• Clinics in Shoulder and Elbow
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• v.18 no.2
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• pp.91-95
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• 2015

Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.555-558
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• 2011

Purpose: It is relatively unusual that infraorbital rim fracture is accompanied by nasal bone fracture. In order to correct effectively, subciliary approach and intranasal manipulation are applied simultaneously. But if reduction is not successful, intranasal manipulation may become aggressive and this often causes complications. We introduce a method using intermaxillary fixation screws for decreasing such complications and effective reduction of fracture. Methods: Total seven patients with fracture of frontal process of maxilla were treated with this method. The fracture site was exposed through the subciliary approach, and one or two screws were inserted into the displaced fracture fragment. During the traction of the screws using the wire, the fracture fragment was pushed upward from the intranasal side using an elevator supplementarily and fixed with a plate and the screws. Results: In all patients, the fracture fragment was reduced successfully and no complication occurred during one year's postoperative follow-up. Conclusion: When reduction cannot be attained through a bone hook or an elevator alone, reduction of fracture fragment can be done easily using intermaxillary fixation screws. This method is less likely to cause a mucosal injury because intranasal manipulation is not aggressive. Furthermore, as the screw can be inserted and removed easily, this method is considered effective not only for fracture of frontal process of maxilla but also for fractures in other regions.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.4
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• pp.482-491
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• 2007

Statement of problem: The screws of dental implant, having various thread types, can be categorized into different classes by their geometrical form, and each type transmits dissimilar amount and form of stress to alveolar bone. Purpose: The purpose of this study was to find an inclination angle of the screw thread that is favorable in distributing the stresses to alveolar bone. Material and methods: In this study, We used three dimensional finite element analysis with modeling having three types of thread inclination angles and fixed pitch-0.8 mm (single thread type with $3.8^{\circ}$ inclination, double thread type with $7.7^{\circ}$ inclination, triple thread type with $11.5^{\circ}$ inclination). Results: The results obtained from this study were as follows; 1. When the number of thread increased, the amount of Von-Mises stress was reduced since the generated stress was effectively distributed. 2. Since the maximum principal stress affects on the alveolar bone can influence deeply on the longevity of the implants when comparing the magnitude of the maximum principal stress double thread had least amount of stress. This shows that the double thread screw gave best result. Conclusion: In conclusion, double, and triple thread screws were found to be more effective on distribution of the stress than the single thread screws. But, increasing in the thread inclination angle such as triple thread screw relate on the magnitude of the maximum principal stress affecting on the alveolar bone can become problematic. Thus, effective combination of thread number and thread inclination angle can help prolonging the longevity of implant.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.413-417
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• 2022

The authors present a unique case of osteonecrosis of a cortical half of a fibula free flap that has not been reported in the literature yet. This complication was associated with the impairment of the vascularization of periosteum in the cortical half of fibula that was fixated with a nonlocking reconstructive 2.0-mm plate and screws but other factors could have been involved. The patient was submitted to excision of a cemento-ossifying fibroma that resulted in a left hemimaxilectomy mesoinfrastructure defect classified as the Cordeiro type 2B. The 42-year-old female patient was submitted to reconstruction with an osteomusculocutaneous fibula free flap plus a segment of fibula graft. The two bone segments of the free flap used to reconstruct the anterior and left alveolar crest were fixated with a reconstructive 2.0-mm plate of matrixMANDIBLE system. The only reported complication was an oronasal fistula that healed with conservative treatment and the referred osteonecrosis of the external cortical half of the fibula free flap with plate exposure at 2.5 years postoperatively. Surgical excision of the osteonecrosed cortical half of the fibula with the plate and screws was performed, while the other cortical underwent bone union as corroborated by computed tomography scans.

• Journal of Trauma and Injury
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• v.35 no.1
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• pp.34-42
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• 2022

Purpose: Percutaneous iliosacral (IS) screw fixation for pelvic ring injuries is a minimally invasive technique that reduces the amount of blood loss and shortens the procedure time. Moreover, two unilateral IS S1 screws exhibit superior stability to a single IS screw and are also safer for neurological injuries than an S2 screw. Therefore, this study aimed to evaluate fixation using percutaneous two unilateral IS S1 screws for pelvic ring injuries and its subsequent clinical outcomes. Methods: We retrospectively reviewed 38 patients who underwent percutaneous two unilateral IS S1 screw fixation for pelvic ring injuries. The procedure time, blood loss, achievement of bone union, radiological outcomes (Matta and Tornetta grade), and postoperative complications were evaluated. Results: The mean procedure time, hemoglobin loss, bone union rate, and time to union were 40.1 minutes (range, 18-102 minutes), 0.6 g/dL (range, 0.3-1.0 g/dL), 100%, and 153.2 days (range, 61-327 days), respectively. The Matta and Tornetta grades were excellent, good, and fair in 24 (63.1%), 11 (28.9%), and three patients (7.9%), respectively, and the postoperative complications were S1 screw loosening, widening of the symphysis pubis (2.3 and 2.5 mm), lumbosacral plexopathy, and S1 radiculopathy in one (2.6%), two (5.3%), one (2.6%), and one patient (2.6%), respectively. However, all neurological complications recovered spontaneously. Conclusions: Percutaneous two unilateral IS S1 screw fixation was useful for treating pelvic ring injuries. In particular, it involved a short procedure time with little blood loss and also led to 100% bone union and good radiological outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.451-458
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• 2009

Metallic bone plates and screws have been commonly used in oral and maxillofacial surgery for internal fixation. However, there are several disadvantages such as atrophy of cortical bone inherent to excessive rigid fixation systems, growth disturbance in growing individual, allergy reaction, interference with radiographic imaging, palpability, thermal sensitibity and the need for subsequent removal. To overcome these disadvantages and avoid additional surgery of removal of plates and screws, there have been many studies of biodegradable plates and screws. But, It also has complication such as foreign body reactions. We have undertaken a clinical and retrospective study on 140 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from February 2006 to March 2009. The purpose of this study is to report the clinical cases and review of the literatures with biodegradable plates and screws. And we concluded following results. 1. 6 cases(3.4%) of the 177 operation sites(140 patients) experienced complications. 1 case(0.6%) was a failure of initial fixation, 1 case(0.6%) was a postoperative infection, 4 cases(2.3%) were inflammations or foreign body reaction. 2. Postoperative infections, inflammations and foreign body reactions were completely recovered with incision and drainage, supporative care with antibiotic coverage and removal of biodegradable plates. 3. Biodegradable plates and screws provide acceptable rigidity and stability clinically. But, long-term observation is required for the tissue reactions around the biodegradable plates and screws because of long resorption periods of the biodegradable materials.

• The korean journal of orthodontics
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• v.52 no.6
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• pp.412-419
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• 2022

Objective: This study evaluated the effect of cyclic pre-calcification treatment on the improvement of bioactivity and osseointegration of Ti-6Al-4V mini-screws. Methods: The experimental groups were: an untreated group (UT), an anodized and heat-treated group (AH), and an anodized treatment followed by cyclic pre-calcification treatment group (ASPH). A bioactive material with calcium phosphate was coated on the mini-screws, and its effects on bioactivity and osseointegration were evaluated in in vitro and in vivo tests of following implantation in the rat tibia. Results: As a result of immersing the ASPH group in simulated body fluid for 2 days, protrusions appearing in the initial stage of hydroxyapatite precipitation were observed. On the 3rd day, the protrusions became denser, other protrusions overlapped and grew on it, and the calcium and phosphorus concentrations increased. The removal torque values increased significantly in the following order: UT group (2.08 ± 0.67 N·cm), AH group (4.10 ± 0.72 N·cm), and ASPH group (6.58 ± 0.66 N·cm) with the ASPH group showing the highest value (p < 0.05). In the ASPH group, new bone was observed that was connected to the threads, and it was confirmed that a bony bridge connected to the adjacent bone was formed. Conclusions: In conclusion, it was found that the surface treatment method used in the ASPH group improved the bioactivity and osseointegration of Ti-6Al-4V orthodontic mini-screws.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.157-162
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• 2020

A 6-year-old Thoroughbred mare presented to the Korea Racing Authority Equine Hospital with dropping of the left front fetlock due to an injury sustained while racing. Radiographic examination revealed a comminuted fracture of both proximal sesamoid bones of the affected fetlock. Arthrodesis of the fetlock joint using a broad dynamic compression plate with a tension band wire was performed as a salvage procedure for the future use as a broodmare. After surgery, however, a delayed union of the bones and surgical site infection was present for a prolonged period. Staphylococcus aureus was persistently identified from the surgical site, and antimicrobial therapies were based on antibiotic sensitivity tests, including regional perfusions. The removal and replacement of surgical implants associated with seropurulent discharge was based on coordinating the development of fetlock ankylosis and infection control over 13 months. Firstly, seven screws associated with surgical drainage were replaced and bone morphogenetic protein-2 (BMP-2) and local antibiotics were placed into the surgical site to accelerate bone fusion at postoperative month 7. Further six screws, along with drainage, were removed at postoperative month 10. The plate and screws were removed from the limb due to the progression of bone fusion at postoperative month 13; BMP-2 and local antibiotics were also used. Delayed healing of arthrodesis due to surgical site infection and implant instability were treated by implant removals and antibiotic therapies, and the horse eventually showed improved weight-bearing ability of the affected limb.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.59-63
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• 1998

There have been numerous methods to obtain a stable arthrodesis of the tibiotalar joint. However, a controvercy has arisen over the most successful and reproducible method to obtain an arthrodesis. The objective of this report is to show that an ankle arthrodesis can be performed successfully and advantageously by using cannulated screws under arthroscopic control and that our csaes will be a part of the multicentric study of arthroscopic ankle arthrodesis in korea. Between May 1996 and May 1997, we perfomed 3 ankle arthrodesis under arthroscopy using cannulated screws. Two patients had post-traumatic osteoarthritis and one had rheumatoid arthritis. Clinical ankylosis in one case and radiological union in two cases were obtained in 12 weeks postoperatively. We propose that arthroscopic ankle arthrodesis is effective procedure in patient who has minimal deformity and bone loss, advantages like small incision, minimal morbidity, low infection rate and rapid return to normal daily activity, but more cases and comparision with open tecnique will be needed.

• Clinics in Shoulder and Elbow
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• v.23 no.4
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• pp.198-202
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• 2020

Simple clavicle fractures can achieve satisfactory results through conservative treatment, and the less frequency of nonunion. Non-union or malunion can occur in displaced clavicle fractures or comminuted shaft fractures. Treatment of displaced comminuted clavicle shaft fractures is performed by holding together the free fragments with interfragmentary screws or wires and fixing them to the clavicle with a plate. Therefore, we performed interfragmentary fixation using open reduction and internal fixation with bioresorbable screws (Mg-Ca alloy, Resomet bioresorbable bone screw; U&I Corp.) and bioresorbable wires (Mg-Ca alloy, Resomet bioresorbable K-wire and pin, U&I Corp.) for displaced comminuted clavicle fractures (Robinson type 2B) and additionally used a metal plate. We expected decreased irritation and infection due to absorption after surgery. We report four cases that were treated in this way.