• Archives of Reconstructive Microsurgery
• /
• v.9 no.1
• /
• pp.49-55
• /
• 2000

Nonunion and avascular necrosis are well-recognized complications of severe ankle injury especially aftrer talar neck fracture. The treatment of avascular necrosis is controversial and methods of treatment are limited. Many modalities have been introduced for the treatment of avascular necrosis of talus. The prolonged non-weight bearing for 2~3 years is not practical but also is occasionally complicated by late segmental collapse. Operative treatment includes tibiotalar arthrodesis and talectomy with tibiocalcaneal arthrodesis, but arthrodesis in patients with talar avascular necrosis is technically demanding and cause stiff, immobile foot and relatively high failure rate was reported. It is desirable to preserve their original joint if possible. Vascularized fibular grafting has been reported as a joint preserving treatment option for osteonecrosis of the hip but has not been described for the ankle. The authors applied free vascularized fibular grafts for 3 cases of avascular necrosis of talus. We observed evidences of revascularization of necrotic talar body and progression of fracture healing and obtained satisfactory results at mean 8 months of follow-up. Vascularized fibular grafting is one of the better alternatives for treating avascular necrosis of talus. It is expected that vascularized fibular grafting can prevent the necrotic talar dome from progressing to collapse and promote directly restored vascularization and new bone formation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.2
• /
• pp.224-227
• /
• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.4
• /
• pp.318-323
• /
• 2020

Purpose: To examine the relationship between total fat infiltration (TFI) rate, which quantifies the reduction of muscles around the spine and is an important factor for sarcopenia, and the factors affecting osteoporotic vertebral compression fracture. Materials and Methods: Patients treated for osteoporotic compression fractures of the lumber spine from January 2012 to December 2016 were analyzed retrospectively. Among them, this study included ninety-eight patients who were 1) diagnosed with osteoporosis with a bone mineral density (BMD) T score of less than 2.5 g/cm², 2) received vertebroplasty or kyphoplasty for lumbar fractures, 3) involved one segment of the lumbar spine, and 4) were followed-up for more than one year. The TFI rate confirmed by analyzing magnetic resonance imagings with the Image J program was studied. Based on this, the relationship between the TFI of the multifidus and erector spinae muscles and the factors of osteoporosis were analyzed. Results: The mean TFI of the multifidus and erector spinae was 14.66±10.16. The spine BMD showed a positive correlation with the hip BMD, but a negative correlation with the TFI. A positive correlation was observed between the hip BMD and body mass index. In addition, vitamin D was positively correlated with both the hip and spine BMD but negatively correlated with the TFI rate. Conclusion: Muscle growth helps treat osteoporosis, and can prevent fractures that occur frequently in osteoporosis patients. Increasing the vitamin intake can also slow the progression of muscle atrophy.

• Journal of Powder Materials
• /
• v.26 no.6
• /
• pp.508-514
• /
• 2019

In the development of advanced ceramic tools, material improvements and design freedom are critical in improving tool performance. However, in the die press molding method, many factors limit tool design and make it difficult to develop innovative advanced tools. Ceramic 3D printing facilitates the production of prototype samples for advanced tool development and the creation of complex tooling products. Furthermore, it is possible to respond to mass production requirements by reflecting the needs of the tool industry, which can be characterized by small quantities of various products. However, many problems remain in ensuring the reliability of ceramic tools for industrial use. In this study, alumina inserts, a representative ceramic tool, was manufactured using the digital light process (DLP), a 3D printing method. Alumina inserts prepared by 3D printing are pressurelessly sintered under the same conditions as coupon-type specimens prepared by press molding. After sintering, a hot isostatic pressing (HIP) treatment is performed to investigate the effects of relative density and microstructure changes on hardness and fracture toughness. Alumina inserts prepared by 3D printing show lower relative densities than coupon specimens prepared by powder molding but indicate similar hardness and higher fracture toughness values.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.3
• /
• pp.244-253
• /
• 2019

Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

• Journal of Veterinary Clinics
• /
• v.36 no.1
• /
• pp.53-61
• /
• 2019

Total hip arthroplasty (THA) is a successful surgical treatment for both patients with chronical lameness and dogs who are nonresponsive to medical treatments, providing excellent joint function for returning dogs to the normal gait in 80% to 98% of hip dysplasia (HD) patients. The THA surgical implant system manufactured by BioMedtrix and Kyon are today widely accepted. When comparing the BioMedtrix biological fixation (BFX) system to the BioMedtrix cemented fixation (CFX) system, the many advantages of BFX, which include longer potential implant life, decreased risk of postoperative or later infection, and better implant stability, become evident. However, BFX implies a greater risk of femoral fracture during reaming and requires a more precise surgical technique to achieve good implant fit, given the press-fit nature of cementless THA. The purposes of this study are to both describe the mistakes and complications during stem implantation for beginner surgeons with both the BFX and the CFX systems and to document the initial result of 12 implantations in canine cadavers. Given the detailed evaluations of 3 specialists, who are Diplomate American College of Veterinary Surgeons (DACVS), only 3 of 11 stems were appropriately sized. Specifically, 6 stems were anteverted rather than being retroverted; further, although 7 stems were coaxial with the femoral long axis in the frontal plane, the other stems were in the varus at the frontal plane, with the proximal medial stem adjacent to the medial femoral cortex. Moderate angulation from the cranial to the caudal directions was found in 4 cases in the sagittal plane. Additionally, 1 case of femoral fissure and 1 case of perforated femoral cortex were reported. It is not easy for surgeons performing cementless THA for the first time to achieve a good result, even though they completed an educational course about it and given that catastrophic complications often occurred during early surgical clinical cases. Therefore, ex-vivo studies are sincerely required to get an expertise by rehearsing the preparation of the femoral envelop in isolated bones. Further studies should be conducted to achieve both highly accurate implant size and correct orientation during the preoperative planning. Additionally, surgeons' learning curve should be examined in future investigations.

• Biomaterials and Biomechanics in Bioengineering
• /
• v.2 no.4
• /
• pp.197-206
• /
• 2015

This paper presents three-dimensional finite element method analyses of the distribution of equivalents stress of Von Mises. Induced around a cavity located in the bone cement polymethylmethacrylate (PMMA). The presences and effect of its position in the cement was demonstrated, thus on the stress level and distribution. The porosity interaction depending on their positions, and their orientations on the interdistances their mechanical behaviour of bone cement effects were analysed. The obtained results show that micro-porosity located in the proximal and distal zone of the prosthesis is subject to higher stress field. We show that the breaking strain of the cement is largely taken when the cement, containing the porosities very close adjacent to each other.

• 대한예방의학회:학술대회논문집
• /
• 2005.10a
• /
• pp.304-304
• /
• 2005

• Journal of the Korean Society of Manufacturing Process Engineers
• /
• v.12 no.4
• /
• pp.3-9
• /
• 2013

Falling related injuries are categorized as the most serious and common medical problems experienced by the elderly. Hip joint fracture, one of the most serious consequences of falling in the elderly, occurs in only about 1% of falling. In this study, according to the loading conditions, the analysis is the behavior of the femur. The CT images using the commercial program "Mimics" the bones of three-dimensional CAD data generated, and we will analyze the results of finite element analysis. The boundary conditions on the basis of existing research has been simplified. In this paper, the whole femur was assumed to be isotropic linear elastic material. Predicted the behavior of the femur according to the loading condition, it can be help the development of high-precision artificial bones and joints can be treated with surgery and will be able to perform efficiently.

• 대한예방의학회:학술대회논문집
• /
• 2002.10a
• /
• pp.256-257
• /
• 2002