• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.240-244
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• 2009

목적: 본 논문은 오구 쇄골 인대가 온전하면서 견봉-쇄골 관절 탈구를 동반한 오구 돌기 골절에서 봉합나사를 이용한 고정술의 소개와 임상적 결과를 알아보고자 하였다. 대상 및 방법: 26세 남자 환자로 제3형 견봉-쇄골 탈구와 동반된 오구돌기 골절을 최초로 봉합 나사를 이용한 간접적 정복술을 시행하였다. 결과: 술 후 3개월에 골절의 완전한 유합 및 정상 견관절 운동 범위 및 기능의 회복을 얻었으며, 합병증의 소견은 없었다. 결론: 봉합나사를 이용한 간접적 정복 및 고정술은 견봉-쇄골 관절 탈구를 동반한 오구돌기 골절의 치료에 있어서 안전하고 유용한 수술 방법으로 사료된다.

• 대한정형외과학회지
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• 제55권6호
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• pp.545-549
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• 2020

슬관절 인공관절 치환술 중 드물게 발생하는 내측 측부 인대 견열 골절의 치료는 보조기나 캐스트 등의 보존적 치료, 금속 나사못을 이용한 고정 등의 다양한 치료법이 소개되고 있다. 생흡수성 봉합 나사못은 생체 적합성, 방사선 투과성, 제거를 위한 2차 수술이 불필요하다는 장점 등으로 여러 부위에서 금속 고정물을 대체해 사용되고 있으나 골용해 등의 합병증이 보고되고 있다. 저자들은 슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 심각한 골용해 소견을 경험하여 사용에 신중을 기해야 한다는 판단하에 이에 대한 문헌 고찰과 함께 보고하고자 한다.

• 대한족부족관절학회지
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• 제26권1호
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• pp.9-15
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• 2022

Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic techniques and management options. Bony avulsions or malleolar fractures are commonly associated with syndesmotic disruptions. Even unstable isolated syndesmosis injuries are associated with a latent or frank tibiofibular diastasis and should not be ignored in the early phase. A relevant instability of the syndesmosis with diastasis results from collateral ligaments tears and requires operative stabilization. The treatment involves an anatomic reduction of the distal tibiofibular articulations followed by stable fixation. Syndesmotic transfixation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favorable outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotopic ossification, tibiofibular synostosis, chronic instability, and posttraumatic arthritis. In particular, the correct diagnosis and evidence-based treatment options for unstable syndesmotic injury should be considered.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권3호
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• pp.157-170
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• 1993

To prove the effct of semi-rigid fixation which utilize wire and rigid fixation which utilizes miniplate toward cranio-facial growth and development of growing children for teenagers, 28 rabbits-6 weeks, about 1.5kg-were experimented. They were classified three groups the semi-rigid group was 12 rabbits which were fixed with 26 gauge stainless steel wire to cross a fronto-nasal suture, the rigid group was the other 12 rabbits which were fixed with miniplate and screw, the control group was 4 rabbits which were get rid of only periosteum. The sample of fronto-nasal of rabbits which were sacrified after 2 weeks, 4 weeks, 8 weeks, and 12 weeks of the operation were investigated and made a comparative study with the light microscops. 1. At the control group, the central part of bony suture was connected with colagen bundle, the osteoblastic layer was investigated at the bony ending, new bone which covered the inside and outside faces of the bone suture was formed between periosteum. 2. Two weeks later from the experiment, ran slightly irregularly the collagen bundle which connects both bony endings of the rigid group. 3. Four weeks later from the experiment, collagen bundle of bone surface were arranged parally a little and comparing to the semi-rigid group, newly formed woven bone of surface of the adjacent bone was made obviously a little. 4. Eight weeks later from the experiment, collagen bundle which is located between both bony ending become close. Both the semi-rigid group and the rigid group showed significant formation of new bone at the periosteum and the bone surface. 12 weeks later from the experiment, both the semi-rigid group and the rigid group showed the regular running in the collagen bundle and smooth, dense periosteum. Then they assumed a similar aspect of the control group. I think that it does not give the influence to the cranio-facial growth of children or teenager to utilize a rigid fixation for a short period. Because as the time goes on, the surface of the bone suture was recovered and adjacent bone surface of the miniplate fixation showed compensatory growth, although both the semi-rigid group which utilized wire and rigid group which utilized a miniplate brought about the change of the area of the bone suture at the early period.

• 한국임상수의학회지
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• 제16권1호
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• pp.1-7
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• 1999

The purpose of the present study was to evaluate the easiness of suture and fixation of modified total ring prostheses (m-TRP). Twelve healthy dogs (B.W.2-10 kg) were randomly assigned to three groups. In group A (3 dogs), total ring prostheses was fixed by penetrating a suture material through tracheal mucosa. In group B (3 dogs), TRP was fixed by suturing on tracheal cartilage and muscular layer not penetrating through tracheal mucosa. m-TRP was applied to the cervical portions (group M-C,3 dogs), and thoracic portions (group M-T,3 dogs). Operating time of group M-C (37.33$\pm$6.80 min.) was shorter than those of groups B (83.33$\pm$8.50 min.) and A (63.33$\pm$11.06 min.) (p＜0.01). Clinical complications were minimal and limited to mild, short-term hematoma, vomiting, edema, and inflammation. Coughing remarkably decreased in group B rather than group A. Dyspnea was not showed in group A, B, and M-C, but group M-T had a mild dyspnea. Gross postmortem findings were similar in all groups. Mild adhesions were present between prostheses and adjacent structures, but tracheal lumen was clean. Severe adhesions were present where m-TRP had been applied in the thoracic portions. Histopathologic abnormalities included mild to moderate adventitial and periprosthetic fibrosis and mild adventitial inflammation. The present study indicated that m-TRP were easier in suture and fixation than TRP and had no differences in support for trachea and side effects.

• 대한두개안면성형외과학회지
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• 제23권5호
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• pp.211-219
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• 2022

Background: Correction of secondary cleft nose deformity is one of the most important portions in the management of cleft lip patients. Various techniques have been introduced to achieve adequate shape, balance, and symmetry of anatomical landmarks. None of these methods can claim to universally solve all aspects of the problems encountered in secondary cleft deformity surgery. Some authors overlook the aspect of functional rehabilitation with regard to nasal respiratory pathway problems, which is present in over 90% of the patients. This study aimed to evaluate the aesthetic and functional improvements of the authors' non-destructive technique. Methods: With over 15 years of experience, open rhinoplasty was performed, which included total remodeling of the deformed lower lateral cartilage using several suture fixation techniques without any graft or implantation with septo-turbinoplasty. A total of 150 questionnaires were sent by e-mail, but 55 completed questionnaires were returned. Surgical outcomes were evaluated using questionnaire responses, and outcomes were divided into five categories each for esthetic and functional analyses. Results: The satisfaction rate ranged from 75 % to 98%, which means "more or less," "very much," and "absolutely yes" in the esthetic and functional viewpoints. Conclusion: The results of this study strongly recommend performing the suture fixation technique and functional rehabilitation simultaneously for cleft lip/nose correction.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2005년도 제3차 연수강좌
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• pp.198-205
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• 2005

1. Many design features including suture type, anchor size and geometry, and anchor material, play a role in the overall strength of the anchor. In addition, technical considerations such as implant orientation, pattern, and location may affect the ultimate success of the repair. 2. Multiple fixation points provide a biomechanically sounder construct in Bankart repair. The size of the glenoid and its rim make anchor size a critical consideration in implant selection and implementation.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.222-229
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• 2017

Background: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. Methods: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. Results: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were $156.7^{\circ}$, $152.2^{\circ}$, $61.1^{\circ}$, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. Conclusions: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.

• 대한관절경학회지
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• 제3권2호
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• pp.132-137
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• 1999

목 적 : 관절경하에서 전위된 경골극 골절을 suture hook와 PDS를 이용하여 견인봉합술을 실시하고 그 수술수기와 임상적 결과를 보고하고자 한다. 재료 및 방법 : 1997년 2월부터 1998년 6월까지 견인봉합술을 시행한 12명의 환자중 최소 1년이상 추시관찰이 가능하였던 7명의 환자를 대상으로 하였다. 7예 모두 수상후 3주이내의 급성 손상이며 증상 발현부터 수술까지의 평균 기간은 6.1일이었다. 7예중 4예에서 반월상 연골판파열, 내측 측부 인대손상등의 동반손상이 발견되었고 경골극 골절에 대한 수술시 동반손상에 대한 수술적 치료도 병행하였다. 결 과 : 추시기간은 평균 16.6개월로서, 7례 모두에서 골유합을 얻을수 있었으며 골유합시기는 평균 7.4주였다. 후방십자인대 견열골절 및 외측 반월상 연골판손상이 동반된 환자중 1례에서 관절 운동의 제한이 있었으나 수술후 1년 뒤 관절경적 유착 제거술이후 정상 관절 운동 범위를 보였다. 1명의 환자에서 경도의 전방 불안정성의 소견을 보였으나 자각증세나 일상생활의 제한이 없었다. 결 론 : Suture hook과 PDS를 이용한 관절경적 수술은 골편이 작거나 분쇄골절인 경우에도 해부학적 정복을 얻을수 있고, 조기 재활도 가능하므로 전위된 경골극 골절치료에 있어서 유용한 방법의 하나로 사료된다.

• 대한정형외과학회지
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• 제56권6호
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• pp.540-545
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• 2021

슬개골 횡골절은 수술이 필요한 전위된 슬개골 골절의 가장 흔한 형태이다. 이러한 슬개골 횡골절은 골절선을 지나 평행하게 삽입된 Kirschner-강선이나 나사못에 장력대 강선을 추가적으로 고정한 기법이 흔히 사용된다. 그러나 고식적인 고정 방법의 경우 삽입된 강선이나 핀의 돌출에 의한 합병증이 흔히 발생한다. 이러한 합병증은 내고정물의 제거를 위한 추가적인 수술을 필요로 하고, 의료비 상승 및 슬관절의 기능 제한을 일으킬 수 있다. 이에 슬개골 횡골절에 대해 안정적인 고정력을 제공하고 수술 시 연부조직 손상을 최소화하여 골절부 혈류를 보존하고 수술 후 통증을 감소시키며, 내고정물에 의한 자극과 그에 따른 통증을 감소시켜 관절 운동 제한 발생 위험을 감소 시키는 최소 침습 부하 분산 경피적 슬개건 봉합술을 이용하여 치료한 사례들을 수술 술기와 함께 보고하고자 한다.