• 제목/요약/키워드: fracture/fracture criteria

검색결과 333건 처리시간 0.037초

골다공증 유병률, 인지율, 치료율 및 영향요인의 성별 비교: 국민건강영양조사 자료(2008~2011년) 활용 (Gender Difference in Osteoporosis Prevalence, Awareness and Treatment: Based on the Korea National Health and Nutrition Examination Survey 2008~2011)

  • 김윤미;김정환;조동숙
    • 대한간호학회지
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    • 제45권2호
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    • pp.293-305
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    • 2015
  • Purpose: The aim of the study was to assess and identify gender differences in factors associated with prevalence, awareness, and treatment of osteoporosis. Methods: Data for 3,071 men and 3,635 women ($age{\qeq}50$) from the Korea National Health and Nutrition Examination Survey 2008~2011 were included. Osteoporosis was defined by World Health Organization T-score criteria. Impact factors and odds ratios were analysed by gender using multivariate logistic regression. Results: Osteoporosis prevalence rates were 7.0% in men and 40.1% in women. Osteopenia rates were 45.5% and 46.0% respectively. Among respondents with osteoporosis, 7.6% men and 37.8% women were aware of their diagnosis. Also 5.7% men with osteoporosis and 22.8% women were treated. Higher prevalence was found among respondents who were older, at lower socioeconomic levels, with lower body mass index and shorter height in both genders, and among women with fracture history, and non-hormonal replacement therapy. Awareness and treatment rates for the risk groups were similar compared to the low risk controls for both genders. Fracture history increased awareness and treatment rates independently for both genders. Women with perceived poor health status and health screening had increased awareness and treatment rates, but not men. Conclusion: Results indicate that postmenopausal women have a higher prevalence of osteoporosis than men and awareness and treatment rates were higher than for men. Despite gender difference in prevalence, osteoporosis was underdiagnosed and undertreated for both genders. Specialized public education and routine health screenings according to gender could be effective strategies to increase osteoporosis awareness and treatment.

Numerical simulations of progression of damage in concrete embedded chemical anchors

  • Sasmal, S.;Thiyagarajan, R.;Lieberum, K.H.;Koenders, E.A.B.
    • Computers and Concrete
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    • 제22권4호
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    • pp.395-405
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    • 2018
  • In this paper, the performance of post-installed adhesive bonded anchor embedded in concrete is assessed using numerical simulations. This study aims at studying the influence of parameters on the performance of a chemically bonded anchorage system. Non-linear finite element modelling and simulations are carried out by properly using the material properties and phenomenon. Materials parameters such as characteristic length, fracture energy, damage criteria, tension retention and crack width of concrete and interface characteristics are carefully assigned so as to obtain a most realistic behaviour of the chemical anchor system. The peak strength of two different anchor systems obtained from present numerical studies is validated against experimental results. Furthermore, validated numerical models are used to study the load transferring mechanism and damage progression characteristics of various anchors systems where strength of concrete, strength of epoxy, and geometry and disposition of anchors are the parameters. The process of development of strain in concrete adjacent to the anchor and energy dissipated during the course of damage progression are analysed. Results show that the performance of the considered anchorage system is, though a combined effect of material and geometric parameters, but a clear distinction could be made on the parameters to achieve a desired performance based on strength, slip, strain development or dissipated energy. Inspite the increase in anchor capacity with increase in concrete strength, it brings some undesirable performance as well. Furthermore, the pullout capacity of the chemical anchor system increases with a decrease in disparity among the strength of concrete and epoxy.

Comparison of Posterior Fixation Alone and Supplementation with Posterolateral Fusion in Thoracolumbar Burst Fractures

  • Hwang, Jong-Uk;Hur, Jin-Woo;Lee, Jong-Won;Kwon, Ki-Young;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.346-352
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    • 2012
  • Objective : We compared the radiological and clinical outcomes between patients who underwent posterior fixation alone and supplemented with fusion following the onset of thoracolumbar burst fractures. In addition, we also evaluated the necessity of posterolateral fusion for patients treated with posterior pedicle screw fixation. Methods : From January 2007 to December 2009, 46 consecutive patients with thoracolumbar burst fracture were included in this study. On the basis of posterolateral fusion, we divided our patients into the non-fusion group and the fusion group. The radiological assessment was performed according to the Cobb's method, and results were obtained at immediately, 3, 6, 12 months after surgery. The clinical outcomes were evaluated using the modified Mcnab criteria at the final follow-up. Results : The demographic data and the mean follow-up period were similar between the two groups. Patients of both groups achieved satisfactory clinical outcomes. The mean loss of kyphosis correction showed that patients of both groups experienced loss of correction with no respect to whether they underwent the posterolateral fusion. There was no significant difference in the degree of loss of correction at any time points of the follow-up between the two groups. In addition, we also compared the effect of fixed levels (i.e., short versus long segment) on loss of correction between the two groups and there was no significant difference. There were no major complications postoperatively and during follow-up period. Conclusion : We suggest that posterolateral fusion may be unnecessary for patients with thoracolumbar burst fractures who underwent posterior pedicle screw fixation.

레일강의 균열발생·천이 및 피로균열진전거동 (Behavior of the Crack Initiation, Transition and Fatigue Crack Growth of Rail Steel)

  • 이종선;강기원;최린;김정규
    • 한국강구조학회 논문집
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    • 제11권1호통권38호
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    • pp.33-42
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    • 1999
  • 궤도용 차량의 안전성 확보를 위한 연구의 일환으로서 레일강의 균열 발생 조건과 모재와 용접부에 대한 정적파괴거동 및 단일모드 하중하의 피로균열진전거동을 검토하였다. 레일에서 횡방향 균열의 원점은 표면하층균열이며 이는 최대전단응력에 의해 발생하였다. 또한 표면하층균열의 크기가 증가함에 따라 균열의 진전은 전단모드에서 혼합모드로 천이될 가능성이 증가하였다. 용접부의 평면변형률 파괴인성은 조직의 조대화와 경도의 상승으로 인하여 모재에 비하여 약 10% 저하하였다. 용접부의 제 2단계 영역의 피로 균열진전속도는 낮은 ${\Delta}K$ 영역에서 모재에 비하여 저하하였으나 높은 ${\Delta}K$영역에서는 이의 차이가 소멸되었으며 이러한 경향은 R=0.1의 낮은 응력비에서 현저하였다. 이는 용접부의 미시조직이 모재에 비하여 성장하였기 때문이라고 판단된다.

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척추 압박골절 환자에서의 풍선 척추체 복원술의 치료 효과 (Balloon Kyphoplasty for the Treatment of Vertebral Compression Fractures)

  • 한경림;김찬;양종윤;한승탁;김의석
    • The Korean Journal of Pain
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    • 제19권1호
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    • pp.56-62
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    • 2006
  • Background: Balloon kyphoplasty is the new technique that helps to decrease the pain and improve mobility as well as restore the vertebral body height and kyphotic curve in fractured vertebrae. We evaluated the outcome of balloon kyphoplasty in the reduction of vertebral body height, kyphotic curve and clinical improvement in the patients with painful vertebral compression fractures. Methods: From July 2002 to February 2005, 84 levels of vertebral compression fractures in 66 patients were treated with balloon kyphoplasty. The assessment criteria were the changes over time in visual analogue scale (VAS) and mobility score. We evaluated the vertebral body height and kyphotic curve at preoperative 1 day and postoperative 1 day. Results: Procedures were performed in 66 patients with a total of 84 affected vertebral bodies. The anterior wall height was restored in 74 / 84 (88%) levels with a mean increment of 2.9 mm, and the mid-vertebral body height was restored in 79 / 84 (94%) levels with a mean increment of 4.2 mm. Kyphosis correction was achieved in 60 / 84 (71.4%) from 10.1 degrees to 7.5 degrees. Pain intensity reduced by 60% in one day after operation and by 75-85% in later time. Mobility scores of all patients were improved immediately after the procedure. Cement leakage occurred in 3 levels but there was no clinical problem. Conclusions: Kyphoplasty is an efficient and safe treatment of painful vertebral compression fracture in pain relief, mobility improvement, and reduction of deformity.

FRACOD를 이용한 취성 암석의 손상 및 파괴에 대한 경계요소 해석 (A Boundary Element Analysis for Damage and Failure Process of Brittle Rock using ERACOD)

  • 이희석
    • 터널과지하공간
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    • 제14권4호
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    • pp.248-260
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    • 2004
  • 응력 증가에 의한 취성 암석의 손상은 미세균열의 개시로부터 시작하여 각 개별 균열들의 전파 및 결합에 의해 거시적인 파괴면을 발생시킨다. 전통적으로 암반의 손상 및 파괴현상을 설명하기 위해 거시적인 파괴 기준이나 탄소성 모델과 같은 연속체적인 접근법이 주류를 이루어왔다. 하지만 개별적인 균열들의 개시와 전락 과정을 명시적으로 고려할 수 있다면 현상론적인 관점에서 보다 실제에 가까운 암석 손상 및 파괴 과정을 재현할 수 있을 것이다. 본 연구에서는 암석의 균열 진전 모델링을 위해 개발된 경계요소 코드인 FRACOD를 이용하여 암석의 손상 및 파괴 과정을 모사한 결과를 제시한다. 수치일축압축시험을 통해 개발된 모델의 적정성을 검증하고 암반의 치수효과를 고려한 현실적인 암석 파괴 과정을 재현하였다. 또한 이러한 접근법의 적용 사례로서, 실제 굴착이 진행중인 심부 수갱 암반 주변에서 심도와 암반 특성에 따라 균열 진전과 이에 따른 암반 손상의 범위를 예측한 결과를 제시하였다. 이 접근법은 취성도가 큰 암반에서 발생하는 안정성 문제에 대한 공학적인 해법을 찾는데 기여를 할 수 있을 것으로 기대된다.

하악골 골절에 대한 수술 시 예방적 항생제 사용과 술후 항생제 투여의 효율성 (ANTIBIOTIC PROPHYLAXIS IN THE OPERATION OF THE CLOSED MANDIBULAR FRACTURES AND THE EFFICACY OF POSTOPERATIVE ANTIBIOTICS)

  • 강상훈;최영수;변인영;김문기
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권1호
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    • pp.31-34
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    • 2009
  • Purpose: This study compared the frequency of postoperative infections in patients for a closed mandibular fracture with that without the postoperative antibiotic prophylaxis. Patients and Methods: 48 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The 24 patients in group 1 received only a second-generation cephalosporin ($Cefotetan^{(R)}$) intravenously from admission to immediate after the surgery. Likewise, 24 patients in group 2 received 1.0g of $Cefotetan^{(R)}$ twice daily longer than the third day after surgery. The mean (SD) duration of antibiotics administration after surgery was 6.9 (${\pm}3.56$). The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. Results: Postoperative infections were encountered in 2 out of 24 patients in group 1, who received antibiotic medication until shortly after surgery, and in 3 out of the 24 patients in group 2, in whom the medication was continued even after the surgery. There was no sig nificant difference in the incidence of postoperative infections between the two groups. Conclusion: From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

노인과 청장년의 족근관절 골절에 대한 임상적 비교 (Clinical Comparison of Ankle Fractures Between the Young and the Elderly)

  • 이기행;문찬웅;김윤수;김형민;정상룡
    • 대한족부족관절학회지
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    • 제9권1호
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    • pp.105-109
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    • 2005
  • Purpose: We compared the clinical features of the ankle fractures treated by operation between the elderly and the young, and reviewed the principles of treatment of the ankle fractures in the elderly. Materials and Methods: We reviewed 49 cases of the ankle fractures, which were treated by open reduction from August 1991 to July 2002. Patients aged more than 60 were designated as the elderly, and patients aged between 15 and 33 were designated as the young. The average follow-up period was 13.2 months. Using the Lauge-Hansen classification, We defined stage I or II fractures as low stage and stage III or IV fractures as high stage fractures. Results: There were 15 cases of high stage fractures (78.9%) in the elderly and 11 cases (36.7%) in the young. High stage fracture rate was significantly higher in the elderly (P=0.004). Hospital day, period between primary injury and operation, and union time were significantly longer in the elderly (P<0.001). However, there was no statistical difference in immobilization time between the two groups. The results of treatment were satisfactory clinically and radiologically by the Meyer's criteria in both groups. Conclusion: In the elderly, high stage fractures were more common and longer hospitalization and union time were needed than the young. However, the result of surgical treatment was satisfactory.

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

  • 이준영;조용진;강신욱;조영민;최현배
    • 대한족부족관절학회지
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    • 제24권1호
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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.

거골 경부 골절의 치료 (Treatment for Fracture of Neck of the Talus)

  • 손성근;김병환;박수진
    • 대한족부족관절학회지
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    • 제3권1호
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    • pp.40-48
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    • 1999
  • The neck of the talus is its most vulnerable and fragile segment, because of narrow diameter, devoid of hyaline padding and honeycombed internally by vascular channels etc. Talar neck fractures comprise 50% of all major to the talus. The majority occurs as a result of high-energy injuries, such as motor vehicle accidents or fall from a height. Anatomically, talar surface is covered mainly with articular cartilage and blood supply to the talus is very poor. So, complications, such as non-union, avascular necrosis and post traumatic arthritis, are frequent. The authors reviewed fourteen cases of talar neck fractures treated in our clinics from Jan. 1992 to Mar. 1997, and average follow-up period was over 15 months. The results obtained were as follows; 1. Patients' average age was 31.2 years. 2. The most common cause was traffic accident(9/14, 64%), and hyperdorsiflexion injury of the ankle was common mechanism of the fractures. 3. According to the modified Hawkins classification, type I was four cases, type II was nine cases, type III was one case and type IV was no case. 4. Hawkins sign of subcortical radiolucency was found in 64% (9/14) of the fractures. 5. Avascular necrosis was occurred in 21% (3/14) of the fractures(in two cases of type II fractures, and in one of type III). 6. According to the Hawkins criteria, four cases in type I, five in type II were an excellent result. Two cases, one in type II and one in type III were good result, and two in type II were fair. One in type II was poor result.

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