• Title/Summary/Keyword: 완관절

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Clinical Significance of Lateral Ankle Radiograph after the Reduction of a Syndesmosis Injury (원위경비인대결합 손상 정복 후 관찰된 측면 방사선 영상의 임상적 중요성)

  • Suh, Jae Wan;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.128-134
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    • 2017
  • Purpose: To introduce reliable and newly developed radiographic measures based on a lateral ankle radiograph to assess a syndesmotic reduction after screw fixation and to compare with the radiographic measures based on the anteroposterior (AP) and mortise radiographs. Materials and Methods: The postoperative ankle radiographs of 34 ankle fracture cases after screw fixation for concurrent syndesmosis injury were reviewed. Two radiographic parameters were measured on each AP and mortise radiograph; tibiofibular clear space (TFCS) and tibiofibular overlap (TFO). Five radiographic parameters were measured on the true lateral radiographs; the anteroposterior tibiofibular (APTF) ratio, anterior tibiofibular ratio (ATFR), posterior tibiofibular ratio (PTFR), distances of intersection of the anterior fibular border and the tibial plafond to anterior cortex of the tibia (AA'), and the intersection of posterior fibular border and tibial plafond to the tip of the posterior malleolus (BB'). In addition, the distance (XP) between the fibular posterior margin (X) crossing tibial plafond or the posterior malleolus and posterior articular margin (P) of the tibial plafond was measured on the lateral view. Results: Using TFCS and TFO in the AP and mortise radiographs, malreductions of syndesmosis were estimated in 17 of 34 cases (50.0%). Using the introduced and developed radiographic measures in the lateral radiographs, syndesmotic malreductions were estimated in 16 out of 34 cases (47.1%). Seventeen cases (50.0%) showed no evidence of postoperative diastasis using the radiographic criteria on the AP and mortise view, 10 cases (58.8%) of whom showed evidence of a malreduction on the lateral radiograph. The newly developed measurements, XP, were measured 0 in 11 out of 34 cases (32.4%). Conclusion: The reduction of syndemosis after screw fixation can be accurately assessed intraoperatively with a combination of several reliable radiographic measurements of the lateral radiograph and traditional radiographic measurements of the AP and mortise radiograph.

Behavior Analysis of the Treated Femur and Design of Composite Hip Prosthesis (대퇴부 거동 해석 및 복합재료 보철물 설계)

  • 임종완;하성규
    • Journal of Biomedical Engineering Research
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    • v.23 no.2
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    • pp.119-130
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    • 2002
  • The nonlinear finite element program has been developed to analyze the design performance of an artificial hip prosthesis and long term behavior of a treated femur with stems made of composite material after cementless total hip arthroplasty(THA). The authors developed the three dimentional FEM models of femoral bone with designed composite stem which was taken with elliptic cross section of 816 brick elements under hip contact load and muscle farce in simulating single leg stand. Using the program, density changes, stress distributions and micromotions of the material femoral bone were evaluated by changing fiber orientation of stems for selected manufacturing method such as plate cut and bend mold. The results showed that the composite materials such as AS4/PEEK and T300/976 gave less bone resorption than the metallic material such as cobalt chrome alloy, titanium alloy and stainless steal. It was found that increasing the long term stability of the prosthesis in the femur could be obtained by selecting the appropriate ply orientation and stacking sequence of composite.

Analysis of finite element stress on the articular disc of jaw during function (기능중 두개골 내 관절원판의 유한요소 스트레스 분석)

  • Kang, Dong-Wan;Lim, Seung-Jin;Ahn, Kwang-Hyun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.17 no.2
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    • pp.75-84
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    • 2001
  • The purpose of this study is to to analyze the mechanical stress on articular disk of the dentated skull with the condition of unilateral posterior molar missing. For this study, the three dimensional finite element model of human skull scanned by means of computed tomography. (G.E. 8800 Quick, USA) was constructed. The finite element model of jaws is composed of 98,394 elements and 38,321 nodes, and it consists of articular disc, maxilla, mandible, teeth, periodontal ligament and cranium. Boundary condition included rigid restraints at the first molar and endosteal cortical surfaces of the insertion points of temporal bone. The data derived from Nelson's study were used for the loading conditions of mandible during clenchings and for maxilla, new loading and constraint conditions were applied. A clenching task during intercuspal position was modeled to the three dimensional finite element model. The stress level and displacement of articualr disc on the model with unilateral posterior molar missing under bilateral clenching task can be analyzed. During bilateral clenchings, the compressive stress level and diplacement of the articular disk on the side of unilateral posterior molar missing is greater than that on the case with full dentition, whereas a higher stress was found on the disk on the balancing side of the full dentition. Although this kind of study is not enough to explain the role of occlusion as an etiologic factor of TMD, there may be a possibiliy that the condition of posterior molar missings may contribute in part to the TMJ biomechanics.

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Full mouth rehabilitation on the patient with severe tooth wear and tooth fracture using reestabilishment of occlusal vertical dimension (심한 치아 마모 및 파절 환자의 수직고경거상을 동반한 전악 수복 증례)

  • Lee, Ho-Sun;Joo, Se-Jin;Jin, Soo-Yoon;Kang, Dong-Wan;Lee, Gyeong-Je
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.3
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    • pp.224-231
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    • 2016
  • Severe dental attrition causes pathological changes of the tooth, imbalanced occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension that can incur temporomandibular joint and muscular complications. Before restoring the vertical dimension with full-mouth prosthetic restorations, it is important to determine the amount of vertical lifting through complete diagnosis. In this study, a 59 year-old male patient with generalized attrition and fracture of teeth was treated with full-mouth zirconia prosthetic restoration in order to recover vertical dimension and aesthetics. Through the analysis of physiologic rest position and inter-canine distance, the treatment was planned for lifting 3 mm in vertical dimension. Interim crown were fabricated after full-mouth wax up, having the patient use for 6 months. The final monolithic and bilayered zirconia restorations were completed. The patient showed satisfaction in function and aesthetics for 18 months of follow-up since delivering the final restorations.

A Comparative Study between Genetic Programming and Central Pattern Generator Based Gait Generation Methods for Quadruped Robots (4족 보행로봇의 걸음새에 대한 Genetic Programming 기법과 Central Pattern Generator 기반 생성기법의 비교 연구)

  • Hyun, Soo-Hwan;Cho, Young-Wan;Seo, Ki-Sung
    • Journal of the Korean Institute of Intelligent Systems
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    • v.19 no.6
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    • pp.749-754
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    • 2009
  • Two gait generation methods using GP(genetic programming) and CPG(Central Pattern Generator) are compared to develop a fast locomotion for quadruped robot. GP based technique is an effective way to generate few joint trajectories instead of the locus of paw positions and lots of stance parameters. The CPGs are neural circuits that generate oscillatory output from a input coming from the brain. Optimization for two proposed methods are executed and analysed using Webots simulation for the quadruped robot which is built by Bioloid. Furthermore, simulation results for two proposed methods are experimented in real quadruped robot and performances and motion features of GP and CPG based methods are investigated.

Clinical Spectrum and Short-term Effects of Enzyme Replacement Therapy for Mucopolysaccharidosis Type II (제2형 뮤코다당증의 임상적 스펙트럼과 효소대치요법의 단기간 효과)

  • Cheon, Chong Kun;Hwu, Wuh-Liang
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.3
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    • pp.78-86
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    • 2018
  • Purpose: We aimed to delineate clinical spectrum and short-term effects after enzyme replacement therapy (ERT) for 5 mucopolysaccharidosis type II (MPS II). Methods: Five patients were diagnosed with MPS II by clinical findings, enzyme activity, and genetic testing. Idursulfase was administered by intravenous infusion at a dose of 0.5 mg/kg every week. Observational chart analysis of patients, who underwent systematic investigations more than 12 months after initiation of ERT was done retrospectively. Results: Three patients were classified as having the attenuated type, and 2 patients were classified as having the severe type. The median age at the diagnosis was 9.6 years (range 3.4-26 years). Four different mutations in 5 Korean patients (4 families) with MPS II were identified, among which two were novel mutations (1 small insertion mutation: p.Thr409Hisfs*22, and 1 missense mutation: p.Gly134Glu). Two severe type sibling patients with the same mutation had different clinical manifestation. Urinary glycosaminoglycan excretion decreased within the twelve months of ERT (P=0.043). Liver and spleen volumes showed reductions that were maintained in all patients (P=0.043 and P=0.043, respectively). Improvements were also noted in left ventricular mass index (P=0.042), shoulder flexion (P=0.043), shoulder abduction (P=0.039), knee flexion (P=0.043), elbow flexion (P=0.042), and respiratory distress index (P=0.041). Conclusion: This study demonstrates that Korean patients with MPS II are clinically heterogeneous and indicates that idursulfase is relatively effective in several clinical parameters including heart size and respiratory distress index without infusion-related reactions in patients with MPS II.

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Posterior Cruciate Ligament Augmentation Using an Autogenous Hamstring Tendon Graft and the Posterior-Posterior Triangulation Technique (만성 단독 후방십자인대 파열에서 자가 슬괵건과 후-후 삼각술기를 이용한 만성 후방십자인대 보강술)

  • Kim, Yeung Jin;Chae, Soo Uk;Choi, Byong San;Kim, Jong Yun;Lee, Hwang Yong;Han, Chang Wan;Han, Su Hyoun
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.24-30
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    • 2013
  • Purpose: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique with preservation of ligament remnant or elongated ligament. Materials and Methods: From January 2002 to December 2009, we performed PCL augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique in 32 patients. The mean age was 35.2 years. Twenty two cases were male and 10 cases were female. Average follow-up period was 5 years and 5 months (range: 2-7.9). Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, International Knee Documentation Cominittee (IKDC) grade, and second look arthroscopic examination. Results: At last follow up posterior displacement by the Telos stress test decreased from $10.8{\pm}5.1\;mm$ to $2.8{\pm}3.7\;mm$ (p<0.05). The final Lysholm knee score improved from $60.4{\pm}5.8$ to $84.6{\pm}4.8$. Tegner activity score improved from 3.2 to 4.8. The final IKDC grade was A in 18, B in 11, C in 3. Postoperative Lysholm knee score, IKDC grades, Tegner activity scale, and posterior displacement demonstrated statistically significant improvement compared to the preoperative state (p<0.05). Conclusion: Arthroscopic PCL reconstruction using an autogenous hamstring tendon with preservation of ligament remnant showed a good clinical results and posterior stability.

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AN EPIDEMIOLOGIC STUDY ON THE TEMPOROMANDIBULAR JOINT SOUND IN ADOLESCENT (청년기의 측두악관절 잡음에 관한 역학적 연구)

  • Kim, Bong-Kap;Kang, Dong-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.1
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    • pp.39-50
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    • 1993
  • The purpose of this study was to investigate the association between characteristics of temporomandibular joint sound and possible contributing factors of temporomandibular joint sound. 1487 high school students (798 men and 689 women) aged from 16 to 18 were asked by questionnaires which was made for this study by T.M.J. clinic, dental infirmary, School of Dentistry, Chosun University, and data obtained from questionnaires were analyzed by chi-square test. The following results were obtained: 1. The prevalence of temporomandibular joint sound were found in 35.7% of all the subjects. 2. Temporomandibular joint sound could be unchanged, reduced and increased frequencey over time dependent on the individual. 3. The intensity of temporomandibular joint sound could be unchanged and increased during the chewing of hard food dependent on the individual. 4. The unilateral chewing and bruxism were not considered as possible contributing factors upon the occurring of temporomandibular joint sound. 5. Statistical significant association was found between clenching, stiffness, stress and tempore-mandibular joint sound, respectiely.(P<0.001, P<.01, P<0.05).

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Retromandibular Approach for the Open Reduction of Fractured Mnadibular Condyle (하악과두 골절의 관혈적 정복술을 위한 하악 후방 접근법)

  • Kim, Hak-Kyun;Kim, Su-Gwan;Kang, Dong-Wan;Oh, Sang-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.4
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    • pp.283-288
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    • 2006
  • There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.

A Combined CPG Foot Trajectory and GP Joint Compensation Method for Adaptive Humanoid Walking (적응적인 휴머노이드 보행을 위한 CPG 궤적 및 GP 관절 보정의 결합 기법)

  • Jo, Youngwan;Kim, Hunlee;Seo, Kisung
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.65 no.9
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    • pp.1551-1556
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    • 2016
  • A combined CPG (Central Pattern Generator) based foot trajectory and GP (Genetic Programming) based joint compensation method is presented for the adaptive humanoid walking. The CPG based foot trajectory methods have been successfully applied to basic slops and variable slops with slow rates, but have a limitation for the steep slop terrains. In order to increase an adaptability of humanoid walking for the rough terrains, a GP based joint compensation method is proposed and combined to the CPG (Central Pattern Generator) based foot trajectory method. The experiments using humanoid robot Nao are conducted in an ODE based Webots simulation environmemt to verify a stability of walking for the various aslope terrains. The proposed method is compared to the previous CPG foot trajectory technique and shows better performances especially for the steep varied slopes.