• Title/Summary/Keyword: Clavicle

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Subclavian artery pseudoaneurysm of 10 days after a traffic accident: A Case Report (교통 사고 10일 후 발생한 쇄골하 동맥 가성동맥류 1례)

  • Hwang, Yong;Shin, Sangyol;Choi, Jeong Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.7
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    • pp.4651-4655
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    • 2015
  • The subclavian artery pseudoaneurysm in blunt trauma is uncommon and rarely occurs secondary to penetrating injury. Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-threatening hemorrhages, pseudoaneurysm formation and compression of brachial plexus. Most injuries were related to clavicle fracture, gunshot, other penetrating trauma, and complication of central line insertion. The presence of large hematomas and pulsatile palpable mass in supraclavicular region should raise the suspicion of serious vascular injury and these clinical evidences must be carefully worked out by physical examination of the upper limb. Since the first reports of endovascular treatment for traumatic vascular injuries in the 1993, an increasing number of vascular lesions have been treated this way. We report a case of subclavian artery pseudoaneurysm 10 days after blunt chest trauma due to traffic accident, treated by endovascular stent grafting.

CLEIDOCRANIAL DYSPLASIA WITH FAMILIAL HISTORY - A CASE REPORT (가족력을 보이는 쇄골두개 이형성증에 관한 증례보고)

  • Hwang, Ji-Young;Choi, Sung-Chul;Lee, Keung-Ho;Kim, Kwang-Chul;Park, Jae-Hong
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.2
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    • pp.82-87
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    • 2008
  • Cleidocranial dysplasia (CCD) is an autosomal dominant skeletal dysplasia and is caused by mutation in the CBAFA1 gene of 6p21 chromosome band. Patients with CCD express skeletal dysplasia such as hypoplastic/aplastic clavicle, brachycephalic skull, midface hypoplasia and moderate short stature. In addition to skeletal dysplasia, specific symptoms may appear in respiratory organs, auditory area, and the more distinguished, dentition. Dental findings include: delayed eruption of permanent tooth, multiple supernumerary tooth more than five, malocclusion, etc. In Patients presenting excessive SNT, complications of SNT could be prevented and will be managed through pertinently timed treatment such as tooth extraction, using space maintainer, and orthodontic management after early diagnosis. This case is about the treatment of eruption disorders in permanent teeth owing to SNT in CCD patients, who are three family members in the $3^{rd}$ generation inherited from maternal grandfather through atavism. We performed the extraction of numerous SNT and orthodontic treatment on them in this case. On evaluating panoramic and cephalometric views, some classical signs of skeletal dysplasia due to CCD were recognized in a pool of three patients, the clavicle was distinctively displayed in all patients.

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CLEIDOCRANIAL DYSPLASIA : CASE REPORT (쇄골두개 이형성증 환아의 증례 보고)

  • Park, Young-Ok;Kim, Eun-Jung;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.372-380
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    • 2004
  • Cleidocranial dysplasia(CCD) is a congenital disorder of skeletal and dental abnormality, which is mesodermal dysfunction influencing many tissues and organs. Skeletal abnormalities in CCD are delayed closure of cranial suture and fontanelle, presence of wormian bone and clavicle aplasia. And CCD has an effect on the long bones, phalanges, spine, pelvis, muscles, and central nervous system. Dental manifestations include retention of deciduous teeth, multiple supernumerary teeth, delayed or absent eruption of permanent teeth and formation of cysts around nonerupted teeth. But as a result in common with a lack of medical and physical disability patient may have no substantive complaint, there are many masticatory and psychological problem by absent eruption of permanent teeth after exfoliation of deciduous teeth. For this reason CCD is necessary fo early diagnosis and must be improvement of the patient's appearance as well as provision of a functioning masticatory mechanism by treatment of surgical removal of supernumerary teeth, followed orthodontically eruption of the natural permanent teeth at adequate time.

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A Case of Bilateral Subclavian Venous Thrombosis Associated with Sternocostoclavicular Hyperostosis (흉쇄늑골과골증에 동반된 양측성 쇄골하정맥혈전 1예)

  • Jeong, Hoon;Sim, Young-Mog;Yoo, Bin;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Dong-Soon;Kim, Won-Dong;Kim, Woo-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.379-385
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    • 2001
  • Sternocostoclavicular hyperostosis is an uncommon disease, characterized by an inflammatory arthrosteitis of the sternocostoclavicular region. Clinically, it manifests as a painful swelling of the upper anterior chest wall, which is associated with occasional pustulosis palmaris and plantaris. A 48-year-old man had suffered from pain in both shoulders and the upper anterior part of the chest for 6 months. On examination, a venous engorgement in the neck with dilated collateral veins in the upper chest and shoulders was observed. Swelling was noticed in his face, neck and both arms. Radiologically, the clavicles, the sternum and the first ribs were enlarged with complete fusion between them. 99Tc scintigraphy showed increased uptake in the clavicles and the sternum. Selective venography resulted in a bilateral subclavian and brachiocephalic vein occlusion, which resulted from a subclavian vein thrombosis. All the above suggested a sternocostoclavicular hyperostosis. He underwent a vascular graft interposition between the right jugular vein and the left innomianate vein (using 8mm ringed Gore-Tex graft) and a resection of the bilateral medial half of clavicle and 1st rib. Here, we present a case on sternoclavicular hyperostosis with subclavian and brachiocephalic vein thrombosis, and report this case study with a review of the appropriate literature.

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Coracoclavicular Ligaments Reconstruction for Acromioclavicular Dislocation using Two Suture Anchors and Coracoacromial Ligament Transfer (견봉 쇄골 탈구의 봉합 나사못과 오구 견봉 인대 이전술을 이용한 오구 쇄골 인대 재건술)

  • Shin, Sang-Jin;Roh, Kwon-Jae;Jeong, Byoung-Jin
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.46-52
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    • 2008
  • Purpose: This study examined the outcomes of reconstruction of the coracoclavicular ligaments with using two suture anchors and performing coracoacromial ligament transfer in patients with acromioclavicular dislocation. Material and methods: Forty patients with complete acromioclavicular dislocation were included in this study. According to the preoperative radiographs, 5 patients with AC dislocations were diagnosed as type III, 4 patients as type IV and 31 patients as type V. Two 3.5mm suture anchors with four strands of nonabsorbable sutures were separately placed on the anterolateral and posteromedial portion of the base of the coracoid process to stabilize the distal clavicle. The coracoacromial ligament was then transferred to the undersurface of the distal end of the clavicle for augmentation. Results: At a mean follow-up of 28 months, the average Constant score improved to 97 points. All the patients returned to normal life at an average of 3.2 months postoperatively. At the last follow-up, 37 patients achieved anatomical reduction and three patients showed complete redislocation. However, the clinical results of the patients with redislocation were satisfactory. Conclusion: Anatomical coracoclavicular reconstruction using two suture anchors and coracoacromial ligament transfer for treating complete acromioclavicular dislocation is a safe, effective procedure for restoring a physiologically stable acromioclavicular joint.

Osteological Development of the Larvae and Juveniles of Sebasticus tertius (Barsukov et Chen) in Korea (한국산 붉은쏨뱅이 Sebasticus tertius (Barsukov et Chen) 자치어(仔稚漁)의 골격발달)

  • Han, Kyeong-Ho;Lim, Sang-Ku;Kim, Kwang-Su;Kim, Chul-Won;Yoo, Dong-Jae
    • Korean Journal of Ichthyology
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    • v.13 no.1
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    • pp.63-68
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    • 2001
  • The skeletal development of the larvae and juvenile of red marbled rockfish, Sebasticus tertius (Barsukov et Chen) was studied based on individuals that were discharged and reared in the laboratory from April to May 1997. In 8 days after bearing, the postlarvae attained 4.42 mm in total length (TL), and its parasphenoid, premaxillary, maxillary, and clavicle were ossified for the first time at this stage. In 15 days after bearing, the postlarvae attained 5.23 mm in TL, and its pterotic, basioccipital, exoccipital, opercle, and preopercle were ossified, with one spine on the each cranium and preopercle. In 27 days after bearing, the postlarvae attained 8.81 mm in TL, its vertebra were posteriorly ossified to the 15th centrum, and five spines were formed on the preopercle. In 39 days after bearing, the juveniles attained 14.21 mm in TL, and the all bones were almost completed at this stage.

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A Cause Analysis of Missed Fractures in an Emergency Medical Center (응급센터에 내원한 외상환자에서 간과된 골절의 요인 분석)

  • Park, Deuk-Hyun;Lee, Sung-Sil;Kim, Dong-Un;Cho, Hyun-Young;Lee, Young-Geun;Kim, Jun-Su;Jun, Jin;Kim, Young-Sik;Ha, Young-Rock;Sin, Tae-Yong
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.37-43
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    • 2009
  • Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.

Development of a Semi-Atomatic Protocol for embodiment of a desirable 3D breast shape and deployment of bra cup pattern (3차원의 바람직한 유방형상 구현을 위한 Semi-Atomatic Protocol 개발 및 브래지어 컵 패턴으로의 전개)

  • Sohn, Boo-hyun;Kweon, Soo-ae
    • Journal of Fashion Business
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    • v.20 no.4
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    • pp.189-206
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    • 2016
  • A breast model was for the human body was devised by studying a body scan and human body index of a desirable breast type. Thus, when manufacturing various 3D models, these results can accordingly become a fundamental basis for realizing a desirable breast model. This study aims to provide a basic data for designing the cup patterns of brassieres in order to improve the function and wearing comfort. The comfort of three kinds of brassieres were compared: one manufactured by the actual measured size; another manufactured as per the ratio of desirable upper and lower breast lengths; and the third manufactured by the 3D model attained by the desirable human body ratio. In this study, we suggest a process for realizing the desirable breast model using the ratio of bust breadth and waist front length, which are the components for deciding the appropriate position and size of breast, and which are easy to measure. The ideal breast shape is an equilateral triangle formed by connecting the nipple with the center of the clavicle. After deciding the interval between the nipples, this value can be used to configure the locations of nipples by drawing a tangent, with equal length, from the anterior neck point (which is the center of clavicle) to the nipple. Also, since inside points of breast do not exist, the outer point of breast, upper point of breast, and below point of breast on the same plane, and the depths from the nipple point to the respective points, are applied to simulate a 3D image, by modifications along the x, y, and z axes. Depending on the type of breast, the length from the center of shoulder to the nipple, the diameter of breast, upper length of breast, and the position of nipple, are different. In conical or protruding breast, the wearing sensation is better when the nipple point of brassiere was lifted, by modifying the upper and lower lengths of breast. Considering the wearing sensation and function of a brassiere, it was better to leave the wearer's size as it is and use a pad within the same cup, rather than increase the basal area of the breast in order to increase the volume.

Concomitant open distal clavicle excision is associated with greater improvement in range of motion without increased risk of acromial stress fracture after reverse total shoulder arthroplasty: a retrospective cohort study

  • Ajay C. Kanakamedala;Dhruv S. Shankar;Neil Gambhir;Matthew R. Boylan;Michael Boin;Matthew G. Alben;Mandeep S. Virk;Young W. Kwon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.357-365
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    • 2023
  • Background: The purpose of this study was to evaluate the effect of concomitant open distal clavicle excision (DCE) on postoperative clinical outcomes and incidence of acromial and scapular stress fractures (ASFs) in patients with symptomatic acromioclavicular joint osteoarthritis (ACJ OA) undergoing reverse total shoulder arthroplasty (RTSA). Methods: A single-surgeon retrospective cohort study was conducted including patients who underwent primary elective RTSA with or without DCE from 2015 to 2019 with a minimum 6-month follow-up period. Shoulder active range of motion (AROM) and visual analog scale (VAS) pain were recorded preoperatively and postoperatively. ASFs and other adverse events were identified using postoperative notes and/or radiographs. Characteristics and outcomes were compared between the RTSA and RTSA-DCE groups. Results: Forty-six RTSA patients (mean age, 67.9±8.7 years; 60.9% male; mean follow-up, 24.9±16.6 months) and 70 RTSA-DCE patients (mean age, 70.2±8.9 years; 20.0% male; mean follow-up, 22.7±12.9 months) were included. There were no significant intergroup differences in rates of ASF (RTSA, 0.0% vs. RTSA-DCE, 1.4%; P=1.00), stress reactions (RTSA, 8.7% vs. RTSA-DCE, 11.4%; P=0.76), reoperation, revision, or infection (all P>0.05), or in pre-to-postoperative reduction in VAS pain (P=0.17) at latest follow-up. However, the RTSA-DCE group had greater pre-to-postoperative improvement in flexion AROM (RTSA, 43.7°±38.5° vs. RTSA-DCE, 59.5°±33.4°; P=0.03) and internal rotation (IR) AROM (P=0.02) at latest follow-up. Conclusions: Concomitant DCE in RTSA improves shoulder flexion and IR AROM, alleviates shoulder pain, and does not increase the risk of ASFs. Level of evidence: III.

RASA1-Related Parkes Weber Syndrome in a Neonate

  • Koh, Hong Ryul;Lee, Yeon Kyung;Ko, Sun Young;Shin, Son Moon;Han, Byoung-Hee
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.126-130
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    • 2018
  • Parkes Weber syndrome is a rare congenital vascular anomaly, related to the RAS p21 protein activator 1 (RASA1) gene. It is characterized by capillary cutaneous malformations, bony and soft tissue hyperplasia, and multiple arteriovenous fistulas throughout the affected upper or lower extremity. These arteriovenous fistulas can be associated with life-threatening complications such as bleeding, thrombosis, and high output heart failure. In this report, we present a neonate who had a disproportionately hypertrophied left upper limb with port-wine stain, dystrophy of the left humerus, and hypertrophy of the left clavicle on X-ray, and arteriovenous malformation and massive dilatation of the left subclavian artery on magnetic resonance angiography. Exome sequencing analysis revealed a novel heterozygous splicing mutation (c.1776+2T>A) in the RASA1 gene. To the best of our knowledge, this report is the first case of RASA1-related Parkes Weber syndrome in Korea.