• Title/Summary/Keyword: Surgical stabilization

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Current Concepts in the Treatment of Traumatic C2 Vertebral Fracture : A Literature Review

  • Subum Lee;Junseok W Hur;Younggyu Oh;Sungjae An;Gi-Yong Yun;Jae-Min Ahn
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.6-13
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    • 2024
  • The integrity of the high cervical spine, the transition zone from the brainstem to the spinal cord, is crucial for survival and daily life. The region protects the enclosed neurovascular structure and allows a substantial portion of the head motion. Injuries of the high cervical spine are frequent, and the fractures of the C2 vertebra account for approximately 17-25% of acute cervical fractures. We review the two major types of C2 vertebral fractures, odontoid fracture and Hangman's fracture. For both types of fractures, favorable outcomes could be obtained if the delicately selected conservative treatment is performed. In odontoid fractures, as the most common fracture on the C2 vertebrae, anterior screw fixation is considered first for type II fractures, and C1-2 fusion is suggested when nonunion is a concern or occurs. Hangman's fractures are the second most common fracture. Many stable extension type I and II fractures can be treated with external immobilization, whereas the predominant flexion type IIA and III fractures require surgical stabilization. No result proves that either anterior or posterior surgery is superior, and the surgeon should decide on the surgical method after careful consideration according to each clinical situation. This review will briefly describe the basic principles and current treatment concepts of C2 fractures.

Arthroscopic Stabilization of Acromioclavicular Joint Dislocation using TightRope® (TightRope®를 이용한 내시경하 급성견봉쇄골관절 탈구의 고정술 메리놀병원 정형외과)

  • Choi, Sun-Jin;Park, Jong-Hoon;Lee, Hyeong-Seok
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.172-176
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    • 2008
  • Purpose: The proper surgical methods for treating acromioclavicular joint dislocation is still controversial. New methods should provide better early motion with sufficient strength. Materials and Methods: We performed arthroscopic stabilization using TightRope$^{(R)}$ (Arthrex, Inc, Naples, FL) in 10 cases of acromioclavicular joint dislocation between April, 2007, and December, 2007, and followup for a minimum of 10 months. We performed radiologic evaluation by comparing the clavicle anteroposterior radiograph with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Imatani's methods. Results: In clinical evaluation, 6 cases were excellent, 3 cases were good, and 1 case was poor. In radiologic evaluation, 9 cases were excellent and 1 case was poor. Redislocation occurred in 1 case. Conclusion: During short-term followup, 9 of 10 patients who underwent arthroscopic stabilization using TightRope$^{(R)}$ had excellent results in Imatini tests and radiologic evaluation, except 1 patient with redislocation.

Stabilization using Screws, Wire, and PMMA for Traumatic Cervical Fracture in a Maltese Dog (말티즈 견에서 Screw, Wire와 PMMA를 사용한 외상성 경추 골절의 안정화)

  • Kim, KeunYung;Kim, Minkyung;Park, Ji-Hun;Shin, Jeong-In;Kim, Junsu;Jang, Yun-Seol;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.519-522
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    • 2014
  • A 2-year-old, 2 kg Maltese dog was evaluated for progressive tetraparesis and neck pain. The dog had been treated with steroids for the preceding 2 weeks after unknown trauma but was deteriorating progressively and had become tetraparetic. The dog was presented with a non-ambulatory tetraparesis. Radiographic and computed tomographic examinations revealed a transverse C2 fracture with subluxation of the atlantoaxial joint and C2-C3. In addition, hydrocephalus was observed on magnetic resonance imaging. Stabilization of C1-C3 using screws, wires, and polymethyl methacrylate (PMMA) was performed. Application of ventral screws, wires, and PMMA resulted in improvement of the clinical signs after 4 weeks, and the dog could walk as before the tetraparesis 6 weeks after the operation. This stabilization method is an effective surgical treatment for management of cervical instability.

Nanowire Patterning for Biomedical Applications

  • Yun, Young-Sik;Lee, Jun-Young;Yeo, Jong-Souk
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.08a
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    • pp.382-382
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    • 2012
  • Nanostructures have a larger surface/volume ratio as well as unique mechanical, physical, chemical properties compared to existing bulk materials. Materials for biomedical implants require a good biocompatibility to provide a rapid recovery following surgical procedure and a stabilization of the region where the implants have been inserted. The biocompatibility is evaluated by the degree of the interaction between the implant materials and the cells around the implants. Recent researches on this topic focus on utilizing the characteristics of the nanostructures to improve the biocompatibility. Several studies suggest that the degree of the interaction is varied by the relative size of the nanostructures and cells, and the morphology of the surface of the implant [1, 2]. In this paper, we fabricate the nanowires on the Ti substrate for better biocompatible implants and other biomedical applications such as artificial internal organ, tissue engineered biomaterials, or implantable nano-medical devices. Nanowires are fabricated with two methods: first, nanowire arrays are patterned on the surface using e-beam lithography. Then, the nanowires are further defined with deep reactive ion etching (RIE). The other method is self-assembly based on vapor-liquid-solid (VLS) mechanism using Sn as metal-catalyst. Sn nanoparticle solutions are used in various concentrations to fabricate the nanowires with different pitches. Fabricated nanowries are characterized using scanning electron microscopy (SEM), x-ray diffraction (XRD), and high resolution transmission electron microscopy (TEM). Tthe biocompatibility of the nanowires will further be investigated.

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Current Methods for the Treatment of Alveolar Cleft

  • Kang, Nak Heon
    • Archives of Plastic Surgery
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    • v.44 no.3
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    • pp.188-193
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    • 2017
  • Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

Indirect revascularization surgery for moyamoya disease in children and its special considerations

  • Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Kim, Seung-Ki;Cho, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.11
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    • pp.408-413
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    • 2012
  • Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.

Surgical Tratment and Result of Coronary Artery Bypass Grafting in Patients with Left Main Coronary Artery Stenosis (좌주관동맥 병변의 수술방법 및 결과)

  • Choe, Jong-Beom;Jo, Seon-Hwan
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.191-195
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    • 1994
  • Twenty-four patients with left main coronary artery stenosis exceeding 50% underwent coronary artery bypass grafting from January 1991 through June 1993. Four patients [17%] had stenosis only in left main coronary artery and 20 patients [83%] had associate lesion[s] in left anterior descending , circumflex, or right coronary artery. Sixteen patients [67%] had higher degrees of stenosis [>70%] in left main coronary artery. Preoperatively 18 patients [75%] had unstable angina pectoris even during aggressive medical treatment. Preoperatively aggressive medical treatment was performed to relieve the symptom in patients with unstable angina. All patients were perioperatively treated with continuous infusion of isosorbide dinitrate to stabilize symptomatic and hemodynamic states. Twenty patients underwent elective coronary bypass surgery and 4 patients urgent operations due to severe unstable angina. There was no thirty-day mortality or late death. Angina recurred in 1 patient, but coronary angiographic study showed good patency of grafts and the symptom was relieved with medical treatment. We concluded that coronary artery bypass grafting can be safely performed by perioperative efforts, including continuous infusion of isosorbide dinitrate, for hemodynamic stabilization in patients with left main coronary artery stenosis.

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Serratus anterior muscle exercise for The Winging Scapula: Case Study (익상견갑에 대한 전거근 운동: 증례 보고 1.)

  • Jang, Jun-Hyeok;Koo, Bong-Oh;Kim, Suhn-Yeop
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.9 no.2
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    • pp.69-77
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    • 2003
  • Objective: The purpose of this study is to describe the effect of the serratus anterior muscle exercise in a patient with winging of the scapular. Background and Purpose: The patient was a 33-year-old man with an 3 years history of the left deltoid region. He had not responded to previous treatments of rest, TENS and medicine. Materials and Methods: After Surgical operation of the shoulder, the patient was treated for 6 months in 144 visits. treatment consisted of push-up with plus in the standing position with his hands against the wall and unique push-up with quadruped position at mat. Also, Sling exercise therapy was utilized to control scapular stabilization and reduce stress on the scapulohumeral joint. Result: Following 104 physical therapy visits, the patient was able to full range of motion of the shoulder without shrug motion. Conclusion and Discussion: Scapular winging and serratus anterior muscle function are important consider in the rehabilitation of the shoulder dysfunction. Therefore, specific exercise program for people with the winging scapular should be considered.

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Pigmented Villonodular Synovitis of the Ankle and Subtalar Joint Treated by Surgical Excision and Ligament Reconstructions: A Case Report

  • Shin, Jae-Hyuk;Lee, Byung Hoon;Kim, Gab-Lae;Kim, Kwon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.192-195
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    • 2016
  • Diffuse pigmented villonodular synovitis (PVNS) involving ankle joint needs complete mass excision and total synovectomy to reduce recurrence rate, while surrounding ligaments can be easily damaged. So the concurrent ligament reconstruction should be considered for post-excisional instability in subtalar joint as well as lateral ankle joint. We describe our experience in the management of a diffuse type PVNS, invades lateral talocrural joint extended to subtalar joint and introduce a new technique of all-in-one reconstruction for anterior talofibular,calcaneofibular and cervical ligament. Our new reconstruction technique applying modified Chrisman and Snook technique is useful in stabilization for deficiencies of the ligament complexafter PVNS excisionat lateral ankle and subtalar joint.

Minimally Invasive Plate Osteosynthesis of Radius-Ulna Fracture using Circular External Fixator in a Dog

  • Kwon, Yong-hwan;Kang, Jin-su;Kim, Young-ung;Cho, Hyoung-sun;Lee, Ki-chang;Kim, Nam-soo;Kim, Min-su
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.47-49
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    • 2017
  • Fracture stabilization techniques continue to evolve and provide approaches that minimize the iatrogenic trauma associated with surgical procedures. Minimally invasive plate osteosynthesis (MIPO) is a recently described method of biological internal fixation performed by introducing a bone plate via small insertional incisions that are remote to the fracture site. Indirect reduction techniques can generally be utilized when performing MIPO. In this case report, we describe MIPO of a radius-ulna fracture by indirect reduction using circular external fixation for alignment and distraction in a dog.