• Title/Summary/Keyword: Surgical fixation

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Push-in Head Restraining Apparatus for Intracranial Self Stimulation Tasks in Rats

  • Roh, Mootaek;Jang, Il-Sung;Lee, Maan-Gee
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.2
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    • pp.103-108
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    • 2014
  • Head restraining is an experimental technique that firmly secures the animal's head to a fixation apparatus for the precise control and sensing of behaviors. However, procedural and surgical difficulties and limitations have been obstructing the use of the technique in neurophysiological and behavioral experiments. Here, we propose a novel design of the head-restraining apparatus which is easy to develop and convenient for practical use. Head restraining procedure can be completed by sliding the head mounter, which is molded by dental cement during implantation surgery, into the port, which serves as matching guide rails for the mounter, of the fixation bar. So neither skull-attached plates nor screws for fixation are needed. We performed intracranial self stimulation experiment in rats using the newly designed device. Rats were habituated to acclimatize the head-restraint environment and trained to discriminate two spatially distinguished cues using a customized push-pull lever as an operandum. Direct electrical stimulation into the medial forebrain bundle served as reward. We confirmed that head restraining was stable throughout experiments and rats were able to learn to manipulate the lever after successful habituation. Our experimental framework might help precise control or sensing of behavior under head fixed rats using direct electrical brain stimulation as a reward.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

  • Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.291-300
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    • 2012
  • The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

Implementation of Cervical Pedicle Surgical Guide for Safe Surgery

  • Kwak, Ho-Young;Huh, Jisoon;Lee, Won-Joo
    • Journal of the Korea Society of Computer and Information
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    • v.22 no.12
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    • pp.125-130
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    • 2017
  • Screw insertion surgery is frequently required among surgical procedures. Especially, very careful attention should be paid to the insertion of screw in the operation of the cervical vertebra. Therefore, there is a need for a guide that allows the surgeon to reliably and promptly perform treatment by calculating the desired insertion angle and length for screw insertion. In this study, the center and direction of the pedicle were calculated through 3D modeling and 3D vector numerical analysis using the CT or MRI image of the patient for the safe operation of the guide, and based on this, After that, we will implement surgical guide based on this.

Complications after Surgical Correction of Hallux Valgus (무지 외반증 교정 수술 후 합병증)

  • Bae, Su-Young;Lee, Oei-Jong
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.2
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    • pp.50-54
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    • 2017
  • The goal of surgical correction for hallux valgus is to achieve a painless, shoe-wearable, and relatively straight toe with a balanced joint motion that results in aesthetically and functionally satisfactory toe. To date, there has not been a consensus on the ultimate surgical procedure for hallux valgus correction. Unfortunately, such a consensus may be difficult since it is not uncommon to encounter complications after hallux valgus correction. Postoperative soft tissue complications include difficult wound healing, infection, hypertrophy, or pain of the scar, joint stiffness, and tendon or sensory nerve damage. Postoperative bony complications include malunion, nonunion, failure of fixation, failure of angle correction, recurred deformity, osteomyelitis, and failure of balance between the metatarsal heads. Herein, we review common complications after surgical correction of hallux valgus, such as stiff joint, bony complications, recurrence of the deformity, and hallux varus.

Arthroscopic Latarjet procedure: current concepts and surgical techniques

  • Sang-Jin Shin;Jae Hyung Kim;Jonghyun Ahn
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.445-454
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    • 2023
  • The Latarjet procedure is a surgical procedure that can effectively restore glenohumeral stability, especially in patients with anterior shoulder instability and glenoid bone loss. Many studies have shown comparable clinical outcomes between patients undergoing the arthroscopic Latarjet procedure and those undergoing traditional open methods or other glenohumeral joint stabilization procedures. However, the arthroscopic Latarjet procedure is a challenging technique due to the unfamiliar portal placements, proximity of neurovascular structures, and serious postoperative complications. The arthroscopic Latarjet procedure has not yet been widely applied, and a clear understanding of the anatomical structure and the precise methods is required prior to operation performance. Satisfactory clinical outcomes can be achieved by thorough preoperative planning and proper implant fixation methods.

Management of the PCL Injuries (후방 십자 인대 손상의 치료)

  • Jung, Young Bok;Jung, Ho Joong
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.25-32
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    • 1998
  • The distinction between isolated and combined injuries is crucial both for treatment and prognosis. For most combined injuries, surgical treatment continues to be favored over nonoperative treatment. It is generally agreed that isolatel PCL injuries do well without surgery. There has been an interest by many authors to fix the graft directly to the posterior aspect of the tibia(tibial inlay). With this procedure, tibial graft fixation will be more direct and theoretically reduce the bending effects of the graft with a fixation site far away from the tibial insertion. Modified tibial inlay technique, which is the posterior approach does not require the patient to be in the prone or lateral decubitus position during the operation. Use of a double-bundle reconstructive technique is attractive and has been performed by some surgeons. At this time, this procedure is still being investigated and should not be routinely used in the clinical setting until studies have indicated an advantage over current single-bundle techniques. However theologically, double-bundle reconstructive technique is more useful in severe posterior unstable knee. Recent advances have increased our knowledge of the anatomy and mechanical characteristics of the PCL. Basic science research has further increased our awareness of the interaction of the posterolateral structures with the PCL. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the postero-lateral structures. Surgical treatment is often complex and requires a wide range of surgical techniques and skills to treat associated injuries. When the PCL is reconstructed, most surgeons choose to reconstruct the anterolateral component using a graft of sufficient size and strength. The initial postoperative rehabilitation should be addressed cautiously in an effort to avoid excessive forces on delicate repairs and reconstructions in these complex injuries. Further research is necessary to evaluate new surgical approaches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

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National utilization of rib fracture fixation in the geriatric population in the United States

  • Brewer, Jennifer M.;Aakjar, Leah;Sullivan, Kelsey;Jayaraman, Vijay;Moutinho, Manuel;Jeremitsky, Elan;Doben, Andrew R.
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.173-180
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    • 2022
  • Purpose: The use of surgical stabilization of rib fractures (SSRF) has steadily increased over the past decade. Recent literature suggests that a larger population may benefit from SSRF, and that the geriatric population-as the highest-risk population-may receive the greatest improvement from these interventions. We sought to determine the overall utilization of SSRF in the United States. Methods: The National Trauma Database was analyzed between 2016 and 2017. The inclusion criteria were all patients ≥65 years old with rib fractures. We further stratified these patients according to age (65-79 vs. ≥80 years old), the presence of coding for flail chest, three or more rib fractures, and intervention (surgical vs. nonoperative management). The main outcomes were surgical interventions, mortality, pneumonia, length of stay, intensive care unit length of stay, ventilator use, and tracheostomy. Results: Overall, 93,638 patients were identified. SSRF was performed in 992 patients. Patients who underwent SSRF had improved mortality in the 65 to 79 age group, regardless of the number of ribs fractured. We identified 92,637 patients in the age group of 65 to 79 years old who did not undergo SSRF. This represents an additional 20,000 patients annually who may benefit from SSRF. Conclusions: By conservative standards and the well-established Eastern Association for the Surgery of Trauma clinical practice guidelines, SSRF is underutilized. Our data suggest that SSRF may be very beneficial for the geriatric population, specifically those aged 65 to 79 years with any rib fractures. We hypothesize that roughly 20,000 additional cases will meet the inclusion criteria for SSRF each year. It is therefore imperative that we train acute care surgeons in this skill set.

Comparison of Three Surgical Method Outcomes for Dorsal Communition Distal Radial Fractures: External Fixation, External Fixation with Allogenous Bone Graft (DBM) and Volar Locking Plate Fixation (배측 분쇄가 있는 원위부 요골 관절내 골절의 3가지 수술적 치료 결과 비교: 외고정 기구 단독, 외고정 기구와 동종골이식 및 수장측 잠김 압박 금속판)

  • Choi, Joon-Cheol;Na, Hwa-Yeop;Lee, Young-Sang;Kim, Woo-Sung;Oh, Kyung-Soo;Song, Woo-Suk;Kim, Se-Jun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.115-120
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    • 2009
  • Purpose: To evaluate the outcomes of three different surgical approaches in treating a distal radius fracture with dorsal communition. Materials and Methods: From April, 2006 to May, 2009, 49 patients over age of 60years old with unstable dorsal communition distal radius fracture were analyzed. We compared maintainability of reduction by radiological follow-up observations and clinical outcomes using Mayo wrist scores. One-Way ANOVA test was performed to examine the statistical correlation between the methods. Results: All three approaches provided satisfactory post-op reduction results. However, follow-up observations showed significant loss of reduction in the external fixation only group compared to the added bone graft group and the volar anatomical locking plate group (P<0.05). Mayo wrist score was indifferent between the three groups. Conclusion: Treatment of a distal radius fracture with severe dorsal communition using an external fixation only appears to be insufficient in maintaining reduction of a cancellous bone defect.

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Early Failure of Cortical-Bone Screw Fixation in the Lumbar Spinal Stenosis (요추부 협착에서의 피질골 궤도 나사못 고정의 초기 실패 사례에 대한 고찰)

  • Kwon, Ji-Won;Kim, Jin-Gyu;Ha, Joong-Won;Moon, Seong-Hwan;Lee, Hwan-Mo;Park, Yung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.405-410
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    • 2020
  • Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.

용융방사-폴리락타이드 섬유의 구조와 물성

  • 김병철;임승순;김승규;조성무;이화섭
    • Proceedings of the Korean Fiber Society Conference
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    • 1998.10a
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    • pp.227-231
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    • 1998
  • Poly(lactic acid)(PLA)는 인체내에서 재흡수성(resorbability), 분해물의 비독성, 성형물의 높은 기계적 강도 등과 같은 바람직한 특성을 가지는 생체 친화성 고분자로서 fracture fixation devices, drug delivery system 및 surgical suture 등과 같은 의료용 소재로의 응용에 관한 연구가 활발히 진행되고 있다[1-2]. (중략)

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