• Title/Summary/Keyword: Screw plate

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Treatment of Blow-out Fractures Using Both Titanium Mesh Plate and Porous Polyethylene (Medpor®) (광범위한 안와파열골절에서 Titanium Mesh Plate와 Porous Polyethylene (Medpor®) 동시 사용의 유용성)

  • Gu, Ja Hea;Won, Chang Hoon;Dhong, Eun-Sang;Yoon, Eul-Sik
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.85-90
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    • 2010
  • Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.

Anatomic Conformity of New Periarticular Locking Plates for Koreans: A Biomechanical Cadaveric Study (한국인에 대한 새로운 관절주위 잠김금속판의 해부학적 적합성: 사체를 이용한 연구)

  • Yoon, Yong-Cheol;Oh, Jong-Keon;Kim, Young-Woo;Kim, Hak Jun;Moon, Hong Joo;Kim, Nam-Ryeol
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.163-169
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    • 2013
  • Purpose: This study was conducted to confirm the anatomic conformity of the new periarticular locking plates designed by Zimmer on Korean adult bones and to identify the structures at risk during the application of these implants. Methods: The study was performed on the humerus, radius, and tibia of 10 adult cadavers(6 males and 4 females) procured from the cadaveric lab of our hospital. Anteroposterior (AP) and lateral X-rays were taken to confirm that the cadavers were free of any unusual lesions or anatomic variations. We used the 3.5-mm proximal humerus plate, 2.7-mm distal radius plate, 3.5- and 5.0-mm proximal tibia plates, and 3.5-mm distal tibia plate developed by Zimmer, Inc. (Zimmer periarticular locking plate). The longest plate from each group was used to confirm anatomical conformity. Standard approaches were used for each area, and soft tissue was retracted in order to pass the plate beneath the muscle. The position of the plate was confirmed using standard AP and lateral view X-rays. After this procedure had been completed, the region was dissected along the length of the implant to determine the conformity of the implant to bone and the penetrations of screws into the articular surface or violations of any vital structures, such as nerves, blood vessels, or tendons. Results: Excellent anatomical conformity was observed with Zimmer periarticular locking plates for Korean adults. The tibial nerve and the posterior tibial artery were found to be structures at risk when applying a distal tibial plate. Conclusion: Additional posterolateral fixation is recommended when dealing with cases of tibial plateau fracture when the fracture line extends to the posterolateral cortex. We recommend taking proper views using 10~15 degrees of internal rotation to ensure correct screw length and, thus, avoid penetration of vital structures and tendons.

Compression Plate Fixation with Autogenous Bone Graft for Humerus Shaft Nonunion (상완골 간부 불유합에 대한 금속판 고정 및 자가골 이식술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Bae, Ki-Cheor;Kim, In-Kyoo;Kwon, Doo-Hyun
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.33-37
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    • 2009
  • Purpose: To evaluate the results of the compression plate fixation and autogenous bone graft in the management of humerus shaft nonunion. Materials and Methods: Eighteen cases were treated for humerus shaft nonunion using compression plate fixation and an autogenous iliac bone graft. The mean follow-up period was 28 months. Bony union was confirmed from the serial radiographs and the clinical outcomes were assessed according to ASES scoring system. Results: In 12 cases of initial plate fixation, the causes of nonunion were 6 cases of inadequate plate length, 2 with a broken plate, 2 with screw loosening, 1 infection and 1 noncompliance of a psychiatric patient. In 3 cases of initial intramedullary fixation, the cause of nonunion was a distraction of the fracture site. In 3 cases of external fixation, the cause of nonunion was inadequate fixation. All cases showed bony union after an average of 24 weeks. The clinical outcomes were 11 excellent, 6 good and 1 fair. Conclusion: In the treatment for nonunion, compression plate fixation with autogeneous bone graft after complete removal of the fibrous and necrotic tissue is believed to give satisfactory results.

Fatigue Characterization of Glass/Polypropylene Composite Bone Plates Locked with an Artificial Tibia under Moisture Environment (인조골에 체결된 유리섬유/폴리프로필렌 복합재료 고정판의 수분 환경 피로 특성)

  • Han, Min-Gu;Chang, Seung-Hwan
    • Composites Research
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    • v.26 no.5
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    • pp.328-333
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    • 2013
  • In this study, bone plate made of glass/polypropylene composite material which was applied to an artificial bone was tested to check the service ability under fatigue loading. To check serviceability of composite bone plates fatigue test was carried out considering changes in the moisture absorption rate, locking position of screws and loading condition. Test results showed that all the tested specimens had the fatigue life more than one million cycles which was much higher fatigue life than the expected value of 650,000 cycles. Screw position was not critical impact on the deformation of the fracture site. In this paper, the mechanical performance of the glass/polypropylene composite was verified by fatigue test under various water absorption conditions, and this result may give useful information on the design of composite bone plate.

Numerical Study of Face Plate-Type EPB Shield TBM by Discrete Element Method (개별요소법을 활용한 면판형 토압식 쉴드TBM의 수치해석 연구)

  • Lee, Chulho;Chang, Soo-Ho;Choi, Soon-Wook;Park, Byungkwan;Kang, Tae-Ho;Sim, Jung Kil
    • Journal of the Korean Geosynthetics Society
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    • v.16 no.4
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    • pp.163-176
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    • 2017
  • The Discrete Element Method (DEM) has been widely used in civil engineering as well as various industrial fields to simulate granular materials. In this study, DEM was adopted to predict the performance of the face plate-type earth pressure balance (EPB) shield TBM (Tunnel Boring Machine). An analysis of the TBM excavation performance was conducted according to two pre-defined excavation conditions with the different rotation speeds per minute (RPM) of the cutterhead. The TBM model which was used in this study has a 6.64 m of diameter and six spokes. Also, 37 precutters and 98 scrapers at an each spoke were modeled with a real-scale specification. From the analysis, compressive forces at the cutterhead face, shield and cutting tools, resistant torques at the cutterhead face, muck discharge rate and accumulated muck discharge by the screw auger were measured and compared.

One-Stage Treatment of Chronic Calcaneal Osteomyelitis with Bone Morphogenetic Protein 2 and Local Antibiotic Delivery in a Cat

  • Kim, Hyungkyoo;Jeong, Heejun;Park, Chul;So, Kyung-Min;Park, Jiyoung;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.33 no.5
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    • pp.300-303
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    • 2016
  • An age-unknown, 4.8 kg, male, wild, domestic short-hair cat was presented for left hindlimb lameness. A physical examination revealed a draining tract which was suspected of bite on left calcaneal bone. The left tarsal joint was markedly swollen and exudates were observed around the draining tract. Sequestrum at left calcaneus bone, and osteolysis were identified by radiography. The sequestrum and its surrounding exudative tissue were debrided during surgery and the tissue was submitted for bacterial culture and sensitivity test. The debridement caused a bone defect ($1.5cm{\times}0.5cm{\times}0.5cm$) on the medial left calcaneal bone. Plate and screw fixation was performed to the calcaneus bone as buttress plate. Recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded hydroxyapatite was implanted in the bone defect. Furthermore, Amikacin-impregnated collagen sponges were also placed around bone plate to deliver local antibiotics. A systemic antibiotic treatment regimen based on bacterial culture and sensitivity test results was administered for 4 weeks. The wound properly healed without any signs of infection, and the bone healing was confirmed by radiography. The patient showed normal weight bearing ambulation at 18 weeks after surgery. The use of rhBMP-2 and local antibiotic delivery system is a good surgical option for the one-stage treatment of chronic osteomyelitis.

A Study on Development of Press Brake by Data-based Servo Control System (데이터베이스를 이용한 서보제어방식의 절곡기 개발에 관한 연구)

  • 김경석;강기수;송충현;김성식
    • Proceedings of the Korean Society of Machine Tool Engineers Conference
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    • 2002.04a
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    • pp.416-421
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    • 2002
  • The purpose of t his paper is to database each factors from experimental results and develop the servo-controlled feeding system on these database. At first, spring back and bending farce are analyzed by basic theory of bending processing. In database, through practical experiment by the expert various types of bending angel and thickness of plate are tested and classified with SB34P and Aluminum. For the development of servo-controlled feeding system, automatic feeding system is designed and manufactured with ball screw and LM guide and performance of the developed feeding system is tested under condition of standard machine tool examination. Also, Mechanical consideration of mainframe in press brake, development of controller based on NC, program for servo-control are studied. Finally, based on experimental data, the system is operated and compared with theoretical data

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Mycotic Abdominal Pseudoaneurysm due to Psoas Abscess after Spinal Fusion

  • Ryu, Dae Woong;Lee, Sam Youn;Lee, Mi Kyung
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.443-446
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    • 2015
  • A 36-year-old man, who had undergone thoracoscopic anterior spinal fusion using the plate system and posterior screw fusion three months previously, presented to our hospital with left flank pain and fever. Computed tomography indicated the presence of a psoas muscle abscess. However, after two days of percutaneous catheter drainage, a mycotic abdominal aortic pseudoaneurysm was detected via computed tomography. We performed in situ revascularization using a prosthetic graft with omental wrapping. Methicillin-resistant Staphylococcus aureus was identified on blood and pus culture, and systemic vancomycin was administered for one month. Although the abscess recurred, it was successfully treated with percutaneous catheter drainage and systemic vancomycin administration for three months, without the need for instrumentation removal. The patient remained asymptomatic throughout two years of follow-up.

Unilateral Segmental Palatal Distraction in Unilateral Cleft Lip and Palate Patient (편측성 구순구개열 환자에서의 편측성 분절 구개골 신장술)

  • Baek Seung-Hak;Kim Na-Young;Choi Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.43-51
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    • 2003
  • Patients with unilateral cleft lip and palate (UCLP) usually present unilateral cross bite due to collapse of the maxillary minor segment. Unequal expansion of the palate is needed to resolve this problem in UCLP patient. Unilateral segmental palatal distraction (USPD) after Le Fort I osteotomy and the oblique placed orthodontic expansion screw (Hyrax) can be used to correct the unilateral cross bite. 1his case report describes the effects of USPD of the collapsed maxillary minor segment on patient with unilateral cleft lip and palate.

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Zygomaticomaxillary complex fracture after two-jaw surgery

  • Park, Joseph Kyu-hyung;Kim, Sang Wha
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.301-304
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    • 2020
  • Orthognathic surgeries often utilize rigid fixation for stabilization of the osteotomy site. The longterm fate of rigid fixations is still under investigation, and whether they should be routinely removed is under debate despite their low complication rates. Here, we report a case where a 26-year-old man suffered high-velocity trauma to his face 7 years after a two-jaw surgery. Computed tomography examination revealed a zygomaticomaxillary complex fracture, and open reduction and internal fixation was performed along with anterior maxillary wall reconstruction using absorbable mesh. Intraoperative examination revealed a broken L-shaped titanium plate near the fracture site with multiple bony fragments near each titanium screw. The rigid titanium system may have caused comminution of the fracture pattern, worsening the severity of the fracture.