• Title/Summary/Keyword: fracture patterns

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The Patterns of Intraosseous Venography before Percutaneous Vertebroplasty for Osteoporotic Compression Fractures

  • Kim, Dong-Sung;Doh, Jae-Won;Lee, Kyeong-Seok;Yoon, Seok-Mann;Shim, Jai-Joon;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.288-293
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    • 2008
  • Objective : Bone cement leakage is a well-known potential complication of percutaneous vertebroplasty (PVP) in patients with osteoporotic compression fracture. Even though there has been a controversy in the efficacy of antecedent venography to prevent this complication, many authors have performed intra osseous venography before bone cement injection. The goal of this study was to classify the venous drainage patterns of spine before PVP, and compare their patterns at different vertebral levels. Methods : The authors retrospectively reviewed 1,042 intraosseous venographic patterns in 321 patients with 574 osteoporotic compression fractures during six-year period in one institution. To classify venogram patterns, we selected simple lateral X-ray of spine taken immediately after injection of the contrast dye. We classified the venography patterns according to contrast leakage pattern and leakage direction as follows; trabecular (TR), trabecular anterior (TA), trabecular posterior (TP), trabecular anterior-posterior (TAP), trabecular lateral (TL), venous anterior(VA), venous posterior (VP), venous anterior-posterior (VAP), soft tissue (ST). Also, we compared venogram patterns according to different spinal levels. Results : In overall, the most common pattern was TP type accounting for 37.4% (390/1042) of all intraosseous venograms. This is followed by TAP in 21.5%, TR 17.4%, TA 116%, TL 5.8%, ST 4.1%, VA 1.2%, VP 0.6%, and VAP 0.4% in descending order of frequency. According to the spinal level, TR and TAP types were most common in thoracic spine (T6-T10), TP type was most common in thoraco-Iumbar spine (T11-L2), and TP and TAP types were most common in lumbo-sacral spine (L3-S1). Contrast dye leakage to soft tissue such as psoas muscle or disc were detected in 43 (4.1%) venograms. Direct venous drainage without staining of vertebral body was found in 23 (2.2%) venograms. The 8.3% of thoracic venogram showed direct venous drainage. Thoracic level showed a more tendency of direct venous drainage than other spine levels (p<001). Conclusion : The authors propose a new classification system of intra osseous venography during PVP. The trabecular-posterior (TP) type is most common through all spine, and venous-filling (V) type was most frequent in thoracic spine. Further study would be necessary to elucidate the efficacy of this classification system to prevent bone cement leakage during PVP.

Fracture patterns in the maxillofacial region: a four-year retrospective study

  • Park, Kyung-Pil;Lim, Seong-Un;Kim, Jeong-Hwan;Chun, Won-Bae;Shin, Dong-Whan;Kim, Jun-Young;Lee, Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.6
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    • pp.306-316
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    • 2015
  • Objectives: The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods: A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results: The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion: This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures.

Fatigue fracture of different dental implant system under cyclic loading (반복하중에 따른 수종 임플란트의 피로파절에 관한 연구)

  • Park, Won-Ju;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.424-434
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    • 2009
  • Statement of problem: Problems such as loosening and fractures of retained screws and fracture of implant fixture have been frequently reported in implant prosthesis. Purpose: Implant has weak mechanical properties against lateral loading compared to vertical occlusal loading, and therefore, stress analysis of implant fixture depending on its material and geometric features is needed. Material and methods: Total 28 of external hexed implants were divided into 7 of 4 groups; Group A (3i, FULL $OSSEOTITE^{(R)}$Implant), Group B (Nobelbiocare, $Br{\aa}nemark$ $System^{(R)}$Mk III Groovy RP), Group C (Neobiotec, $SinusQuick^{TM}$ EB), Group D (Osstem, US-II). The type III gold alloy prostheses were fabricated using adequate UCLA gold abutments. Fixture, abutment screw, and abutment were connected and cross-sectioned vertically. Hardness test was conducted using MXT-$\alpha$. For fatigue fracture test, with MTS 810, the specimens were loaded to the extent of 60-600 N until fracture occurred. The fracture pattern of abutment screw and fixture was observed under scanning electron microscope. A comparative study of stress distribution and fracture area of abutment screw and fixture was carried out through finite element analysis Results: 1. In Vicker's hardness test of abutment screw, the highest value was measured in group A and lowest value was measured in group D. 2. In all implant groups, implant fixture fractures occurred mainly at the 3-4th fixture thread valley where tensile stress was concentrated. When the fatigue life was compared, significant difference was found between the group A, B, C and D (P<.05). 3. The fracture patterns of group B and group D showed complex failure type, a fracture behavior including transverse and longitudinal failure patterns in both fixture and abutment screw. In Group A and C, however, the transverse failure of fixture was only observed. 4. The finite element analysis infers that a fatigue crack started at the fixture surface. Conclusion: The maximum tensile stress was found in the implant fixture at the level of cortical bone. The fatigue fracture occurred when the dead space of implant fixture coincides with jig surface where the maximum tensile stress was generated. To increase implant durability, prevention of surrounding bone resorption is important. However, if the bone resorption progresses to the level of dead space, the frequency of implant fracture would increase. Thus, proper management is needed.

Alteration of Trabecular Bone Microarchitecure at Tibial Epiphysis due to Knee Joint Instability by Anterior Cruciate Ligament Rupture: Difference between Medial and Lateral Part (전방십자인대 손상으로 인한 슬관절 불안정성에 따른 경골 골단 해면골 미세구조 변화 : 내방과 외방에서의 해면골 미세구조 패턴 변화)

  • Lee, Joo-Hyung;Chun, Keyoung-Jin;Kim, Han-Sung;Lim, Do-Hyung
    • Journal of Biomedical Engineering Research
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    • v.33 no.2
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    • pp.78-88
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    • 2012
  • Knee joint instability by anterior cruciate ligament(ACL) rupture is allowing the abnormal loading condition at the tibial epiphysis locally, resulting in producing locally different bone bruise. The study examined difference between local alteration patterns of trabecular bone microarchitecture at medial and lateral parts of the tibial epiphysis by ACL rupture. Fourteen SD rats were divided into Control(CON; n = 7) and Anterior Cruciate Ligament Transection(ACLT; n = 7) groups. The tibial joints were then scanned by in vivo ${\mu}$-CT at 0, 4, and 8 weeks post-surgery. The results showed that alteration pattern on trabecular bone microarchitecture at medial part was significantly higher than that at lateral part of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). Tb.Th and Tb.Sp distributions were well corresponded with differences between aforementioned trabecular bone microarchitectural alteration pattens at medial and lateral parts of the tibial epiphysis in ACLT group from 0 to 8 weeks(P < 0.05). These findings suggest that the alteration patterns of trabecular bone microarchitecture should be locally and periodically considered, particularly with respect to the prediction of bone fracture risk by ACL rupture. Improved understanding of the alteration patterns at medial and lateral trabecular bone microarchitectures at the tibial epiphysis may assist in developing more targeted treatment interventions for knee joint instability secondary to ACL rupture.

A large scale simulation of floe-ice fractures and validation against full-scale scenario

  • Lu, Wenjun;Heyn, Hans-Martin;Lubbad, Raed;Loset, Sveinung
    • International Journal of Naval Architecture and Ocean Engineering
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    • v.10 no.3
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    • pp.393-402
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    • 2018
  • While interacting with a sloping structure, an ice floe may fracture in different patterns. For example, it can be local bending failure or global splitting failure depending on the contact properties, geometry and confinement of the ice floe. Modelling these different fracture patterns as a natural outcome of numerical simulations is rather challenging. This is mainly because the effects of crack propagation, crack branching, multi fracturing modes and eventual fragmentation within a solid material are still questions to be answered by the on-going research in the Computational Mechanic community. In order to simulate the fracturing of ice floes with arbitrary geometries and confinement; and also to simulate the fracturing events at such a large scale yet with sufficient efficiency, we propose a semi-analytical/empirical and semi-numerical approach; but with focus on the global splitting failure mode in this paper. The simulation method is validated against data we collected during the Oden Arctic Technology Research Cruise 2015 (OATRC2015). The data include: 1) camera images based on which we specify the exact geometry of ice floes before and after an impact and fracturing event; 2) IMU data based on which the global dynamic force encountered by the icebreaker is extracted for the impact event. It was found that this method presents reasonably accurate results and realistic fracturing patterns upon given ice floes.

The Study of Nondestructive Test about Impact Damage of Plate Composite Materials (판형 복합재료의 충격 손상에 대한 비파괴시험적 고찰)

  • 나성엽;김재훈;최용규;류백능
    • Journal of the Korean Society of Propulsion Engineers
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    • v.5 no.4
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    • pp.20-30
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    • 2001
  • This study represents the Nondestructive Test about impact damage of composite materials made by different lay-up patterns and degrees. For this study, they were examined by the drop test on composite materials of two type lap-up patterns with fabric and unidirectional prepreg and examined nondestructive test of those. Nondestructive methods were X-ray test with $ZnI_2$ penetrant and Ultrasonic C-scan. The defect detectability of X-ray and Ultrasonic test was compared according to defect species. And the amounts of damage on impacted zone wert compared according to impact energy on two type test specimens. At results, Ultrasonic test was more effective to detect delamination and Penetrant X-ray test was more effective to detect matrix crack and fiber fracture. There were some differences in defect shapes and grades according to lay-up patterns and degrees, and the trend appeared that matrix crack, delamination, fiber fracture occured and increasing defects sizes according to increasing impact energy.

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Fracture resistance of ceramic brackets to arch wire torsional force (토오크 양에 따른 세라믹 브라켓의 파절 저항성)

  • Han, Jung-Heum;Chang, Minn-Hii;Lim, Yong-Kyu;Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.37 no.4
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    • pp.293-304
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    • 2007
  • The purpose of this study was to estimate the fracture resistance of commercially available ceramic brackets to torsional force exerted from arch wires and to evaluate the characteristics of bracket fracture. Methods: Lingual root torque was applied to maxillary central incisor brackets with 0.022-inch slots by means of a $022\;{\times}\;028-inch$ stainless steel arch wire. A custom designed apparatus that attached to an Instron was used to test seven types of ceramic brackets (n = 15). The torque value and torque angle at fracture were measured. In order to evaluate the characteristics of failure, fracture sites and the failure patterns of brackets were examined with a Scanning Electron Microscope. Results: Crystal structure and manufacturing process of ceramic brackets had a significant effect on fracture resistance. Monocrystalline alumina (Inspire) brackets showed significantly greater resistance to torsional force than polycrystalline alumina brackets except InVu. There was no significant difference in fracture resistance during arch wire torsional force between ceramic brackets with metal slots and those without metal slots (p > 0.05). All Clarity brackets partially fractured only at the incisal slot base and the others broke at various locations. Conclusion: The fracture resistance of all the ceramic brackets during arch wire torsion appears to be adequate for clinical use.

Pattern of Shear-induced Fracture Development in en Echelon Array : Discrete-element Approach (전단변형 시 안행상 균열의 끝에서 형성되는 새로운 균열 발달 형태 연구 : 개별요소적 접근)

  • Kwon, Soondal;You, Seungwan;Kwon, Sanghoon;Kim, Ki-seog
    • Tunnel and Underground Space
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    • v.25 no.4
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    • pp.359-372
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    • 2015
  • Rock masses include various rock discontinuities such as faults, joints, and bedding planes. These discontinuities appear as complex structures in geometry. In this study, growth patterns of fractures between two stepping shear fracture tips are numerically modeled using PFC2D (Particle Flow Code). The numerical model showed not only incipient growth of fractures at the tips of preexisting fractures but also subsequent growth of the new fractures. It is observed from all of the experiments that the incipient fractures are tensile cracks developed at $30{\sim}57^{\circ}$ to the preexisting fractures and the subsequent growth of these fractures were at low angles to the preexisting fractures this study.

Clinical and Radiological Outcome after Surgical Treatment in Displaced Clavicular Midshaft Fracture

  • Gwak, Heui-Chul;Kim, Jung-Han
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.73-77
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    • 2016
  • Background: The first purpose of this study is to compare the clinical and radiological outcomes of surgical treatment for displaced midshaft clavicle fracture (Robinson type 2B1 vs. 2B2) with 3.5-mm low profile clavicular locking compression plate. The second purpose is to evaluate the difference of the results depending on the presence of accompanying injuries. Methods: Forty-nine patients who underwent an operation for the fractures were reviewed retrospectively. Fracture patterns were classified according to group 2B1 and 2B2 using Robinson's classification. For radiological outcome, time to union after operation was evaluated and for clinical outcome, American Shoulder and Elbow Society (ASES) score, University of California in Los Angeles (UCLA) score, visual analogue scale (VAS), and range of motion (ROM) were evaluated from preoperative period to last follow-up period. Results: The mean time for union was not significantly different in the 2B1 group and 2B2 group (p=0.062). No statistically significant difference in ASES score, UCLA score, and VAS was observed between 2B1 and 2B2 (p=0.619, p=0.896, p=0.856, respectively). In ROM, significant higher mean forward flexion and abduction was observed in 2B2 (p=0.025, p=0.017, respectively) and there was no difference in external rotation and external rotation at shoulder $90^{\circ}$ abduction position (p=0.130, p=0.180, respectively). There was no significant difference in clinical outcomes according to the accompanying injuries. Conclusions: There was no difference in clinical and radiological outcome between Robinson 2B1 and 2B2 type fracture after the operation. Accompanying injuries may not affect the clinical result of displaced midshaft clavicle fractures.

The Effect of Traditional Korean Medicine Treatment and Herbal Network Analysis in Postoperative Hip Fracture Inpatients (고관절 골절 수술 후 한의 입원치료 효과 및 다빈도 처방 약재 네트워크 분석)

  • Oh, Jihong;Lee, Myeong-Jong;Kim, Hojun
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.119-129
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    • 2022
  • Objectives This study aimed to evaluate the effects of Integrative treatment of traditional Korean medicine (TKM) on 7 hospitalized patients after hip fracture surgery, and to identify significant herbs and co-prescribed herbs by using network analysis and association rule mining. Methods A retrospective chart review of the 7 hospitalized patients treated for postoperative hip fractures between January and December 2021 was performed. All TKM treatments for the patients were identified and Wilcoxon signed-rank test was performed to compare hip pain and mobility on admission and discharge. We visualized the network of herbal medicines and complications. By using network analysis, we also identified the significant herbs (high centrality of degree, eigenvector, and sub-graph). Co-prescription patterns for the hip fracture patients were further analyzed by association rule mining. Results We found that TKM treatment significantly relieved hip pain and improved mobility. Accompanying symptoms reported by the patients were general weakness, anorexia, dizziness, delirium, edema, sputum, sore throat, cough, rhinorrhea, and chills. Herbs composed of Sagunja-tang and Samul-tang showed high centralities and high associations with other herbs. In addition, Gupan, Nokyong, Yukjongyong, Useul, and Hyunhosaek were identified as important herbs for postoperative hip fracture patients. Conclusions This study provides evidence for clinical TKM use as an effective postoperative treatment for pain relief and improvement of mobility in patients with hip fractures. In addition, herbs that can be considered in the treatment of patients after hip fracture surgery were identified through network analysis and association rule mining.