• Title/Summary/Keyword: bone malalignment

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Effect of Titanium Prosthesis on Computed Tomography Measurements of Bone Mineral Density

  • Han, S.M.;Zude Feng
    • Journal of Biomedical Engineering Research
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    • v.19 no.2
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    • pp.177-182
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    • 1998
  • This study investigated the effects of a titanium prosthesis, malalignment, field of view, and distal flare of titanium prosthesis on computed tomography( CT) measurements of home mineral density. Eight femora and eight tibiae from fresh male cadavers were used. Fifteen pieces of cancellous bone from the proximal tibiae were milled into rectangular parallelepipeds. Parallelepipeds and femors were scanned with and without titanium prosthesis when centered in the gantry of the CT scanner and malaligned, respectively. Image data were then reconstructed with field of view of 10 and 30 cm. Bone mineral density(BMD) values were obtained from CT images using C-MED software. The effects of titanium prosthesis, malalignmetn, and field of view were investigated. When bone was centered in the gantry of the CT scanner, the mean relative difference of BMD measurements caused by a titanium prosthesis was less than 1% for both cortical and cancellous bone. Field of view had negligible effect on BMD measurements as well. Malalignment and distal flare of prosthesis, however, caused a significant difference in BMD measurements(p<0.0001). The titanium prosthesis did not interfere with malalignment combining the existence of a titnium prosthesis on BMD measurements was significant.

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Effects of Knee Malalignment on Static and Dynamic Postural Stability

  • Chae, Yun-Won;Park, Ji-Won;Park, Seol
    • The Journal of Korean Physical Therapy
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    • v.27 no.1
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    • pp.7-11
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    • 2015
  • Purpose: This study was conducted in order to determine the effects of knee malalignment including genu varum, valgum, and recurvatum on static and dynamic postural stability. Methods: A total of 80 subjects were enrolled in this study. Subjects who showed over 3 cm in the distance between the knees were classified as the genu varum group, and subjects who showed over 3 cm in the distance between the ankles were classified as the genu valgum group. Subjects who showed over 1 cm in the distance between the patella and a table in prone position were classified as the genu recurvatum group. Static and dynamic stability were measured as overall, anterioposterior, and mediolateral balance index using a Biodex Balance System. Results: This study showed that knee alignment affected static and dynamic postural stability. In particular, there were significant differences in the mediolateral stability index among genu varum, valgum group, and the other groups, but no differences in overall and anteriolateral stability index. Significant differences in the anterioposterior stability index were observed between genu recurvatum and the other groups, however, there were no differences in overall and mediolateral stability index. Conclusion: The findings were that knee malalignment affects postural stability toward a specific direction. Treatment to improve postural stability for treatment of knee malalignment or to prevent falling or injuries is needed and postural stability toward a specific direction according to the knee alignment conditions should be considered.

Orthodontic treatment and management of adult patient with cleft lip and palate (성인 구순구개열환자의 교정치료 및 관리)

  • Kim, Seong Sik
    • The Journal of the Korean dental association
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    • v.53 no.7
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    • pp.457-467
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    • 2015
  • Patients with cleft lip and palate require interdisciplinary treatment to achieve successful rehabilitation. However, there are special difficulties in orthodontic treatment of adult cleft lip and palate patients: 1. Lack of Tissue, Bone, and Soft tissue; 2. Heavy Scar Tissue, Vestibule, and Palate; 3. Severe Anteroposterior discrepancy and Impaired Maxilla; 4. Distortion of Alveolar Ridge; 5. Abnormal Eruption Path and Malalignment of Tooth. Solving these problems, orthodontist should have differential diagnosis on extent of cleft site and residual deformities of adult cleft lip and palate patient. The tooth missing area in cleft site was commonly treated with a removable or fixed prosthesis, but this method is not stable to retain maxillary arch shape. To establish the more stable arch shape in cleft lip and palate, endosseous implants in the alveolar clefts with bone graft is helpful for management of adult cleft lip and palate patient.

Bone remodeling after conservative treatment of nasal bone fracture in pediatric patients

  • Kang, Won Ki;Han, Dong Gil;Kim, Sung-Eun;Lee, Yong Jig;Shim, Jeong Su
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.166-170
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    • 2020
  • Background: The standard treatment of nasal bone fractures in pediatric patients is closed reduction. Conservative treatment is sometimes performed, but poses a risk of nasal deformity. The aim of this study was to evaluate the outcomes of bone remodeling in pediatric nasal fractures. Methods: Information was extracted from the medical records of patients under 12 years of age who received conservative treatment for a nasal bone fracture and underwent follow-up computed tomography (CT) examinations. The initial fracture and its outcomes over time were graded as excellent, good, or fair according to the malalignment, displacement, or irregularity of the fractured segments. The outcomes of remodeling were evaluated through changes in the grade of the fracture between initial and subsequent CT scans. Results: The review identified 16 patients between March 2015 and December 2019. Their mean age was 6.2 years, and the average follow-up period was 4.9 months. Three of the five patients with a plane I frontal impact showed improved outcomes of remodeling from good to excellent, and the remaining two patients, improved from fair to good. Eight of the 11 patients with plane I lateral impacts showed improved outcomes, from good to excellent, while one patient, improved from fair to good, one patient, improved from fair to excellent, and one patient showed no interval changes. Conclusion: In 15 of these 16 patients with non-severe fractures, the bony contour improved through remodeling, without surgical intervention. Therefore, we suggest that conservative treatment is a feasible option for mild pediatric nasal fractures.

The Effect of Postural Stability on Genu Varum in Young Adults

  • Chae, Yun-Won;Park, Ji-Won;Park, Seol
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.419-422
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    • 2012
  • Purpose: Malalignment of the lower limbs may increases the difficulty of maintaining equilibrium. The purpose of this study was to study the effects of genu varum and poor posture in the sagittal plane on postural stability. Methods: We had 27 subjects with varus and 27 normal subjects participate in this study. Subjects for whom the distance between the medial epicondyles in the knee joint was more than 3 cm were classified as varus group, and subjects for whom the distance was less than 3 cm were classified as normal group. The measurements of static and dynamic stability were used overall stability index (OSI), anterioposterior stability index (APSI), and mediolateral stability index (MLSI) using a Biodex balance system. Results: When measuring the static stability index, there were significant differences in the mediolateral stability index between the varus and control groups. When measuring the dynamic stability index, there were significant differences in the overall, anteriorposterior, and mediolateral stability index between the varus and control groups. These results demonstrated that genu varum affects mediolateral movement in static stability, and overall, anterioposterior and mediolateral movements in dynamic stability. Conclusion: As genu varum affects static and dynamic stability in young adults, it increases the risk of injuries or falls. Exercise and surgery are required for realigning the genu varum. Future studies about postural stability in young children and elderly people who have a risk of falls due to lower postural control ability, are needed, as well as in young adults.

Application of Joshi External Fixator for Treatment of Femoral Fracture In a Dog (개에서 대퇴골 골절의 치유를 위한 Joshi External Fixator의 적용 예)

  • 연성찬;손해룡;이효종
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.505-509
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    • 2000
  • A five-month old female dog was presented to Teaching Anilmal Hospital, Gyeongasng National University for femur fracture. Previously the dog had been presented to a local hospital. Orthopedic and blood examinations were conducted. There was absent response of conscious propri- oception. The dog stood knuckled onto the digits and had hock dropped, but showed no117a1 values in WBC.RBC, Hb, PCV, BUN, Creatine, Glucose, Cholesterol, AST and ALT. Plain radioaraphs were taken and there were abundant periosteal reaction and malalignment of fragments. The dog was anesthetized and prepared for aseptic surgery. Joshi external fixator and half pins were applied(uni lateral). AT 8 weeks after surgery, the pins were removed from the bone. The fracture was well healed wish no evidence of original fracture line. but mild muscle atropy and shortening of femur were found.

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Anterior Decompression and Internal Fixation with Anterior Instrument and Surgical Titanium Mesh in Thoracolumbar Unstable Spine Injuries (Long-term Follow-up Results) (흉·요추 불안정성 척추 손상 환자에서 전방 감압술과 전방기기 및 Surgical Titanium Mesh를 이용한 내고정술 (장기적 추적 검사 결과))

  • Park, Hwan Min;Lee, Seung Myung;Cho, Ha Young;Shin, Ho;Jeong, Seong Heon;Song, Jin Kyu;Jang, Seok Jeong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.58-65
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    • 2000
  • Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

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Effects of Intramedullary K-wire Insertion on Femoral Lengthening in Canine with Monolateral External Fixator (단측성 외고정 기구를 이용한 개의 대퇴골 신연에 있어서 골수강내 K-강선 삽입의 효과)

  • Hwang, Jae-Min;Kim, Young-Ki;Chin, Hee-Tec;Seok, Seong-Hoon;Lee, Hee-Chun;Koh, Phil-Ok;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.291-299
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    • 2006
  • During long bone lengthening, there are many disadvantages including axial deviation, malalignment and re-fracture which are commonly encountered inspite of its proven abilities. To study the effects of intramedullary K-wire application on the lengthening of long bone, ten skeletally mature mongrel dogs were separated into two groups(Group I, II). Right femurs of group I(5 dogs) were fixed with only monolateral external fixator after subperiosteal osteotomy. Right femurs of group II(5 dogs) were fixed with mono lateral external fixator and intramedullary K-wire after subperiosteal osteotomy. Lengthening was started at 7 days after the surgery with the rate of 0.5 mm per day for 5 weeks and the dogs were sacrificed after 15 weeks postoperatively to examine histologic differences and evaluate bone mineral density. Radiographic examination at an interval of two weeks was done to evaluate the type of callus formed and to analyze complications including instability of external skeletal fixation and axial deviation. Bone mineral density at the lengthened area and contralateral nonlengthened area were measured using quantitative computerized tomography. Histological examination of regenerated bone was performed using Masson's trichrome stain method. The radiographs demonstrated poor callus formation, higher incidence of axial deviation and screw loosening in the group I compared to the group II. The bone mineral density at the lengthened area in the group II was higher than that of the group I(P<0.05). Histological examination showed that the new bone trabeculae in the group II were greater than that of the group I. In conclusion, the combination of monolateral external fixator and intramedullary K-wire can prevent pin loosening, axial deviation and reduce healing period in dogs.

Arthroscopic Anterior Cruciate Ligament Reconstruction - A Prospective Comparison of the Bone-Patellar Tendon-Bone and the Quadrupled Hamstring Tendon Autografts - (관절경적 전방 십자 인대 재건술 - 골-슬개건-골과 4중 슬괵건 자가이식의 전향적 비교 연구 -)

  • Kim, Hyoung-Soo;Park, Seung-Rim;Kang, Joon-Soon;Lee, Woo-Hyoeng;Kim, Young-Hoon;Park, Ju-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.51-58
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    • 1998
  • Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using the central one third bone patellar tendon bone(BPB) autograft versus a quadrupled semitendinosus/gracilis(ST) autograft in patients with "isolated" ACL tears. Materials & Methods : A strict criteria to identify isolated ACL tears was used which included : no previous surgery, no other ligamentous injury, no history of patellofemoral symptoms, no patellofemoral malalignment, no meniscal pathology, no chondromalacia or chondral injury and no limitation of motion of the injured knee. 30 patients (15 BPB, 15 ST) with a mean age of 27.4 years were available for a mean follow up of 18 months (between 12 months and 26 months). Preoperatively, there was no significant difference between the two groups with respect to age, sex and degree of laxity. Results : Postoperatively, we couldn't find significant differences between the two groups with respect to subjective Lysholm score, objective laxity including Lachman test, pivot shift test and KT-2000 measurements. Mean side to side difference of KT-2000 scores at 20lbs were 1.5mm for the BPB group and 1.4mm for the ST group. Positive Lachman test was found in 26.7% and 33.3% and positive pivot shift was found in 20% and 33.3% of the patients in the BPB and ST groups, respectively. Anterior knee pain (33.3%) was more common in the BPB group. There were 80% of the patients in both groups above nearly normal grade according to the IKDC grade. Conclusions : In patients with "isolated" ACL tears, the overall results, ligamentous stability for the patellar tendon and the quadrupled semitendinosus/gracilis were comparable. We consider that the quadrupled autogenous hamstring tendon is a good alternative substitute in ACL reconstruction together with the bone patellar tendon bone.

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Open Source-Based Surgical Navigation for Fracture Reduction of Lower Limb (오픈소스 기반 수술항법장치의 하지 골절수술 응용검토)

  • Joung, Sanghyun;Park, Jaeyeong;Park, Chul-Woo;Oh, Chang-Wug;Park, Il Hyung
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.38 no.5
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    • pp.497-503
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    • 2014
  • Minimally invasive intramedullary nail insertion or plate osteosynthesis has shown good results for the treatment of long bone fractures. However, directly seeing the fracture site is impossible; surgeons can only confirm bone fragments through a fluoroscopic imaging system. The narrow field of view of the equipment causes malalignment of the fracture reduction, and radiation exposure to medical staff is inevitable. This paper suggests two methods to solve these problems: surgical navigation using 3D models reconstructed from computed tomography (CT) images to show the real positions of bone fragments and estimating the rotational angle of proximal bone fragments from 2D fluoroscopic images. The suggested methods were implemented using open-source code or software and evaluated using a model bone. The registration error was about 2 mm with surgical navigation, and the rotation estimation software could discern differences of $2.5^{\circ}$ within a range of $15^{\circ}$ through a comparison with the image of a normal bone.