• 제목/요약/키워드: Comminution

검색결과 59건 처리시간 0.029초

원위 경비골 골절에 대한 골수강내 금속정술에서 비골 고정이 족근 관절 기능에 미치는 영향 (The Effect of Fibular Fixation on Ankle Function in Intramedullary Nailing for Distal Tibiofibular Fractures)

  • 서병호;이수원;공규민;김동준;오현근
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.169-174
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    • 2009
  • Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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Preventing Varus Deformity in Senile Patients with Proximal Humerus Fractures and Poor Medial Support

  • Kim, Young-Kyu;Kang, Suk-Woong;Kim, Jin-Woo
    • Clinics in Shoulder and Elbow
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    • 제19권4호
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    • pp.216-222
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    • 2016
  • Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.

관절내 종골 골절의 전산화 단층촬영에 따른 분류 및 수술적 치료 (Computed Tomographic Classification and Operative Treatment of Intraarticular Calcaneal Fractures)

  • 노재영;배서영;김성덕
    • 대한족부족관절학회지
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    • 제6권2호
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    • pp.149-155
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    • 2002
  • Purpose: To propose a new comprehensive classification system of intraarticular calcaneal fracture based on CT images. Materials and methods: Fourty intraarticular calcaneal fractures which were treated operatively were evaluated retrospectively. We classified fracture types according to severity of comminution on the posterior facet and calcaneocuboid joint by CT images. And we evaluated postoperative results of each fracture types in terms of the quality of fixation and reduction by the postoperative plain radiograghs. Results: By the classification of the posterior facet, 18 cases were P-I, 15 were P-II, and 7 were P-III. Among the P-I cases, 7 were P-IA, 9 were P-IL, 1 was P-IM and 2 were P-IT. According to the classification of calcaneocuboid joint, II cases were C-I, 18 were C-II and 11 were C-III. Qualities of fixation were excellent in 27 cases (67.5%), fair in 9(22.5%) and poor in 4(10%). Qualities of reduction were excellent 23 cases(57.5%), fair in 11(27.5%) and poor in 6(15%). Conclusion: Our new classification system based on the CT images could provide informations about the fracture configuration and severity of comminution around calcaneocuboid joint as well as the posterior facet. And the high grade fractures such as type P-III are need to be taken care of fixation of articular surfaces.

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리포익산 나노 입자의 식욕 억제에 대한 고분자의 영향 (Polymer Effects on Appetite Suppression by Lipoic Acid Nanoparticles)

  • 최혜민;박철호;이기업;박중열;고은희;김현식;이종휘
    • Journal of Pharmaceutical Investigation
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    • 제37권6호
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    • pp.349-354
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    • 2007
  • For decades, the various virtues of ${\alpha}-lipoic$ acid (ALA), a natural material synthesized in most cells, have been intensively studied and proved. Recently it was reported that ALA caused significant bodyweight reduction via appetite suppression. Unfortunately, the efficacy requires an administration over 50 mg/kg. The low bioavailability and the short plasma half life of ALA lead us to explore novel pharmaceutical dosage forms using nanoparticles. In this study, the effect of polymeric stabilizers on the bioavailability improvement of ALA nanoparticles was investigated. The reduction of particle size via nano-comminution technology was successful resulting in volume average particle sizes of 320 - 340 nm. The in vitro release rate of ALA did not reflect the decrease of particle size, possibly because of the self polymerization of ALA during nano-comminution. The type of polymeric stabilizers could not affect the release rate either. However, the in vivo food intake results of ALA showed that nano-suspensions were more effective than microparticles or a salt form. The nano-suspension containing polyvinyl pyrrolidone as the primary stabilizer and polyacrylic acid as the secondary stabilizer showed more improved efficacy for 2 hours.

Zygomaticomaxillary complex fracture after two-jaw surgery

  • Park, Joseph Kyu-hyung;Kim, Sang Wha
    • 대한두개안면성형외과학회지
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    • 제21권5호
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    • pp.301-304
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    • 2020
  • Orthognathic surgeries often utilize rigid fixation for stabilization of the osteotomy site. The longterm fate of rigid fixations is still under investigation, and whether they should be routinely removed is under debate despite their low complication rates. Here, we report a case where a 26-year-old man suffered high-velocity trauma to his face 7 years after a two-jaw surgery. Computed tomography examination revealed a zygomaticomaxillary complex fracture, and open reduction and internal fixation was performed along with anterior maxillary wall reconstruction using absorbable mesh. Intraoperative examination revealed a broken L-shaped titanium plate near the fracture site with multiple bony fragments near each titanium screw. The rigid titanium system may have caused comminution of the fracture pattern, worsening the severity of the fracture.

자가 비골이식술을 이용한 족관절 유합술: 2예 보고 (Ankle Arthrodesis Using Auto Fibula Bone Graft: Two Cases Report)

  • 이창호;윤원식;오진록
    • 대한족부족관절학회지
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    • 제15권2호
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    • pp.102-106
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    • 2011
  • Recently, development and improvement in joint replacement therapy, the need for arthrodesis has been decreasing. However, result of joint replacement is not always satisfactory, and most cases are rather indicative to ankle arthrodesis than ankle replacement. Often, ankle arthrodesis can be more beneficial salvage method to treat cases with failure in joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation. In cases with large bone defect that need to be treated with ankle arthrodesis using internal fixation, it is difficult to fill the defect with conventional auto-iliac bone or all-bone graft. Thus, we make a report on our experience in treating 2 cases with ankle arthrodesis using auto-fibular bone graft and plate fixation.

Acute limb shortening and modified pantarsal arthrodesis for the treatment of a highly comminuted distal tibial articular fracture in a dog

  • Bruno Santos;Ines Gordo;Ronan Mullins
    • Journal of Veterinary Science
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    • 제24권2호
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    • pp.28.1-28.7
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    • 2023
  • A three-year-old female spayed Lurcher was referred for the treatment of a highly comminuted distal tibial articular fracture. Resection of the area of comminution with a transverse osteotomy of the tibial diaphysis and talar ridges was performed, followed by modified pantarsal arthrodesis and a calcaneotibial screw. The treatment resulted in 7 cm of tibial shortening, equating to a 28% reduction in the total tibial length. Radiographic union of the arthrodesis was successful. Fair use of the pelvic limb was documented long-term. Combined acute limb shortening and modified pantarsal arthrodesis resulted in an acceptable outcome and could be considered in cases of highly comminuted distal tibial fractures.

쇄골 간부 골절의 보존적 치료 분석 (The Analysis of Conservative Treatment in Midshaft Fractures of Clavicle)

  • 차승도;정수태;김용훈;박상준
    • Clinics in Shoulder and Elbow
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    • 제13권1호
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    • pp.27-33
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    • 2010
  • 목적: 대부분 쇄골 골절은 보존적 치료하는데 골 유합에는 여러 요인들이 있다. 본 연구의 목적은 보존적 치료를 시행한 쇄골 간부 골절 환자에서 골 유합과 골 유합 후 기능에 미치는 요인들을 분석하여, 좀 더 빠르고 명확한 치료법의 결정을 내리는데 도움이 되도록 하고자 한다. 대상 및 방법: 2004년 1월부터 2009년 6월까지 본원에서 관찰이 가능했던 쇄골 골절 환자 총 523예에서 보존적 치료를 통해 골 유합을 얻은 270예에 대해 수상 직후부터 촬영한 단순 방사선 사진을 이용하여 연령, 골절 위치, 분쇄 및 분리 정도와 쇄골 길이 단축 등 골 유합에 영향을 미칠 수 있는 인자들과 골 유합 후 기능에 미치는 영향에 대해 연구, 분석하였다. 결과: 쇄골 간부 골절을 보존적으로 치료한 결과, 골절의 분리 정도가 증가할수록 골 유합 기간이 증가함을 알 수 있었고 나이는 골 유합 기간이 13세 이상에서 12세 이하보다 2배 정도 증가함을 확인할 수 있었으며 분쇄 정도는 골절부의 분쇄가 없는 경우가 분쇄가 있는 경우보다 2배 정도 골 유합이 빨리 이루어졌다. 그리고 추시 중 골절편의 전위는 2주 이내에 주로 일어남을 확인하였다. 결론: 쇄골 간부 골절 치료시 나이가 13세 이상이고 분쇄가 있는 경우는 수상 기전과 전위 정도를 고려하여 골 유합 기간을 예상할 수 있고 골 유합이 늦어질 것으로 예상되는 경우는 재활 치료의 시기를 늦추는 것이 필요하며 보존적 치료 중 2주 이내에는 전위가 일어날 가능성이 높으므로 적극적인 관찰을 하고 전위가 증가한다면 수술적 치료를 고려해 보아야 한다.

High Pressure Liquid Jet Technology for Nano Particles Production

  • Mazurkiewicz, Marian;Rhee, Chang-Kyu;Weglinski, Bogumil
    • 한국분말재료학회지
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    • 제15권5호
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    • pp.411-421
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    • 2008
  • Principles and historical background of high pressure liquid jet (HPLJ) technology is presented in the paper. This technology can be applied, among others, for production of nano particles. This target can be achieved in various type of disintegration systems developed and designed on the base of this technology. The paper describes principles of two examples of such systems: HPLJ-reactor, called also a linear comminuting system, HPLJ- centrifugal comminuting system, which prototypes have been manufactured. A linear mill, being high energy liquid jet reactor, has been developed and tested for micronization of various types of materials. The results achieved so far, and presented in the paper, show its potential for further improvement toward nano-size particle production. Flexibility of adjustment of the reactors and the mechanism of the process allows for the creation of particles with unprecedented rheology. The reactor can be especially suitable to micronize, mix and densify materials with a wide range of mechanical properties for various industrial needs. Presented prototypes of comminution systems generate interesting potentials toward production of nano particles. Their performance, based on up today research, confirms expected high efficiency of materials disintegration, which opens a new challenge for industrial applications. The paper points out benefits and area of possible applications of presented technology.

Color Ratios of Parallel-Component Polarization as a Maturity Indicator for the Lunar Regolith

  • Kim, Sungsoo S.;Jung, Minsup;Sim, Chae Kyung;Kim, Il-Hoon;Park, So-Myoung;Jin, Ho
    • 천문학회보
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    • 제40권1호
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    • pp.62.1-62.1
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    • 2015
  • Polarization of the light reflected off the Moon provides information on the size and composition of the particles in the lunar regolith. The mean particle size of the regolith can be estimated from the combination of the albedo and degree of polarization, while the color ratio of the parallel-component polarization (CP) has been suggested to be related to the amount of nanophase metallic iron (npFe^0) inside the regolith particles. Both the mean size and npFe^0 abundance of the particles have been used as maturity indicators of the regolith since sustained impacts of high energy particles and micro-meteoroids cause comminution of particles and production of npFe^0. Based on our multispectral polarimetric observations of the whole near side of the Moon in the U, B, V, R, and I bands, we compare the maps of the mean particle size, CP, and the optical maturity (OM). We find that the mean particle size map is sensitive to the most immature (~0.1 Gyr) soil, the OP map to the intermediate immaturity (a few 0.1 Gyr) soil, and the CP map to the least immature (~1 Gyr) soil.

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