• Title/Summary/Keyword: Bone fragment

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Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau (관절면을 침범한 경골 외측 고평부 골절에 대한 관절경을 이용한 정복 및 내고정술)

  • Kim, Juhan;Kim, Dong Hwi;Lim, Jae-Hwan;Jang, Hyunwoong;Kim, Young Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.227-236
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    • 2019
  • Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.

CONSERVATIVE APPROACH ON THE SEVERELY DISPLACED ROOT FRACTURE OF PRIMARY INCISORS : CASE REPORT (심하게 변위된 유전치 치근파절의 보존적 접근)

  • Kim, Jee-Young;Lee, Kwang-Hee;Kim, Dae-Eop;Ra, Ji-Young;Lee, Dong-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.571-577
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    • 2008
  • Root fracture of primary teeth is relatively uncommon because the more pliable alveolar bone allows displacement of the tooth. Root fracture of primary teeth is occupied $2{\sim}7%$ in trauma pattern of primary teeth. A horizontal root fracture is classified based on the location of the fracture in relation to the root tip : the apical third, middle third, or cervical third of the root. The prognosis worsens the further cervically the fracture has occurrer. Root fracture of primary teeth should be treated by splinting the incisor to the adjacent normal teeth with a resin-wire splint for $8{\sim}12$ weeks. However, if a portion of the root is abscessed or extremely mobile, it can be extracted, and the remaining root fragment will resorb normally. For coronal third fracture in primary teeth, the coronal third is extracted, leaving the apical portion of the root to resorb normally. These root fracture cases of primary teeth were treated by resin-wire splinting despite extremely mobile coronal fragment. Even though they seems like healing well, They need to be monitored regularly until their successors erupt.

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INTENTIONAL REPLANTATION OF CROWN-ROOT FRACTURED TOOTH WITH OPEN APEX (의도적 재식술을 이용한 치관-치근 파절된 미성숙영구치의 치험례)

  • Ryu, Jung-A;Lee, Jae-Ho;Choi, Byung-Jai;Son, Heung-Kyu;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.267-272
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    • 2004
  • This case report describes an uncommon treatment method for crown-root fractured incisor with immature root. A 7-year-old girl was referred for treatment of crown-root fractured maxillary central incisor. The fracture line extended to 1/2 of the total tooth length with incomplete root formation. The prognosis of crown-root fracture is usually poor and extraction is usually undertaken. But, in the mixed dentition, extraction of maxillary permanent incisor results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation and mastication. Conservative therapy in the permanent dentition comprises of few treatment modalities; supragingival restoration, gingivectomy, orthodontic extraction of apical fragment, surgical extrusion of apical fragment with or without rotational replantation. However, in this case, these indications are not applicable, so intentional replantation with adhesive resin system is the treatment of choice. The tooth was followed-up for 12 months. Currently, there are no symptoms. Since this modality adopts the respective advantages of both intentional replantation and adhesive treatment, it might be the treatment of choice in cases of vertical crown-root fracture.

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KNEE: Basic Science and Injury of Bone (슬관절 주위 글격의 기초과학 및 스포츠 손상)

  • Kim Hee-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.77-81
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    • 2003
  • Purpose: The biomechanics and kinematics of knee joint were reviewed in this article. And then the common sports injuries were presented. Anatomy and Kinetics: None of the pairs of bearing surfaces in the knee joint is exactly congruent This allows the knee six degrees of freedom of motion. Tibiofemoral Kinematics: In flexion and extension, the axis of motion is not perpendicular to the medial-lateral plane of the joint, nor is it perpendicular to the axis of longitudinal rotation. This results in coupled varus angulation and internal rotation with flexion and in valgus angulation and external rotation with extension. Patellofemoral Articulation: Loads across the patellofemoral joint are indirectly related to the angle of knee flexion and directly related to the force generated within the quadriceps mechanism. Fractures of the Patella: Nonoperative treatment is indicated if the extensor mechanism is intact and if displacement of fragment is minimal. The specific type of internal fixation depends on the fracture pattern. It is important to repair retinaculum. Acute and Recurrent Patellar Instability: The degree of dysplasia and the extent of the instability play a large part in determining the success of nonoperative treatment. Patients who experience recurrent dislocations and patients with major anatomic variations require surgery to minimize their instability. Sports Injuries in School-age Atheletes: Patellar pain in young athletes groups a number of conditions, including Idiopathic Adolescent Anterior Knee Pain, Osgood- Schlatter Disease, and Sinding-Larsen-Johansson Disease.

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A STUDY OF VON-MISES YIELD STRENGTH AFTER MANDIBULAR SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지시상분할골절단술 시행 후 von-Miese 항복강도에 대한 유한요소법적 연구)

  • Yoon, Ok-Byung;Kim, Yeo-Gab
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.3
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    • pp.196-204
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    • 2002
  • For the study of its stability when the screw has been fixed after sagittal split ramus osteotomy(SSRO) of the mandible, the methods of screw arrangement are classified into two types, triangular and straight. The angles of screws to the bone surface are classified as perpendicular arrangements, the $60^{\circ}$ anterioinferior screw, known as triangular, and the most posterior screw, called straight arrangement, thus there are four types. The finite element method model has been made by using a three dimensional calculator and a supercomputer. The load directions are to the anterior teeth, premolar region, and molar region, and the bite force is 1 Kgf to each region. The distribution of stress, the von-Mises yield strength, and safety of margin refer to the total sum of transformed energy have been studied by comparison with each other. The following conclusion has been researched : 1. When shear stress is compared, in the triangular arrangement in the form of "ㄱ", the anterosuperior screw is seen at contributing to the support of the bone fragment. In the straight arrangement, substantial stress is seen to be concentrated on the most posterior angled screw. 2. When the von-Mises yield strength is compared, it seemed that the stress concentration on the angled anteroinferior screw is higher, it shows a higher possibility of fracture than any other screw. In the straight arrangement, stress appeared to be concentrated on the most posteriorly angled screw. 3. When the safety margins of the transfomed energy are compared, the energy conduction is much greater in the case of the angled screw than in the case of the perpendicular screw. The triangular arrangement in the form of "ㄱ" shows a superior clinical sign to that of the straight arrangement. Judging from the above results, when the screw fixation is made after SSRO in practical clinical cases, two screws should be inserted in the superior border of mandibular ramus and a third screw of mandibular inferior border should be inserted in the form of triangular. All screws on the bony surface should be placed perpendicularly-$90^{\circ}$ angles apparently best promote bony support and stability.

Intracorporeal reduction of condylar fracture using both pedicled condylar and seperated ramal fragments after vertical ramal osteotomy

  • Kim, Il-Kyu;Jang, Jun-Min;Cho, Hyun-Young;Seo, Ji-Hoon;Lee, Dong-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.5
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    • pp.343-350
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    • 2017
  • The aim of this study is to introduce a surgical technique that can maintain blood supply to prevent condylar resorption in the extracorporeal reduction of condylar fracture. Neither the medial pterygoid muscle on the ramal bone nor the lateral pterygoid muscle on the condylar fragment was detached after vertical ramal osteotomy. Thus, reduction was performed in the intracorporeal state. Therefore, blood supply was expected to be maintained to the fragments of both the condylar and ramal bones. On postoperative radiographs, the anatomical outline of the fractured condyle was well restored, and the occlusion was stable. In the unilateral case, there were no signs of mandibular condylar resorption until postoperative 3 weeks. In the 2 bilateral cases, condylar displacements with plate fractures and screw loosening were observed at postoperative 1 month or 5 months, but radiodensity at the displaced fracture site increased during the follow-up period. Finally, complete remodeling of the condylar fragments with restored anatomic appearance was observed on 8-month or 2-year follow-up radiographs. All cases exhibited good healing aspects with no signs or symptoms of mandibular condylar dysfunction during the postoperative remodeling period after intracorporeal reduction of condylar fracture.

Long Term Follow-up of Children with Facial Asymmetry: A Case Report (안면 비대칭을 보이는 아이의 장기 추적 관찰 : 증례보고)

  • Oh, Yoonjeong;Oh, Sohee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.378-385
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    • 2018
  • Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.

Association of Single Nucleotide Polymorphisms in Exon 6 Region of BMPRIB Gene with Litter Size Traits in Sheep

  • Jia, Cunling;Li, Ning;Zhao, Xingbo;Zhu, Xiaoping;Jia, Zhihai
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.10
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    • pp.1375-1378
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    • 2005
  • The objective of this study was to investigate polymorphisms of BMPRIB (bone morphogenetic protein type IB receptor) gene and its effect on litter size traits in sheep. Three populations including 101 Small Tailed Han sheep, 79 Poll Dorset and 81 hybrids (Poll Dorset${\times}$Small Tailed Han sheep) were used to detect the polymorphisms in exon 6 region of sheep BMPRIB gene. A fragment of approximately 190bp was amplified by one pair of primers, the polymorphism was revealed from the analysis of three populations by the technique of PCR -SSCP, and a mutation from A to G at 746 of the coding region was confirmed by sequencing in several individual. Statistical results indicated the distribution of allele B (with a A$\longrightarrow$G mutation) and A (without mutation) or genotype AA, AB and BB frequencies differed in three populations. BB genotype (44.55%) and B allele (66.34%) frequencies of Small Tailed Han sheep were higher than those of the others. Analysis of variance showed that the polymorphism of BMPRIB gene was associated with positive effect on litter size traits. The means of genotype BB and AB were about 1.04 and 0.74 more than genotype AA for litter size (p<0.05). Analysis of BMPRIB genotype effects on litter size in three populations indicates the existence of genotype BB or B allele increases the litter size. It suggested that the polymorphism in exon 6 (at 746 in the coding region) of sheep BMPRIB gene may be used as a marker for early selection of prolificacy in sheep.

Experimental Study for DNA Fingerprint from Teeth of Charred Body (소사체 치아에서의 유전자지문 분석을 위한 실험적 연구)

  • Jong-Hoon Choi
    • Journal of Oral Medicine and Pain
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    • v.21 no.2
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    • pp.351-367
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    • 1996
  • In the field Of individual identification in forensic Science, if the body is charred, it is sometimes impossible to identify the morphologic changes and charred tissue such as blood, muscle and bone can not be identified by forensic microbiologic method such as DNA typing. So the author used the characteristics of teeth which is relatively firm compare to other organs and stable to external environment such as heat and also possess cells needed for the DNA typing. The author conducted the experiment on teeth to detect DNA related to individual identification regarding to temperature in which other charredorgans can not be detected. The experiment was done on 64 extracted third molars consisted of unheated ones, and heated teeth to $100^{\circ}C$, $150^{\circ}C$, $200^{\circ}C$ for 45 min, 90 min, and 120 min respectively and to $250^{\circ}C$ for 45 min. DNA was extracted from each tooth and amplified fragment length polymorphism procedure(AMP-FLPs) using polymerase chain reaction(PCR) was applied and observed for the matching DNA in HumTH01 and HumCD4 locus and the followings Are the results : 1. It was able to detect matching DNA in HumTH01 and HumCD4 locus in every teeth which no heating has been done. 2. It was able to detect matching DNA in HumTH01 and HumCD4 locus in every teeth heated to $100^{\circ}C$ for 45, 90 and 120 min. 3. It was able to detect matching DNA in HumTH01 and HumCD4 locus in teeth heated to $l00^{\circ}C$, $200^{\circ}C$ for 45, 90, 120 min. 4. It was impossible to detect matching DNA in HumTH01 and HumCD4 locus in teeth heated to $250^{\circ}C$. So, it is possible to extract DNA from teeth that otherwise can not be extracted from other organs in the charred body and it can be concluded that teeth are highly reliable and applicatable as forensic odontology for individual identification.

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Operative Treatment of Nonunion after Intra-articular Calcaneal Fracture (종골의 관절내 골절 후 발생한 불유합의 수술적 치료)

  • Eun, Il-Soo;Jung, Chul-Young;Kim, Jin-Wan;Ko, Young-Chul;Huh, Jung-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.85-90
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    • 2009
  • Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9${\sim}$7.6 cm) preoperatively and 7.34 cm (range, 6.0${\sim}$8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6${\sim}$8 degrees) preoperatively and 13.1 degrees (range, 5.7${\sim}$21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14${\sim}$36) and 4 (range, 3${\sim}$6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54${\sim}$68) and 3 (range, 2${\sim}$4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.

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