• Title/Summary/Keyword: mechanical fixation

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The Timing of Femur Fracture Fixation is an Important Factor for Prolonged Mechanical Ventilation

  • Choi, Hyung Chul;Jung, Kwang Hwan;Kyoung, Kyu Hyouck;Choi, Seong Ho
    • Journal of Trauma and Injury
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    • v.32 no.4
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    • pp.220-225
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    • 2019
  • Purpose: Mechanical ventilation (MV) is an essential life-saving modality for severely injured patients. However, the long-term use of MV is a major risk factor for late mortality. The surgical correction of long bone fractures plays a critical role not only in improving functional outcomes, but also in reducing physiological derangements, including MV duration. This study investigated the factors affecting prolonged MV (PMV) in severely injured patients with femur fractures. Methods: We retrospectively evaluated all severely injured patients (injury severity score >15) with femur fractures who were taken to the emergency department within 12 hours of the causative accidents between January 2016 and December 2018. PMV was defined as MV lasting for ≥7 days. We analyzed the factors affecting PMV. Results: In total, 35 patients were enrolled and 21 (33.3%) were included in the PMV group. The PMV group required more red blood cell (RBC) transfusions within 7 days RBC (7dRBC) (12.8 vs. 6.8 units; p=0.03) and the time to femur fracture fixation (TFFF) was longer (7.9 vs. 2.7 days; p=0.018). The area under the curve (AUC) for TFFF was 0.740 (95% confidence interval [CI]: 0.572-0.908; p=0.018) and the AUC for 7dRBC was 0.718 (95% CI: 0.546-0.889; p=0.031). Conclusions: This study indicates that TFFF is an independent risk factor for PMV. Early fixation of femur fractures might prevent PMV and its associated complications.

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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    • v.38 no.5
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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.

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

  • Yoon, Bum-Chul;Lee, Myoung-Hwa;Kim, Nan-Soo;Hong, Hye-Jung;Yu, Byong-Kyu
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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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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The Change of Biomechanical Milieu after Removal of mstnnnentation in lrunbar Arthrodesis Stiffness of fusion Mass: Finite Element Analysis (척추 유합술 후, 인접 분절의 스트레스에 대한 척추경 나사못에 대한 영향)

  • Kang, Kyoung-Tak;Chun, Heoung-Jae;Son, Ju-Hyun;Kim, Ho-Joong
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.664-667
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    • 2008
  • Since the advent of pedicle screw fixation system, posterior spinal fusion has markedly increased This intemal fixation system has been reported to enhance the fusion rates, thereby becoming very popular procedure in posterior spinal arthrodesis. Although some previous studies have shown the complications of spinal instruments removal, i.e. loss of correction and spinal collapse in scoliosis or long spine fusion patients, there has been no study describing the benefit or complications in lumbar spinal fusion surgery of one or two level. In order to clarify the effect of removal of instruments on mechanical motion profile, we simulated a finite element model of instrumented posterolateral fused lumbar spine model, and investigated the change of mechanical motion profiles after the removal of instrumentation.

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A Study on Development of Humeral Intramedullary Fixation Nail based on Korean Cadaver Tests (한국인 Cadaver Test에 대한 상완골 골수정 개발에 관한 연구)

  • Chon, Chang-Soo;Lee, Jae-Won;Ko, Cheol-Woong;Oh, Jong-Keon;Woo, Soo-Heon;Lee, Sung-Jae
    • Journal of the Korean Society for Precision Engineering
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    • v.28 no.8
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    • pp.984-991
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    • 2011
  • The aim of this study is to develop a humeral Intramedullary fixation nail (HIFN) suitable for Korean people. In this study, CT images were obtained from 72 Korean cadaveric humeral bones and 3D Korean humeral bone models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of HIFN were selected using the morphological measurement information of the Korean humeral bone models. Through finite element analysis and mechanical tests, the developed HIFN prototype was compared with the Polarus HIFN ($ACUMED^{(R)}$, USA), and it was found that the HIFN prototype showed similar and/or superior mechanical performance compared to the Polarus HIFN. Also, clinical validation for the HIFN prototype was carried out to check predictable troubles in surgical operations. Finally, optimal design modification was proposed to prevent the possible axillary nerve injury due to the locking screw system of the HIFN prototype.

Comparison of changes in ventilation volume according to fixation method of I-gel during cardiopulmonary resuscitation: a study using a simulated manikin (심폐소생술 시 아이젤의 고정 방법에 따른 환기량의 변화 비교: 시뮬레이션 마네킨을 이용한 연구)

  • Kim, Seon Tae;Shin, Sang-Yol;Choi, Jeong Woo
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.7-16
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    • 2021
  • Purpose: The I-gel device is Korea's most frequently used airway management method during pre-hospital cardiopulmonary resuscitation (CPR). This study aimed to compare changes in ventilation volume according to the fixation method with a simulated manikin. Methods: We placed I-gel into an advanced life support simulator and compared tape and band fixation conditions. CPR was performed according to the 2020 Korean CPR guidelines, using a mechanical chest compression device and an adult bag. The positional shift of I-gel and the ventilation volume of the simulated manikin were measured after performing CPR for 20 minutes. Five trials were carried out in each setting. Statistical analysis was carried out with SPSS 27.0. P < .05 was considered significant. Results: Positional shift after 20 minutes of CPR was as follows: tape fixation, 7.2 ± 0.2 mm; band fixation, no change, indicating a significant difference between the two groups (p=.003). The mean ventilation volume was tape fixation, 482.63 ± 30.84 mL; band fixation, 544.96 ± 22.98 mL, showing a significant difference (p=.002). Conclusion: When using the I-gel during pre-hospital CPR, using a band-type fixing device with elasticity rather than fixing the tape provides stable and appropriate ventilation by maintaining the fixed position.

PHILOS plate fixation with polymethyl methacrylate cement augmentation of an osteoporotic proximal humerus fracture

  • Kim, Do-Young;Kim, Tae-Yeong;Hwang, Jung-Taek
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.156-158
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    • 2020
  • PHILOS plate fixation in osteoporotic proximal humerus fracture of old age is well-known for high complication rate, especially metal failure, providing various augmentation techniques, such as calcium phosphate cement, allogenous or autologous bone graft. We report a case of polymethyl methacrylate augmentation to provide appropriate reduction with a significant mechanical support. This can be a treatment option for displaced unstable osteoporotic proximal humerus fracture with marked bony defect.

Enhancing anti-calcification efficacy in veterinary cardiovascular surgeries: evaluating short-term ethanol's role in glutaraldehyde fixed pericardial tissues in rats

  • Kyung-Min Kim;Won-Jong Lee;Woo-Jin Kim;Chang-Hwan Moon;Jaemin Jeong;Hae-Beom Lee;Seong-Mok Jeong;Dae-Hyun Kim
    • Korean Journal of Veterinary Research
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    • v.64 no.2
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    • pp.16.1-16.9
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    • 2024
  • Autologous pericardial tissues are utilized in veterinary cardiovascular surgeries due to their accessibility and effectiveness. To enhance handling and biomechanical properties, glutaraldehyde (GA) fixation is applied. However, GA fixation can induce calcification, leading to tissue failure. This study aimed to establish an optimal rapid anti-calcification protocol by integrating ethanol treatment with the proven effective GA concentration and fixation time, facilitating application from collection to utilization. Pericardia were fixed with 0.625% GA for 20 min and subjected to ethanol treatment for 0 (group A, control), 20 (group B), and 30 minutes (group C). The treated tissues underwent mechanical test and were implanted subcutaneously in 3-week-old male rats for 7 weeks before extraction, followed by calcium analysis and histological examination via hematoxylin and eosin staining. No significant differences in mechanical properties were observed among the groups. The ethanol-treated groups (groups B and C; p < 0.05) exhibited significantly lower calcium levels than control (group A). Microscopy confirmed collagen and elastic fibers preservation, without significant immune cell variance. However, higher fibrocyte presence was noted in the ethanol-treated groups. This study presents a rapid anti-calcification protocol combining ethanol treatment with optimal GA fixation, suitable for direct surgical use of autologous tissues. Further research is necessary for long-term efficacy evaluation.

Enhancement and Evaluation of Fatigue Resistance for Spine Fixation System (척추고정장치의 피로성능 평가와 향상)

  • Kim, Hyun-Mook;Kim, Sung-Kon
    • Journal of the Korean Society for Precision Engineering
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    • v.26 no.8
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    • pp.142-147
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    • 2009
  • Spinal fixation systems provide surgical versatility, but the complexity of their design reduces their strength and fatigue resistance. There is no published data on the mechanical properties of such screws. Screws were assembled according to a vertebrectomy model for destructive mechanical testing. A group of two assemblies was tested in static compression. One group was applied to surface a grit blasting method and another group was applied to surface a bead blasting method. Modes of failure, yield, and ultimate strength, yield stiffness, and cycles to failure were determined for six assembles. Static compression 2% offset yield load ranges was from 327 to 419N. Fatigue loads were determined two levels, 37.5% and 50% of the average load from static compression ultimate load. An assembly of bead blasting treatment only achieved 5 million cycles at 37.5% level in compression bending.

Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture (외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술)

  • Bae, Jang-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.234-242
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    • 1996
  • Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and hone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient arc remained back pain. According to above results we concluded that anterolateral internal fixation combined with hone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.

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