• Title/Summary/Keyword: Screw plate

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Preventing Varus Deformity in Senile Patients with Proximal Humerus Fractures and Poor Medial Support

  • Kim, Young-Kyu;Kang, Suk-Woong;Kim, Jin-Woo
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.216-222
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    • 2016
  • Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.

Fine Structure of the Sperm in the Myotis daubentonii ussuriensis (물윗수염박쥐(Myotis daubentinii ussuriensis)의 정자미세구조)

  • Kim, Hyun-Hee;Lee, Jung-Hun
    • Applied Microscopy
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    • v.41 no.1
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    • pp.31-35
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    • 2011
  • The fine structures of the sperm morphology in the Myotis daubentonii ussuriensis were observed by transmission electron microscope. The results showed that the sperm head revealed bullet shaped, the width was showed a slender more than toward the posterior region to anterior region of nucleus. The sperm head was about $4.5{\mu}m$ in length, being about $2.0{\mu}m$ in width. The nuclear length was $4.3{\mu}m$, occupied most of the sperm head. The nucleus and acrosome were separated by the apical body. The neck region was composed the basal plate, capitulum and segmented columns. The segmented columns were about 12 to 14 in number and connected with the outer dense fibers of the middle piece. The mitochondria sheath were arranged like the thread of a screw, and the total number of mitochondrial gyres were 57. The satellite fibers were observed irregularly among the outer dense fibers in the middle piece. Except the middle piece they are not observed in the principal and end pieces of the tail. In general, the tail show axoneme composed of a 9+2 microtubular pattern, and microtubules of the end piece were arranged irregularly.

PHOTOELASTIC STRESS ANALYSIS OF LOAD TRANSFER TO SATELLITE ABUTMENT AS AN IMMEDIATE ABUTMENT (인공치아의 즉시부하를 위해 새로이 개발된 인공치아 지대주(Satellite Abutment)의 광탄성 응력 분석)

  • Park, Sang-Kyu;Lee, Baek-Soo;Engelke, W;Kim, Boo-Dong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.472-479
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    • 2002
  • Since $Br^{\circ}anemark$ introduced the osseointegrated implants, they have been granted for useful methods for the restoration of oral function. The original $Br^{\circ}anemark$ protocol recommended long stress-free healing periods to achieve the osseointegration of dental implants. However, many clinical and experimental studies have shown that the osseointegration is no wonder in almost cases and that early and immediate loading may lead to predictable osseointegration. So we are willing to introduce the Satellite Abutment newly invented for immediate loading. We think that it will make the occlusal forces dispersed to surrounding bone and that we can restore the oral function immediately after implant installation not disturbing osseointegration. In case of using Satellite abutment, stress concentrated to bone contact area of implant was distributed not only fixation plate and screws but also superior, middle portion of implant and cortical layer of jaw bone. It was clearly decreased on the bone contact surfaces around dental implants. 1. Stress was decreased more than 76.5% when satellite straight abutment was used. 2. Stress was decreased more than 50% when satellite angled abutment was used. 3. The stress around dental implant was well distributed along the cortical bone surface and the fixation plate and screw. This study concludes that satellite abutment can be used as all immediate loading implant prothesis because it was possible to distribute periimplant occlusal stress through implant contact bone surface and cortical layer of jaw bone.

A study on the forming condition of a bone plate made of a glass/polypropylene composite (Twintex) (유리섬유/폴리프로필렌 복합재료 (Twintex)를 이용한 고정판 성형조건에 관한 연구)

  • Park, Seok-Won;Yoo, Seong-Hwan;Lee, Jae-Eung;Chang, Seung-Hwan
    • Composites Research
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    • v.23 no.6
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    • pp.55-60
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    • 2010
  • In this paper, tensile and bending tests of glass/polypropylene composite (Twintex) specimens fabricated by various forming conditions were carried out and the results were compared according to the forming conditions to find the appropriate condition for the forming composite bone plates. From the tests it was found that the most appropriate forming conditions were $230^{\circ}C$, 3MPa. Composite bone plates were formed using this condition by two different fabricating methods for screw holes: one was a net shape molding and the other was drilling. The forming and bending tests revealed that the drilling process provided much better bending stiffness of bone plates. This paper provided the most appropriate condition for forming composite bone plates and this result was also expected to offer informative data on forming of other Twintex structures.

Analysis of Biomechanical Responses for the Anterior Cervical Plate Fixation in relation to Bone Mineral Density (골밀도에 따른 전방 내고정 장치 시술 후 경추부의 생체역학적 거동에 대한 분석)

  • Shin, T. J.;Lee, S. J.;Shin, J. W.;Chang, H.
    • Journal of Biomedical Engineering Research
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    • v.22 no.1
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    • pp.69-80
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    • 2001
  • 본 연구에서는 환자의 골다공증 유무에 따른 내고정 장치 시술 직후 및 융합 후의 안정성을 평가하기 위해 다양한 하중 모드에서 C5-C6 운동분절의 생체역학적 거동을 분석하였다. 이러한 목적으로 먼저, C5-C6 경추부의 유한요소 모델을 구현하여 검증하였다. 모델의 결과는 기존 실험치와 유사하여 신뢰성이 부여되었다. 검증된 모델은 Smith-Robinson 방식으로 골이식물을 삽입한 후 전방 내고정 장치를 적용한 시술 상황을 재현하기 위해 수정되었다. 수정된 모델은 두 종류로 구현되었다. (1) 첫 번째 모델에서는, 시술 직후의 상황을 재현하기 위해 골이식물과 종판의 경계면에 접촉요소를 사용하였다. (2)두 번째 모델에서는 완전히 융합된 상황을 나타내기 위해 골이식물을 종판에 고정하였다. 골다공증의 효과를 예측하기 위하여 두 모델의 해면골에 대한 탄성계수를 변화시켰다(정상: 100MPa, 골다공증: 40MPa). 각 모델의 C5 주체의 상위면에 73.6N의 압축 하중을 가한 후에 108Nm의 굴곡/신전, 굽힘, 비틀림 하중을 가하였으며, C6 추체의 하단면은 모든 방향에 대하여 구속하였다. 전체적인 결과에 있어서 상대적 회전운동, 미끄럼운동, 골이식물 내에서의 von Mises 응력의 경우 정상 모델에 비해 골다공증 모델에서 증가함을 보였으며, 특히 시술 직후의 모델에서 비틀림 하중이 가해진 경우, 상대적 회전운동 및 미끄럼 운동이 가장 높게 예측되었다. 이는 골다공증환자에게 전방 내고정 장치를 시술한 경우 골이식물의 파단 및 유합의 실패가 비틀림 하중에서 발생할 수 있음을 나타낸다. 해면골의 von Mises 응력은 시술 직후에 골다공증 모델의 모든 하중 모드에서, 유합 후에는 굽힘 하중 외의 모든 하중에서 ultimate strength를 초과하는 것으로 나타나 골다공증 환자에게 screw의 해리가 발생할 가능성이 높은 것으로 예측되었다. 따라서 골다공증 환자에게 과도한 운동이 발생하지 않도록 하기 위해서 시술 후 세심한 주의와 halo 같은 견고한 정형술이 필요할 것으로 사료된다.

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Anterior Cervical Instrumentation Using Intradiscal Cage with Integrated Plate

  • Ahn, Kyoung-Rok;Ryu, Kyeong-Sik;Chang, In-Bok;Cho, Byung-Moon;Park, Se-Hyuck;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.260-264
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    • 2006
  • Objective : The retrospective study is undertaken to report clinical results of anterior cervical interbody fusion with an intradiscal cage with an integrated plate [PCB cervical plating system]. Methods : 38 patients underwent anterior cervical interbody fusion with PCB cervical plating system and followed $6{\sim}24\;months$. The authors investigated overall surgical results; clinical outcome, fusion rate, change of interspace height & lordotic angle, and complications. Results : No complication was observed during the operation. Clinical improvement was identified in 34 cases [89.5%]. Bone fusion observed in 44 out of 49 sites [90.7%]. After operation, the interspace height increased from $5.4{\pm}1.3mm$ to $7.8{\pm}1.5mm$ and maintained $7.4{\pm}1.1mm$ and, interspace angle went up from $4.2{\pm}0.7^{\circ}$ to $4.8{\pm}1.1^{\circ}$ and maintained $4.6{\pm}$0.9^{\circ}. The loosening of screw was observed in 6 cases, one of which had reoperation because of the expulsion of the device accompanied. Conclusion : PCB cervical plating system could restore interbody height and lordosis in anterior cervical interbody fusion. But, if the insertion of the spacer is not precise, the frequencies of hardware failure are relatively high. It is considered necessary for the operator to be careful in the procedure.

Analysis of End-Plated Propellers by Panel Method (패널법에 의한 날개끝판부착 프로펠러의 해석)

  • C.S. Lee;I.S. Moon;Y.G. Kim
    • Journal of the Society of Naval Architects of Korea
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    • v.32 no.4
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    • pp.55-63
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    • 1995
  • This paper describes the procedure to analyze the performance of the end-plated propeller(EPP) by a boundary integral method. The screw blade(SB) and end-plate(EP) are represented by a set of quadrilateral panels, where the source and normal dipole of uniform strength are distributed. The perturbation velocity potential, being the only unknown via the potential-based formulation, is determined by satisfying the flow tangency condition on the blade and the end-plate at the same time. The Kutta condition is satisfied through an iterative process by requiring the null pressure jump across the upper and lower sides of the trailing edges of both the SH and the EP. Sample calculations indicate that the EP increases the loading near the tip of the SB while spreading the trailing vortices along the trailing edge of the EP, thus avoiding the strong tip-vortex formation. Predicted performance of the EPP shows good correlations with the experimental results. The method is therefore considered applicable in designing and analyzing the EPP which may be an alternative for energy-saving propulsive devices.

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Cephalometric evaluation of skeletal stability and pharyngeal airway changes after mandibular setback surgery: Bioabsorbable versus titanium plate and screw fixation

  • Phu Hnin Thet;Boosana Kaboosaya
    • Imaging Science in Dentistry
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    • v.54 no.2
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    • pp.181-190
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    • 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.

Anterior Cervical interbody Fusion with Cervical Spine Locking Plate (경추 물림 금속판을 이용한 경추 전방추체간 유합술)

  • Park, Joo-Tae;Ahn, Gil-Young;Lee, Young-Tae;Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.209-219
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    • 1997
  • Objectives: Anterior approach to achieve arthrodesis of the cervical spine has become a widely accepted and often-used approach since its earliest reports by Bailey and Badgley, Smith and Robinson and Cloward. However, anterior interbody fusion in the presence of the posterior instability may be complicated by the bone graft dislodgement, kyphotic defomity or nonunion. As an attemp to prevent this undesirable complication, additional methods such as skeletal traction, halo appratus or even posterior fusion has been utilized. Therefore, The cervical spine locking plate(CSLP) with the anterior intervertebral body bone grafting provide immediate cervical stabilization and widely successful in achieving fusion. Material and methods: This study analysed 14 patients who underwent a single anterior procedure and application of CSLP for the treatment of the cervical spinal disorder. Eleven patients were disc herniations and three patients were traumatic lesion. The average age of the patient was 47 years and the mean follow up periods was 20 months ranging from 13 to 27 months. Results: Ambulation was started 2nd day after the operation with the aid of the Philadelpia orthoses. Bone union was observed 13 cases on average 12 weeks after operation. The one case was nonunion with plate breakage without clinical symptom. Conclusion: Anterior fusion with CSLP are thought to be a safe and valuable method for treating cervical spine disorder.

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Analysis and Design of a New 6-DOF Haptic Device Using a Parallel Mechanism (병렬구조를 이용한 새로운 6 자유도 역감제시장치의 설계 및 해석)

  • Yoon, Jung-son;Ryu, Je-Ha
    • Journal of Institute of Control, Robotics and Systems
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    • v.7 no.1
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    • pp.1178-1186
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    • 2001
  • This paper presents design and analysis of a 6 degree-of-freedom new haptic device using a par-allel mechanism for interfacing with virtual reality. The mechanism is composed of three pantograph mecha-misms that, driven by ground-fixed servomotors. stand perpendicularly to the base plate. Three spherical joints connect the top of the pantograph with connecting bars, and three revolute joint connect connecting bars with a mobile joystick handle. Forward and inverse kinematic analyses have been performed and the Jacobian matrix is derived by using the screw theroy. Performance indices such as GPI(Global Payload Index), GCI(Global Conditioning index), Traslation and Orientation workspaces, and Sensitivity are evaluated to find optimal pa-rameters in the design stage. The proposed haptic mechanism has better load capability than those of the ex-isting haptic mechanisms due to the fact that motors are fixed at the base. It has also wider orientation work-space mainly due to RRR type spherical joints.

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