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Conversion to Internal Fixation after Temporary External Fixation for Femoral Shaft Fractures in Polytrauma Patients (다발성 외상 환자의 대퇴골 간부 골절에서 임시 외고정술 후 내고정술로의 전환)

  • Choo, Suk-Kyu;Kang, Kyung-Woon;Kim, Young-Woo;Oh, Hyoung-Keun
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.151-157
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    • 2014
  • Purpose: We report the surgical outcomes for femoral shaft fractures in polytrauma patients who were temporarily treated with external fixation and subsequently converted to internal fixation. Methods: From August 2008 to April 2012, we enrolled 13 patients with multiple traumas due to high-energy injuries and concurrent femoral shaft fractures in which temporary external fixation was carried out. The mean age was 39 years, with a range from 18 to 55 years. Ten were men and 3 were women. According to the AO/OTA classification of fractures, type A was found in 5 patients, type B in 6, and type C in 2, with open fractures being found in 6 patients and femoral artery rupture occurring in 2. For internal fixation, intramedullary nailing was performed in 7 patients, and minimally-invasive fixation of locking compression plates was used in 6. Results: Of the 7 patients converted to intramedullary nailing, 1 experienced delayed union. Of the 6 patients treated with minimally-invasive plate fixation, delayed union occurred in 5, and an auto-bone graft was performed within, on average, 8 months (range: 5~10 months), leading to bone union in all cases in the final follow-up. None of the patients experienced infections or complications involving other organs after having been converted to internal fixation. During the mean follow-up of 19 months, patients achieved satisfactory functional outcomes. Conclusion: In polytrauma patients with a femoral shaft fracture who have been treated with temporary external fixation and who may need internal fixation due to the occurrence of delayed union, an appropriate internal fixation method needs to be selected based on the patient's physical status, and the fracture type.

The Clinical Results of the Proximal Opening Wedge Osteotomy Using a Low Profile Plate in Hallux Valgus: Comparison with Proximal Chevron Osteotomy Fixed with K-wires (무지외반증에서 저상형 금속판 고정을 이용한 근위 개방형 절골술의 임상적 결과: 근위 갈매기형 절골술 후 K-강선 고정술과의 비교)

  • Seo, Eun-Seok;Bang, Tae-Jung;Jeon, Suk-Ha
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.302-308
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    • 2013
  • Purpose: To present clinical results of proximal first metatarsal opening wedge osteotomy and low profile plate fixation in hallux valgus deformity. Materials and Methods: Thirty-two patients (39 feet) underwent surgery for hallux valgus deformity. Fourteen patients (18 feet; Group A) underwent proximal first metatarsal opening wedge osteotomy fixed with low profile titanium plate ($Arthrex^{(R)}$), and 18 patients (21 feet; Group B) underwent proximal chevron osteotomy with two K-wires. Improvement in hallux valgus angle (HVA), 1, 2 intermetatarsal angle (IMA), range of motion of 1st metatarsophalangeal joint, VAS score, and the length of first metatarsal on weight-bearing radiograph were evaluated preoperatively and at final follow-up. Results: HVA improved from $36.2{\pm}6.6$ degrees to $11.7{\pm}5.1$ degrees, and 1, 2 IMA improved from $15.7{\pm}2.6$ degrees to $7.2{\pm}1.9$ degrees. VAS score improved from $7.2{\pm}1.2$ to $1.4{\pm}0.9$. There were no significant differences clinically and radiologically. Conclusion: Proximal first metatarsal opening wedge osteotomy with stable fixation using low profile plate may be an effective surgical option for correction of hallux valgus deformity.

An Analysis for Gender-Role Stereotyping of Illustrations in Elementary Science Textbooks Based on the 7th Curriculum (7차 초등학교 과학 교과서의 삽화에 나타난 성역할 고정관념 분석)

  • 노태희;차정호;왕혜남
    • Journal of Korean Elementary Science Education
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    • v.23 no.1
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    • pp.85-91
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    • 2004
  • The illustrations in elementary science textbooks and experimental workbooks based on the 7th national curriculum were analyzed for gender-role stereotyping, and compared with those of the 6th curriculum. The frequencies of men and women who appeared on text illustrations were counted and the types of roles assigned to males and females were investigated. The results were as follows. 1) The 7th national curriculum textbooks contained double the numer of illustrations in the textbooks based on the 6th curriculum. 2) Boys and girls were illustrated in 'learning activities' with equal frequency, but boys were more frequently represented than girls in illustrations of 'other' activities. 3) Both boys and girls were generally depicted in 'active' processes and the ratio of 'passive girl' illustrations decreased as compared with the 6th national curriculum. 4) Male adults were more frequently represented than female adults in both textbooks and experimental workbooks. 5) 40% of female adults were illustrated doing housework, while male adults were rarely illustrated in such a role.

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Diagnosis and Management of Suspected Deltoid Injury (삼각인대 손상 의심 시 진단과 치료방법)

  • Yang, Sung Hun;Lee, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.16-21
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    • 2022
  • When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

Frequency and Pattern of Partial Thickness Rotator Cuff Tear in SLAP Lesions (SLAP 병변에서 회전근 개 부분층 파열의 빈도와 양상)

  • Cho, Duck-Yun;Yoon, Hyung-Ku;Kim, Hyoung-Jun;Rhee, Seung-Young;Kim, Jae-Hwa
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.119-123
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    • 2004
  • Purpose: The purpose of this study is to check the range of motion of shoulder and inverstigate the frequencies and patterns of partial thickness rotator cuff tear in SLAP lesions. Materials and Methods: Forty-six patients, forty-seven cases who had SLAP lesions at shoulder arthroscopy were analyzed spectively using the medical records, intra-operative arthroscopic photo & video for SLAP lesions and rotator cuff articular side partial tear. Under the interscalene anesthesia, the range of notion of foreward elevation, internal rotation and external rotation was measured on fixed scapula and 90 degree abduction of the shoulder. Results: The rang of Motion are 150 degree on foreward elevation, 65.5 degree on external rotation, 61.7 degree on internal rotation. By Snyder's classification, type ll SLAP lesion is noted in 24 cases (five cases in type 1, one case in type IV). Rotator cuff articular side partial tear is noted in 24 cases ( one case in type I, 22 cases in type II, one case in type IV SLAP). All the rotator cuff articular side partial thickness tear were located in the anterior part of the supraspinatus. Conclusion: The rotator cuff partial thickness tear is mostly noted on the articular side and frequently found in the relatively more unstable type of SLAP lesions. So we consider that SLAP lesion may be a one of the causes for partial tear of the rotator cuff articular side.

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A Three-dimensional Photoelastic Analysis of Stress Distributions Around Osseointegrated Implants and Abutment Teeth According to Bridge Connecting Type (골유착성(骨癒着性) 임플란트와 치아간(齒牙間)의 보철물(補綴物) 연결(連結) 형태(形態)에 따른 주위(周圍) 골조직(骨組織)의 응력분산(應力分散)에 관한 3차원적(次元的) 광탄성(光彈成) 분석(分析))

  • Lee, Moo-Geon;Cho, Sung-Am
    • The Journal of Korean Academy of Prosthodontics
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    • v.32 no.1
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    • pp.120-147
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    • 1994
  • This study was performed for the purpose of evaluating the stress distribution around threaded type implants, cylindrical type implants and teeth connected with rigid or non-rigid connector. The stress distribution around the surrounding bone was analyzed by three-dimensional photoelastic method. Twelve mandibular photoelastic epoxy resin models and a circular polariscope were used to record the isochromatic fringes. After the stress distribution around the implant and tooth was observed, the results were as follows ; 1. In threaded type implants, stress concentrated patterns were observed at the neck either vertical or 25 degree lateral force. 2. The stress concentrated patterns were observed at the tooth apical portion and neck portions of the implant and tooth when a threaded implant was connected with the tooth by either a rigid or non-rigid connector. More force was generated at the tooth neck portion by a rigid connector and more force at the implant neck portion by a non-rigid connector. 3. The stress concentrated patterns were observed at the apical portion of the implant and tooth when a cylindrical type ,implant was connected with the tooth either by a rigid or non-rigid connector. More force was generated at the tooth apical portion by a rigid connector and more force at the neck portion of the tooth and implant by a non-rigid connector. 4. The stress around the tooth was more equally distributed in a threaded type implant than in a cylindrical implant when the tooth was connected with either a rigid or non-rigid connector. 5. The stress around a threaded type implant was progressively more equally distributed in the following order : 1) when used a single implant, 2) a non-rigid connection with the implant and tooth, 3) a rigid connection with the implant and tooth, 4) a rigid connection with two implant fixtures.

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Evaluation of Accuracy on Hitchcoke CT/angio localization system using QA head phantom (QA용 두부 팬톰을 이용한 Hitchcoke CT 및 혈관조영 정위적 시스템에 대한 정확도 평가)

  • 김성현;서태석;윤세철;손병철;김문찬;신경섭
    • Progress in Medical Physics
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    • v.9 no.1
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    • pp.1-9
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    • 1998
  • In order to provide complementary image data, CT(computed tomography), MR(magnetic resonance) and angiography have been used in the field of Stereotactic Radiosurgery(SRS) and neurosurgery. The aim of this work is to develop 3-D stereotactic localization system in order to determine the precise shape, size and location of the lesion in the brain in the field of Stereotactic Radiosurgery(SRS) and neurosurgery using multi-image modality and multi purpose QA phantom. In order to obtain accurate position of a target, Hitchcoke stereotactic frame and CT/angiography localizers were rigidly attached to the phantom with nine targets dispersed in 3-D space. The algorithms to obtain a 3-D stereotactic coordinates of the target have been developed using the images of the geometrical phantom which were taken by CT/angiography. Positions of targets computed by our algorithms were compared to the absolute position assigned in the phantom. Outlines of targets on each CT image were superimposed each other on angiography images. A spatial mean distance errors were 1.02${\pm}$0.17mm for CT with a 512${\times}$512 matrix and 2mm slice thickness, 0.41${\pm}$0.05mm for angiogra- phy localization. The resulting accuracy in the target localization suggests that the developed system has enough Qualification for Stereotactic Radiosurgery (SRS).

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An Experimental Study on Fire Spreading External Wall of Buildings Using Dry Construction Method (건식공법을 이용한 건축물의 외벽 화재 확산의 실험적 연구)

  • Park, Jung-Woo;Cho, Nam-Wook
    • Fire Science and Engineering
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    • v.32 no.4
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    • pp.75-85
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    • 2018
  • The Grenpell tower fire in England in June of 2016 is a representative example of damage caused by a vertical fire spreading through external insulation. Organic insulation materials, which are widely used in external insulation, have the disadvantage that they have good insulation performance but are vulnerable to fire. Aluminum composite panels are used as exterior wall finishing materials, and plastics used in aluminum are regarded as the cause of vertical fire spread. Due to the steel frame used to secure the aluminum composite panel to the outer wall, a cavity is formed between the outer wall and outer wall finish. When a fire occurs on the outer wall, the flammable outer wall as well as the flame generated from the heat-insulating material spreads vertically through the cavity, resulting in damage to people and property. In Korea, material unit performance tests are carried out by the Ministry of Land, Infrastructure and Transport notice 2015 - 744. However, in the UK, the BS 8414 test is used to measure the vertical fire spreading time on the outer wall in real scale fire tests. In this study, the risk of external wall fire was evaluated in an actual fire by conducting a real scale wall fire test (BS 8414), which was carried out in Europe, using aluminum composite panels of semi-noncombustible materials suitable for current domestic standards. The purpose of this study was to confirm the limitations of material unit evaluation of finishing materials and to confirm the necessity of introducing a system to prevent the spread of outer wall fire through an actual scale fire test.

Plant Growth-Promoting Activity Characteristics of Bacillus Strains in the Rhizosphere (근권에 존재하는 Bacillus 속 균주들의 식물 생장 촉진 활성 특성)

  • Oh, Ka-Yoon;Kim, Ji-Youn;Lee, Song Min;Kim, Hee Sook;Lee, Kwang Hui;Lee, Sang-Hyeon;Jang, Jeong Su
    • Microbiology and Biotechnology Letters
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    • v.49 no.3
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    • pp.403-412
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    • 2021
  • This study aimed to identify plant growth-promoting activity, phytopathogenic fungi growth inhibitory activity, mineral solubilization ability, and extracellular enzyme activity of the genus Bacillus in soil and the rhizosphere. With regards to antifungal activity against phytopathogenic fungi, DDP257 showed antifungal activity against all 10 pathogenic fungi tested. ANG20 showed the highest ability to produce indole-3-acetic acid, a plant growth-promoting factor (70.97 ㎍/ml). In addition, 10 species were identified to have 1-aminocyclopropane-1-carboxylate deaminase production ability, and most isolates showed nitrogen fixation and siderophore production abilities. Thereafter, the isolated strains' ability to solubilize minerals such as phosphate, calcite, and zinc was identified. With extracellular enzyme activity, the activity appeared in most enzymes. In particular, all the strains showed similar abilities for alkaline phosphatase, esterase (C4), acid phosphatase, and naphtol-AS-BI-phosphohydrolase production. This result was observed because the genus Bacillus secreted various organic substances, antibiotics, and extracellular enzymes. Therefore, through the results of this study, we suggest the possibility of using strains contributing to the improvement of the soil environment as microbial agents.

Arthroscopically assisted Operative Treatment of Tibial Plateau Fracture (관절경을 이용한 경골 고평부 골절에 대한 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.45-52
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    • 2006
  • Purpose: We evaluated the results of operative treatment of tibial plateau fractures using both arthroscopy and fluoroscopy. Materials and Methods: From May 1999 to February 2003, tibial plateau fractures were treated with arthroscopy. Tweenty seven patients are followed up over two years and the average follow-up period was fourty one months. We classified the fractures according to the Schatzker classification. We reduced the fracture over 2mm depression and displacement on articular surface in simple radiologic finding. Firstly, we treated the associated injuries and reduced the fractures using Steinmann pins. Then, we accomplished internal fixation or external fixation. Both the postoperative clinical and radiological results were evaluated by Rasmussen system. Results: In all tweenty seven cases, the fractures were healed completely in average fourty one months. According to Rasmussen classification, we obtained the excellent or good results in 23 cases. An average range of motion was between 2.5 degrees and 130 degrees. However, postoperative infection developed in one case and the other had loss of reduction. Conclusions: We consider that arthroscopically assisted operative treatment of tibial plateau fracture is a useful method. We can reduce joint surface correctly and treat associated injuries with arthroscopy. There are less complications.

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