• Title/Summary/Keyword: 고정술

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Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures (제 5 수지 중수골 골절에서 평행 핀 또는 플레이트 고정술 이후 골절각 변화에 대한 비교 연구)

  • Lee, Myungchul;Shin, Hyojung;Choi, Hyungon;Kim, Jeenam;Shin, Donghyeok
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.230-238
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    • 2018
  • Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation. Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group. Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, $20^{\circ}{\pm}7^{\circ}$; group 2, $19^{\circ}{\pm}5^{\circ}$). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, $24^{\circ}{\pm}10^{\circ}$). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, $18^{\circ}{\pm}6^{\circ}$). Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.

A MODIFICATION OF THE MICHELET TECHNIQUE FOR SLIDING HORIZONTAL OSTEOTOMY;A CASE REPORT (MICHELET 테크닉의 변형을 이용한 이부성형술의 치험례)

  • Lee, Jin-Gew;Davis, Isaac E.;Swift, James Q.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.145-151
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    • 1994
  • 앞 턱 부위가 짧고 후방으로 위치해 있을 때 턱의 높이를 증가시키고 전방으로 돌출시키는 축조 이부성형술의 방법으로는, 매식체 삽입술, 골 절단술, 골 절제술 또는 이들을 동시에 시행하는 혼합술등이 행해져 왔다. 그러나 매식체 삽입술에서는 감염 또는 매식체의 유동성 등의 합병증의 발병이 빈발하고 매식체의 밑 부위에 골이 흡수된다든지 연조직의 변화를 예측하기 어렵다든지 하는 복잡한 문제점들이 종종 보고되고 있다. 따라서 매식체를 이용하지 않는 골 절단술이나 골 절제술만을 이용한 다양한 방법의 이부성형술이 많이 시행되고 있다. 하악골이 전후방 관계로 발육부전인 환자에게 양측 하악지 시상분할술을 시행하여 전방 이동시킨 후 앞 턱의 위치를 좀더 개선하기 위하여 $Michel{\'{e}}t$ 테크닉의 변형법을 이용한 이부성형술을 추가로 시행하였다. 이 방법의 이부성형술은 턱의 수직적, 수평적 길이를 증가시키기 위하여 하악결합면 부위에 장부와 장붓구멍 모양을 한 골 절단술을 시행하고 광범위한 연조직경을 보존하여 골편으로의 혈류 차단을 최소화하였으며 나사를 이용한 견고한 고정을 용이하게 하였다. 이 술식은 턱을 수직적으로 증가시킬 때 두 골편 사이의 공간에 골 이식을 시행할 필요가 없으며, 금속판을 이용하지 않아도 정확한 위치에 골편을 고정하기가 용이하고, 또한 고정용 나사가 향후 골형성 부위에 위치하게 된다는 장점을 경험하게 되어 이에 한 증례를 보고하는 바이다.

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Revision Anterior Cruciate Ligament Surgery Using Hamstring Autograft (슬괵건을 이용한 전방 십자 인대 재 재건술)

  • In Yong;Bahk Won-Jong;Kwon Oh-Soo;Suh Young-Wan;Im Dong-Sun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.183-188
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    • 2003
  • Purpose : The purpose of this study is to evaluate the results of revision surgery for failed anterior cruciate ligament (ACL) reconstruction using quadruple hamstring tendon autograft. Materials and Methods : From May 2000 to July 2002, six patients received ACL revision surgery using quadruple hamstring autograft for failed ACL reconstruction. Femoral tunnels were made 40 mm in depth and fixed with a cross pin and a bioabsorbable interference screw to fill the bone defect. In tibial tunnels, the grafts were fixed with Intrafix(Mitek, Norwood, MA). In case of tibial tunnel widening, additional screw-washer fixation was done. Follow up was at least 12 months postoperatively. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee(IKDC) evaluation form and manual maximal side to side difference using KT-2000 arthrometer. Results : The average Lysholm knee score improved from 77.2 preoperatively to 87.7 postoperatively. At the final IKDC evaluation, 1 case was graded as normal, 4 nearly normal, 1 abnormal. Mean side to side difference of manual maximum anterior displacement using the KT-2000 arthrometer was 1.8mm. The success rate was $83\%$. Conclusion : ACL revision surgery using quadruple hamstring autograft with double fixation is considered good procedure with successful results.

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Operative Treatment of Symptomatic Os Acromiale (견봉 골의 수술적 치료)

  • Ji, Jong-Hun;Kim, Weon-Yoo;Park, Sang-Eun;Kim, Young-Yul;Moon, Chang-Yun
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.123-130
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    • 2008
  • Os acromiale is the rare shoulder disease and its treatment is controversial. Despite conservative treatments for 6 months include medication, exercise, physical therapy and subacromial steroid injections, operative treatment for uncontrolled symptomatic Os acromiale is considered the treatment of choice. Operative treatment includes excision, arthroscopic or open reduction and internal fixation with a bone graft. Open reduction with tension band wiring and a bone graft is now the preferred treatment. We experienced 8 patients with symptomatic Os acromiale from March, 2001 to March, 2006. The average patient's age was 45 years and the man and women ratio were 2: 6. All 8 cases of symptomatic Os acromiale of the mesoacromion were treated with open reduction and internal fixation using tension-band wiring. The preoperative ASES($47.3\pm24.4$) and UCLA ($16.6\pm5.8$)scores were improved to $88.8\pm7.3$ and $31.5\pm1.9$, respectively, at the 2 year follow up. The overall UCLA score showed 1 excellent result and 7 good results. We think that symptomatic Os acromiale is a specific disease entity, and open reduction and internal fixation using tension-band wiring with K-wire is a good treatment modality.

The evaluation for usefulness of the custom made immobilization device for the anteroperitoneal resection patients with rectal cancer (복 회음부 절제술 환자를 위한 고정용구 제작 및 유용성 평가)

  • Yang Oh Nam;Lee Woo Seok;Hong Tack Kyun;Jo Young Pil;Yun Hwa Ryong;Kim Jung Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.15 no.1
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    • pp.61-65
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    • 2003
  • I. Purpose Patient immobilization is essential factor for successful radiation therapy and major problem is reproducibility to maintain patient position during total radiation therapy period. Purpose of this study is evaluation for usefulness of the custom made immobilization device for the anteroperitoneal resection patients with rectal cancer II. Materials and Methods The object of this study were patients who underwent anteroperitoneal resection and undergo radiation therapy at present with rectal cancer. We made immobilization device for patient individually and analyzed its set up reproducibility, patient position deviation and errors. III. Results There was $5mm{\sim}10mm$ deviation in patient position without individual immobilization device, but we improved the deviation within few mm limitation with individual immobilization device. IV. Conclusion Custom made immobilization device was very helpful for anteroperitoneal resection patient with rectal cancer. We improved the patient position deviation within few mm limitation, shorten the set up time and we could give the comfort to patients.

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SURGICAL REDUCTION OF DISPLACED SUBCONDYLAR FRACTURES OF MANDIBLE USING OF SAGITTAL SPLIT AND OBLIQUE SUBCONDYLAR OSTEOTOMY (시상골절단과 사선골절단술을 이용한 하악골 과두골절의 외과적 치험예)

  • Kim, Hyoun-Chull
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.87-95
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    • 1989
  • The therapeutic methods and follow - up prognosis of subcondylar fractures in adults have always been sources of controversy. To improve the therepeutic results in subcondylar fractures with displacement, and especially, the bicondylar ones, the auther employ the surgical reduction using of sagittal split and oblique subcondylar osteotomy. This report is illustrated by six clinical cases.

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Clinical Outcomes After Arthroscopic Double-Row Rotator Cuff Repair and Evaluation of Cuff Integrity by CT Arthrography (관절경적 2열 고정 회전근개 복원술 후의 임상 결과 및 CT 관절조영술을 이용한 건의 치유 평가)

  • Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.

Use of Minimally Invasive Plate Osteosynthesis for Tibial Diaphyseal Fracture in Three Dogs (경골 골간 골절에서의 최소 침습적 금속판 고정술의 이용 3례)

  • Heo, Su-Young;Lee, Ki-Chang;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.29 no.4
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    • pp.339-343
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    • 2012
  • Three dogs were presented with diaphyseal fracture of the tibia following separate motor vehicle accidents. On physical and orthopedic examinations, the dogs were noted to have soft-tissue swelling and a closed fracture in these tibia sites. Radiographs revealed a simple, short oblique fracture (case 1), a comminuted, spiral fracture (case 2), and a simple, spiral fracture (case 3) in tibia. Minimally invasive percutaneous plate osteosynthesis (MIPO) using a veterinary cuttable plate or locking plate was applied for the treatment of these fractures. The surgery was successful, and the fractures healed without any complications by 7 weeks (case 1), 10 weeks (case 2) and 8 weeks (case 3) after surgery. Our patients showed fast bone healing times and early weight-bearing during the treatment of their tibia fractures. Therefore, MIPO was a useful procedure for diaphyseal fracture of the tibia in veterinary orthopedics.

Ultrasonographic Diagnosis of Extensor Tenosynovitis Caused by Dorsal Screw Prominence after Volar Plate Fixation of Distal Radius Fracture: Case Report (원위 요골 골절의 수장측 금속판 고정술 후 발생한 신전건 활막염에 대한 초음파를 이용한 진단: 증례 보고)

  • Lim, Tae Kang;Kim, Sang Yeol;Kang, Hong Je;Hah, Dae Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.60-64
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    • 2013
  • After volar locking plating of distal radius fracture, complications arising from unrecognized dorsally prominent screws penetrating the extensor compartments are increasingly reported. However, standard radiography and fluoroscopy may not adequately visualize screw lengths, because of complex shape of dorsal cortex of the distal radius. We presented case of ultrasonography diagnosis of extensor tenosynovitis caused by dorsal screw prominence after volar plate fixation of distal radius fracture.

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Evaluation on usefulness of three dimensional reconstructive computed tomography images after pedicle screws fixation (척추경 나사못 고정술 시행 후 3차원 재구성CT영상의 유용성 평가)

  • Kim, Hyeon-Ju;Jang, Hyun-Chul;Cho, Jae-Hwan
    • Journal of Digital Contents Society
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    • v.11 no.4
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    • pp.553-559
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    • 2010
  • By applying the various reformation techniques by using a circle raw data of after computed tomography image in the patient enforcing the spine screw fixation, this research tried to look into the various information including the exact location of the position of the screw spike and accuracy of an operation. In a clinical, by applying the or multi planar reformatting(MPR), that is the re-composition technique used mainly, maximum intensity projection (MIP), and volume rendering technique(VRT) and transformation removal from a register modifying VRT, video data were compared and were analyzed by the quantitative method and qualitative method. It is judged as the transformation volume rendering technique of the re-composition technique which is most useful in minimizing the artifact shadow by the exact location of the position of a screw and metal among the analysis and evaluation result computed tomography image reformation technique of the reformation image after the spine screw fixation.