• 제목/요약/키워드: Closed Reduction

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거골하 관절 후방탈구 - 1례 보고 - (Posterior Subtalar Dislocation -1 Case Report -)

  • 임수재;서우석
    • 대한족부족관절학회지
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    • 제4권1호
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    • pp.39-43
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    • 2000
  • A subtalar dislocation of the foot is a dislocation of the talonavicular and talocalcaneal joint while the tibiotalar relationship is unchanged. Posterior subtalar dislocation in particular, is a extremely rare. Only a few cases were reported previously in the literature. We treated a 25 year-old man who sustained the posterior subtalar dislocation in high energy traffic accident. The dislocation of subtalar joint was reduced by closed means with excellent clinical result. In this paper, we report 1 case of posterior dislocation of the subtalar joint and describe the pathomechanics, diagnosis, and treatment.

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TITO 시스템의 LQ-PID 제어기 동조 (A LQ-PID Controller Tuning for TITO System)

  • 이동배;서병설
    • 한국통신학회논문지
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    • 제29권9C호
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    • pp.1252-1257
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    • 2004
  • 본 논문에서는 TITO 시스템에서 분산된 LQ-PID 제어기 설계방법을 제안하고,주파수 영역의 설계사양인 명령추종, 외란제거, 센서 잡음 저감도를 만족하도록 제어기를 설계하였다. 설계방법은 PID 제어요소를 포함한 폐루프 상태방정식과 LQR 폐루프 상태방정식의 관계를 유도하고 루프형성절차를 통해 가격함수의 가중치 요소 Q와 R을 선정함으로써 성능 및 안정도 강인성이 보장되도록 하였다.

셸 형상의 3차원 폐곡면상에서 추출된 점데이터군으로부터 중립곡면 계산에 관한 연구 (A Study on Medial Surface Extraction from Point Samples on 3D Closed Surfaces in Shell Shapes)

  • 우혁제
    • 한국CDE학회논문집
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    • 제15권1호
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    • pp.33-42
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    • 2010
  • In this study, new medial surface calculation methods using Voronoi diagrams are investigated for the point samples extracted on closed surface models. The medial surface is defined by the closure of all points having more than one closest point on the shape boundary. It is a one of essential geometric information in 3D and can be used in many areas such as 3D shape analysis, dimension reduction, freeform shape deformation, image processing, computer vision, FEM analysis, etc. In industrial parts, the idealized solid parts and shell shapes including sharp edges and vertices are frequently used. Other medial surface extraction methods using Voronoi diagram have inherent separation and branch problems, so that they are not appropriate to the sharp edged objects and have difficulties to be applied to industrial parts. In addition, the branched surfaces on sharp edges in shell shapes should be eliminated to obtain representative medial shapes. In order to avoid separation and branch problems, the new approach by analyzing the shapes and specially sampling on surfaces has been developed.

Effect of angle stiffeners on the flexural strength and stiffness of cold-formed steel beams

  • Dar, M. Adil;Subramanian, N.;Rather, Amer I.;Dar, A.R.;Lim, James B.P.;Anbarasu, M.;Roy, Krishanu
    • Steel and Composite Structures
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    • 제33권2호
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    • pp.225-243
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    • 2019
  • Cold-formed steel (CFS) sections when used as primary load carrying members often require additional strengthening for retrofitting purposes. In some cases, it is also necessary to reduce deflections in order to satisfy serviceability requirements. The introduction of angle sections, screwed to the webs so as to act as external stiffeners, has the potential to both increase flexural strength as well as reduce deflections. This paper presents the results of ten four-point bending tests, on built-up CFS sections, both open and closed, with different stiffening arrangements. In the laboratory tests, the stiffening arrangements increased the moment capacity and stiffness of the CFS beams by up to 85% and 100% respectively. The increase in moment capacity was more evident for the open sections, while that reduction in deflection was largest for the closed sections.

Management of Unilateral Facet Dislocation of the Cervical Spine

  • Baek, Geum-Seong;Lee, Woo-Jong;Koh, Eun-Jeong;Choi, Ha-Young;Eun, Jong-Pil
    • Journal of Korean Neurosurgical Society
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    • 제41권5호
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    • pp.295-300
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    • 2007
  • Objective : Unilateral facet dislocation of the cervical spine occurs by flexion and rotation injuries and cannot be easily reduced by axial traction. We analyzed 14 consecutive patients with unilateral facet dislocation of the cervical spine to increase knowledge about anatomical reduction of locked facet and factors for successful reduction. Methods : Fourteen patients [10 men and 4 women] with unilateral facet dislocation of the cervical spine were retrospectively analyzed. Plain X-ray, computerized tomography scan, and magnetic resonance imaging were performed. All patients underwent manual reduction and surgery with anterior interbody fusion and plate fixation. The manual reduction was performed by neck flexion and rotation to the opposite side of dislocation, followed by rotation and flexion of the head toward the side of dislocation and extension with relaxation of traction. Mean follow-up period was 17 months. The level of spine, amount of subluxation, combined facet fracture, and time from injury to initial reduction were analyzed using the data obtained from medical records. Results : Thirteen [93%] patients were reduced successfully. Immediate reduction was achieved in 7 patients but failed in 7 patients. Seven patients underwent delayed closed reduction under general anesthesia, and successful reduction was achieved in 6 patients. Only one patient with bone chips between articular facets failed to achieve anatomical reduction. Conclusion : In order to reduce the locked facet more easily and safely, we recommend manipulative traction with anterior interbody fusion and plate fixation under general anesthesia after being aware of spinal cord injury with magnetic resonance imaging.

Comparison of postoperative outcomes between early and delayed surgery for pediatric nasal fractures

  • Kang, Won Ki;Han, Dong Gil;Kim, Sung-Eun;Lee, Yong Jig;Shim, Jeong Su
    • 대한두개안면성형외과학회지
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    • 제22권2호
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    • pp.93-98
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    • 2021
  • Background: Pediatric nasal fractures, unlike adult nasal fractures, are treated surgically as early as 7 days after the initial trauma. However, in some cases, a week or more elapses before surgery, and few studies have investigated the consequences of delayed surgery for pediatric nasal fractures. The purpose of this study was to evaluate the postoperative outcomes of pediatric nasal fractures according to the time interval between the initial trauma and surgery. Methods: The records of pediatric patients under 12 years old who underwent closed reduction of nasal bone fracture from March 2012 to February 2020 were reviewed. The interval between trauma and surgery was divided into within 7 days (early reduction) and more than 7 days (delayed reduction). Postoperative results were classified into five grades (excellent, good, moderate, poor, and very poor) based on the degree of reduction shown on computed tomography. Results: Ninety-eight patients were analyzed, of whom 51 underwent early reduction and 47 underwent delayed reduction. Forty-two (82.4%) of the 51 patients in the early reduction group showed excellent results, and nine (17.6%) showed good results. Thirty-nine (83.0%) of the 47 patients in the delayed reduction group showed excellent results and eight (17.0%) showed good results. No statistically significant difference in outcomes was found between the two groups (chi-square test p= 0.937). However, patients without septal injury were significantly more likely to have excellent postoperative outcomes (chi-square test p< 0.01). Conclusion: No statistically significant difference was found in the outcomes of pediatric nasal fractures between the early and delayed reduction groups. Successful surgical results were found even in patients who received delayed reduction (more than 7 days after trauma).

비골골절 치료 시 간접 관혈적 정복술 및 외고정술의 유용성 (Usefulness of Indirect Open Reduction and External Fixation in Algorithm Oriented Treatment of Nasal Fracture)

  • 박기린;정규진;김용하
    • 대한두개안면성형외과학회지
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    • 제14권2호
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    • pp.81-88
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    • 2013
  • Background: To suggest the need of more aggressive reduction techniques than closed reduction (CR) technique in nasal fracture treatment, we identified the usefulness of algorithm oriented treatment of nasal fracture that includes indirect open reduction (IOR) and external fixation (EF) as well as the CR. Methods: We compared the clinical course of the group A (n=128) where only the CR was performed regardless of the pattern of the nasal fracture and the group B (n=127) where algorithm oriented treatment including IOR and EF as well as CR was performed depending on the pattern of nasal fracture. And the degree of postoperative pain after CR and IOR technique was compared through the dose of analgesics and pain scores. Results: More than 80% of patients were satisfied the result of reduction in both group A and B. Good contour of nasal bone after reduction was showed 71% of group A and 81% of group B without significant difference. Minor (p>0.05) and major (p<0.05) deformity after reduction were less occurred in the group B than group A. Postoperatively, the dose of analgesics was significantly lower after IOR technique than CR technique (53 mg vs. 142 mg) (p<0.05). Conclusion: Algorithm oriented treatment of nasal fracture including IOR and EF as well as CR reduce major deformity after reduction than treatment of CR alone. It is useful to perform the more aggressive reduction techniques such as IOR and EF according to the pattern of fracture in treatment of nasal fracture.

비중격 골절을 동반한 단순 비골 골절의 치료에 있어 비중격 교정술의 중요성: 비강 통기도 검사를 이용한 평가 (The Importance of Septoplasty in The Treatment of Nasal Bone and Grade I Septal Fracture: Estimation with Acoustic Rhinometry)

  • 김준형;신동우;최태현;손대구;한기환
    • Archives of Plastic Surgery
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    • 제37권5호
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    • pp.626-632
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    • 2010
  • Purpose: Nasal bone fractures are often classified as minor injury. However, the incidence of posttraumatic nasal deformity remains alarmingly high. It is because of unnoticed septal fracture. This study was conducted to determine the necessity of septoplasty for patients with nasal bone fracture accompanying grade I septal fractures. Methods: Among 105 patients with nasal bone fractures, 52 who had grade I septal fracture were diagnosed based on physical examination and computed tomography. Patients' age ranged from 14 to 65 years (mean 29.25 years), and 35 were male and 17 female. Patients were divided into 2 groups according to surgical treatment methods: patients who underwent closed reduction only (group 1, n=28) and those who underwent simultaneous closed reduction and septoplasty (group 2, n=24). The treatment outcomes were evaluated by comparing changes in nasal airway volume measured by acoustic rhinometry before the surgery, 3 months and 6 months after the surgery according to the timing of surgical repair and surgical treatment methods. Results: Nasal airway volume increased after the surgery by 17.8% in 3 months after the surgery, 25.2% in 6 months in group 1 and by 22.7% in 3 months, 35.8% in 6 months in group 2. The increase in airway volume after the surgery by 26.3% in 3 months after the surgery, 34.2% in 6 months after the surgery in operation within 1 week after trauma and by 12.1% in 3 months, 22.2% in 6 months after the operation later 1 week after trauma. The difference was statistically significant. Three patients in group 1 complained of intermittent nasal obstruction, two of whom showed a decrease in nasal airway volume by acoustic rhinometry. Conclusion: Most patients with nasal bone fractures accompanying grade I septal fractures have been treated with closed reduction in clinical settings. However, the results of this study suggest that septoplasty be performed after a correct diagnosis of septal fracture is made through comprehensive physical examination and computed tomography. Septoplasty is important to obtain more favorable outcomes and reduce complication.

Electrognathography를 이용한 측두하악장애환자의 저작양태에 관한 연구 (A Study of the Chewing Patterns in Patients with Temporomandibular Disorders by Electrognathography)

  • Moon-Gyu Kim;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • 제20권2호
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    • pp.291-306
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    • 1995
  • Mandibular movement is composed of border movement and functional movement. Border movement such as maximal mouth opening, hinge opening ad lateral eccentric movement has good reproducibility, but functional movement such as chewing, swallowing and speech has also reproducibility. Especially for chewing movement, individual reproducibility has been confirmed by many studies. Study of chewing pattern is still in controversy. In new approach for raising the diagnostic value, numeric parameters and morphologic characteristics could be used for evaluation of chewing pattern. This study was performed to investigate the differences between chewing pattern in controls and in patients with temporomandibular disorders. Sixty-three patients with temporomandibular disorders participated in this study, and they were divided into unilaterally affected subjects or bilaterally affected subjects. Then unilaterally affected subjects were classified into closed lock group, disk displacement with reduction group, and degenerative joint disease group. For recording of chewing pattern, subjects were asked to chew one piece of presoftened chewing gum on both sides, and the chewing movement was recorded with the Electrognatho- Graphy(Bio-Research Associates Inc., U.S.A.). Tooth contact pattern for occlusal stability (Total left-right statistics )was also recorded with T-Scan(Tekscan Co., U.S.A.). The dta related to chewing pattern and total left-right statistics were statistically analyzed by SAS/stat program. The obtained results were as follows : 1. In patient group, mean value of A-P distance and the ratio of A-P distance to vertical distance were larger than control group, but the value of lateral distance in affected side and the closing velocity in unaffected side were smaller than that of control group, respectively. 2. In case of unilateral affected patients, chewing pattern of other side had tendency to restricted movement and slow velocity in closed lock group or degenerative joint disease group than control group or disk displacement with reduction group. 3. In bilateral degenerative joint disease patients, contralateral side had tendency to large range of motion and slow chewing velocity than preferred chewing side. 4. The patients with restricted mouth opening below than 35mm had higher value of total left-right statistics than patient group mouth opening above 35mm. Also closed lock group had higher total left-right statistics than disk displacement with reduction group, degenerative joint disease group and control group. 5. There was some difference in morphologic characteristics of chewing pattern between in control group and in affected side of unilateral patient group, but no difference between control group and unaffected side of unilateral patient group. 6. There were positive correlations between vertical distance and A-P distance, between vertical distance and chewing velocity, between A-P distance and chewing velocity, and between opening velocity and closing velocity in unilateral affected patients.

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비골 골절 교정 후 Rolled Silastic Sheet를 이용한 비강 충진의 효과 (The Effect of Nasal Packing with Rolled Silastic Sheet after Closed Reduction of Nasal Bone Fracture)

  • 손경민;양정열;김규보;한윤주;천지선
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.602-608
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    • 2011
  • Purpose: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. Methods: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I (n=92), $Merocel^{(R)}$ was used for nasal packing, for Group II (n=152) vaseline gauze was used, and Rolled silastic sheet (RSS) with vaseline gauze packing (VGP) was used for Group III (n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. Results: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased ($p$ <0.05) and the postoperative complication (deviation) were decreased comparing to vaseline gauze packing and $Merocel^{(R)}$ packing, however, these differences were not statistically significant ($p$ >0.05). Conclusion: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.