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The First Metatarsophalangeal Arthrodesis with Screws Fixation (나사못을 이용한 제 1 중족 족지 관절 유합술)

  • Seo, Woo-Young;Sung, Il-Hoon;Cho, Hyun-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.142-145
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    • 2009
  • Purpose: The aim of this study was to retrospectively evaluate the clinical and radiological results of the first metatarsophalangeal joint arthrodesis with two crossed screws fixation. Materials and Methods: We treated 23 patients (24 cases) with arthrodesis of the first metatarsophalangeal joint using two crossed screws fixation between December 2000 and May 2005. There were 3 male patients and 20 female patients. Ages ranged from 28 to 74 years (mean, 50 years). Follow-up ranged from 4.1 to 8.2 years (mean, 6.5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) score and their satisfaction was evaluated clinically, foot anteroposterior and lateral radiograph, radiologically. Results: Of the 24 cases, 6 had surgery for dorsal plate and screws fixation because of failure to acquire firm fixation with two crossed screws fixation. All 6 cases acquired bony union. Fusion of the hallux first metatarsophalangeal joint occurred in 16/18 cases (89%). Nonunion occurred in 2 cases (11%) and was asymptomatic. At last follow-up, hallux valgus angle ranged from 11 to 25 degrees(mean, 17.7 degrees), dorsiflexion ranged from 15 to 25 degrees (mean, 22 degrees).The mean preoperative AOFAS score of 37 points(range, 28 to 45 points) improved to a mean of 77 points (range, 65~90 points) postoperatively. The result of the procedure as rated subjectively by the patient was excellent for 5 cases, good for 11 cases and fair for 2. Conclusion: Comparatively, the arthrodesis of the first metatarsophalangeal joint with crossed screws fixation showed a satisfactory clinical results, we thought that require technical attention for firm fixation in operation.

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Effect of Fixation Methods on the Flame Retardant and Performance Properties of MDPPA/HMM treated Cotton (MDPPA/HMM처리 면직물의 고착방법에 따른 방염성과 물성의 변화)

  • 지주원;오경화
    • Journal of the Korean Society of Clothing and Textiles
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    • v.24 no.1
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    • pp.15-23
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    • 2000
  • Effect of fixation methods on the flame retardant(FR) and performance properties of MDPPA/HMM treated cotton fabrics were studied. Combination of three different fixation methods - premercerization, swelling agent treatment, pad dry cure fixation, and wet fixation - were applied to flame retardant finish of cotton with MDPPA/HMM. As a result, an increase in internal volume of cotton fiber by pre-mercerization and addition of swelling agent, and wet fixation increased %add-on of FR agent improving FR efficiency and wash fastness. Tensile strength of MDPPA/HMM treated cotton fabrics by wet fixation and swelling agent were slightly decreased, but that of premercerized cotton was improved. Wet fixated fabric showed lower bending rigidity and better compressional properties which improved fabric hand. Retention of swelling ability of cotton treated with MDPPA/HMM improved moisture absorption properties.

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Outcomes of Immediate Operative Treatment of Ankle Trimalleolar Open Fractures (족관절 개방성 삼과골절의 즉각적인 수술의 결과)

  • Lee, Jun-Young;Cho, Yong-Jin;Kang, Sin-Wook;Cho, Yung-Min;Choi, Hyun-Bai
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.1
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    • pp.25-30
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    • 2020
  • Purpose: Generally, the treatment of ankle trimalleolar open fractures is divided into two stages: external fixation and debridement; and secondary internal fixation. On the other hand, this two-stage operation takes considerable treatment time and is challenging in procedures requiring reduction. The purpose of this study was to evaluate the radiologic and clinical results of an immediate one-stage internal fixation operation considering the wound conditions to overcome two stage operation disadvantages. Materials and Methods: From September 2009 to January 2018, 24 cases of ankle trimalleolar open fractures, who underwent immediate internal fixation and were followed up for at least one year, were studied retrospectively. The open wound was divided into the Gustilo-Anderson classification. Open reduction and internal fixation were performed on every medial and lateral malleolar fracture. On the other hand, with posterior malleolar fractures, surgical or conservative treatment was performed depending on the fragment size. The radiologic outcome was evaluated using the Burwell and Charnley criteria and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and complications, such as infection and posttraumatic arthritis, were used for the clinical evaluation. Results: The wound was classified into eight cases (33.3%) of type I, 11 cases (45.8%) of type II, and five cases (20.8%) of type IIIa. The degree of reduction was anatomical, fair, and poor in 16 cases (66.7%), six cases (25.0%), and two cases (8.3%), respectively. The mean AOFAS score was 79 points, and there were complications, such as infection in three cases (12.5%) and post-traumatic arthritis in two cases (8.3%). Conclusion: Satisfactory results were obtained through immediate surgical treatment in ankle trimalleolar open fractures of types I, II, and IIIa.

Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report (리스프랑 관절 손상 수술 중 시행하는 프리어 검사법)

  • Young, Ki Won;Lee, Hong Seop;Park, Seongcheol;Jeong, Gu Min
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.165-167
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    • 2020
  • Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.

The Outcomes of Open Ankle Fractures in Patients Managed by Early or Delayed Definitive Fixation: A Comparative Analysis of 73 Patients

  • Raghavendra Kaganur;Bhaskar Sarkar;Pragadeeshwaran Jaisankar;Nirvin Paul;Md Quamar Azam;Anurag Bhakhar
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.8-14
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    • 2024
  • Purpose: Ankle fracture fixation is the gold standard of treatment but it does have its own complications. There is inadequate data regarding the comparative effectiveness of early vs. delayed fixation for open ankle fracture outcomes. This study compares the clinical and functional outcomes of open ankle fractures treated by early or delayed definitive fixation and identifies the limitations of both methods. Materials and Methods: All 73 patients enrolled in the study underwent surgical intervention within 24 hours of injury. The early fixation group (group A) consisting of 39 patients underwent definitive fixation as an index procedure, while the delayed fixation group (group B) consisted of 34 patients who underwent debridement and external fixator application as an index procedure and definitive fixation when soft tissue condition was conducive. All patients were evaluated at 2, 6, and 12 weeks postoperatively and then three monthly for a year. Results: Enneking and American Orthopaedic Foot and Ankle Society scores were markedly higher in the early fixation group at 6 months postoperatively (p-values <0.001 and 0.011, respectively). However, no discernible intergroup difference was evident at 12 months postoperatively. Between 6 and 12 months, group functional outcome scores were significantly different. At 6 months, there was a substantial difference in dorsiflexion between the two groups (p-values 0.001 and <0.001, respectively), but no difference was observed at 12 months postoperatively. At 6 and 12 months, group average plantar flexions were non-significantly different. Conclusion: Early definitive fixation of complex ankle fractures using a targeted approach produced promising results for lower grade open fractures (grades 1 and 2), and delayed definitive fixation, after initial external fixation to allow for soft tissue stabilization, produced promising results for higher grade open fractures (grades 3A and 3B). At 12-month follow-ups, clinical and functional outcomes achieved using these strategies were equivalent.

Clinical Applications of Endoscopic-Assisted Open Reduction and Internal Fixation of Subcondylar Fractures (아래턱뼈 관절돌기밑 골절에서 내시경을 이용한 관혈적 정복술 및 내부고정술의 임상적 적용)

  • Han, Seung Youl;Kang, Seok Joo;Park, Jin Hyung
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.735-742
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    • 2009
  • Purpose: The management of fractures of mandibular subcondyle continues to be controversial between open and closed treatment. The purpose of this article is to explain the endoscopic assisted open reduction and internal fixation and minimize the controversy. Methods: Nine patients of mandibular subcondylar fracture were reduced and fixed by using intraoral endoscopic - assisted open reduction and internal fixation and were followed up for 14 ~ 24 months after surgery. Results: Eight patients of mandibular subcondylar fracture had been treated without significant complications. One patient, whose malocclusion had been remained, was recovered normal occlusion by maxillomandibular fixation using intermaxillary screws for 3 weeks. Conclusion: The advantages of endoscopic - assisted open reduction and internal fixation are direct visualization, accurate fracture repair, minimized scar, decreased morbidity. And maxillomandibular fixation is not needed when it is done by accurate reduction and rigid fixation with one miniplate in the region of subcondylar fracture. With the above consideration, endoscopic - assisted open reduction and internal fixation can be considered as one of the best treament for subcondylar fracture of the mandible.

Evaluation of Copper-Chromium-Arsenic Preservatives Fixation on Wood by Measuring the Density of Surface Electric Charge (표면전하밀도(表面電荷密度)를 이용(利用)한 동(銅)·크롬·비소계(砒素系) 방부방충제의 정착(定着)에 관(關)한 연구(硏究))

  • Kim, Yeong-Suk
    • Journal of the Korean Wood Science and Technology
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    • v.18 no.1
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    • pp.24-30
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    • 1990
  • This study was attempted to propose a method evaluating fixation of active ingredients in Copper-Chromium-Arsenic preservatives treatment. Fixated amount of active ingredients on wood was obtained by measuring the density of surface electric charge based on $\varsigma$ potential. Data accumulated from density of surface electric charge showed that the fixated amount of preservatives on wood increased linearly as concentration of treating solution increaced, which indicatied quantitative reactions in fixation of preservatives.

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Surface Electrochemical Study on the Fixation Properties of New Water-borne Preservatives in Red Pine (새로운 수용성(水溶性) 방부방충제(防腐防蟲劑)의 재중(材中) 정착성(定着性)에 관한 계면전기화학적(界面電氣化學的) 특성(特性))

  • Kim, Yeong-Suk
    • Journal of the Korean Wood Science and Technology
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    • v.24 no.4
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    • pp.93-99
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    • 1996
  • In order to investigate the extent of fixation of new water-borne preservatives in blocks of pinus densiflora sapwoods the streaming potential through the column with preservative treated wood was measured at various conditions. The rates of leachability of ingredients in the treated wood were estimated by the measurement of electric conductivity of the solution with the leached components. The solution was also analyzed by Atomic absorption spectrophotometer (AA). As a results, the experimental data indicated that the fixation of CCB, CCFZ and ACQ in wood were relatively unstable. The fixation rates of CCB, CCFZ were improved by increasing heat and drying time. The amounts of the leached ingredients were apparently higher in CCB and CCFZ than in CCA, while the rate of leaching of ACQ was not changed at various drying temperature.

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A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels

  • Kim, Sam Yeol;Yoon, Seung Hwan;Kim, Dokeun;Oh, Chang Hyun;Oh, Seyang
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.691-700
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    • 2017
  • Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.