• Proceedings of the Materials Research Society of Korea Conference
• /
• 2003.03a
• /
• pp.242-242
• /
• 2003

DLC(Diamond-Like Carbon)는 높은 경도, 내마모성, 화학적 안정성, 생체친화성 및 열전도율이 우수하여 VTR 헤드드럼, CRT Gun, Video Tape, 인공골절, 면도날 등에 널리 사용되고 있다. 에어컨용 Al 냉각핀은 높은 냉각성능의 향상으로 인한 전기절전 효과와 내부식성 및 친수성 등이 요구된다. DC-Sputtering법에 의한 에어컨용 알루미늄 냉각핀에 인가전압의 변화 (300V, 500V, 600V)와 증착시간 (3시간, 5시간 증착)의 변화에 따른 DLC 박막을 합성하여 AFM, XRD 및 Raman spectroscopy 측정을 통하여 분석하고, Micro Vickers Hardness 및 Roughness 등을 측정하였다.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.1
• /
• pp.42-50
• /
• 2021

Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.140-145
• /
• 2011

Purpose: Installing a radial head prosthesis has developed into a reliable procedure to replace the native radial head for treating unreconstructible radial head fracture when this is associated with an unstable elbow or forearm. A variety of implants have been developed and these are now commercially available. This article reviews the literature related to the indications, the available implants and the surgical techniques of radial head replacement arthroplasty. Materials and Methods: The main indication for a metallic radial head prosthesis is a comminuted fracture that is not amenable to reconstruction, and particularly if it is associated with complex elbow injuries. Excision of the radial head should be avoided in the presence of combined injured ligaments or interosseous membrane injury. Three different implants are available in Korea, including the bipolar, press fit monopolar and loose fit monopolar radial head prostheses. A primary technical goal of radial head arthroplasty is the insertion of an implant that closely replicates the native radial head. The major pitfall when using a metallic radial head prosthesis is the insertion of a longer implant, which results in overstuffing of the radiocapitellar joint. Results and Conclusion: Satisfactory clinical results can be anticipated when a radial head prosthesis is used for the correct indications and when a systemic approach is undertaken to ensure proper sizing. For the future studies, we need data regarding the long term outcomes and comparison of the various types of prostheses.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.6
• /
• pp.574-578
• /
• 2019

For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

• The Journal of Pediatrics of Korean Medicine
• /
• v.15 no.1
• /
• pp.219-227
• /
• 2001

중국 낙양의 평악곽씨(平樂郭氏) 정골법은 중국의학의 골상과(骨傷科) 중에서 중요한 학술유파로 널리 알려져 있다. 그 치료법에 있어서 독특하고 체계적인 시술법을 갖추고 있는데, 교정 수기법, 고정방법, 기능훈련, 약물치료 등의 내용을 포함하고 있다. 창상(創傷)에 대한 약물요법에서 "파(破) 화(和) 보(補)" 3단계로 분류된 약물사용 원칙을 제시하였는데, 즉 골정손상의 초기에는 기혈어체(氣血瘀滯)의 병리기전에 입각하여 약물은 활혈화어제(活血化瘀劑)를 주로 사용하고, 중반에는 기혈부화(氣血不和) 경락부통(經絡不通)의 기전으로 파악하고 주로 활혈통락(活血通絡)시키는 약물을 사용하며, 말기에는 구병(久病)으로 기형(氣血)이 휴손(虧損)되므로 보기혈(補氣血) 및 장근골(壯筋骨)의 약물을 주로 사용한다. 이와 같은 평악곽씨(平樂郭氏)의 正骨(정골)에 관한 약물사용 원칙을 토대로 선조의 처방과 경험방 및 후세의 통용방(協定方)을 근간으로 심은 평악곽씨(平樂郭氏)의 正骨(정골)에 대한 전통약물시리즈가 형성되었다. 이러한 처방들은 장기간의 임상활용에서 그 효과가 뛰어나고 안전성이 확보된 것으로 입증되었다. 근골통소환(筋骨痛消丸)은 활혈행기(活血行氣), 온경통락(溫經通絡), 소종지통(消腫止痛)의 효능이 있어 근골의 퇴행성 질환이나 만성 노손(勞損)으로 일어나는 종창(腫脹), 통증, 관절활동의 제한, 목 어깨 허리 다리 등의 통증, 발꿈치 통증, 골절 후 지체(肢體)의 종통(腫痛), 어혈 등에 활용한다. 활혈접골지통고(活血接骨止痛膏)는 접골속근(接骨續筋), 통락지통(通絡止痛)의 효능이 있어 골상(骨傷)을 입은 후 지체(肢體)의 종창(腫脹)이나 통증 또는 골절 등에 사용한다. 이 약은 크림제와 고약제 두가지가 있다. 평악내복접골교양(平樂內服接骨膠襄)은 활혈소종(活血消腫), 접골속근(接骨續筋)의 효능이 있어 각종 근육의 손상이나 골정상에 활용된다. 평낙전근단(平樂展筋丹)은 활혈화어(活血化瘀), 서근지통(舒筋止痛), 통리관절(通利關節), 등의 효능이 있어 타박상으로 인한 지체(肢體)의 종통(腫痛), 관절강직, 활동제한 및 골관절 질환과 풍습비통(風濕痺痛) 등을 치료한다. 전통적으로 외용(外用)에 사용되는 산제(散劑)는 마사지에 주로 활용된다. 임상에서 다양한 제형(劑型)으로 개발되어 분무형태로 쓰이는 근상정(筋傷酊)과 마사지 크림으로 사용되는 평악낙전근접마유제(平樂展筋接摩乳劑)가 있다. 소종활혈(消腫活血) 대포제(袋泡劑)는 산제(散劑)를 티팩 형식으로 사용하는 외용제형(外用劑型)이며, 서근활혈(舒筋活血), 소종지통(消腫止痛)의 효능이 있어 타박상 말기에 근육이 굳어지고, 어반이 형성되면서 통증이 나타나며, 종창(腫脹) 등이 생길 때 사용한다. 사용방법은 따뜻한 물에 담가 우려낸 다음 상처부위를 씨어주면 된다. 특별히 제작된 접골환(接骨丸)은 배보간신(培補肝腎), 익기건비(益氣健脾), 활혈통락(活血通絡), 강근건골(强筋健骨) 등의 작용이 있어 파박상이나 골절이 잘 치유되지 않고 오래 지속되는 경우에 사용된다. 이와 같은 다양한 평악곽씨(平樂郭氏)의 전통적인 정골(正骨)에 관한 약물들은 약리학적 실험을 거쳐 그 독성반응이나 부작용 및 임상효과를 관찰한 결과 통제학적으로 p<0.05-0.01로 나타나 98%의 치료효과를 보였으며, 독성 및 부작용이 없어 안정성이 인정되었으므로 긍정적인 치료효과를 확인할 수 있었다.

• Journal of the Korean Arthroscopy Society
• /
• v.14 no.2
• /
• pp.88-91
• /
• 2010

전방십자인대 재건술시 자가건 선택에 대해서는 많은 논쟁의 소지가 존재하며 많은 보고들이 나오고 있으나, 현 시점에서 이식건으로써 자가 골-슬개건-골이 표준(gold standard)라는 주장은 이제 변화하고 있으며, 골-건 고정방법의 개선에 따른 조기 슬관절 안정성의 호전으로 자가 슬괵건의 사용이 점점 증가되고 있는 추세이다. 자가 골-슬개건-골은 이식건으로써 강한 물성, 튼튼한 고정, 장기 추시에서 높은 성공률 등으로 젊고, 강한 활동을 요하는 운동선수에서 종종 선택되고 있으며 조기에 강한 활동으로의 운동 복귀를 할 수 있다. 그러나 슬관절 전방 통증, 무릎을 꿇을 때의 통증, 슬개골골절, 슬개-대퇴 관절의 염발음 및 대퇴사두근력의 감소 등 이식물 채취로 인한 공여부 이환이 문제가 되었다. 그래서 자가 골-슬개건-골의 이식건으로서의 문제점 및 문헌상 고찰을 하여 논하고자 한다.

• Proceedings of The Korean Cleft Lip And Palate Association
• /
• 2002.05a
• /
• pp.35-35
• /
• 2002

• The Journal of Korean Academy of Prosthodontics
• /
• v.58 no.2
• /
• pp.145-152
• /
• 2020

It is essential to record maxillomandibular relationship accurately for the harmony of esthetic and function in complete denture. Gothic arch tracing visually demonstrates the movement of the mandible, and is useful to establish accurate and reproducible centric relation. Proper retention and stability of complete denture in patients with severe alveolar bone resorption is difficult to attain. In such case, the closed mouth impression technique might be recommended. The denture border and impression are determined by patient's physiologic movement in the closed mouth impression technique. And, denture peripheral border is entirely closed with oral mucous membrane. This report presents satisfactory complete denture restoration using closed mouth impression technique and gothic arch tracing in patients with mandibular condyle fracture and severe absorption of mandibular alveolar ridge.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.5
• /
• pp.427-432
• /
• 2021

Delayed treatment of volar dislocation of the distal radioulnar joint can result in wrist pain, limited rotation of the forearm, and degenerative arthritis that could be managed only by salvage procedures. A 24-year-old male patient presented with wrist pain and a loss of forearm rotation after surgery for a radial shaft fracture. The shaft of the radius was fixed with a plate and screws with a volar angulation of 7°. The ulnar head was dislocated volar to the distal radius, and the bone defect in the ulnar head was impacted into the volar rim of the sigmoid notch of the radius, preventing the head from being reduced in the joint. Corrective osteotomy of the malunited radial shaft and sliding osteotomy of the proximal ulnar head were performed to fill the distal bone defect. Pain and range of the forearm rotation were improved at postoperative 19 months.

• Clinics in Shoulder and Elbow
• /
• v.15 no.1
• /
• pp.37-42
• /
• 2012

Purpose: To consider the proper management of proximal humerus fracture on gunshot wounds. Materials and Methods: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done. Result: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus. Conclusion: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.