• 제목/요약/키워드: fixation

검색결과 2,829건 처리시간 0.047초

Posterior Screw Fixation in Previously Augmented Vertebrae with Bone Cement : Is It Inapplicable?

  • Park, Jae Hoo;Ju, Chang Il;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • 제61권1호
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    • pp.114-119
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    • 2018
  • Objective : The purpose of this study was to determine the feasibility of screw fixation in previously augmented vertebrae with bone cement. We also investigated the influence of cement distribution pattern on the surgical technique. Methods : Fourteen patients who required screw fixation at the level of the previous percutaneous vertebroplasty or balloon kyphoplasty were enrolled in this study. The indications for screw fixation in the previously augmented vertebrae with bone cement included delayed complications, such as cement dislodgement, cement leakage with neurologic deficits, and various degenerative spinal diseases, such as spondylolisthesis or foraminal stenosis. Clinical outcomes, including pain scale scores, cement distribution pattern, and procedure-related complications were assessed. Results : Three patients underwent posterior screw fixation in previously cemented vertebrae due to cement dislodgement or progressive kyphosis. Three patients required posterior screw fixation for cement leakage or displacement of fracture fragments with neurologic deficits. Eight patients underwent posterior screw fixation due to various degenerative spinal diseases. It was possible to insert screws in the previously augmented vertebrae regardless of the cement distribution pattern; however, screw insertion was more difficult and changed directions in the patients with cemented vertebrae exhibiting a solid pattern rather than a trabecular pattern. All patients showed significant improvements in pain compared with the preoperative levels, and no patient experienced neurologic deterioration as seen at the final follow-up. Conclusion : For patients with vertebrae previously augmented with bone cement, posterior screw fixation is not a contraindication, but is a feasible option.

시선 고정 유도방법이 시야 검사에 미치는 영향 (The Effect of Gaze Fixation Induction Method on Visual Field Testing)

  • 이지형;최영근;;이나현;오건희;김영균;강자헌;유희천
    • 대한산업공학회지
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    • 제42권6호
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    • pp.412-420
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    • 2016
  • A visual field tester using a fixation target with a lack of distinctiveness decreases accuracy and usability in visual field testing. The present study is intended to develop various induction methods of gaze fixation for effective visual field testing. Proposed were four new gaze fixation induction methods (color changing dot; alphanumeric characters; flashing black dot; and bulls eye and cross hair, BECH) by considering visual attention factors such as color, meaning, flashing, and shape and the proposed methods were compared with the existing black dot (BD) method in terms of gaze fixation performance and subjective satisfaction by 32 participants in their 20s to 30s. BECH was found most preferred by increasing gaze fixation performance by 4.8% and subjective satisfaction by 0.4 to 2.0 in a 7-point scale compared to BD. BECH can be applied to tests such as visual field testing and macular pigment optical density testing in which gaze fixation is crucial for accuracy and usability.

족관절 내과 골절에 대한 금속나사고정술과 변형 긴장대고정술의 임상적 비교 (Comparison between Screw Fixation and Modified Tension Band Wiring for Medial Malleolar Fracture)

  • 고상훈;박영준;정유영;김우석
    • 대한족부족관절학회지
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    • 제6권1호
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    • pp.54-59
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    • 2002
  • Purpose: To compare the clinical results between the screw fixation and modified tension band wiring in the treatment of medial malleolar fracture. Materials and Methods: From September 1998 to April 2002, 52 patients were treated by screw fixation and 43 patients were treated by modified tension band wiring for medial malleolar fracture. Results: Accoding to Lauge- Hansen classification, there were 28 cases of supination-external rotation type (53.8%), 9 of supination-adduction type (17.3%), 8 of pronation -external rotation type (15.4 %), 7 of pronation -abduction type (13.5 %) in screw fixation group and 21 (48.9%),11 (25.6%), 7 (16.3%) 4 (9.3%) of each type in tension band wiring group. The average time to union was 15.7 weeks in screw fixation group and 12.8 weeks in tension band wiring group.(p<0.05) In the functional outcome (according to Meyer and Kumler), 29 patients treated (76.2 %) with screw fixation showed excellent results and 34 patients (86.6%) treated with tension band wiring had excellent results (p<0.05). Conclusion: We concluded that more satisfactory result could be obtained with modified tension band wiring compared with screw fixation in the treatment of the medial malleolar fracture.

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제한적 내고정술 및 외고정술을 이용한 경골 Pilon 골절의 치료 (Limited Internal Fixation and External Fixation of the Pilon Fractures)

  • 최원태;엄두섭;임영택;유현종;정상돈
    • 대한족부족관절학회지
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    • 제3권1호
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    • pp.26-32
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    • 1999
  • Fractures of the tibial pilon are the severe injuries to the ankle joint resulted from axial compression, shear and/or rotational forces. The pilon fractures have been difficult in management due to the severe comminution of articular surface and frequent soft tissue problem. Among many treatment options, limited internal fixation of the tibia with long screws and multiple pins augmented with external fixation or casting provide adequate stabilization without soft tissue compromise. Among the patients of pilon fracture admitted to our hospital from March 1993 to March 1997 who treated by limited internal fixation and external fixation or casting, 25cases are included who could be follow up for more than 10months. According to Ruedi and Allgower, typeI 3cases, typeII 14cases, typeIII 8cases. The authors analyzed the clinical and radiological results of the tibial pilon fractures according to Magnusson. The results were as follow. 1. 10cases at Ruedi-Allgower typeII were obtained above fair and 5cases at Ruedi-Allgower typeIII were obtained above fair. 2. The postoperative complications were skin problem(3cases) and infection(2cases), which were treated by antibiotics and flap surgery.

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Three-dimensional finite element analysis of the stress distribution and displacement in different fixation methods of bilateral sagittal split ramus osteotomy

  • Yun, Kyoung In;Cho, Young-Gyu;Lee, Jong-Min;Park, Yoon-Hee;Park, Myung-Kyun;Park, Je Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권5호
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    • pp.271-275
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    • 2012
  • Objectives: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. Materials and Methods: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. Results: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6 (fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). Conclusion: Types 2 and 6 fixation methods provide better stability than the others.

하악골 양측 하악지 시상분할 골절단술 후 흡수성 고정의 안정성에 관한 연구 (The study of stability of absorbable internal fixation after mandibular bilateral sagittal split ramal osteotomy)

  • 최병환;박수원;장수미;손한나;박봉찬;손장호;조영철;성일용
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권4호
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    • pp.255-261
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    • 2010
  • Introduction: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. Materials and Methods: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. Results: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) Conclusion: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.

흰쥐의 후지 석고 고정, 탈신경 및 부유에 의한 근위축의 비교 (Comparison of Muscle Atrophy Induced by Cast Fixation, Denervation and Suspension of Rat Hindlimb)

  • 윤범철;이명화;김난수;홍혜정;유병규
    • The Journal of Korean Physical Therapy
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    • 제13권3호
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    • pp.665-675
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    • 2001
  • The aim of this study was to compare features of muscle atrophy induced by cast fixation. denervation and suspension of rat hindimb. Muscle mass and glycogen of the soleus and plantaris muscles were studied after 3, 7, or 14 days of cast fixation, denervation and suspension. The results as follows: 1. Body weight of rats decreased significantly after 3 days and showed gradually increase after 7 and 14 days of hindlimb cast fixation, denervation and suspension. Particularly hindlimb suspended rats showed a rapid decrease after 3 days in body weight. 2. Relative weight of soleus and plantaris musclcs decreased significantly by hindlimb cast fixation, denervation and suspension, particularly after 7 days. The decrease rate was the lowest in suspended rats. 3. Glycogen content of soleus muscle decreased significantly after 14 days of hindlimb cast fixation, denervation and suspension. Also glycogen content of plantaris muscle decreased significantly after 14 days of hindlimb cast fixation and denervation, but not significantly after hindlimb suspension. These results indicate that suspension of hindlimb muscles causes less atropy than cast fixation or denervation, likely due to maintainment a few activities during hindlimb suspension. We concluded that the decrease in mechanical strains imposed on the muscle during inactivity was the main factor for the development of atrophy. These basic data suggest that some experimental conditions such as electrostimulation or stretching, participate in countermeasure programmes.

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개방성 치조골 골절의 고정법: 응급실에서 간편하게 적용할 수 있는 방법 (Fixation of Open Alveolar Bone Fractures: Easily Applicable Method in the Emergency Department)

  • 설승환;차수현;최상천;안정환;김기운;최혜경;조준필;정윤석
    • Journal of Trauma and Injury
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    • 제20권2호
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    • pp.72-76
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    • 2007
  • Purpose: The purpose of this clinical trial was to evaluate the fixation method for treating alveolar fractures in an emergency department. Methods: The efficiency of using the fixation method was judged on the basis of clinical criteria. Stability, occlusion state, bleeding amount after fixation, operation time, and difficulties during procedural operation were recorded. Results: Eight patients were enrolled in this study. In all instances, the fixation method was effective in bleeding control. Each patient had a noticeable decrement in bleeding. A wire was used for four of the eight patients, and nylon strings was used for the others. The average operation time was 6.3 minutes for the wire patients and 2.8 minutes for the Nylon string patients. No specific problem was identified during the procedural operation. However, the difference in the fixation material influenced the effectiveness of the procedure, the operation time, and the satisfaction of the doctor. Conclusion: In the emergency department, the fixation method using wire or nylon string in the treatment of alveolar fractures is effective in bleeding control

TransFix 경골부 고정을 이용한 경 경골 두 다발 후방십자인대 재건술 - 수술 술기 - (Transtibial Double Bundle PCL Reconstruction using TransFix Tibial Fixation - Technical Note -)

  • 이용석;정영복;안진환;강번중;신윤창;공제관
    • 대한관절경학회지
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    • 제10권2호
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    • pp.203-208
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    • 2006
  • 목적: 후방십자인대의 경 경골 두 다발 재건술에 있어서 기존의 방법들은 공여 인대가 길어야 하는 문제 때문에 이식건의 선택이 제한적인 경우가 많으며 경골부에서 이중의 고정을 해야 하는 문제점 등이 있다. 이에 저자들은 두 다발 재건술을 실시하면서 경골부에서 초기에 단일 고정으로써 안정성을 얻고, 공여 인대 길이에 제한을 덜 받는 방법을 소개하고자 한다. 수술 술기: 진단적 관절경 검사를 실시 한 후 두 다발 재건술을 위한 이식건을 준비하고, 경골 터널 및 TransFix 고정을 위한 준비를 한다. 대퇴부에 2개의 터널을 만들고, 이식건을 전 내측 입구를 이용하여 경골부, 대퇴부 순으로 통과시킨 후 TransFix를 이용하여 경골부에 고정을 먼저 실시하고, 대퇴부의 2 다발을 각각의 고정 위치에서 고정을 실시한다. 결론: 경경골 터널을 이용한 두 다발 후방십자인대 재건술에서 TransFix를 이용한 경골부의 고정은 단일 고정으로써 강한 고정을 제공하면서 이식건의 길이에 제한을 받지 않고, 전 내측 입구로 이식건을 통과시킴으로써 이식건의 손상을 방지할 수 있는 좋은 방법이라고 생각한다.

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족근-중족 관절 골절 탈구의 치료경험 (Treatment for Tarsometatarsal Fracture-Dislocation)

  • 정영기;유정한;박용욱;노동근;하성한
    • 대한족부족관절학회지
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    • 제1권2호
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    • pp.112-118
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    • 1997
  • Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

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