• 제목/요약/키워드: orthopedic force

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New Fluid Flow System for Simulation of Mechanical Loading to Bone Cells During Human Gait Cycle

  • Ahn, Jae-Mok
    • 대한의용생체공학회:의공학회지
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    • 제28권3호
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    • pp.377-386
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    • 2007
  • Mechanical loading to bone cells using simple sine wave or constant wave fluid flow has been widely used for in vitro experiments. Human gait is characterized by a complex loading to bones of lower extremities which results from a series of events consisting of heel strike, foot flat and push-off during the stance phase of the gait cycle. Telemetric force analyses have shown that human femora are subject to multiphasic loading. Therefore, it would be ideal if the physiologic loading conditions during human walking can be used for in vitro mechanotransduction studies. Here, for a mechanotransduction study, we develop it fluid flow system (FFS) in order to simulate human physiologic mechanicalloading on bone cells. The development methods of the FFS including the COR (Center for Orthopedic Research), monitor program are presented. The FFS could generate various multiphasic loading conditions of human gaits with output flow. Wall shear distribution was very uniform, with 81 % of the effective loading area of the culture on a glass slide. Our results demonstrated that the FFS, provide a new translational approach for unveiling molecular mechanotransduction pathways in bone cells.

회전근 개 파열의 봉합에서 UU 봉합법은 변형된 MA(Mason-Allen) 봉합법을 대치할 수 있는가? - UU 봉합법과 변형된 MA 봉합법의 생역학적 비교- (Is the UU Stitch Really Alternative to Modified MA (Mason-Allen) Stitch for Rotator Cuff Repair? - Biomechanical Comparative Study of UU to Modified MA Stitch -)

  • ;고상훈;박기봉;전형민;김태원;임현우;염영진
    • Clinics in Shoulder and Elbow
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    • 제12권2호
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    • pp.207-214
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    • 2009
  • 목적: 관절경 하 회전근 개 봉합에서 일반적으로 건-봉합간 접촉면 (tenon-suture interface) 에 약한부위 (weak link)가 형성되어 있어 관절경 하 회전근 개 봉합은 개방적 봉합술보다 높은 재파열율을 가진다. 이 연구의 목적은 봉합사를 뼈에 고정할 때 관절경으로 사용할 수 있는 UU (Ulsan University) 봉합과 개방적 변형 MA (Mason-Allen) 봉합의 강도를 비교하는 것이다. 대상 및 방법: 한 구의 사체 극상근 건을 채취하여 절반으로 나눈 후 다시 절반을 나누어 사체의 어깨 관절 한 구당 네 개의 건을 만들어 총 24개의 검체를 만들었다. 두 봉합 형태 (UU, MA)는 무작위로 선택하였으며 각각의 건에 시행하였다. 검체는 0.25 Hz에서 5~30N의 조절된 외력하에서 50회 주기 부하 (cyclic loading)를 받았다. 각 검체는 초당 1mm의 전이가 되는 상황하에서 파열이 발생할 때(ultimate tensile load)까지 부하를 받았다. 조건 이완 (condition elongation), peak-to-peak 전이(displacement), 기울기 (stiffness), 최대 인장력 (ultimate tensile load), 파열 양상 (mode of failure) 등을 기록하였다. 결과: 주기 부하 실험에서 두 봉합 형태 간 유의 있는 차이는 없었다. 최대 장력 실험에서 UU 봉합과 변형 MA (Mason-Allen) 봉합 간에 통계학적으로 유의한 차이는 없었다 (109.4 N, and 110.6 N). 양 봉합 형태에서 가장 흔한 파열 양상은 봉합의 빠짐 (suture pull-out)이었다. 결론: UU 봉합과 변형 MA 봉합은 유사한 생역학적 특성을 가진다.

후방 척추고정술에서 척추경 나사못의 크기와 형태가 척추 고정력에 미치는 영향에 대한 연구 (Effects of Screw Diameter and Thread Shape on the Strength of Transpedicular Screw Fixation in Posterior Spinal Fusion)

  • 문무성;류제청;유명철;김기택
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1995년도 춘계학술대회
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    • pp.23-26
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    • 1995
  • The objectives of the present study are 1)to find the effect of the diameter of transpedicular screws on their fixational strength in pedicles under static pull-out loading, 2)to determine the biomechanical correlation between the pedicle diameter and the screw diameter, and 3)to find the effects of other factors in the screw design, such as materials, screw pitch, thread height and shape on their fixational strength. Biomechanical tests (Test I) were performed to evaluate the effect of the screw diameter on pull-out strength by using 60 porcine pedicls and six groups of custom-made pedicle screws with different diameters (the major and the minor diameter of the screws used in the testing varied from 4mm upto 9mm and from 3mm upto 8mm, respectively) while all other factors (materials, screw pitch, thread height and shape etc.) were fixed. In Test II, by using 61 porcine pedicles, the relationship between the ratio of the pedicle diameter and the screw diameter(=aspect ratio) of the custum-made screw and the pull-out strength of the screw was investigated. Test III was performed with 94 porcine pedicles and 8 different types of the commercial screws from 6 major productors in order to determine the effect of the screw diameter, pitch and the thread shape on the pull-out strength of the screw, respectively. The results of Test I showed that the axial pull-out resistance of the screw could be increased prportionaly to the screw diameter(P<0.05). But this increase in the pull-out resistance did not found when the screws of 4mm or 9mm in the diameter were employed. It was found from the results of Test II that the screws had its maximum pull-out resistant force when the aspect ratio ranging 40 - 69% (P<0.05). based on the results for the major diameter against the minor diameter of screw, the maximal pull-out resistance was found at 60-65% (P<0.05). According to these biomechanical testing results, it seems that the screw with a moderately large pitch is more desirable and the buttress-shaped screw can provide stronger fixation than the V-shape one can, if other designal factor and conditions were fixed.

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수술 침습도에 따른 등장성 요부선전운동이 술후 체간 선전근력에 미치는 영향 (The Effort after Isotonic Lumbar Extension Exercise According to Surgery Invasiveness)

  • 남건우;이현옥;김종순
    • 대한정형도수물리치료학회지
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    • 제11권2호
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    • pp.83-95
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    • 2005
  • The purpose of this study is to analyze, durability of motor effort after finishing rehabilitation program and the influence from the isotonic lumbar region extension exercise after an operation according to the different operation way in invasive degrees. We selected randomly 80 patients who have no complication and musculoskeletal system diseases with finishing the 12 weeks' rehabilitation program after getting laser discectomy, but fail to conservative treatment, about Lumbar HNP, and divided into minimal invasive groups 38 and invasive groups 42 for study. As the results, in minimal invasive group, after finishing cure and 6 months later, the degree of hold muscle of women is much better than that of men. but in Invasive group, that of men is better than that of women, in case of women, the $0^{\circ}$ and $72^{\circ}$ in lumbar flexion angle have weaken or no improvement than before beginning exercise. and muscle force in $72^{\circ}$ in lumbar flexion angle increased to all men and women than before beginning exercise in Minimal invasive group. but in invasive group. it decreased. When analyze the lapsed time in Minimal invasive group, the groups who start the exercise within 3 months are better than the groups who start the exercise above 3 months after an operation the hold muscle degree all angles after finishing cure and 6 months later. Meanwhile, in invasive group, the groups who start the exercise within 3 months are better than the groups who start the exercise above 3 months after an operation about the hold muscle degree in 36-72 of lumbar flexion angle but 0-36 are not good after finishing cure and 6 months later. When analyze BMI in Minimal invasive group, the normal groups are better than the overweight groups about hold muscle degree in all angles after finishing cure and 6 months later.

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안정한 지지면과 불안정한 지지면에서 팔굽혀펴기 운동시 견갑골 주위 근육의 근활성도 비교 (A Comparison of Muscle Activity in Periscapular Muscles during Push-up plus Exercise on Stable Support and Unstable Support)

  • 박수경;이현옥;김종순;김선엽
    • 대한정형도수물리치료학회지
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    • 제11권2호
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    • pp.71-82
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    • 2005
  • The couple force of the scapular stabilizers for upward rotation that include the upper and lower trapezius, serratus anterior muscles is essential to maintain the stability of shoulder joint. But if there is an imbalance of these muscles, it would occur many problems of shoulder joint. A push-up plus exercise with an unstable support is used in order to increase the muscle activity and stimulate the proprioception of shoulder joint. The purpose of this study was to compare the muscle activity of upper and lower trapezius, serratus anterior muscles and to determine which exercise is more effective when subjects perform push-up plus exercise in the stable support and unstable support. 15 healthy subjects and 15 painful subjects with injury of shoulder joint participated in this study. Surface electromyography data were collected during plus phase of push-up plus exercise. The types of push-up plus exercise were composed of three conditions. Stable type is subjects performed the push-up plus exercise on the fixed support and unstable type 1 is on the sling without shaking and unstable type 2 is on the sling with shaking by tester's manual. The upper and lower trapezius activities of injured group were higher than uninjured group at three measure conditions, but serratus anterior activities were not. The UT/SA ratio of injured group was higher than uninjured group at three measure conditions. The serratus anterior activities were most high at unstable 2 measure in both groups. The UT/SA ratio was most low at unstable 2 measure condition in injured group only. The present result revealed that push-up plus exercise in the unstable support with shaking which took most high serratus anterior activities and most low of UT/SA ratio is optimal cure method that can improve the imbalance of the scapular stabilizer.

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초기 진단에 어려움이 있는 불안정성 족근 중족 관절 미세 손상에 대한 도수 정복 및 내고정술 후 임상적 결과 (Clinical Results after Closed Reduction and Internal Fixation for Unstable Subtle Injuries of Lisfranc Joint)

  • 유선오;박용욱;김주성;이기준
    • 대한족부족관절학회지
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    • 제8권1호
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    • pp.71-75
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    • 2004
  • Purpose: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. Materials and Methods: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Results: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs. Conclusion: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.

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Zygomatic miniplates for skeletal anchorage in orthopedic correction of Class III malocclusion: A controlled clinical trial

  • Bozkaya, Erdal;Yuksel, Alime Sema;Bozkaya, Suleyman
    • 대한치과교정학회지
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    • 제47권2호
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    • pp.118-129
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    • 2017
  • Objective: To evaluate the effects of facemask therapy, which was anchored from the zygomatic buttresses of the maxilla by using two miniplates, in skeletal Class III patients with maxillary deficiency. Methods: Eighteen skeletal Class III patients (10 girls and 8 boys; mean age, $11.4{\pm}1.28$ years) with maxillary deficiency were treated using miniplate-anchored facemasks, and their outcomes were compared with those of a Class III control group (9 girls and 9 boys; mean age, $10.6{\pm}1.12$ years). Two I-shaped miniplates were placed on the right and left zygomatic buttresses of the maxilla, and a facemask was applied with a 400 g force per side. Intragroup comparisons were made using the Wilcoxon test, and intergroup comparisons were made using the Mann-Whitney U-test (p < 0.05). Results: In the treatment group, the maxilla moved 3.3 mm forward, the mandible showed posterior rotation by $1.5^{\circ}$, and the lower incisors were retroclined after treatment. These results were significantly different from those in the control group (p < 0.05). No significant anterior rotation of the palatal plane was observed after treatment. Moreover, changes in the sagittal positions of the maxillary incisors and molars were similar between the treatment and control groups. Conclusions: Skeletally anchored facemask therapy is an effective method for correcting Class III malocclusions, which also minimizes the undesired dental side effects of conventional methods in the maxilla.

Recovery and Return to Work After a Pelvic Fracture

  • Papasotiriou, Antonios N.;Prevezas, Nikolaos;Krikonis, Konstantinos;Alexopoulos, Evangelos C.
    • Safety and Health at Work
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    • 제8권2호
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    • pp.162-168
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    • 2017
  • Background: Pelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF. Methods: During the years 2003-2012, 282 injured individuals aged 20-55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews. The questionnaire included variables related to injury, treatment and activities, and the Majeed pelvic score. Univariate and multiple regression analyses were used for statistical assessment. Results: Almost half of the injured (46.7%) fully RTW, and earning losses were reported to be 35% after PRF. The univariate analysis confirmed that RTW was significantly related to accident site (labor or not), the magnitude of the accident's force, concomitant injuries, duration of hospitalization, time to RTW, engagement to the same sport, Majeed score, and complications such as limp and pain as well as urologic and sexual complaints (p < 0.05 for all). On multiple logistic regression analysis, the accident sustained out of work (odds ratio: 6.472, 95% confidence interval: 1.626-25.769) and Majeed score (odds ratio: 3.749, 95% confidence interval: 2.092-6.720) were identified as independent predictive factors of full RTW. Conclusion: PRFs have severe socioeconomic consequences. Possible predictors of RTW should be taken into account for health management and policies.

HEAD GEAR가 상악골에 미치는 영향에 관한 유한요소법적 분석 (A FINITE ELEMENT ANALYSIS ON THE EFFECT OF THE HEADGEAR IN HUMAN MAXILLA)

  • 이인수;손병화
    • 대한치과교정학회지
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    • 제15권2호
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    • pp.211-227
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    • 1985
  • The purpose of this study was to analyze the stress distribution and the displacement in the maxillary complex after the application of the three kinds of the head gear. (high pull head gear, straight pull head gear, cervical pull head gear.) Orthopedic force, 300 gram, was applied to the maxilla of the dry human skull in a high, straight and cervical direction. The stress distribution and the displacement within the maxillary complex was analyzed by a 3-dimensional finite element method. The results were as follow: 1. In won, the stress of conical pull head gear was the greatest stress and straight pull head gear was the medium stress and high pull head gear was the least stress. 2. The compressive stress was observed on the anterior portion of premaxilla, especially anterior nasal spine area, when the three kinds of head gear were applied to the dry kuman skull. 3. It appeared that the stress of the anterior portion of the zygomatic bone was greater than the posterior portion in the case of three kinds of head gear application and compressive stress was noted only at the below of the frontozygomatic suture of the zygomatic bone. 4. The backward, upward, sideward displacement of the alveolar area was observed in a high pull head gear application but in the case of straight pull head gear and cervical pull head gear application, the backward, downward, sideward displacement was observed. 5. The forward, downward, sideward displacement was observed on the midpalatine suture and premaxilla on the sagittal plane and transverse palatine suture in the case of three kinds of headgear application.

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두가지 두부 방사선 사진 중첩 방법의 비교 - Nasion-Sella line 중첩과 Anterior cranial base 중첩 (Comparision of two cephalometric superimposition methods - Nasion-sella line method and Anterior cranial base method)

  • 경승현;문윤식
    • 대한치과교정학회지
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    • 제27권4호
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    • pp.633-641
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    • 1997
  • 성장 또는 치료로 인한 악안면골의 변화는 두부 방사선을 중첩 함으로써 판단할 수 있다. 중첩에 대한 평가는 중첩방법에 따라 변화되므로 좀더 정확한 중첩 방법을 선택하는 것은 치료 효과에 대한 분석이나 성장 변화에 대한 평가를 정확히하는 선결 요건이 될것이다. 3년 정도의 비교적 짧은 성장기간을 가진 11세 전후의 여자 환자 19명을 대상으로, 가장 널리쓰이는 중첩 방법인 Nasion-Sells line중첩과 Bjork가 주장하는 Anteirior cranial base (ACB)중첩을 비교하여 다음과 같은 결론을 얻었다. 1 Nasion-Sells line중첩과 ACB중첩은 중첩오차(registration error)의 크기가 거의 같아서 reliability에 있어서 큰차이가 없는 것으로 나타났다 2. 검사자간 차이(interobserver difference)에 있어서 Nasion-Sells line중첩은 7개의 측정 항목 모두에서 두 검사자간에 차이가 없었으나 ACB중첩은 7개의 측정 항목중 4개의 측정 항목에서 두 검사자간 유의성 있는 차이가 나타났다. 3. 중첩방법의 차이 (intermethod difference)에 있어서 Nasion-Sella line중첩으로 측정한 계 측치와 ACB 중첩으로 측정한 계측치가 유의성있게 차이가 나지 않았다.

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