• 제목/요약/키워드: 나사못

검색결과 162건 처리시간 0.026초

생체흡수성 나사못을 이용한 원위경비관절 이개의 치료 (Treatment of syndesmotic injury of ankle with bioabsorbable screw)

  • 강재도;김광열;김형천;임문섭;김진형;김성훈
    • 대한족부족관절학회지
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    • 제7권1호
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    • pp.88-94
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    • 2003
  • Purpose: Bioabsorbable screws are used to fix the syndesmotic injury of ankle because of no need for additional operation to remove it. The purpose of this study is to assess the efficacy of polylevolactic acid (PLLA) screws of in the treatment of the syndesmotic injury of ankle. Materials and Methods: Eight patients of the syndesmotic injury of ankle with malleolar fracture were evaluated in this study. They were managed with plate and screw fixation for malleolar fracture and polylevolactic acid screw fixation for syndesmotic injury, followed by plaster splinting for 6 weeks. Clinical and radiographic evaluation were done and functional scores were assessed. Results: In all cases, malleolar fractures were healed without problematic widening of syndesmosis. There were no sinus tract formation and no wound complication. Of eight patients, five had excellent results and three had good results. Conclusion: We conclude that polylevolactic acid screw is good material for fixation of the syndesmotic injury of ankle.

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견봉 쇄골 탈구와 쇄골 외측단 골절에서 일시적 오구 쇄골간 나사못 고정술 (Coracoclavicular Screw Fixation for AC Dislocation and Unstable Distal Clavicle Fracture)

  • 김진섭;전진호;정영기
    • Clinics in Shoulder and Elbow
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    • 제2권2호
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    • pp.133-137
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    • 1999
  • Purpose: There are so many different methods with the their own advantages and disadvantages for acute AC dislocation and distal unstable clavicle fracture. We evaluated the usefulness of temporary Bosworth's coracoclavicular fixations using the cannulated screw and reviewed our clinical results. Materials and Methods: We evaluated 34 cases of temporary coracoclavicular fixations with cannulated screw and washer for acute AC dislocation(25cases in the Type V, Ⅲ) and distal unstable clavicle fracture(9cases in the Type ⅡB, Ⅱ+Ⅲ). All cases were fixed by the same techniques, guided cannulated screw under C-arm after the repair of the CC ligament within 1 week. Bases on the regular check, screws were removed at the 6-12 weeks under local anesthesia. The final clinical and radiological results(average 14 months follow-up) were rated with the UCLA scale. Results : All shoulders were gained nearly full ROM passively at the 3-4 weeks. The overall satisfactory resuIts(excellent or good) were achieved 88%(22/25) in the acute AC dislocation and all in the distal unstable clavicle fracture. There were no definite complications except three initial fixations loosening. Conclusion: Temporary Bosworth's coracoclavicular fixation using the cannulated screw with guided pin was simple precedure and provided enough initial stability for acute AC dislocation and distal unstable clavicle fracture.

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원위 경비 인대 결합 고정 긴장도와 기간이 나사못 제거 후 이개 및 임상 증상에 미치는 영향 (The Impacts of Fixation Tightness and Duration on the Remnant Syndesmotic Widening and Clinical Symptom after Removal of Screws)

  • 배서영;손수인;성민규
    • 대한족부족관절학회지
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    • 제17권4호
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    • pp.264-271
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    • 2013
  • Purpose: We aimed to analyze the effect of fixation tightness of the syndesmotic screw and its indwelling period on the recurrence of the syndesmosis widening after screw removal and the clinical outcomes. Materials and Methods: Forty consecutive patients with acute syndesmotic injury were retrospectively reviewed. The tibiofibular clear space is measured by digitalized measurement tool on serial radiographs. We analyzed the effect of time from trauma to fixation, syndesmotic screw indwelling duration, and fixation methods. Residual symptoms at the last follow up were evaluated. The student t-test, correlation test, and chi-square test were used for statistical analysis. Results: Eighteen ankles (45%) had recurrent syndesmosis widening (greater than 5% compared to the contralateral side). Seven patients had pain and five had limitation of motion in the ankle joint. Fixation tightness had significant effect on reducing the recurrence while the severity of the initial widening, time to fixation, and duration of fixation did not affect the outcome. Conclusion: Tight fixation of syndesmotic screw is essential for achieving final syndesmotic stability and reducing recurrence.

견관절의 삼중 관절와 순 병변 - 증례 보고 - (Triple Labral Lesion of Shoulder - A Case Report -)

  • 최남용;송현석;윤재웅
    • Clinics in Shoulder and Elbow
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    • 제12권1호
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    • pp.80-83
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    • 2009
  • 목적: 삼중 관절와 순 병변(triple labral lesion)은 전방, 후방, 상방 관절와 순의 파열이 동시에 발생한 경우를 말한다. 문헌 보고가 드물어서, 수상 기전과 증상에 대하여 아직 정립되지는 않았다. 대상 및 방법: 본 저자들은, 교통 사고 후 우측 견관절의 동통과 능동적 외전 장애를 보인 39세 남자에서 삼중 관절와 순 병변을 경험하였다. 내원 시에 관절와 상완 관절의 불안정에 대한 증상을 호소하지는 않았다. 흡수성 봉합 나사못과 봉합 갈고리를 사용하여 관절와 순에 대한 봉합술을 시행하였다. 결과: 수술 후 18개월 추시에서, 능동적 운동범위는 정상으로 호전되었으며 일상 생활 중에는 어려움이 없었다.

협부형 척추전방전위증에 대한 후방가동관절 이용한 골유합술 및 척추경나사못 고정술의 수술적 결과 (Surgical Results of Patients with Isthmic Spondylolisthesis with Transpedicular Screw Fixation and Posterior Lumbar Interbody Fusion Using Posterior Movable Segment)

  • 김찬;이승명;신호
    • Journal of Korean Neurosurgical Society
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    • 제30권sup1호
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    • pp.108-114
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    • 2001
  • Objective : Posterior lumbar interbody fusion(PLIF) provides the favorable outcome to degenerative lumbar disease, especially isthmic spondylolisthesis. To determine the long-term effect of PLIF using psterior movable segment, we analysed the results of follow-up radiologic changes and surgical outcome retrospectively Patients and Method : During the past 11 years(1989. 1.-1999. 9.), 148 patients with symptomatic lumbar spondylolisthesis were managed at our department and the clinical wants were throughly recieved and final outcome is determined at last follow up. PLIF using antogenous bone(posterior movable segment, iliac bone and rib) were performed in 106 case. Results : After an average follow-up period of 33 months(range ; 15-58 months), the results were excellent in 66 cases, good in 37 cases, fair in 2 cases and poor in 1 cases. And the satisfactory results were 103 cases(98.2%) in PLIF,. Conclusion : In conclusion, patients who underwent PLIF with autologous bone graft had good clinical and radiological outcomes without significant neurological complications.

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무지외반증 환자의 근위 갈매기형 절골술에서 생체 흡수성 나사못을 이용한 고정 (Bioabsorbable Screws Used in Hallux Valgus Treatment Using Proximal Chevron Osteotomy)

  • 신우진;정영우;안기용;서재웅
    • 대한족부족관절학회지
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    • 제22권4호
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    • pp.181-183
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    • 2018
  • Hallux valgus is a deformity that causes pain in the first metatarsophalangeal joint. Surgical methods are quite diverse and a range of osteotomies are used at the proximal and distal part of the metatarsal bone and proximal phalange. Fixation methods, such as plate, screw, K-wire, and others have been used in various ways. The fixation device is often removed with various side effects due to the fixation devices. In the case of instruments that are absorbed in vivo, these procedures are not necessary to remove and there is an advantage of not performing the second operation. Three patients were treated, in which a proximal chevron osteotomy was used with a bioabsorbable screw (K-$MET^{TM}$; U&I Corporation).

척추의 해부학적 요소를 고려한 척추경 나사못 디자인의 Pullout 특성 연구 (A Study on Pullout Characteristics of Pedicle Screw Design Considering Anatomical Structure of the Lumbar Spine)

  • 유경주;박광민;안경기;안윤호
    • 대한의용생체공학회:의공학회지
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    • 제42권1호
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    • pp.1-6
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    • 2021
  • Recently, various types of pedicle screws have been developed considering the anatomical structure of the spine. The purpose of this study was to evaluate the pullout stiffness and strength of two types of commercial pedicle screws. The design of two type screws were single pitched thread (ST) pedicle screw and dual pitched thread (DT) pedicle screw, respectively. The tests were conducted in accordance with the ASTM standards using polyurethane (PU) test blocks which has anatomical structure of the spine. There was no significant difference in pullout stiffness between two types of screw. However, DT exhibited higher pullout strength than ST (p<0.05). Pedicle screw with dual pitched thread showed higher pullout strength without decrease in pullout stiffness compared to the standard pedicle screw. In conclusion, dual pitched thread design of the pedicle screw is considered to be more suitable than the single pitched thread for the anatomical structure of the spine.

불안정성 흉·요추부 골절에 대한 단 분절 척추경 나사못 고정술 및 추체 보강 성형술 - 예 비 보 고 - (Short Segment Pedicle Screw Fixation with Augmented Intra-Operative Vertebroplasty in Unstable Thoraco-Lumbar Fracture - Preliminary Report -)

  • 김영우;오성한;윤도흠;진동규;조용은;김영수
    • Journal of Korean Neurosurgical Society
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    • 제30권11호
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    • pp.1271-1277
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    • 2001
  • Objectives : Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. Material and Methods : The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography. Results : Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. Conclusions : In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.

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유한요소해석 기반 척추 고정분절 변화에 따른 척추 안정성 평가 (Spinal Stability Evaluation According to the Change in the Spinal Fixation Segment Based on Finite Element Analysis)

  • 김철정;손승민;허진영;이치승
    • 한국전산구조공학회논문집
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    • 제33권3호
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    • pp.145-152
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    • 2020
  • 본 논문에서는 유한요소해석을 이용하여 흉요추 후방 고정술의 고정분절 변화에 따른 척추 안정성을 평가하였다. 이를 위해 추간판, 인대, 추간관절(Facet joint) 등을 포함한 정상 흉요추(T10-L4)의 유한요소모델을 구축하였으며, 문헌으로 보고된 재료물성치를 부여하였다. 한편, L1을 병변 부위로 가정하였으며, L1-L2, T12-L2, T12-L1-L2 총 3가지 종류의 후방 고정술을 흉요추 유한요소모델에 구현하고 전방 굽힘, 후방 굽힘, 측면 굽힘, 축 회전의 하중 조건을 부여하였다. 시리즈 유한요소해석을 통해 고정분절에 따른 척추경 나사못, 척추골, 추간판의 변형량, 등가 응력, 운동 범위, 모멘트를 계산하였으며, 그 결과를 바탕으로 척추 안정성을 평가하였다.

회전근 개 파열에 대한 관절경적 봉합술 중 일열 봉합술의 유용성 (Arthroscopic Rotator Cuff Repair by Single Row Technique)

  • 염재광
    • Clinics in Shoulder and Elbow
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    • 제11권2호
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    • pp.77-81
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    • 2008
  • 회전근 개 파열에 대한 봉합 수술의 목적은 봉합 초기에 고정력을 높이고 건-골 사이의 간격 형성을 최소화 하며 반복적인 부하에 기계적인 안정성을 유지시키고 회전근 개의 끝이 뼈에 부착되어 치유될 때까지 건-골 사이의 치유 환경을 최적화시키는 것이다. 일열 봉합은 원래의 회전근 개 부착부에 건을 완전히 부착시키는 면적이 제일 적고 간격 형성에 취약하다. 이열 봉합은 고정 실패를 방지하는 힘이 일열 봉합보다는 우수하고 간격 형성도 더 적으며 교량형 봉합은 최대 인장력이 가장 크며 전단력 및 회전력에 강하고 간격 형성도 제일 적다. 이러한 것을 볼 때 이열 봉합 및 교량형 봉합이 일열 봉합보다 우수한 점이 많지만 수술 시간이 좀 더 오래 걸리고 삽입하는 나사못의 개수도 많아 수술료가 비싸다는 단점도 가지고 있다. 따라서 일열 봉합도 회전근 개의 점액 낭측 부분층 파열이나 작은 완전 파열에 쓰여질 수 있는 아직은 유용한 방법으로 사료된다.