• Title/Summary/Keyword: postoperative stability

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Comparison of postoperative changes in the distal and proximal segments between conventional and sliding mini-plate fixation following mandibular setback

  • Kim, Seong-Sik;Kwak, Kyoung-Ho;Ko, Ching-Chang;Park, Soo-Byung;Son, Woo-Sung;Kim, Yong-Il
    • The korean journal of orthodontics
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    • v.46 no.6
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    • pp.372-378
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    • 2016
  • Objective: The purpose of the present study was to evaluate the postoperative three-dimensional (3D) changes in the proximal segments after mandibular setback sagittal split ramus osteotomy and to compare the changes between the conventional mini-plate fixation and semi-rigid sliding plate fixation. Methods: Cone-beam computed tomography (CBCT) images were used to evaluate the postoperative 3D changes in the proximal segments during the healing process. CBCT images were superimposed using the symphysis and the lower anterior mandible as references. Results: There were no statistically significant differences between the conventional mini-plate and semi-rigid sliding plate groups (p > 0.05). With respect to the distribution of changes greater than 2 mm in the landmarks, the right condylion, right coronoid process, and left condylion showed ratios of 55.6%, 50.0%, and 44.4%, respectively, in the semi-rigid sliding plate group; however, none of the landmarks showed ratios greater than 30% in the conventional mini-plate group. Conclusions: There were no statistically significant differences in postoperative changes in the segments between the conventional mini-plate and semi-rigid sliding plate groups. Nevertheless, while selecting the type of fixation technique, clinicians should consider that landmarks with greater than 2 mm changes were higher in the semi-rigid sliding plate group than in the conventional mini-plate group.

Clinical Experience with IABP in Cardiac Surgery (개심술시 Intra-aortic balloon pump (IABP)의 임상적 적용)

  • 옥창석;지현근
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.34-39
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    • 1997
  • Between May, 1994 and December, 1995, 122 adult cardiac surgical procedures requiring cardiopulmonary bypa s were performed at Kang Dong Sacred Heart Hospital, including 18 cases(14.8%) that were associated with preoperative(n:9), intraoperative(n=7), postoperative(n:2) use of an IABP (intra-aortic balloon pump). The reasons for IABP were low cardiac output and PTCA(percutaneous transluminal coronary angioplasty) failure in preoperative period, CPB(cardiopulmonary bypass) weaning difficulty in intraoperative period, and intractable arrhythmia in postoperative period. The mean age of the IABP patients was 61.8 $\pm$ 6.9 years(range, 39 to 75years). The overall hospital mortalities in patients with preoperative and intraoperative IABP insertion were 3 and 42.9% respectively. Two patients with postoperative IABP insertion are alive. The rate of IABP weaning is 66.7% for preoperative group, 85.7% for intraoperative group and 100% for postoperative group . In conclusion, if there were no irreversible myocardial damages, IABP could be used safely and emergently at any perioperative period for hemo ynamic stability, CPB weaning, and to overcome low cardiac output syndrome.

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Arthroscopic Stabilization Using Remplissage Technique In Recurrent Shoulder Instability with Large Hill-Sachs Lesion - Minimum Six Months Follow-Up Results - (광범위한 Hill-Sachs 병변에서 Remplissage 술기를 이용한 관절경적 재건술 - 최소 6개월 이상 추시 결과 -)

  • Ko, Sang-Hun;Jung, Kwang-Hwan;Jeon, Hyung-Min;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.47-52
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    • 2010
  • Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.

Congenital postrolateral diaphragmatic hernia; a report of two cases (선천성 횡격막탈장 :수술 치험2례)

  • 전찬규
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.640-643
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    • 1995
  • Bochdalek hernia is the congenital posterolateral defect in the diaphragm caused by a failure of the pleuroperitoneal canal to close at 8 weeks, gestation. Infants with hernia diagnosed at birth have poor prognosis. Survival rate depends on pulmonary growth and development, preoperative stability and postoperative care. We experienced two cases of Bochdalek hernia, one in right was repaired with patch closure using sheet and the other in left was repaired with simple closure.

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THE STUDY ON VERTICAL STABILITY OF ANTERIOR OPEN BITE PATIENTS AFTER BSSRO (전치부 개교합 환자의 하악지시상분할골절단술 후 수직적 안정성에 관한 연구)

  • Kim, Jong-Won;Jeon, Ha-Ryong;Hong, Jong-Rak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.5
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    • pp.422-426
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    • 2005
  • Purpose : The purpose of this study was to investigate the vertical stability after BSSRO surgery in skeletal class III malocclusion patients with mild anterior open bite and to present a method to increase the stability. Materials and methods : 36 patients, 11 male and 25 female, who received BSSRO surgery with the diagnosis of skeletal class III with anterior open bite at the Department of Oral and Maxillofacial Surgery in Samsung Medical Center, from January 2002 to August 2003, were selected for this study. The patients were between 18 to 45 years of age. Preoperative and postoperative (immediate, 6 months, and 1 year after operation) lateral cephalograms were compared to evaluate the vertical stability by measuring the distance of nasion-menton, mandibular plane angle, and overbite. Results : The nasion-menton distance decreased by 1.65mm immediately after the operation in comparison to the preoperative value. This distance further decreased by 0.60 mm at 6 months and 1.06mm at 1 year after the operation. The mandibular plane angle increased after the operation and further increased at 6 months and 1 year. The amount of overbite increased by the operation was 2.34mm and an additional increase of 0.70mm at 6 months and 0.94mm at 1 year were shown. Conclusion : Clinically, none of the patients showed relapse of anterior open bite and the vertical stability is highly influenced by orthodontic treatment after the operation. In this study, BSSRO surgery is considered to be a rather reliable procedure that restores stability to skeletal class III malocclusion patients with slight anterior open bite.

Rehabilization after ACL Reconstruction (전방십자인대 재건술후 재활치료)

  • Shin, Dong-Min
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.86-90
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    • 1997
  • Good stability and complete range of motion should be the ultimate goal of a rehabilitation program after ACL reconstruction. In previous years. the rehabilitation of the ACL reconstructed knee focused on protecting the new ligament by blocking terminal knee extension, hut, despite good stability, this approach led to numerous postoperative complications. Nowadays, most of surgeons agree the accelerated rehabilitation program based on the concept of ligamentization and clinical experience. Accelerated rehabilitation program consists of maintain of full extension of the knee, early weight bearing and prompt recovery of ROM, and closed kinetic chain exercise. Meeting this goal requires effective communication between-members of the health care team-the physician, physical therapist, atheletic trainer, and the patient. We have to know the importance of rehabilitation, knowlege about the physical therapy, and to introduce for special physical therapist and equipment.

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Skeletal Stability after Le Fort I Osteotomy in the Cleft Patients; Preliminary Report (구순구개열 환자의 Le Fort I 골절단술 후 상악골의 위치적 안정성에 관한 연구 ; 예비보고)

  • Kim Myung-Jin;Yu Ho-Seok;Kim Jong-Won;Kim Kyoo-Sik
    • Korean Journal of Cleft Lip And Palate
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    • v.2 no.1_2
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    • pp.15-22
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    • 1999
  • It is well known that the postoperative skeletal instability after Le Fort I osteotomy for advancement of maxilla in the cleft patients is one of the major surgical problems. So we had tried to compare the amount of relapse after Le Fort I advancement surgery in the horizontal and vertical positional change, angular change of reference points between cleft patients and non-cleft patients. Longitudinal records of 10 consecutive cleft patients (test group) and 20 non-cleft patients (control group) were analyzed. Lateral cephalograms were taken preoperatively, immediately postoperatively, and 2, 6, 12 months postoperatively. We measured horizontal and vertical changes (ANS, PNS, AI) and angular change (SNA) of the reference points and lines. In the test group, horizontal relapse of ANS, PNS, AI point are 36.4%, 37.5%, 32.0% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 25.3%, 32.3%, 39.1% respectively at 12 months postoperatively. The angular change of SNA is 33.6% at 12 months postoperatively. In the control group, horizontal relapse of ANS, PNS, AI point are 23.8%, 30.2%, 21.7% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 22.7%, 27.3%, 25.1% respectively at 12 months postoperatively. The angular change of SNA is 22.2% at 12 months postoperatively. The cleft patients have a larger tendency of skeletal and dental relapse compared with non-cleft patients after Le Fort I surgery. So the oral and maxillofacial surgeons must keep in mind these facts in order to minimize the relapse phenomenon from the beginning of surgical planning to postoperative care.

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A Study on the Interface Micromotions of Cementless Artificial Hip Replacement by Three-Dimensional FEM (무시멘트형 인공고관절 대치술후 초기의 경계면 미세운동의 3차원 FEM 연구)

  • Kim, S.K.;Chae, S.W.;Choi, H.Y.
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.71-74
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    • 1994
  • In cementless total hip arthroplasty(THA), an initial stability of the femoral component is mandatory to achieve bony ingrowth and secondary long term fixation. Bone ingrowth depends strongly on relative micromotion and stress distributions at the interface. Primary stability of the femoral component can be obtained by minimizing the magnitude of relative micromotions at bone-prosthesis interface, Hence an accurate evaluation of interface behavior and stress/strain fields in the bone implant system may be relevant for better understanding of clinical situations and improving THA design. However, complete evaluation of load transfer in the bone remains difficult to assess experimentally, Hence, recently finite element method (FEM) was introduced in orthopaedic research field to fill the gap due to its unique capacity to evaluate stress in structure of complex shape, loading and material behavior. The authors developed the 3-dimensional numerical finite element model which is composed of totally 1179 elements off and 8 node blick. We also analyzed the micromotions at the bone-stem interface and mechanical behavior of existing bone prosthesis for a loading condition simulating the single leg stance. The result indicates that the values of relative motion for this well fit Multilock stem were $150{\mu}m$ in maximum, $82{\mu}m$ in minimum, and the largest relative motion developed in medial region of proximal femur with anterior-posterior direction. The proximal region of the bone was much larger in motion than the distal region and the stress pattern shows high stress concentration on the cortex near the tip of the stem. These findings indicates that the loading in the proximal femoral bone in the early postoperative situation can produce micromotions on the interface and clinically cementless TEA patient should not be allowed weight bearing strictly early in the postoperative period.

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A Three-Dimensional Finite Element Study of Interface Micromotion in a Non-Cement Total Hip stem (FEM 3차원 모델을 이용한 인공관절 대퇴 Stem 경계면의 미세운동 분석)

  • Kim, Sung-Kon;Choi, Hyung-Yun;Chae, Soo-Won
    • Journal of Biomedical Engineering Research
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    • v.17 no.1
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    • pp.61-70
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    • 1996
  • In cementless total hip arthroplasty(THA), an initial stability of the femoral component is mandatory to achieve bony inyowth and secondary long term fixation. Primary stability of the femoral component can be obtained by minimizing the magnitude of relative micromotions at bone stem interface. An accurate evaluation of interf'ace micromotion and stress/strain fields in the bone-implant system may be relevant for better understanding of clinical situations and improving THA design. Recently finite element method(FEM) was introduced in'orthopaedic research field due to its unique capacity to evaluate stress in structure of complex shape, loading and material behavior. The authors developed the 3-dimensional finite element model of proximal femur with $Multilock^{TM}$ stem of 1179 blick elements to analyse the micromotions and mechanical behaviors at the bone-stem inteface in early post-operative period for the load simulating single leg stance. The results indicates that the values of relative motion for this well fit stem were $150{\mu}m$ in maximum $82{\mu}m$ in minimum and the largest relative motion was developed in medial region of Proximal femur and in anterior-posterior direction. The motion in the proximal bone was much greater than in the distal bone and the stress pattern showed high stress concentration on the cortex near the tip of the stem. These findings indicate that the loading on the hip joint in the early postoperative situation before achieving bony ingrowth could produce large micromotion of $150{\mu}m$ and clinicaly non-cemented THA patient should not be allowed weight bearing strictly early in the postoperative period.

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Treatment of Metacarpal Bone Fracture Using Biodegradable Plates and Screws (흡수성 고정판과 나사를 이용한 중수골 골절의 치료)

  • Cho, Jeong-Mok;Eun, Seok-Chan;Baek, Rong-Min
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.458-464
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    • 2011
  • Purpose: Metacarpal fractures are common hand injury that may require operative intervention to ensure adequate reduction and stabilization. Traditionally, titanium miniplate was used for rigid fixation of bone fractures. However, the use of permanent plate lends itself to multiple complications such as infection, exposure of the hardware, tendon adhesions, tendon rupture, prolonged pain, bony atrophy and osteoporosis (stress shielding), metal sensitization, and palpation under the skin. This study evaluated the usefulness and stability of biodegradable plates and screws for treatment of metacarpal bone fractures. Methods: There was 17 patients who had surgery for metacarpal bone fracture from April 2007 to June 2010. All patients had open reduction and internal fixation. We used absorbable plates and screws (Inion CPS$^{(R)}$) for internal fixation. Postoperative results were assessed with x-ray. Stability of plates and screws, healing process and its complications were observed by clinical and radiographic assessment. Results: All patients were successfully reduced of bone fracture, and fixations with absorbable plates and screws were stable. The mean follow up period was 7.1 months. 2 patients complained postoperative pain, but they were relieved with analgesics. All patients experienced transient stiffness, but they were relieved with active assistive range of motion after removal of splint. No patients suffered complications which could be occurred by using metallic plate. Conclusion: There was no critical complications such as re-fracture or nonunion among patients. No patients suffered side effects related with metallic implants. Biodegradable implants can offer clinically stable and attractive alternative to metallic implants to stabilize metacarpal bone fractures in the hand.