UCLA score was 33.2 (31∼35) at last follow up. Conclusion: There are many advantage of the use of Hook plate on management of unstable Neer II distal clavicle fracture in spite of several disadvantage. There have not yet been reported in our country. So we obtained good to excellent clinical result in surgical treatment of 6 cases on type II displaced lateral end fracture of the clavicle. But we think that more cases will be review and longer follow up will be needed in the future.

• Clinics in Shoulder and Elbow
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• 제5권1호
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• pp.23-28
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• 2002

Purpose Displaced lateral end fracture of clavicle and acromioclavicular dislocation type Ⅲ∼Ⅵ may be required surgical treatment. Material and Methods : From May 1998 to March 2001, we operated with Welter plate with minimal incision by one surgeon. Immediately, pendulum and passive exercise was initiated after surgery. The shoulder function was evaluated using UCLA score. Average follow up was on 28(12∼45) months. Results : All 11 patients were regained satisfactory function. Average UCLA score was 31.9(29~35) at last follow up. Conclusion . The merit of Welter plate fixation with minimal incision is simple technique, reduced surgical time, smaller scar than large plate, strong fixation, early exercise, reduced implant failure. The disadvantage is expensive, skin irritatatation by long hook. But Welter plate fixation with minimal incision is a good method of internal fixation and excellent clinical result in surgical treatment of type H displaced lateral end fracture of the clavicle and type Ⅲ∼Ⅵ acromioclavicular dislocation.

• Clinics in Shoulder and Elbow
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• 제17권2호
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• pp.77-79
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• 2014

The migration of metallic devices such as Kirschner's wire (K-wire) from the shoulder is a well-recognized and significant complication of operation, the wire ending up in the lungs, the heart, the esophagus, the aorta or the subclavian artery. However, spinal migration is very rare. We report the case of a 72-year-old female patient with K-wire migration into the C7-T1 intervertebral foramen, 2 months after surgery for a lateral end fracture of left clavicle.

• Journal of Chest Surgery
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• 제28권2호
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• pp.218-220
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• 1995

This 51 years old male patient was admitted to the department of thoracic and cardiovascular surgery via OPD because of anterior chest pain. 7days before admission, He got the chest trauma after traffic accidents,the lateral chest roentgenogram showed complete transverse sternal fracture. He also complained of mild dyspnea. We also noticed that he had depressed anterior chest wall. It looks like funnel chest. The operative findings revealed dislocated & callus formations at the both 4th and 5th costochondral junction and transverse fracture of sternal body between 4th and 5th costochondral junction, the upper end of sternal fracture was situated below the lower end of sternal fracture. The two ends of sternal fracture were situated at the same level and reapproximated the two ends by two-interrupted wire sutures. The patient is well on the road to recovery after the operation.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.66-71
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• 1998

The fractures of lateral end of clavicle can be treated by conservative or operative treatment, but many authors report the higher rate of non-union with conservative treatment and that the operative treatment is more effective for the type II fractures. The authors reviewed and analysed 15 cases of lateral end fracture of clavicle which had been treated at Department of Orthopedic Surgery, Kyungpook National University Hospital from 1991 to 1996. The results were as follows; 1. Among the 15 patients, male was 6,female 9 and the average age was 46.2 years ranged from 21 to 72 years. 2. According to the classification by Rockwood, type II a was 8 cases and II b was 7 cases. 3. We treated operatively 12 cases, 9 cases with tension band wiring and 3 cases with intramedul-Iary K-wire fixation. And we treated conservatively 3 cases with Velpeau cast, but I case of nonunion was treated with tension band wiring. 4. The average follow-up was 3.2 years ranged from 2.1 to 4.7 years. 5. The functional results were evaluated with Weitzman's classification. 6. In the operatively treated cases, there were 4 cases(30.7%) in excellent, 7 cases(53.8%) in good and 2 cases(15.3%) in fair result. But, in the conservatively treated cases, there were 2 cases in good and I case in poor result, and the poor case did not united and had open reduction and internal fixation. 7. In conclusion, the operative treatment revealed good functional results in most cases (10/12) and early open reduction and internal fixation was better method than conservative treatment.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.168-171
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• 2016

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

• 대한관절경학회지
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• 제13권1호
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• pp.46-52
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• 2009

목적: AO C-형 원위 대퇴골 골절의 치료로서 대퇴골 외측에 금속판을 삽입한 후, 관절경 보조하 최소 침습적 금속판 제거를 시행하였던 환자들을 대상으로 술식의 유용성을 조사하였다. 대상 및 방법: 2002년 10월부터 2005년 11월까지 AO C-형 원위 대퇴골 골절로 관혈적 정복 및 대퇴골 외측면에 금속판 내고정술을 시행하였던 환자들 중 대퇴골 외과 부위의 불편감으로 인해 관절경 보조하 최소 침습적 금속판 제거를 시행하였던 17예와 관절경 없이 고식적인 방법으로 금속판 제거슬 시행한 15예, 총 32예를 대상으로 하였다. 평균 연령은 42.6세(20~66세), 최초 골절 상태는 AO/ASIF 분류상 C1 16예, C2 11예, C3 5예였다. 술 중 확인된 관절내 병변, 술 후 합병증 및 술 후 일상 생활로의 복귀 시간, 수술에 대한 만족도, 술 전 및 술 후 6개월 추시상의 슬관절 통증을 조사하였다. 결과: 전 예에서 금속판의 최고 원위부는 슬관절 내에 위치하였고, 23예에서 이와 접촉하는 외측 관절낭의 손상이 확인되었다. 관절경 보조하 금속판 제거술을 시행한 군에서 금속판 제거술 후 지속적 창상 배액으로 세척술 및 창상 재 봉합술을 시행한 경우가 1예 있었다. 술 후 일상 생활로의 복귀는 관절경 보조하 금속판 제거술을 시행한 군에서 평균 7일이었고, 고식적 금속판 제거술을 시행한 군에서 평균 7.6일 이었다. 관절경 보조하 금속판 제거술을 시행한 군은 14예(82.4%)에서 '보통' 이상의 수술 만족도를 보였으며, VAS 통증 지수는 수술 전 4.9에서 수술 후 6개월에 1.9로 감소하였다. 고식적 금속판 제거술을 시행한 군은 13예(86.7%)에서 보통' 이상의 수술 만족도를 보였으며, VAS 통증 지수는 수술전 5.2에서 수술 후 6개월에 2.5로 감소하였다. 결론: 본 술식은 원위 대퇴골에 삽입된 금속판 제거와 함께 슬관절 내의 다양한 병변의 확인 및 치료가 가능한 장점이 있었다. C-형 원위 대퇴골 골절의 치료를 위해 삽입된 금속판에 의한 슬관절 외측 관절낭의 손상이 매우 빈번히 확인되었고, 금속판을 제거함으로서 슬관절 통증이 감소하는 것을 확인하였음으로, C-형 원위 대퇴골 골절과 같이 금속판의 최고 원위부가 관절내에 위치하는 경우에는 골절의 유합이 이루어지면 금속판을 제거되어야 할 것으로 사료된다.

• Steel and Composite Structures
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• 제27권5호
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• pp.577-598
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• 2018

The imperfect steel-concrete interface bonding is an important deficiency of the concrete-filled double skin tubular (CFDST) columns that led to separating concrete and steel surfaces under lateral loads and triggering buckling failure of the columns. To improve this issue, it is proposed in this study to use longitudinal and transverse steel stiffeners in CFDST columns. CFDST columns with different patterns of stiffeners embedded in the interior or exterior surfaces of the inner or outer tubes were analyzed under constant axial force and reversed cyclic loading. In the finite element modeling, the confinement effects of both inner and outer tubes on the compressive strength of concrete as well as the effect of discrete crack for concrete fracture were incorporated which give a realistic prediction of the seismic behavior of CFDST columns. Lateral strength, stiffness, ductility and energy absorption are evaluated based on the hysteresis loops. The results indicated that the stiffeners had determinant role on improving pinching behavior resulting from the outer tube's local buckling and opening/closing of the major tensile crack of concrete. The lateral strength, initial stiffness and energy absorption capacity of longitudinally stiffened columns with fixed-free end condition were increased by as much as 17%, 20% and 70%, respectively. The energy dissipation was accentuated up to 107% for fixed-guided end condition. The use of transverse stiffeners at the base of columns increased energy dissipation up to 35%. Axial load ratio, hollow ratio and concrete strength affecting the initial stiffness and lateral strength, had negligible effect of the energy dissipation of the columns. It was also found that the longitudinal stiffeners and transverse stiffeners have, respectively, negative and positive effects on ductility of CFDST columns. The conclusions, drawn from this study, can in turn, lead to the suggestion of some guidelines for the design of CFDST columns.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.51-57
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• 1998

Comminuted fracture of the distal end of the humerus in adults is very rare and difficult to treat. In operative treatment, an implant which can achieve accurate anatoraical reduction and rigid fixation is needed. But the pre­existing Y -shaped plate had wide and thick limbs and some problems in fixation for most distal humeral fractures. So we devised a modified plate which is more narrow and th1n and has a different hole distance and wing length (long lateral wing). The aim of the study was to evaluate the clinical result of this modified anatomical Y -plate. From 1991 to 1997, we treated 23 cases of distal humeral fractures using modified anatomical plate and the results were as follows. 1. Fracture type in 18 patients(78%) was C-type(C1,C2,C3) which were intraarticular and mostly displaced or comminuted. 2. Bony union was obtained in 22 patients(96%) through rigid fixation and observed radiologically at 3.5 months(2-6months) on the average. 3. In 23 patients, 19 patients(82%) showed satisfactory results after 34 months(6-73months) follow-up. So if the modified anatomical Y-plate is used in the treatment of distal humeral fracture, a satisfactory result can be obtained through a more accurate, easy, and rigid fixation than preexisting plate.