• 대한관절경학회지
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• 제9권2호
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• pp.186-193
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• 2005

목적: ALPSA(anterior labroligamentous periosteal sleeve avulsion) 병변과 Bankart 병변을 관절경하에서 구별할 수 있는지를 알아보고자 하였으며 ALPSA 병변의 임상적 의의를 알아보고자 하였다. 대상 및 방법: 견관절의 전방 불안정성으로 관절경하에서 Bankart 복원술을 시행한 66예를 대상으로 하였다. 자기 공명 영상의 판독상 Bankart 병변은 56예(85%) ALPSA 병변은 10예(15%)였다. 각 병변의 관절경 소견을 분류하였으며 결과는 평균 22개월 추시하였다. 결과: Bankart 병변 보다 ALPSA 병변의 발생 시기가 보다 젊은 층에서 발생하였다 관절경하에서 ALPSA 병변은 여러 형태를 보였으며 특히 하내측으로 많은 전위를 보인 경우가 5예에서 관찰되었다. Bankart 병변도 심한 전위를 보인 경우가 21예였으며 견갑 경부로부터 뚜렷하게 외측 전위되지 않고 하내측으로 전위된 경우는 관절경하에서 ALPSA 병변과 구별하기 어려웠다. 재발은 ALPSA 군에서는 재탈구는 없었으나 불안감이 2예(20%)에서 있었고 하내측으로 많은 전위를 보인 예에서 나타났으며, Bankart 군에서는 재탈구 1예, 아탈구 1예, 불안감 2예로 총 4예(7.1%)에서 있었다. 결론: 하내측으로 심하게 전위된 Bankart 병변과 ALPSA 병변은 식별이 용이하지 않았으며 전위가 심한 ALPSA 병변에서 재발율이 높았다. 따라서 복원술시 ALPSA 병변을 철저하게 재분리하는데 보다 주의가 요할 것으로 사료된다.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.77-81
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• 2003

목적: 슬관절 주위 골격의 기초과학을 생체역학을 중심으로 설명하고 빈도가 높은 스포츠 손상들에 대해 기술하고자 한다. 해부 밀 운동학: 슬관절은 순수한 경첩 관절이 아니며 적합하지 않으므로 여섯 방향의 운동이 가능하다. 경골대퇴간 운동역학: 슬관절의 굴곡-신전 축은 시상면에 수직이 아닐 뿐 아니라, 관상면상 관절선과 평행하지 않으므로, 경골대퇴관절은 굴곡 시 내반과 내회전이 동반되고 신전 시에는 외반과 외회전이 동반된다. 슬개대퇴 관절: 슬개대퇴 관절 압박력은 슬관절의 굴곡 각도와 사두고근력에 비례한다 슬개골은 신전기전의 moment arm을 증가시켜 신전기전의 효율을 증대시키고 지렛대 역할을 한다. 슬개골 골절: 비전위성 골절이면서 하지 직거상 운동이 보존된 경우에 비수술적 치료의 적응증이 되며 수술적 치료 시 고정 방법의 선택은 골절 양상에 따라 결정되겠으나 어느 술식을 선택하여도 신전지대의 봉합은 필수적이며 중요하다 슬개골 불안정성: 선행 해부학적 이상을 조사해야 하며 급성 탈구에서도 골연골 골절편이 있거나 재발의 위험이 높은 운동선수에서 인대 봉합을 고려할 수 있다. 비수술적 치료 및 재활에도 불수하고 계속되는 재발성 아탈구나 탈구는 수술이 필요하다 학령기 스포츠 손상: Idiopathic Adolescent Anterior Knee Pain, Osgood-Schlatter Disease, Sinding-Larsen-Johansson Disease 등이 흔하다

• Journal of Trauma and Injury
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• 제21권1호
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• pp.22-27
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• 2008

Purpose: Treatment and prognosis in patients with pelvic bone fracture depend on the characteristics of the fracture and the stability of the pelvic ring. The purpose of this study is to analyze the characteristics of and the relationships between fracture patterns, injury mechanisms, clinical courses, and prognoses according to the hemodynamic pattern. Methods: Between January 2004 and September 2006, 89 patients under diagnosis of pelvic bone fracture were retrospectively analyzed on the basis of medical records and radiologic examinations. Patients with confirmed hemorragic shock with a systolic pressure of less than 90 mmHg were defined as the shock group. Young's classification was used to characterize fracture patterns. Factors relating to the clinical manifestation and to treatments such as transfusion and surgery were analytically compared. Results: The mean age of the patients was $48.8{\pm}18.7$, among which 49 (55.1%) were male. The numbers of shock and non-shock patients were 35 (39.3%) and 54 (60.7%) respectively. Eighteen (51.4%) of the shock patient had injuries resulting from pedestrian accidents (p=0.008). According to Young's classification, lateral impact fractures amounted to 20 and 33, front-rear impact fractures to 9 and 20, and multiple fractures to 6 and 1 among the shock and non-shock patients, respectively (p=0.027). Thirty-nine (39) cases in non-shock injuries were conservatively managed while 18 cases in shock injuries were surgically treated. In the shock group, the liver and the kidney were often damaged, as well. Among the shock patients, the average admission period was $7.5{\pm}8.7days$ in intensive care and $55.1{\pm}47.9days$ in total, which were longer than the corresponding numbers of days for the non-shock patients (p<0.05). No deaths occurred in the non-shock group while 5 deaths (14.2%) occurred in the shock group (p=0.007). Conclusion: The factors affecting hemodynamic instability in patients with pelvic bone fracture are injury mechanism, classification of fracture, and associated injuries.

• 대한족부족관절학회지
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• 제26권1호
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• pp.40-47
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• 2022

Purpose: The modified Broström repair (BR) technique has yielded good outcomes in patients with chronic ankle instability. This study compared clinical and radiological outcomes between two groups of patients who underwent modified BR or lateral ligament augmentation using suture tapes (ST). Materials and Methods: Seventy-seven patients (ST group [n=47], BR group [n=30]; body mass index <26.61 kg/m²; mean age, 30.7±11.0 years [range, 17~39 years]; mean follow-up, 34.0±12.0 months [range, 24~59 months]) were retrospectively reviewed between January 2014 and July 2017. The Foot and Ankle Outcome Score (FAOS), American Orthopedic Foot and Ankle Score (AOFAS), Foot and Ankle Ability Measure (FAAM), visual analogue scale (VAS) score, and Sefton grading system were used for clinical assessment. The talar tilt angle and anterior talar translation were measured using the Telos stress device (Telos GmbH, Marburg, Germany) at 150 N for radiological evaluation. Results: FAOS, AOFAS, FAAM, and VAS scores improved in both groups at final follow-up (ST, 91.1±5.2, 93±2, 88.1±4.5, 1.5±0.7 vs. BR, 91.3±5.4, 93±3, 83.3±4.8, 1.2±0.7, respectively; p=0.854, 0.971, <0.001, 0.04, respectively). According to the FAOS, mean sports activity scores for the ST and BR groups at the final follow-up were 90.3±3.2 and 76.6±4.2, respectively, reflecting superior outcomes in the ST group (p<0.001). Sefton grading revealed satisfactory functional outcomes (ST, 91.5% vs. BR, 90.0%). There was significant improvement in the talar tilt angle and anterior talar translation in both the ST and BR groups (7.6°±1.2°, 10.5±1.8 mm vs. 4.9°±1.1°, 7.9±1.5 mm, respectively; p<0.001). Conclusion: The ST group demonstrated comparable clinical but better improvement in mechanical stability and FAOS sports scores than the BR group.

• Steel and Composite Structures
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• 제21권5호
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• pp.963-980
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• 2016

The jib system with middle strut is widely used to achieve the large arm length in the large scale tower crane and the deployability in the mobile construction crane. In this paper, an analytical solution for the out-of-plane buckling of the jib system with middle strut is proposed. To obtain the analytical expression of the buckling characteristic equation, the method of differential equation was adopted by establishing the bending and torsional differential equation of the jib system under the instability critical state. Compared with the numerical solutions of the finite element software ANSYS, the analytical results in this work agree well with them. Therefore, the correctness of the results in this work can be confirmed. Then the influences of the lateral stiffness of the cable fixed joint, the dip angle of the strut, the inertia moment of the strut, and the horizontal position of the cable fixed joint on the out-of-plane buckling behavior of the jib system were investigated.

• Steel and Composite Structures
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• 제2권3호
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• pp.209-222
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• 2002

This paper describes the buckling phenomenon of a tubular truss with unsupported length through a full-scale test and presents a practical computational method for the design of the trusses allowing for the contribution of torsional stiffness against buckling, of which the effect has never been considered previously by others. The current practice for the design of a planar truss has largely been based on the linear elastic approach which cannot allow for the contribution of torsional stiffness and tension members in a structural system against buckling. The over-simplified analytical technique is unable to provide a realistic and an economical design to a structure. In this paper the stability theory is applied to the second-order analysis and design of the structural form, with detailed allowance for the instability and second-order effects in compliance with design code requirements. Finally, the paper demonstrates the application of the proposed method to the stability design of a commonly adopted truss system used in support of glass panels in which lateral bracing members are highly undesirable for economical and aesthetic reasons.

• Advances in biomechanics and applications
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• 제1권3호
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• pp.211-225
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• 2014

The usual assumption that the increase of fractures in aging bone is due entirely to lower bone density is taken back with respect to the possibility that aging bone fractures result from a loss of stability, or buckling, in the structure of the bone lattice. Buckling is an instability mode that becomes likely in end-loaded structures when they become too slender and lose lateral support. The relative importance of bone density and architecture in etiology bone fractures are poorly understood and the need for improved mechanistic understanding of bone failure is at the core of important clinical problems such as osteoporosis, as well as basic biological issues such as bone formation and adaptation. These observations motivated the present work in which simplified adaptive-beam buckling model is formulated within the context of the adaptive elasticity (Cowin and Hegedus 1976, Hegedus and Cowin 1976). Our results indicate that bone loss activation process leads systematically to the apparition of new elastic instabilities that can conduct to bone-buckling mechanism of fracture.

• Wind and Structures
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• 제30권3호
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• pp.317-323
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• 2020

A novel approach is presented to improve dynamic responses of a pedestrian bridge by utilizing decorative wind chimes. Through wind tunnel tests, it was verified that wind chimes can provide stabilization effects against flutter instability, especially at positive or negative wind angles of attack. At zero degrees of angle of attack, the wind chimes can change the flutter pattern from rapid divergence to gradual divergence. The decorative wind chimes can also provide damping effects to suppress the lateral sway motion of the bridge caused by pedestrian footfalls and wind forces. For this purpose, the swing frequency of the wind chimes should be about the same as the structural frequency, which can be achieved by adjusting the swing length of the wind chimes. The mass and the swing damping level are other two important and mutually interactive parameters in addition to the swing length. In general, 3% to 5% swing damping is necessary to achieve favorite results. In the study case, the equivalent damping level of the entire system can be increased from originally assumed 1% up to 5% by using optimized wind chimes.

• 한국운동역학회지
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• 제21권1호
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• pp.9-16
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• 2011

The purpose of this study is to analyze the effects of both various shoe types and bare feet on ground reaction force while walking. Ten first-year female university students were selected. A force platform(Kistler, Germany) was used to measure ground reaction force. Six types of shoe were tested: flip flops, canvas shoes, running shoes, elevated forefoot walking shoes, elevated midfoot walking shoes, and five-toed shoes. The control group was barefooted. Only vertical passive/active ground reaction force variables were analyzed. The statistical analysis was carried out using the SAS 9.1.2 package, specifically ANOVA, and Tukey for the post hoc. The five-toed shoe had the highest maximum passive force value; while the running shoe had the lowest. The first active loading rate for running shoes was the highest; meanwhile, bare feet, the five-toed shoe, and the elevated fore foot walking shoe was the lowest. Although barefoot movement or movement in five toed shoes increases impact, it also allows for full movement of the foot. This in turn allows the foot arch to work properly, fully flexing along three arches(transverse, lateral, medial), facilitating braking force and initiating forward movement as the tendons, ligaments, and muscles of the arch flex back into shape. In contrast movement in padded shoes have a tendency to pound their feet into the ground. This pounding action can result in greater foot instability, which would account for the higher loading rates for the first active peak for padded shoes.

• Steel and Composite Structures
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• 제34권6호
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• pp.783-794
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• 2020

Steel-concrete-steel sandwich composite wall is composed of two external steel plates and infilled concrete core. Internal mechanical connectors are used to enhance the composite action between the two materials. In this paper, the compressive behavior of a novel sandwich composite wall was studied. The steel trusses were applied to connect the steel plates to the concrete core. Three short specimens with different truss spacings were tested under compressive loading. The boundary columns were not included. It was found that the failure of walls started from the buckling of steel plates and followed by the crushing of concrete. Global instability was not observed. It was also observed that the truss spacing has great influence on ultimate strength, buckling stress, ductility, strength index, lateral deflection, and strain distribution. Three modern codes were introduced to calculate the capacity of walls. The comparisons between test results and code predictions show that AISC 360 provides significant underestimations while Eurocode 4 and CECS 159 offer overestimated predictions.