• Title/Summary/Keyword: 고정술

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Anatomical Direct Reduction of Bony Mallet Finger Using Modified-Intrafocal Pinning Technique (변형-내초점 핀 고정술을 이용한 골성 망치 수지의 해부학적 직접 정복)

  • Kang, Sang-Woo;Park, Ji-Kang;Jung, Ho-Seung;Cha, Jung-Kwon;Kim, Kook-Jong
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.248-253
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    • 2018
  • Purpose: The purpose of this study was to evaluate the clinical results of anatomic reduction of bony mallet finger using modified-intrafocal pinning technique. Methods: From March 2014 to October 2017, 18 patients with bony mallet finger were treated with modified-intrafocal pinning technique. Kirschner-wire was used to directly reduction the bony fragment, and extension block pinning and distal interphalangeal joint fixation were additionally performed to minimize the loss of reduction. Postoperative pain, range of motion, and radiological evaluation were performed. Duration of bone healing, functional recovery and complication rate were evaluated and Crawford's criteria was used to determine functional outcome after surgery. Results: Bone union was achieved in all cases after a postoperative mean of 6 weeks (5-7 weeks). An average of $2.8^{\circ}$ ($0^{\circ}-10^{\circ}$) extension loss occurred in all patients. All patients showed satisfactory joint congruency and reformation of the joint surface, the mean flexion angle of the distal interphalangeal joint at the final follow-up was $72.2^{\circ}$ ($70^{\circ}-75^{\circ}$). According to Crawford's classification, 12 patients (66.7%) were excellent and 6 patients (33.3%) were good. Conclusion: Modified-intrafocal pinning technique is a method of obtaining anatomical bone healing by directly reduction and fixation of the bony fragment. Combined with other conventional percutaneous pinning procedures, it is expected that good results can be obtained if applied to appropriate indications.

Remplissage Procedure (관절경하 극하건 고정술)

  • Kim, Young-Kyu
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.169-174
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    • 2010
  • 대다수의 견관절 전방 불안정성에서 관절와에 골 소실이 큰 경우는 Bankart 복원술을 튼튼하게 하였을지라도 상완골두를 지탱할 관절 궁이 감소되어 골에 의한 버팀이 줄어들므로 Bankart 복원이 실패할 가능성이 높다. 따라서 관절와 결손이나 상완골 두 결손이 큰 경우 정확한 측정으로 결손의 범위를 파악하여야 하며, 관절와 결손이 25% 이상이거나 상완 골 두 결손이 30% 이상인 경우 추가적인 수술적 처치가 요하여 최근 보고되고 있는 Latarjet 술식이나 관절경적 Remplissage 술식을 시행하는 것이 바람직하다.

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Transpatellar Cannulated Screw Fixation of Displaced Tibial Intercondylar Eminence Fractures (전위성 경골 과간 융기부 골절의 슬개골 하단을 통한 삽관 나사못 고정술)

  • Nha Koung Wook;Jung Byung Hyun;Suh Jin Soo;Suk Seung Yeub;Park Gyu Won;Chae Dong Ju
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.25-30
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    • 2002
  • Purpose : To evaluate the clinical results of displaced tibial intercondylar eminence fractures which were treated with transpatellar cannulated screw fixation. Materials and Methods : Ten patients with displaced tibial intercondylar eminence fractures were treated between December 1998 and May 2001 and then followed up for more than one year. They were treated arthroscopic reduction and fixation of fracture site by cannulated screw through the hole of nonarticular surface of inferior patella. They were prospectively evaluated with regard to their clinical and radiologic results. Results : Radiologic unions occurred at an average of 9.2 weeks. Average anterior displacements were 1.8 mm in stress x-rays and 1.1 mm in KT-2000 arthrometer. Average loss of extension was $4.1^{\circ}$. Functional results were excellent in 7 cases and good in 3 cases. Conclusion : Arthroscopic transpatellar cannulated screw fixation is one of the useful methods for the treatment of displaced tibial intercondylar eminence fractures.

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Surgical Treatment of Osteoporotic Vertebral Compression Fractures at Thoraco-Lumbar Levels: Only Pedicle Screw Constructs with Polymethylmethacrylate Augmentation (흉요추부 골다공증성 척추 압박 골절의 수술적 치료: 골시멘트 보강술을 이용한 척추경 나사 고정)

  • Jun, Deuk Soo;Baik, Jong-Min;Park, Ji Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.327-335
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    • 2019
  • Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm2. The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

Arthroscoic Anterior Cruciate Ligament Reconstruction with Autogenous Hamstring Gratt - Effect of the Additional Fixation after Fixation of the Graft with Intrafix - (자가 슬괵건을 이용한 관절경적 전방 십자 인대 재건술 - INTRAFIX system을 이용한 경골부 고정 후 부가적 고정의 효과 -)

  • Yoo, Jae-Doo;Roh, Kwon-Jae;Shin, Sang-Jin;Yoon, Jong-Suk;Yeo, Sung-Gu
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.51-55
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    • 2005
  • Purpose: To compare the stability and clinical result after anterior cruciate ligament reconstructed knee after graft fixation using Intrafix in tibial tunnel with or without additional tibial post fixation. Materials and Methods: We analyzed 37 cases which were treated with four-strand hamstring tendon autograft during the period from May 2002 to January 2003. The grafts were fixed with Rigidfix system (Mitek Product, Johnson and Johnson, USA) in femur tunnel and Intrafix system (Mitek Product, Johnson and Johnson, USA) in tibial tunnel. After tibial fixation, additional tibial post fixation was done, which was determined by the serial case number prospectively. Patients were followed for average of fourteen months(range, thirteen to twenty-five months) At the time of final follow-up, patients were evaluated in terms of Lachman test, pivot shift test, Lysholm scores, IKDC (International Knee Documentation Committee) assessment, side-to-side KT-1000 maximum-manual arthrometer differences. Results: At last follow-up, Lysholm score was average 93.1(range: 65 to 98), IKDC assessment revealed that 26 cases had score of A, 10 cases had score of B and 1 case had score of C. The average maximum-manual KT-1000 arthrometer side ?to-side difference was 2.5 mm$(0{\sim}6mm)$. There was one case in which the Lachman test was graded as 2+ and four cases in which the Lachman test was graded as 1+ and the remaining thirty-two cases were normal by Lachman test. One case had a 2+ pivot-shift, and 2 cases had a 11 pivot-shift. The remaining 34 knees were normal on pivot -shift testing. The average maximum-manual KT-1000 arthrometer side-to-side difference was average 2.8 mm$(0{\sim}6mm)$ in Intrafix only group and average 2.2 mm$(0{\sim}4mm)$ in additional fixation group (P>0.05). Conclusion: Without additional tibial fixation, the stability of the anterior cruciate reconstructed knee with hamstring graft which was fixed with Intrafix was restored.

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Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture - A Case Report - (유경나사를 이용한 견갑골 관절와 골절의 관절경적 정복 및 내고정 - 증례 보고 -)

  • Ko, Sang-Hun;Jeon, Hyung-Min;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.127-131
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    • 2010
  • Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.

Management of an Open Comminuted Fracture of the Metacarpus using Circular External Skeletal Fixation in a Korean Water Deer (Hydropotes inermis argyopus) (고라니에서 발생한 손허리뼈 개방 복합골절의 원형 외부골격고정법 적용)

  • Heo, Su-Young;Jeong, Seongmok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.359-362
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    • 2015
  • A Korean water deer was rescued after being hit by a motor vehicle. Clinical and radiographic examination revealed a grade III open fracture of the right metacarpus with severe soft tissue injury. The water deer underwent closed reduction of the fracture, which was stabilized by the application of the Ilizarov method of 4-ring circular external skeletal fixation (CESF) as a minimally invasive technique. The water deer was successfully released into the wild. CESF was advantageous for the stabilization of open comminuted fracture and the management of a severely contaminated wound in a Korean water deer. CESF can be used successfully in wild deer with good tolerance and minimal complications.

Physeal Remodeling after Internal Fixation of Slipped Capital Femoral Epiphysis (대퇴골두골단분리증 환자 중 금속내고정술을 시행받은 환자에서의 골단판의 재형성)

  • Kim, Se-Dong;Park, Byung-Won
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.28-35
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    • 2003
  • Purpose: To evaluate physeal remodeling after internal fixation of slipped capital femoral epiphysis, We performed a retrospective review of the medical records and radiographs of 14 children (17 cases) who had had slipped capital femoral epiphysis. Materials and Methods: We reviewed 14 patients who had slipped capital femoral epiphysis. They were divided two groups. Group I were in situ pinning with single screw and group II were corrective osteotomy with multiple pinning. We identified physeal remodeling camparing with their preoperative, postoperative and last follow-up radiographs with measuring physeal-shaft angle. Results: Early closure of the physis was observed in 6 cases among 14 patients (17 hips). Compared with their postoperative radiographs, the last follow up radiographic study revealed that physeal remodeling was observed in 4 patients (4 hips) at group I (mean, $7.8^{\circ}$), in 2 patients (3 hips) at group II (mean, $10.7^{\circ}$). Conclusion: In this study, physeal remodeling was observed in 4 patients (4 hips) in group I and 2 patients (3 hips) in group II. The incidence of physeal remodeling was related with degree of epiphyseal slippage, and age was not related with physeal remodeling potential.

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Neglected Elbow Dislocation Occurred 3 Years Ago: Open Reduction and Hinged External Fixation - A Case Report - (3년전이 경과된 진구성 주관절 탈구: 개방적 정복술과 경첩 외고정 장치 - 1예 보고 -)

  • Kim, Bo-Kun;Kim, Kyung-Cheon;Park, Jun-Yeong;Shin, Hyun-Dae
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.266-269
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    • 2010
  • Purpose: We report case of neglected elbow dislocation for three years. Material and method: A 45 years old female patient presented with neglected elbow dislocation for three years. Since the patient had contracture in both lateral and medial collateral ligament of elbow, dissection was done. After total separation of posterior articular capsule and incision of anterior articular capsule, by manual manipulation, reduction of radiohumeral and ulnohumeral joints were obtained. We applied modified Morrey type hinged external fixation in the elbow and done early elbow exercise. Result and Conclusion: Since we have experienced a satisfactory result in the case with neglected elbow dislocation for 3 years by using open reduction and hinged external fixation, we report it with the literature.

Full mouth rehabilitation of fully edentulous patient with implant-supported fixed prosthesis preceding bone graft: A case report (전악 무치악 환자에서 골이식술을 선행한 임플란트 고정성 보철 수복 증례)

  • An, Ju-Nam;Lee, Jung-Jin;Seo, Jae-Min;Kim, Kyoung-A
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.77-87
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    • 2018
  • Prosthetic treatment using implants in fully edentulous patients includes implant-supported fixed prosthesis, implant hybrid prosthesis, implant retained- or supported-over-denture and implant supported fixed prosthesis has advantages such as psychological stability, pronunciation. If an implant supported fixed prosthesis is planned, the implants should be placed in consideration of pronunciation, esthetics, and oral hygiene. For this, clinical and radiological diagnosis is indispensable. When placing the prosthetic driven implant at the site determined from the diagnosis, a sufficient amount of alveolar bone and soft tissue support are required. If these requirements found to be insufficient, a wide range of bone grafting should be performed in advance. In this case, a fully edentulous patient with severe alveolar bone resorption due to periodontal disease was treated with a full mouth rehabilitation using implant-supported fixed prosthesis preceding maxillary sinus graft and alveolar bone augmentation. We report this patient were satisfied with esthetic and function.