• Clinics in Shoulder and Elbow
• /
• v.2 no.1
• /
• pp.14-20
• /
• 1999

Purpose: Despite of the popular use of the reconstruction plate for the fixation of clavicular shaft fractures, some disadventages have been raised such as long period of immobilization, long skin incision, loosening of plate and screws, and increased chance of nonunion due to severe periosteal injury. Thus, the authors have performed intramedullary multiple Steinmann pins fixation that could reduce the disadvantages of plate fixation in order to compare the treatment results between the two groups. Materials & Methods: From 1994. Jan. to 1997. Dec. the department of orthopaedic surgery of the Kwak's hospital treated operatively for 56 cases of the clavicular shaft fractures in adult. 39 cases of them were treated with the plate fixation and 17 cases with the intramedullary multiple Steinmann pins fixation(SP group). Reconstruction plates(Plate group) were used for 26 out of 39 patients treated with plate fixation. Among the Plate group and SP group, each 15 cases were selected by age and sex and compared each other according to the bone union time, union rate, complication, and functional results. The follow-up period was 12 months at the shortest and 48 months at the longest and the average was 16 months. Results: The Plate group showed that the bone union time was 7 weeks and the bone union rate was 93%. The SP group showed 6.5 weeks and 100% respectively. In complication, the Plate group had 1 case of loosening of plate and screws and delayed union; SP group had 1 case of pin migration. The functional results according to Kang's criteria, 87% of the Plate group and 93% of the SP group showed good or excellent. Conclusion : The SP group showed very comparable results in terms of the bone union time, bone union rate, complication, and functional results comparing to the Plate group. The intramedullary multiple Steinmann pins fixation showed several advantages over the reconstruction plate fixation, which were simple operative technique, easy removal of pins, being able to perform immediate postoperative full range of motion exercise. Therefore, the intramedullary multiple Steinmann pins fixation is thought to be one of the useful operative techniques in treatment of the clavicular shaft fractures in adult.

• Clinics in Shoulder and Elbow
• /
• v.11 no.2
• /
• pp.143-149
• /
• 2008

Purpose: The purpose of this study is to compare the results of using a locking compression plate and an unlocked plate for treating proximal humeral fractures. Materials and Methods: This study was based on 20 patients who underwent plate fixation for proximal humeral fractures out of the 87 patients with proximal humeral fractures and who were admitted from 2003 to 2007 in our hospital. Of the 20 patients, 10 were treated with a locking compression plate and the other 10 were treated with an unlocked plate. Each group was evaluated according to the humeral neck shaft angle, the period until bony union, the complications and the Constant score. The humeral neck shaft angle was based on plain x-rays taken immediately after the operation and at 6 months postoperatively. The Constant score was evaluated on the last visit to our clinic. Results: There was no significant statistical difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. Yet, there were three cases of screw migration in the unlocked plate group. Conclusion: There was no significant difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. The locking compression plate is considered to achieve more effective fixation for proximal humerus fractures because there were less complications such as screw migration.

• The Journal of the Korea Contents Association
• /
• v.12 no.12
• /
• pp.335-344
• /
• 2012

Osteoporosis is increasing in Korea as it becomes an aging society with the rapid economic growth and the development of medical technology. Osteoporosis also develops due to chemo and radiation therapy of cancer which also increases owing to Westernized diet. Osteoporosis is caused by reduced bone density, has close relationship with the change of geometry of proximal femur, which is a factor of hip fracture risk. The purpose of this study was the analysis of the correlations of osteoporosis and the change of geometry of proximal femur, which was observed according to T-score variance. The 350 male and female patients are chosen from D hospital in Busan, who were classified by age, sex and T-score values (normal, osteopenia, and osteo porosis). The results show that the age and gender have significant difference in the incidence of osteoporosis; the disease classification according to T-score value has significant difference in the geometry of the proximal femur such as Cortical ratio calcar, Cortical ratio shaft, Hip/shaft Angle, Strength index, Section modulus, CSMI, and CSA, and is highly correlated with the incidence of osteoporosis. Therefore, the findings of this research is that the change of the geometry of the proximal femur could be used as an indicator in the diagnosis of osteoporosis, could enhance the accuracy of the diagnosis in the future, and could be used as a clinical predictive factors through the analysis of the correlations of T-score variance and the geometry changes of the proximal femur.

• Clinics in Shoulder and Elbow
• /
• v.12 no.1
• /
• pp.33-37
• /
• 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.

• Explosives and Blasting
• /
• v.39 no.3
• /
• pp.15-23
• /
• 2021

Ventilation shafts are pathways in mines and tunnels for the removal of dust or smoke during underground space construction and operation. In mines, blasting with long blast holes is preferred for the excavation of a ventilation shaft in the 10~20m long crown pillar section. In this case, the bottom part of the blast hole is completely drilled in order to determine the drilling error, and this causes a problem of lowering the explosive charge and blasting efficiency. It is possible to solve the problem of explosive loading and to increase the blast efficiency by covering the curb of the blasthole by using stemming material. In this study, simulations for the blasting of a ventilation shaft were performed with various stemming lengths and the blasthole diameters(45, 76mm) using AUTODYN 2D SPH(Smooth particle hydrodynamics) analysis technique. Also the optimal bottom stemming column was derived by checking the size of the boulder and burden line according to blasting. Analysis result, blasting efficiency is lessened in case of stemming length less than 30cm and the optimal length of the stemming material should be 30cm or higher to achieve high efficiency of blasting.

• Clinics in Shoulder and Elbow
• /
• v.15 no.1
• /
• pp.25-31
• /
• 2012

Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

• Journal of the korean Society of Automotive Engineers
• /
• v.13 no.6
• /
• pp.101-108
• /
• 1991

During torsional fatigue of externally cracked cylindrical specimen, crack face rubbing may occur. At this time, normal contact forces arise when shear displacements cause the crack faces to be wedged open due to mismatch of the fracture surface asperities. These normal forces, in turn, generate friction force which act in opposition to the applied shear stresses and reduce the effective stress intensity factor. The premise of the proposed work is that friction and wedging can be studied by measuring the shear and normal displacement across the crack mouth. We have measured the crack mouth compliance using the new biaxial extensometer.

• Journal of Yeungnam Medical Science
• /
• v.23 no.1
• /
• pp.96-102
• /
• 2006

Jehovah's Witnesses refuse a transfusion of blood or blood products because of religious beliefs; this refusal at times presents a dilemma for the treating physician. We report a case of a 25-year-old Jehovah's Witness patient who underwent a reoperation for a previous proximal humerus shaft fracture and experienced unexpected massive hemorrhage intraoperatively and postoperatively. The postoperative lowest hemoglobin level was 2.9 g/dl. The patient recovered from the severe anemia without any clinical sequala. We review the legal, ethical and religious issues and suggest the best possible medical care that Jehovah's Witness patient would permit.

• Journal of Chest Surgery
• /
• v.52 no.3
• /
• pp.162-164
• /
• 2019

A male patient weighing 2.5 kg was admitted for respiratory difficulty, and a large ventricular septal defect (VSD) was diagnosed. During care, sudden right leg swelling with a femur shaft fracture occurred. The patient's father had a history of recurrent lower extremity fractures; thus, osteogenesis imperfecta was considered. The patient's respiratory difficulty became aggravated, and VSD repair in the neonatal period was therefore performed with gentle sternal traction and great vessel manipulation under total intravenous anesthesia to prevent malignant hyperthermia. The patient was discharged without notable problems, except minor wound dehiscence. Outpatient genetic testing revealed that the patient had a COL1A1/COL1A2 mutation.

• Journal of Yeungnam Medical Science
• /
• v.10 no.2
• /
• pp.388-399
• /
• 1993

The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993, 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft fractures. 3. The Interlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of fracture and then made early joint motion exercise and ambulation.