• Title/Summary/Keyword: 나사못 고정술

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Arthroscopic Anterior Talofibular Ligament Repair for Grade II Chronic Ankle Instability - Two Cases Report - (족관절 중등도 불안정성의 관절경적 전거비인대 봉합 - 증례 보고 -)

  • Song, Baek-Yong;Young, Ki-Won;Kim, Jin-Su;Park, Young-UK;Kim, Tae-Won;Lee, Kyung-Tai
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.22-27
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    • 2011
  • The modified Brostrom procedure is first considered for the treatment of chronic ankle instability (CAI). Recently, ankle arthroscopy is also recommended for the treatment of concomitant intra-articular lesions during the open repair of the lateral ligaments. We arthroscopically repaired the anterior talofibular ligament with a use of bio suture anchor for CAI as well as performing the multiple drilling procedure for combined osteochondral lesion of talus. We report the cases with a review of the literature.

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Percutaneous Fixation with Cannulated Screws and Ilizarov External Fixator in Triplane Fracture of the Distal Tibial Epiphysis in Children (소아 경골 원위 골단부 삼면 골절의 경피적 나사못 고정술과 Ilizarov 외고정 장치를 이용한 치료)

  • Hyun, Yun-Seok;Kim, Gab-Lae;Lee, Kwang-Nam;Lee, Eun-Su
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.180-184
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    • 2008
  • Purpose: To evaluate the result of percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fracture of the distal tibial epiphysis in children. Materials and Methods: Between May 2004 and December 2007, 14 cases with triplane fractures were treated by percutaneous fixation with cannulated screws and Ilizarov external fixator after underwent CT imaging to assess the fracture pattern, articular disruption and to plan further management. Mean age and follow-up period were 14.1 years old and 15 months respectively. Results: There were satisfactory results in all 14 cases that had excellent reduction and stable fixation. All cases regained full range of movement within 6 weeks. Conclusion: We obtained satisfactory result after percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fractures of the distal tibial epiphysis in children.

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Comparative Analysis of Biomechanical Behaviors on Lumbar with Titanium and Carbon Fiber Reinforced PEEK Connecting Rods for Fusion Surgery (티타늄과 탄소 섬유 강화 PEEK로 구성된 요추 유합술용 연결봉의 의공학적 영향에 대한 비교 분석)

  • Seo, Hye-Sung;Kang, Hae-Seong;Chun, Houng-Jae
    • Composites Research
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    • v.34 no.3
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    • pp.186-191
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    • 2021
  • The lumbar spinal fusion is a treatment performed to restore the stability of the degenerated lumbar. In this study, the intervertebral discs between two or more segments are removed and a bone graft is inserted to harden the segments. The pedicle screw system is inserted to vertebral bodies to fix two or more segments so that they can be firmly fused. In this study, a total of 7 patient-specific lumbar finite element models were created and pedicle screw systems were installed. The connecting rods made of titanium and CFR-PEEK was inserted to the generated models. Finite element analysis was conducted for four representative spine behaviors and statistical analysis was performed to investigate the biomechanical effects by the material properties of connecting rods. The intradiscal pressure of adjacent segments and the range of motion of the joints of each segment were investigated. In the subjects who used CFR-PEEK instead of Ti for connecting rods, the intradiscal pressure of adjacent segments tend to decrease and the range of motion of each segment tend to increase. However, no statistically significant difference in tendency was observed under all loading conditions.

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.

Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures (상완골 간부 골절에서 교합성 골수강 내 금속정 고정 후 잔존한 골절편 전위에 대한 임상적, 방사선학적 추시)

  • Yum, Jae-Kwang;Lim, Dong-Ju;Jung, Eui-Yub;Sohn, Su-Een
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.107-114
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    • 2013
  • Purpose: This study is designed to evaluate the clinical and radiographical results for the displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures. Materials and Methods: We retrospectively reviewed the results of 8 cases of humeral shaft fractures that have displacements of over 10 mm and under 20 mm after interlocking intramedullary nailing between July 2004 and August 2011. The mean age was 54.1 years (range, 43 to 70 years) and there were 3 male and 5 female patients. Radiographically, the time to bony union, change of displacement and angulation of the fracture site, and degree of improvement of these two factors were measured. Clinically, the range of motion of shoulder and elbow joints, postoperative pain and complications were evaluated. Results: All cases showed complete bony union in last follow-up. The mean time to bony union was 16.1 weeks. At the last follow-up, almost all cases had normal range of motion of shoulder and elbow joints. But, one case had stiffness of shoulder joint. Therefore, arthroscopic capsular release and manipulation was performed. One case had transient shoulder pain and the other case had transient elbow pain. In the two cases, pull-out of proximal interlocking screw were noted, but they finally had bony union. Conclusion: Although considerable displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures was present, we had excellent radiographical and clinical outcomes. Therefore, an additional procedure, such as open reduction or another fixation for the fracture site, was not necessary.

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

  • Yum, Jae-Kwang
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.77-81
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    • 2008
  • The goal of rotator cuff repairs is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading and optimize the biology of the tendon-bone interface until the cuff heals biologically to the bone. Single row repairs are least successful in restoring the footprint of the rotator cuff and are most susceptible to gap formation. Double row repairs have an improved load to failure and minimal gap formation. Transosseous equivalent repairs (suture bridge technique) have the highest ultimate load and resistance to shear and rotational forces and the lowest gap formation. Even though the superior advantages of double row and transosseous equivalent repairs, those techniques take longer surgical time and are more expensive than single row repairs. Therefore single row repairs can be useful in bursal side partial thickness or small size full thickess rotator cuff tear.

Arthroscopic Treatment of an Anterior Cruciate Ligament Avulsion Fracture: Physeal-Sparing, All-Inside Suture Bridge Repair (전방십자인대 견열 골절의 관절경적 치료: 성장판을 보존한 All-Inside 교량형 봉합술)

  • Park, Byeong-Mun;Lee, Seung-Hwan;Yang, Bong-Seok;Kim, Ji-Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.444-449
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    • 2020
  • An anterior cruciate ligament (ACL) avulsion fracture is an uncommon injury that occurs predominantly in the pediatric and adolescent population. Accurate reduction and fixation of an avulsed fragment are necessary to restore and maintain the length of the ACL and normal knee biomechanics. Several techniques are available to repair an ACL avulsion fracture. On the other hand, treatment is controversial in skeletally immature patients due to risk of physeal injury. This paper reports a case of an ACL avulsed fracture in a skeletally immature patient treated with arthroscopic all-inside suture bridge repair, in which an excellent result and firm stability were obtained without physeal injury.

Posterior C1-2 Transarticular Screw Fixation without C1-2 Sublaminar Wiring in Atlantoaxial Instability (제 1, 2 경추간 판하철사고정술 없는 후방 경관절 나사못 고정술 및 골유합술)

  • Shin, Yong Hwan;Hwang, Jeong Hyun;Sung, Joo Kyung;Hwang, Sung Kyu;Hamm, In Suk;Park, Yeun Mook;Kim, Seung Lae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1469-1475
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    • 2000
  • Objective : The goal of this study was to evaluate the clinical outcome of the posterior C1-2 transarticular screw fixation without C1-2 sublaminar wiring in atlantoaxial instability. Methods : Between Apr. 1995 and Feb. 2000, we used this technique in treat randomly selected 17 patients (11 men, 6 women) who had atlantoaxial instability. The causes of instability were : type II-A odontoid process fracture(10 cases) ; type II-P odontoid process fracture(1 case) ; Os odontoideum(2 cases) ; transverse ligament laxity due to rheumatoid disease(1 case) ; and, transverse ligament injury without bone fracture(3 cases). All cases were operated with posterior C1-2 transarticular screw fixation with 3.5mm cortical screw and interlaminar iliac graft without sublaminar wire fixation. The mean follow-up period was 28 months(5 to 58 months) and the mean age at the time of operation was 41 years(15 to 68 years). All Patients were allowed to ambulate with Philadelphia neck collar on the first post-operation day. Results : Bony fusion was successfully achieved in all cases demonstrated at 3-month follow-up studies. There was no operative mortality or morbidity. Conclusion : The authors conclude that the posterior transarticular screw fixation without C1-2 sublaminar wiring provide adequate stability with high bony union rate in atlantoaxial instability of various causes.

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The Complications of the Graf Stabilization for Lumbar Disc Herniation with Posterior Instability (후방불안정성을 동반한 요추 추간판 탈출증에서 Graf 고정술후 발생한 합병증 분석)

  • Park, Joo-Tae;Shin, Young-Shik;Yang, Jeong-Ho;Min, Kang-Woo
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.164-172
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    • 1998
  • The Graf stabilization has been introduced in treating lumbar spinal disorder associated with posterior instability. This study reviewed some problems of the Graf instrumentation as a soft stabilizer. The purpose of this study is to analyse the problems of the soft stabilization in spinal instability. We reviewed 145 cases which were operative treatment using the Graf instrument for lumbar spinal disorder associated with posterior instability at our department from May, 1991 to Dec, 1995. The mean follow up periods was 29 months ranging from 24 months to 6 years 8 months. Of the 145 cases, 22 cases were showed the problem. The diagnostic method were simple x-ray, flexion-extension lateral stress view and CT scan. Results were as follows: Adjacent segmental instability was 10 cases(6.9%), disc space narrowing was 8 cases(5.5%), screw loosening was 3 cases(2.1%) and breakage of the Graf band was 1 case(0.6%). The problems of the soft stabilization were adjacent segmental instability, disc space narrowing, screw loosening, and breakage of the Graf band. But the rate of adjacent segmental instability and disc space narrowing was lower than other lumbar spinal instrumentation.

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One Stage Revision Anterior Cruciate Ligament Reconstruction (일단계 전방 십자 인대 재 재건술)

  • Ra, Ho-Jong;Ha, Jeong-Ku;Kim, Sang-Bum;Sung, Jung-Hwan;Seo, Jeong-Gook;Kim, Jin-Goo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.143-148
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    • 2009
  • Purpose: To investigate the causes of failure on ACL reconstructions and evaluate the effectiveness of one stage revision ACL reconstructions. Materials and Methods: From November 2004 to July 2008, thirty three patients who had got revision ACL recontstructions after reruptures of ACL were evaluated. The causes of failure of ACL reruptures were 22 vertical femoral tunnels, 7 neglected PLRI, 3 severe traumas and 1 deep infection after ACL reconstruction. The femoral tunnels were aimed at the 10 or 2 o'clock position and the tibial tunnels were used with previous tunnels. Previous femoral screws from the improper femoral tunnels were removed and filled with the new allograft bones. Results: The average periods of follow up were 22.2 months (12~52 months). There was improvement on an average Lysholm knee score from $61.5{\pm}16.8$ to $86.3{\pm}11.5$, IKDC score from $63.9{\pm}15.1$ to $81.3{\pm}14.3$. Mean side to side difference was decreased from $6.0{\pm}2.2\;mm$ to $1.6{\pm}1.4\;mm$ using KT-2000 arthrometer. Conclusion: One stage revision ACL reconstruction can be a useful method with good clinical results.

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