• Title/Summary/Keyword: Compression Fracture

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Clinical Research Trends on Compression Fracture Treatment Using Traditional Korean Medicine: A Case Study Review

  • Jeong-Du Roh;Jung Won Byun;Soo Min Ryu;You Jin Heo;Song Choi;Eun Yong Lee;Cham Kyul Lee;Na Young Jo
    • Journal of Acupuncture Research
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    • v.41 no.1
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    • pp.1-16
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    • 2024
  • This review examined and analyzed clinical research trends in the treatment of compression fractures in traditional Korean medicine using case studies. Accordingly, 5 web databases were searched using relevant Korean and English terms. Based on predefined exclusion and inclusion criteria, 16 case studies were selected, analyzed, and classified according to the journal, publication year, participants, chief complaints, affected vertebrae, treatment and evaluation methods, and improvement. The case studies reported various treatment methods, including acupuncture, herbal medicine, physical therapy, cupping, moxibustion, and band training. All 16 case studies reported the use of combination therapy. All 23 cases reported in these case studies demonstrated improvement in chief complaints, and none reported any side effects.

Deformation and Fracture Behavior of Structural Bulk Amorphous Metal under Quasi-Static Compressive Loading (준정적 압축하에서 구조용 벌크 아몰퍼스 금속의 변형 및 파괴거동)

  • Shin, Hyung-Seop;Ko, Dong-Kyun;Oh, Sang-Yeob
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.27 no.10
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    • pp.1630-1635
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    • 2003
  • The deformation and fracture behaviors of a bulk amorphous metal, Zr-based one (Zr$\_$41.2/Ti$\_$13.8/Cu$\_$12.5/Ni$\_$10/Be$\_$22.5/: Vitreloy), were investigated over a strain rate range (7x10$\^$-4/~4 s$\^$-1/). The uniaxial compression test and the indentation test using 3mm-diameter WC balls were carried out under quasi-static loading conditions. As a result, at the uniaxial compressive state, the fracture stress of the material was very high (~1,700MPa) and the elastic strain limit was about 2%. The fracture strength showed a strain rate independent behavior up to 4 s$\^$-1/. Using indentation tests, the plastic deformation behavior of the Zr-based BAM up to a large strain value of 15% could be achieved, even though it was the deformation under locally constrained condition. The Meyer hardness of the Zr-based BAM measured by static indentation tests was about 5 GPa and it revealed negligible strain hardening behavior. At indented sites, the plastic indentation occurred forming a crater and well-developed multiple shear bands were generated around it along the direction of 45 degree when the indentation load exceeded 7kN. With increasing indentation load, shear bands became dense. The fracture surface of the specimen after uniaxial compressive tests showed vein-like pattern, typical morphology of many BAMs.

Application of Fracture Toughness for Scaled Model Test (파괴인성의 축소모형실험 적용 연구)

  • Kim, Jong-Gwan
    • Tunnel and Underground Space
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    • v.30 no.1
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    • pp.87-97
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    • 2020
  • Fracture toughness of rock is a constant that can indicate the initiation and propagation of cracks due to blasting, excavation, etc. Scaled model tests have been applied to the behavior of tunnels and the stability of limestone mines. Through the scaled model, damaged zone evaluation due to blasting is also carried out, and the scale factor is not applied to the failure-related factors. In this study, DCT (diametral compression test) and finite element method ATENA2D numerical analysis results were compared to determine whether the scale factor could be applied to the fracture toughness of rock. The theoretical values of the scale factor applied to the fracture toughness of the rock and the DCT test results and the numerical results are 0.21~0.46, 0.40, and 0.99MPa ${\sqrt{m}}$ respectively, so these three values should be considered when determining scale factor. It is necessary to derive a suitable scale factor in consideration of the length, time, and mass to which the scale factor is applied, as well as the values of the scale factor of major design factors such as uniaxial compressive strength and density.

Balloon Kyphoplasty for the Treatment of Vertebral Compression Fractures (척추 압박골절 환자에서의 풍선 척추체 복원술의 치료 효과)

  • Han, Kyung Ream;Kim, Chan;Yang, Jong Yoon;Han, Seung Tak;Kim, Yeui Seok
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.56-62
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    • 2006
  • Background: Balloon kyphoplasty is the new technique that helps to decrease the pain and improve mobility as well as restore the vertebral body height and kyphotic curve in fractured vertebrae. We evaluated the outcome of balloon kyphoplasty in the reduction of vertebral body height, kyphotic curve and clinical improvement in the patients with painful vertebral compression fractures. Methods: From July 2002 to February 2005, 84 levels of vertebral compression fractures in 66 patients were treated with balloon kyphoplasty. The assessment criteria were the changes over time in visual analogue scale (VAS) and mobility score. We evaluated the vertebral body height and kyphotic curve at preoperative 1 day and postoperative 1 day. Results: Procedures were performed in 66 patients with a total of 84 affected vertebral bodies. The anterior wall height was restored in 74 / 84 (88%) levels with a mean increment of 2.9 mm, and the mid-vertebral body height was restored in 79 / 84 (94%) levels with a mean increment of 4.2 mm. Kyphosis correction was achieved in 60 / 84 (71.4%) from 10.1 degrees to 7.5 degrees. Pain intensity reduced by 60% in one day after operation and by 75-85% in later time. Mobility scores of all patients were improved immediately after the procedure. Cement leakage occurred in 3 levels but there was no clinical problem. Conclusions: Kyphoplasty is an efficient and safe treatment of painful vertebral compression fracture in pain relief, mobility improvement, and reduction of deformity.

Balloon Kyphoplasty through Extrapedicular Approach in the Treatment of Middle Thoracic Osteoporotic Compression Fracture : T5-T8 Level

  • Kim, Hyeun-Sung;Kim, Seok-Won;Ju, Chang-Il
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.363-366
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    • 2007
  • Objective : Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods : The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, Injected cement volume, clinical outcome and complications. Results : Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was $4.2{\pm}1.5\;cc$. The mean cobb angle and compression rate were improved from $12.1{\pm}6.5^{\circ}$ to $8.5{\pm}7.2^{\circ}$ and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental arte 이 Injury, pulmonary embolism, or epidural leakage. Conclusion : Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.

Operative Treatment with Anatomically Preshaped Locking Compression Plate in Distal Fibular Fracture (해부학적 잠김 압박 금속판을 이용한 원위 비골 골절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.130-135
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    • 2013
  • Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

The Prognostic Factors Influencing on the Therapeutic Effect of Percutaneous Vertebroplasty in Treating Osteoporotic Vertebral Compression Fractures

  • Ryu, Kyeong-Sik;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.16-23
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    • 2009
  • Objective : This retrospective study of 215 patients with 383 symptomatic osteoporotic vertebral compression fractures (VCFs) treated by percutaneous vertebroplasty (PVP), was performed to evaluate the clinical outcomes, and to analyze the various clinical factors affecting these results. Methods : The authors assessed the clinical outcome under the criteria such as the pain improvement, activity, requirement of analgesics, and the patient's satisfaction, and determined the relation to various peri- and intra-operative factors, and postoperative imaging findings. Results : The outcome was determined as 84.2% in relief of pain, 72.0% in change in activity, 65.7% in analgesics use, and 84.7% of satisfaction rate. More severe focal back pain, high uptake bone scan, and the lower mean T-score were related to the better pain relief following PVP. The longer the duration between fracture and PVP, the less severe focal back pain, low uptake bone scan, and leakage of PMMA into the paravertebral space were related to the less improvement in activity. Female and low uptake bone scan showed a correlation with more analgesic use. The longer the duration between fracture and PVP, low uptake bone scan, and the higher the mean T-score were correlated with the less the patients satisfaction. Conclusion : Our study suggests that PVP may be more effective in the acute phase of VCFs, more severe focal pain, and far advanced osteoporosis on BMD. Leakage of PMMA into the paravertebral spcae also could be affecting the surgical results.

A Case Report of Prescribing Doinseunggi-tang (Taorenchenqi-tang) for the Patient with Thoraco-Lumbar Compression Fracture (도인승기탕(桃仁承氣湯)을 투여한 흉요추 압박골절 치험 1례)

  • Jo, Hee-Guen;Chu, Min-Kyu;Park, Soo-Gon;Yang, Mi-Sung;An, Ga-Yong;Kang, Seong-In;Lee, You-Jin;Choi, Jin-Bong
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.3
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    • pp.111-121
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    • 2009
  • Objectives : The Purpose of this study was to investigate the clinical application of traditional Korean herbal therapy to a patient with thoraco-lumbar compression fracture. Methods : The patient who had sudden low back pain, back pain and ambulation disorder due to pain caused by an accidental fall, we prescribed Doinseunggi-tang (Taorenchenqi-tang) for her with acupuncture therapy. And we adopted several scales to estimate to progress of her symptoms. Results : Soon after taking herbal medication with other treatments, the patients pain was controlled and was able to ambulation without pain. Conclusions : In this case, we assume that Doinseunggi-tang(Taorenchenqi-tang) play an important role in improvement of the patient's symptoms. So, the present results suggest that traditional Korean herbal therapy has the positive effect to reduce the pain and shortening the period of treatment.

The Retrial of Percutaneous Vertebroplasty for the Treatment of Vertebral Compression Fracture

  • Kim, Han-Woong;Kwon, Austin;Lee, Min-Cheol;Song, Jae-Wook;Kim, Sang-Kyu;Kim, In-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.278-281
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    • 2010
  • Objective : For the treatment of osteoporotic vertebral compression fracture, percutaneous vertebroplasty (PVP) is currently widely used as an effective and relatively safe procedure. However, some patients do not experience pain relief after PVP. We performed several additional PVP procedures in those patients who did not have any improvement of pain after their initial PVP and we obtained good results. Our purpose is to demonstrate the effective results of an additional PVP procedure at the same previously treated level. Methods : We reviewed the medical records and the radiologic data of the PVP procedures that were performed at our hospital from November 2005 to May 2008 to determine the patients who had undergone additional PVP. We identified ten patients and we measured the clinical outcomes according to the visual analogue scale (VAS) score and the radiologic parameters, including the anterior body height and the kyphotic angulation. Results : The mean volume of polymethylmethacrylate injected into each vertebrae was 4.3 mL (range: 2-8 mL). The mean VAS score was reduced from 8 to 2.32. The anterior body height was increased from 1.7 cm to 2.32 cm. The kyphotic angulation was restored from 10.14 degrees to 2.32 degrees. There were no complications noted. Conclusion : The clinical and radiologic outcomes suggest that additional PVP is effective for relieving pain and restoring the vertebral body in patients who have unrelieved pain after their initial PVP. Our study demonstrates that additional PVP performed at the previously-treated vertebral levels could provide therapeutic benefit.

A Case of Balloon Kyphoplasty in High Risk under Cement Leakage -A case report- (시멘트 누출 위험성이 높은 환자에서의 풍선 척추몸통뼈 복원술 -증례보고-)

  • Choi, Yun Suk;Lee, Mi Geum;Lee, Hyo Min;Jo, Ji Yon;Jeong, Hee Jin;Lee, Chul Joong;Lee, Sang Chul;Kim, Yong Chul;Sim, Sung Eun
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.261-265
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    • 2006
  • A vertebral compression fracture can cause chronic back pain, and may also result in progressive kyphosis. The traditional treatments of a vertebral compression fracture include bed rest, analgesics and bracing. Balloon kyphoplasty can restore the vertebral height and allow safe bone cement injection into the cavity made by the balloon, which significantly reduces the risk of cement leakage compared to vertebroplasty. An 82-year-old female patient suffered from severe low back pain. Due to the intractable pain and immobility, which could not be relieved by conventional care, as well as the empty vertebral body associated with communicated fractures of the vertebral surfaces, balloon kyphoplasty, with a thicker bone cement injection than usual with balloon kyphoplasty, was chosen. The preoperative intractable pain and immobility were dramatically relieved soon after the procedure, without any complications.