• Title/Summary/Keyword: 나사못 고정술

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Compression Plate Fixation with Autogenous Bone Graft for Humerus Shaft Nonunion (상완골 간부 불유합에 대한 금속판 고정 및 자가골 이식술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Bae, Ki-Cheor;Kim, In-Kyoo;Kwon, Doo-Hyun
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.33-37
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    • 2009
  • Purpose: To evaluate the results of the compression plate fixation and autogenous bone graft in the management of humerus shaft nonunion. Materials and Methods: Eighteen cases were treated for humerus shaft nonunion using compression plate fixation and an autogenous iliac bone graft. The mean follow-up period was 28 months. Bony union was confirmed from the serial radiographs and the clinical outcomes were assessed according to ASES scoring system. Results: In 12 cases of initial plate fixation, the causes of nonunion were 6 cases of inadequate plate length, 2 with a broken plate, 2 with screw loosening, 1 infection and 1 noncompliance of a psychiatric patient. In 3 cases of initial intramedullary fixation, the cause of nonunion was a distraction of the fracture site. In 3 cases of external fixation, the cause of nonunion was inadequate fixation. All cases showed bony union after an average of 24 weeks. The clinical outcomes were 11 excellent, 6 good and 1 fair. Conclusion: In the treatment for nonunion, compression plate fixation with autogeneous bone graft after complete removal of the fibrous and necrotic tissue is believed to give satisfactory results.

A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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Significance of tibial intra-tunnel fixation at Arthroscopic ACL Reconstruction with hamstring tendon (Second-look Arthroscopic Evalution) (자가 슬괵건을 이용한 전방 십자인대 재건술시 경골측 골 터널내 고정의 의의 (이차관절경 검사의 평가))

  • Kim, Young-Chang ;Seo, Seung-Suk;Jung, Kyung-Chil;Gwak, Hey-Chul;Kim, Yoon-Jun;Kim, Jin-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.165-172
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    • 2006
  • Purpose: The purpose of this study is to evaluate the effects of intratunnel fixation in the tibial side on the arthroscopic ACL reconstruction with quadruple hamstring tendon at the second look arthroscopy. Materials and Method: From Dec 1999 to May 2005, we arthroscopically reexamined 32 cases who had been done arthroscopic ACL reconstruction with quadruple hamstring tendons. Hamstring tendons of all cases were fixed at femoral side with RigidfixTM. At the tibial side hamstring tendons were fixed only Post-tie (Group I) or Post-tie combined with IntrafixTM (Group II). At the time of second look arthroscopy mean age of cases was 30 years and mean duration for second look arthroscopy was 21.3 months. We analyzed the results with IKDC score, KT-1000 arthrometer under anesthesia, Telos stress radiography, tibial tunnel widening on the radiography and second look arthroscopic findings. Results: Group II had more superior than group I at side to side differences with KT-1000 and Telos stress radiograph, IKDC score, but the differences were insignificant. At arthroscopic evaluation, Group ll also had more superior than group I at graft tension and graft appearance, graft synovialization, but the differences were insignificant. Tibial tunnel widening in the knee AP radiograph was 2.3 mm in Group I and 1.7 mm in Group II and the difference was significant. (P=0.042) Conclusions: Additional procedure of tibial intratunnel fixation in arthroscopic ACL reconstruction with autogenous hamstring tendon significantly prohibited from tibial tunnel widening but clinical results, radiologic joint stability, findings in second look arthroscopy were insignificantly different. We concluded that Post-tie itself induced satisfactory clinical results, joint stability and graft maturation and that tibial tunnel widening did not affect the results.

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Short-Term Results of Subpectoral Tenodesis of the Proximal Biceps Tendon Using by Interference Screw (간섭나사를 이용한 흉근하 상완 이두근 건 고정술의 단기 추시 결과)

  • Kim, Jeong-Woo;Kang, Hong-Je
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.7-13
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    • 2010
  • Purpose: Our purpose was to retrospectively analyze clinical results of subpectoral tenodesis of the proximal biceps tendon using an interference screw. Materials and Methods: We reviewed 23 cases of patients receiving tenodesis of the proximal biceps tendon between January 2008 and January 2009 for whom we had follow-up data for at least 1 year. Twenty-three cases were operated on using subpectoral tenodesis; 16 of these cases had a rotator cuff tear. The results were judged using a visual analog scale (VAS), ASES, tenderness on the biceps groove, fixation failure and the degree of deformity (BAD). Results: VAS and ASES scores were significantly improved in all patients by the time of the final observation. There were no significant complications or fixation failures. The patients without a tear of the rotator cuff had a better result than patients with a tear of the rotator cuff, but the difference between the two groups was not significant (p>0.05). Conclusion: In patients with pathology of the long head of the biceps brachii, benefits of subpectoral interference screw tenodesis include pain relief, maintenance of functional biceps, muscle strength, and cosmesis. Subpectoral biceps tenodesis using interference screw fixation appears to be a promising, reproducible, reliable technique for addressing anterior shoulder pain related to pathology of the long head of the biceps brachii.

The Surgical Treatment of Type V Acute Acromioclavicular Joint Dislocation Using Suture Anchor and Kirschner Wire (봉합 나사못과 Kirschner 강선을 이용한 제 5형 급성 견봉 쇄골 관절 탈구의 수술적 치료)

  • Jung, Gu-Hee;Cho, Chyul-Hyun;Jang, Su-Jin;Jang, Jae-Ho;Kim, Jae-Do
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.217-222
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    • 2010
  • Purpose: We wanted to evaluate the clinical outcomes after operative treatment using two suture anchors and Kirschner wire for treating acute Rockwood type V acromioclavicular joint dislocation Materials and Methods: Between May 2006 and May 2009, 10 patients underwent surgical treatment for acute Rockwood type V acromioclavicular joint dislocation using two suture anchors and Kirschner wire and they were followed for a mean of 12.0 (range: 7-31) months. We analyzed the functional results by the Korean shoulder score, the Constant-Murley score and the reduction state of the acromioclavicular joint at the last follow-up. Results: All the cases achieved a satisfactory outcome. The mean Korean shoulder score was 89.9 (range: 81-100) points and the mean Constant-Murley score was 87.8 (range: 82-93) points. According to the radiologic findings, 8 patients achieved anatomical reduction of the acromioclavicular joint: there was a slight loss of reduction in one patient and a partial loss of reduction in one patient. None of the patients had deep infection or re-dislocation. Conclusion: The operative treatment using two suture anchors and Kirschner wire may be used for acute Rockwood type V acromioclavicular joint dislocation, and it has an advantage in that it can prevent chondral injury of the joint.

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

  • Kim, Cheol-Jeong;Son, Seung Min;Heo, Jin-Young;Lee, Chi-Seung
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.33 no.3
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    • pp.145-152
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    • 2020
  • In this study, we evaluated spinal stability based on the change in the thoracolumbar fixation segment using finite element analysis (FEA). To accomplish this, a finite element (FE) model of a normal thoracolumbar spine (T10-L4), including intervertebral discs (IVD), ligaments, and facet joints, was constructed, and the material properties reported in previous studies were implemented. However, L1 was assumed as the lesion site, and three types of posterior fixation, namely, L1-L2, T12-L2, and T12-L1-L2, were implemented in the thoracolumbar FE model. In addition, the loading conditions for flexion, extension, lateral bending, and axial rotation were adopted. Through the series FEA, the deformation, equivalent stress, range of motion, and moment on the pedicle screws, vertebrae, and IVD were calculated, and the spinal stability was evaluated based on the FEA results.

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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A Case of New Surgical Correction of Angular Limb Deformities Using One Screw Implant & Periosteal Transection in a Thoroughbred Foal (Thoroughbred 망아지에서 단일나사못 장착 및 골막박리를 이용한 지세교정술)

  • Yang, Jae-Hyuk;Lim, Yoon-Kyu
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.177-180
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    • 2012
  • Angular limb deformities (ALD) are common in foals. A 30-days-old Thoroughbred foal was presented for the evaluation of severe ALD of the both forelimbs. On radiographic examination, both distal radiuses were diagnosed as valgus angular limb deformities. But the degree of deviation of right forelimb was so severe that we tried to correct one after the other. We tried new surgical correction method combination of one screw implant on medial aspect for growth retardation and periosteal transection on lateral aspect of the right forelimb. 40 days later, successfully corrected and then removed the screw. After the right forelimb correction, the periosteal transection on left forelimb was performed. We did the inhalation anesthesia using isoflurane. There were no complications such as fibrosis over the screw heads, and overcorrection that produces an opposing deformity identified. These results suggest that combination of one screw implant and periosteal transection technique is able to be a safe and effective method to correct severe ALD in the foal.

Maisonneuve Fractures Treated with Percutaneous Screw Fixation (경피적 나사못 고정술로 치료한 Maisonneuve 골절)

  • Jung, Chol-Yong;Son, Young-Chan;Bae, Jun-Bum;Choi, Moon-Do
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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    • pp.61-66
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    • 2000
  • Purpose: To evaluate the clinical validity of percutaneous screw fixation in Maisonneuve fracture. Material and Methods: Out of 5 Maisonneuve fracture patients hospitalized in the department of orthopedic surgery of Seigang hospital from February 1995 to May 1998, 4 patients were treated with percutaneous screw fixation and 1 patient was treated with percutaneous screw fixation and repair of deltoid ligament altogether. The results were evaluated on the clinical and radiological finding. Results: In all cases, the range of motion of ankle joint was normal, the complication such as postoperative pain and post-traumatic arthritis were not found. Widening of medial clear space or talar shift were not found in the follow up X-ray and tibiofibular distance, compared with normal ankle joint was same on follow up CT. Conclusion: Percutaneous screw fixation is simple, less invasive and more effective method in the treatment of Maisonneuve fracture.

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Arthroscopic Cannulated Screw Fixation Technique for Avulsion Fracture of the Intercondylar Eminence of the Tibia (삽관 나사못(Cannulated screw)을 사용한 경골 과간 융기부 견열 골절의 관절경적 치료 기법)

  • Lee, Kee-Byoung;Chang, Ho-Guen;Lee, Seok-Beom;Moon, Young-Wan;Kang, Ki-Hoon;Lee, Wook-Hyung
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.127-131
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    • 1999
  • Avulsion fractures of the intercondylar eminence of the tibia are not uncommon. In the displaced avulsion fracture, anatomical reduction and firm fixation of fracture fragments are needed but the most of the conventional operative techniques including arthroscopic technique are relatively complex and need. The results were not always satisfactory due to the risk of postoperative complications such as wound infection, premature epiphyseal closure and loss of fixation after early motion etc. So we describe a simple and safe modified method of arthroscopic reduction and fixation for avulsion fractures of the intercondylar eminence of the tibia. In our thirteen cases, we achieved anatomical reduction and secure fixation using cannulated screw through the three arthroscopic portals (anterolateral, medial mid-patellar and central). Postoperatively, immediate limited range of motion of the knee and partial weight bearing were possible. Additional use of the washer afforded safe fixation of comminuted avulsion fracture. The advantage of this technique includes its technical simplicity, easy removal of hardware, ability to treat comminuted type IV fracture with washer, no additional skin incision, no damage to growing plate in growth children and less morbidity.

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