• Title/Summary/Keyword: fixation device

Search Result 91, Processing Time 0.031 seconds

Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture

  • Yoon, Hyungwoo;Kim, Jiye;Chung, Seum;Chung, Yoon-Kyu
    • Archives of Craniofacial Surgery
    • /
    • v.15 no.2
    • /
    • pp.59-62
    • /
    • 2014
  • Background: The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures. The coronal approach for a zygomatic arch fracture has complications. In this study, we introduce our method to reduce a special type of unstable zygomatic fracture. Methods: We retrospectively reviewed zygomatic arch view and facial bone computed tomography scans of 424 patients who visited the Wonju Severance Christian Hospital from 2007 to 2010 with zygomaticomaxillary fractures, among whom 15 patients met the inclusion criteria. Results: We used a Dingman elevator and K-wire simultaneously to manage this type of zygomatic arch fracture. Simple medial rotation force usually collapses the posterior fractured segment, and the fracture becomes unstable. Thus, the posterior fracture segment must be concurrently elevated with a Dingman elevator through Keen's approach with rotation force applied through the K-wire. All fractures were reduced without any instability using this method. Conclusion: We were able to reduce unstable and difficult zygomatic arch fractures without an open incision or any external fixation device.

HISTOLOGICAL CHANGES IN THE ELONGATED BONE AFFECTED BY OSTEODISTRACTION OF THE MANDIBLE IN THE DOG (성견 하악골 절단 후 기계적 골 견인에 의해 형성된 골 신장부에 대한 시기별 조직학적 변화)

  • Baek, Sun-Ho;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.27 no.5
    • /
    • pp.404-416
    • /
    • 2001
  • Purpose : Traditionally, the treatement of choice has been a bone grafting procedure to increase the length of bone in case of actual length discrepancy. But, bone grafting procedure has many disadvantages, for example, graft resorption, donor site morbidity, and so on. So, many trials have been performed to avert the use of autogenous bone graft via introducing new materials or methods. And, one of those trials has been realized by the development of a technique inducing bone lengthening by osteotomy (or corticotomy) and slow gradual distraction of the osteotomized segments. This new technique of bone lengthening dates back to the early 20th century. But, the majority of information concerning the biology of new bone formation during bone lengthening and technical details of the procedure were produced by extensive clinical and experimental studies performed by Ilizarov, a Russian surgeon. According to Ilizarov, with adequate blood supply, preservation of periosteum, rigid fixation of the osteotomized segments, and proper rate and rhythm of distraction, intramembranous bone rapidly develops within the distraction gap in the limb lengthening procedure. In the limb lengthening, many orthopedic surgeons try to observe the biologic and clinical principles recommended by Ilizarov. In the oral and maxillofacial region, however, not a few studies must be performed to apply this surgical technique in the clinical cases. Besides, the mechanism of bone formation in the distraction gap is not clear, yet. The purpose of this experiment was to scrutinize serially the histological changes in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. In addition, it was performed to confirm the presence of specific region(s) which was important in the bone formation in the gap through the observation of the expression pattern of osteocalcin and osteonectin with the immunohistochemical examination. Materials and Methods : The experimental and control specimens were obtained from seven adult male mongrel dogs weighing over 20kg. The distractors were custom-made linear extraoral devices and bicortical fixation screws were 2.3mm in diameter, 50mm in total length, 15mm in screw length. The distractors were devised to produce a linear gap of 0.75mm between two bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side of each animal was corticotomized perpendicular to the occlusal plane and then two bony segments were separated completely by careful manipulation of the segments with bone forceps. The left side of each animal was left intact. This side was served as control. At sixth day after osteotomy and fixation of the segments were performed, distraction of the segments was commenced with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were euthanized at the 16th. 29th, and 44th day after the osteotomy. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with H&E. The prepared specimens were examined under the light microscope. And, immunohistochemical examinations using anti-osteocalcin antibody (OC1, Biodesign, USA) and anti-osteonectin antibody (Haematologic Technologies Inc., Essex, VT) to locate the expressions of osteocalcin and osteonectin, respectively, were performed. Results : 1. New bone was observed already at the 16th. day after osteotomy. This suggests that new bone formation in osteodistraction was commenced at an early stage of the regenerative process. But, radiologically and microscopically, bony union was not completed in the distraction gap at the 44th. day after osteotomy. Therefore, rigid fixation must be maintained between the bony fragments till the complete bony union is confirmed clinically rather than one month or so after the completion of distraction.

  • PDF

Ergonomic Design of the Gauge Cluster Display for Commercial Trucks

  • Kim, Taehun;Park, Jaekyu;Choe, Jaeho;Jung, Eui S.
    • Journal of the Ergonomics Society of Korea
    • /
    • v.34 no.3
    • /
    • pp.247-264
    • /
    • 2015
  • Objective: The purpose of this study is to determine the priority of information presentation and the effective menu type to be placed in the center of a gauge cluster display for commercial trucks and to present a set of ergonomic designs for the gauge cluster display. Background: An effective ergonomic design is specifically needed for the development of the gauge cluster display for the commercial trucks, because more diverse and heavier information is delivered to truck drivers, compared to the information to passenger car drivers. Method: First, all the information that must be shown on the commercial truck display was collected. Then, the severity, frequency of use, and display design parameters were evaluated for those information by commercial truck drivers. Next, an analysis on the information attributes and the heuristic evaluation utilizing the display design principles were carried out. According to the results, a design alternative of the main screen to be displayed was constructed by priority. A comparative analysis between the alternative and existing main screens was also conducted to see the efficacy of the designs. Lastly, we conducted an experiment for the selection of menu type. The experiment was conducted using the driving simulator with an eye-tracking device. The independent variables were four types of the menu reflecting the commercial truck characteristics such as grid type, icon type, list type, and flow type. We measured preference, total execution time, the total duration of fixation on the gauge cluster area, and the total number of fixation on the gauge cluster area as dependent variables. Results: Four types of driver convenience information and six types of driver assistance information were selected as the information to be placed primarily on the main screen of the gauge cluster. The Grid type was the most effective among the menu types. Conclusion: In this study, the information that appears on the main screen of the display, the division of the display and the design of the menu type for commercial truck drivers were suggested. Application: This study is expected to be utilized as guidelines on the ergonomic design of a gauge cluster display for commercial trucks.

Characteristics of the Process of Visual Attention during Spatial Depth Perception (공간의 깊이감 지각과정에 나타난 시각정보획득 특성)

  • Kim, Jong-Ha;Cho, Ji Young
    • Science of Emotion and Sensibility
    • /
    • v.21 no.1
    • /
    • pp.115-128
    • /
    • 2018
  • Understanding the process of spatial perception plays a significant role in the design process as well as in the use of actual spaces. The perception of spatial depth can vary according to the space composition and design even there is no change in the actual size of the space. The properties of 3-dimensional space are its width, height, and depth; however, compared to the perception of spatial width and height, little research and theories exist on spatial depth perception. The reasons may be there less interest lies in the effect of spatial depth perception than that of spaciousness or height of space. This study is an investigation of the process of spatial depth perception using an eye-tracking device with stimuli developed through Computer Graphics. A total of 44 interior design major students participated in the eye tracking experiment; and they looked at three images comprised of an identical room with only changes in the rear wall condition. The results show that a significant difference in the fixation duration per stimulus exists. In addition, a significant difference exists on the fixation duration per stimulus according to the participants' answer of the deepest space. The result of this study can help identify factors for spatial depth perception, validate the assumption on it, and provide knowledge on how to acquire desirable spatial depth by utilizing the research result.

Development of Supplemental Equipment to Reduce Movement During Fusion Image Acquisition (융합영상(Fusion image)에서 움직임을 줄이기 위한 보정기구의 개발)

  • Cho, Yong Gwi;Pyo, Sung Jae;Kim, Bong Su;Shin, Chae Ho;Cho, Jin Woo;Kim, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.17 no.2
    • /
    • pp.84-89
    • /
    • 2013
  • Purpose: Patients' movement during long image acquisition time for the fusion image of PET-CT (Positron Emission Tomography-Computed Tomography) results in unconformity, and greatly affects the quality of the image and diagnosis. The arm support fixtures provided by medical device companies are not manufactured considering the convenience and safety of the patients; the arm and head movements (horizontal and vertical) during PET/CT scan cause defects in the brain fundus images and often require retaking. Therefore, this study aims to develop patient-compensation device that would minimize the head and arm movements during PET/CT scan, providing comfort and safety, and to reduce retaking. Materials and Methods: From June to July 2012, 20 patients who had no movement-related problems and another 20 patients who had difficulties in raising arms due to shoulder pain were recruited among the ones who visited nuclear medicine department for PET Torso scan. By using Patient Holding System (PHS), different range of motion (ROM) in the arm ($25^{\circ}$, $27^{\circ}$, $29^{\circ}$, $31^{\circ}$, $33^{\circ}$, $35^{\circ}$) was applied to find the most comfortable angle and posture. The manufacturing company was investigated for the permeability of the support material, and the comfort level of applying bands (velcro type) to fix the patient's head and arms was evaluated. To find out the retake frequency due to movements, the amount of retake cases pre/post patient-compensation were analyzed using the PET Torso scan data collected between January to December 2012. Results: Among the patients without movement disorder, 18 answered that PHS and $29^{\circ}$ arm ROM were the most comfortable, and 2 answered $27^{\circ}$ and $31^{\circ}$, respectively. Among the patients with shoulder pain, 15 picked $31^{\circ}$ as the most comfortable angle, 2 picked $33^{\circ}$, and 3 picked $35^{\circ}$. For this study, the handle was manufactured to be adjustable for vertical movements. The material permeability of the patient-compensation device has been verified, and PHS and the compensation device were band-fixed (velcro type) to prevent device movements. A furrow was cut for head fixation to minimize the head and neck movements, fixing bands were attached for the head, wrist, forearm, and upper arm to limit movements. The retake frequency of PET Torso scan due to patient movements was 11.06% (191 cases/1,808 patients) before using the movement control device, and 2.65% (48 cases/1,732 patients) after using the device; 8.41% of the frequency was reduced. Conclusion: Recent change and innovation in the medical environment are making expensive medical image scans, and providing differentiated services for the customers is essential. To secure patient comfort and safety during PET/CT scans, ergonomic patient-compensation devices need to be provided. Therefore, this study manufactured a patientcompensation device with vertically adjustable ergonomic ROM according to the patient's body shape and condition during PET Torso scan. The defects in the basal ganglia images due to arm movements were reduced, and retaking was decreased.

  • PDF

Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.2 no.2
    • /
    • pp.168-175
    • /
    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

  • PDF

Open Reduction of Mandibular Condyle Fracture Via Preauricular Approach (전이개 접근을 이용한 하악 과두 골절의 정복)

  • Kim, Bum-Joon;Cha, Yong-Hoon;Lim, Jae-Hyung;Park, Kwang-Ho;Huh, Jong-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.32 no.6
    • /
    • pp.521-528
    • /
    • 2010
  • Purpose: Anatomical reduction of the fractured condylar process is an important prerequisite for re-establishing function. The authors reported about effectiveness of transoral approach for mandibular subcondyle fracture using trochar device in cases that the fracture line is below the reference line, the perpendicular line of the longitudinal axis of condylar process passing the lowest point of sigmoid notch. As a serial study, we report the open reduction via preauricular approach for mandibular condyle fracture, in cases that the fracture line is above the reference line. Patients and Methods: Sixteen condylar fractures of 15 adult patients were divided two groups and treated by open reduction via preauricular approach (8 cases) or by closed reduction (8 cases). The degree of maximal mouth opening, occlusion, anatomical reduction, condylar resorption and complications were assessed and evaluated for the two groups. Results: The open reduction of condyle via preauricular approach leads to good results without permanent complications. Anatomical reduction of open reduction group and maximal mouth opening range of the closed reduction group is significantly better than the other group. No significant differences were found in the condylar resorption and the occlusion. Conclusion: The preauricular approach was useful to reduce and fix the condylar fragment, in cases that the fracture line is above the reference line.

A Study on the Application of Dobak-glue for Fixation Painting Layer of Earthen Mural (토벽화 채색층 고착처리를 위한 도박풀 적용 연구)

  • Kim, Seol Hui;Han, Kyeong Soon;Lee, Hwa Soo
    • Journal of Conservation Science
    • /
    • v.33 no.6
    • /
    • pp.553-564
    • /
    • 2017
  • This report compared and analyzed the degree of surface change and results of a deterioration experiment to assess the possibility of using Dobak glue as an adhesive in the fossilizing treatment of the paint layer in earthen mural paintings. The weathering experiments were performed with a color-difference meter (CR-400, MINOLTA). After the experiment, Cinnabar 3% specimens, which exhibited diverse changes in the durability test, were additionally tested with a reflection-transmission device (CARY-5000, AGILENT). Post UV degradation, most of the Dobak-glue samples exhibited lesser color change than animal-glue samples, and after moisture absorption and drying, the 0.5% and 3% Dobak samples displayed a lower degree of change in the value of color difference. Furthermore, results of the reflection-transmission test after deterioration indicated that Dobak glue presented a lesser color change than animal glue. Therefore, if Dobak glue is used as a consolidating agent, discoloration on account of degradation is minimal.

Correction of Dose Distribution at Total Body Irradiation using Compensator

  • Kim Jong Sik;Cho Hyun Sang;Kim Young Kon;Cho Jung Keun;Ju Sang Kyu;Park Young Hwan
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.9 no.1
    • /
    • pp.87-93
    • /
    • 1997
  • The using of compensator is required to adjust the irregular dose distribution due to irregular thickness of the body in Total Body Irradiation. Aluminuim, copper or lead is generally used as compensator. In our study, we would like to introduce a result of the attenuation and compensation effect of radiation use compensator made by duralumin and its clinical use. The thickness of compensator was calculated by the attenustion of radiation, which was measured by polystyrene phantom and ionization chamber(farmer). The compensation effect of radiation was measured by diode detector. All of conditions were set as in real treatment, and the distanc from source to detector was 446 cm. We also made fixation of device to easily attach the compensator to LINAC. Beam spoiler was menufactured and placed on the patient to irradiate sufficient dose to the skin. diode detector were placed on head, neck, chest, umbilicus. pelvis and knee with each their entranced exit points, and datas of dose distribution were evaluated and compared in each points for eleven patients(Feb. 96-Feb. 97). The attenuation rate of irradiation by duralumin compensator was measured as $1.4\%$ in 2mm thickness. The mean attenuation rate was $1.3\%$ per 2mm as increasing the thickness gradually to 50 mm. By using duralunim compensator, dose distribution in each points of body was measured with ${\pm}2.8\%$ by diode detectior. We could easily calculate the thickness of compensator by measuring the attenuation rate of radiation, remarkably reduce the irragularity of dose distribution duo to the thickness of body and magnify the effect of radiation therapy.

  • PDF

A Novel Fluoroscopic View for Positioning the AO Clavicle Hook Plate Decreases Its Associated in situ Complications

  • Hyun, Yoon-Suk;Kim, Gab-Lae;Choi, Sang-Min;Shin, Woo-Jin;Seo, Dong-Yeon
    • Clinics in Shoulder and Elbow
    • /
    • v.19 no.1
    • /
    • pp.25-32
    • /
    • 2016
  • Background: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. Methods: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. Results: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. Conclusions: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.