• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.159-166
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• 2009

Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.25-31
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• 2012

Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.137-142
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• 2008

Purpose: To evaluate the clinical and radiographic results of the treatment of a proximal humerus fracture with a locking compression plate(LCP). Materials and Methods: This study reviewed the results of 24 cases of a proximal humerus fracture treated with a LCP from January 2005 to April 2007, after a follow up of more than 12 months. There were 8 males and 16 females with a mean age of 68.9(33-90) years. The clinical results were evaluated using the Neer's evaluation criteria, and the radiographic results were evaluated using the bone union time and Paavoleinen method. Results: The mean time for bone union was 11.9 weeks. Using the Neer's functional evaluation, 21 cases of the 24 patients (87%) showed excellent or satisfactory results. Twenty two cases (91%) showed good results according to the Paavoleinen method. The complications encountered were metal failure (1 patient), AVN of the humeral head (1 patient) and joint stiffness (1 patient). Conclusion: The LCP demonstrated good results in the treatment of a proximal humerus fracture and has relatively fewer complications than other internal fixators.

• Journal of Biomedical Engineering Research
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• v.24 no.5
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• pp.401-410
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• 2003

This study investigates the biomechanical efficacies of various cement augmentation techniques with or without pressurization for varying degrees of osteoporotic femur. For this study, a biomechanical analysis using a finite element method (FEM) was undertaken to evaluate surgical procedures, Simulated models include the non-cemented(i.e., hip screw only, Type I), the cement-augmented(Type II), and the cemented augmented with pressurization(Type III) models. To simulate the fracture plane and other interfacial regions, 3-D contact elements were used with appropriate friction coefficients. Material properties of the cancellous bone were varied to accommodate varying degrees of osteoporosis(Singh indices, II∼V). For each model. the following items were analyzed to investigate the effect surgical procedures in relation to osteoporosis of varying degrees : (a) von Mises stress distribution within the femoral head in terms of volumetric percentages. (b) Peak von Mises stress(PVMS) within the femoral head and the surgical constructs. (c) Maximum von Mises strain(MVMS) within the femoral head, (d) micromotions at the fracture plane and at the interfacial region between surgical construct and surrounding bone. Type III showed the lowest PVMS and MVMS at the cancellous bone near the bone-construct interface regardless of bone densities. an indication of its least likelihood of construct loosening due to failure of the host bone. Particularly, its efficacy was more prominent when the bone density level was low. Micromotions at the interfacial surgical construct was lowest in Type III. followed by Type I and Type II. They were about 15-20% of other types. which suggested that pressurization was most effective in limiting the interfacial motion. Our results demonstrated the cement augmentation with hip screw could be more effective when used with pressurization technique for the treatment of intertrochanteric fractures. For patients with low bone density. its effectiveness can be more pronounced in limiting construct loosening and promoting bone union.

• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.208-214
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• 2021

Purpose: Verifying a reliable predictor of the progression of vertebral deformity in patients with acute osteoporotic fractures of the lumbar spine may be useful. A qualitative analysis of the muscle near the spine was performed using magnetic resonance imaging (MRI), and its correlation with a spinal deformity was determined under the hypothesis that the causes of the kyphotic deformity are associated with muscle reduction in the multifidus and erector spinae. Materials and Methods: The study was performed in a retrospective manner using the electronic medical records of patients who presented to the author's institution between January 2007 and March 2018, and were diagnosed with an acute lumbar fracture. The fat infiltration rates of the multifidus and erector spinae were measured using MRI taken at the time of injury, and the mean value was defined as the total fat infiltration rate (TFI). Based on lateral radiographs of the lumbar spine at the one-year follow-up, the loss of height of the vertebral body, the kyphotic angle and the wedge angle were measured. The statistical significance was confirmed by calculating the Pearson correlation coefficient. Results: One hundred twenty-nine patients, of which 30 were male and 99 were female, were examined. The mean age was 71.28 years. The mean T-score was -3.53±0.79 g/cm², and the mean fat infiltration was 15.20%±11.99%. TFI was positively correlated with age (R=0.373, p<0.001), compression rate (R=0.369, p<0.001), and Cobb's angle (R=0.386, p<0.001) after a one year follow-up, but negatively correlated with the BMD score (R=-0.252, p=0.004). As the fracture progressed to the lower lumbar level, the compression rate (R=-0191, p=0.030) and wedge angle (R=-0.428, p<0.001) at the time of injury tended to decrease. Conclusion: In patients with osteoporotic vertebral fractures, the fat infiltration rate may be an important predictor of conservative treatment. The prognosis of patients with a high-fat infiltration rate should be explained during patient education, and the patients must be monitored closely through short-term outpatient follow-up.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.260-265
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• 2010

Purpose: To report the clinical results of two cases of coronoid process fractures that were treated with volar plating through a medial approach. Materials and Methods: Two fractures of the coronoid process that needed to be fixed were managed with open reduction and internal fixation through a medial approach using 2.4 mm locking compression plates (Compact Hand set$^{(R)}$, Synthes, Switzerland). The patients were followed up for 14 months and 17 months and were evaluated using the Mayo Elbow Performance Score (MEPS). Results: The MEPS was 95 for Case 1 and 100 for Case 2. Active elbow joint motions were $5^{\circ}-120^{\circ}$ (Case 1) and $0^{\circ}-130^{\circ}$ (Case 2). Supination and pronation fully recovered. Conclusion: Satisfactory results can be obtained in cases of coronoid process fractures because volar plating through a medial approach allows sound fixation and early mobilization of the elbow joint.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.06a
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• pp.1921-1924
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• 2005

In this paper, three-dimensional finite element analysis have been performed to investigate the biomechanics of vertebroplasty in patient. In order to apply various properties of the spine, the functional relation between the well-known apparent density and HU(Hounsfield unit) from CT image were employed and thus real material property can be assigned to each element of FE model. The FE analysis showed similar results with the experiments. With this approach accurate analysis of the spine and the clinical application can be expected.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.4
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• pp.147-154
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• 2017

The purpose of this study is to report the effectiveness of Fire needling therapy in patients with a vertebral compression fracture. Three patients with a acute vertebral compression fracture were treated using Fire needling therapy. To evaluate the effectiveness of Fire needling therapy, we checked Numerical rating scale on a daily and Oswestry disability index on admission and discharge. Numerical rating scale decreased as the number of Fire needling therapy increased. Oswestry disability index on discharge improved compared to admission. The limitation of this study is the insufficient number of cases and outcome measurements. Further studies are needed to prove effect and safety.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.06a
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• pp.1324-1327
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• 2003

The compressed fracture of spine caused by osteoporosis is one of the most frequent diseases in bone fracture. Recently the vertebroplasty has drawn much attention as a medical treatment for the compressed fracture of spine, which strengthens the vertebral body and corrects deformity, and relieves pain in patients by injecting bone cement. The finite element analysis is used to investigate the vertebroplasty quantitatively. Previous works with finite element analysis have drawbacks in their simplified models geometry of vertebral body and with material properties of bone. In this paper the exact geometry of vertebral body has been constructed from medical image data and the biomechanical property changes of vertebral body in vertebroplasty have been investigate by using three dimensional finite element analysis.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.135-138
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• 1984

A 44-year-old female with cervical cord compression signs had myelographic and computerized tomographic evidence of extradural spinal cord compression without any tuberculous bony lesion or cold abscess. At surgery, cervical spinal cord was compressed by extraosseous extradural granulomatous tissue which was histologically proved a very rare localized extradural tuberculous granuloma.