Background: The purpose of this study was to review whether Korean medicine treatment was effective to maintain the spinal stability and to relieve spinal symptom by reviewing medical records of 18 vertebral compression fracture patients. Methods: The subjects were 18 thoracolumbar compression fracture patients who were taken more than two lateral view x-rays of fractured vertebra from Jan, 2010 to June, 2018. They were divided into two groups: the time admitted into Department of Acupuncture & Moxibustion Medicine, Pohang Korean Medical Hospital of Daegu Hanny University from onset (Research 1) and whether or not they have a past history of osteoporosis (Research 2). Then, they were follow-up observed and compared by compression ratio and numerical rating scale (NRS) and so on. Results: The amount of weekly compression rate increase of 18 patients was 1.76% per week. According to the result of Research 1, the patients group (14 patients) who were admitted into the hospital within 1-2 weeks from getting injury was 1.88% per week whereas the patients group(4 patients) who were admitted into the hospital within 3-4 weeks from getting injury was 1.22% per week. By Research 2 result, the patients group (7 patients) who had been diagnosed as an osteoporosis patient was 2.19% per week, and those (11 patients) who had not was 1.49% per week. There was a statistical significance in the change of the amount of compression rate increase in the case of Research 1, but there was not in the case of Research 2. NRS was decreased without significant difference regardless of the time admitted into the hospital and whether or not the patients had the past history of osteoporosis. Conclusion: Considering that there were more amount of compression rate increase at 1-4 weeks from onset, it is necessary to offer treatment more actively on early time from onset. Further research is needed into the increase of compression rate by the patients' having a past history of osteoporosis or not. Given that NRS decreased without significant difference, it is assumed that Korean medicine treatment has a meaningful effect on relieving subjective symptom of patients who are diagnosed as vertebral compression fractures.
Park, Sang-Kyu;Bak, Koang-Hum;Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun
Journal of Korean Neurosurgical Society
/
v.40
no.2
/
pp.90-94
/
2006
Objective : Acute vertebral burst fractures warrant extensive fixation and fusion on the spine. Osteoplasty [vertebroplasty with high density resin without vertebral expansion] has been used to treat osteoporotic vertebral compression fractures. We report our experiences with osteoplasty in acute vertebral burst fractures. Methods : Twenty-eight cases of acute vertebral burst fracture were operated with osteoplasty. Eighteen patients had osteoporosis concurrently. Preoperative MRI was performed in all cases to find fracture level and to evaluate the severity of injury. Preoperative CT revealed burst fracture in the series. The patients with severe ligament injury or spinal canal compromise were excluded from indication. Osteoplasty was performed under local anesthesia and high density polymethylmethacrylate[PMMA] was injected carefully avoiding cement leakage into spinal canal. The procedure was performed unilaterally in 21 cases and bilaterally in 7 cases. The patients were allowed to ambulate right after surgery. Most patients discharged within 5 days and followed up at least 6 months. Results : There were 12 men and 16 women with average age of 45.3[28-82]. Five patients had 2 level fractures and 2 patients had 3 level fractures. The average injection volume was 5.6cc per level Average VAS [Visual Analogue Scale] improved 26mm after surgery. The immediate postoperative X-ray showed 2 cases of filler spillage into spinal canal and 4 cases of leakage into the retroperitoneal space. One patient with intraspinal leakage was underwent the laminectomy to remove the resin. Conclusion : Osteoplasty is a safe and new treatment option in the burst fractures. Osteoplasty with minimally invasive technique reduced the hospital stay and recovery time in vertebral fracture patients.
Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.
Objectives: This study aimed to determine the effects of Korean medical treatment on a patient with compression fractures. Methods: The patient was treated with herbal medicine and acupuncture for 51 days. Symptom changes were measured using the Numerical Rating Scale (NRS), Range of Motion (ROM), Oswestry Disability Index (ODI), and European Quality of Life Five Dimensions (EQ-5D) Scale. Results: The NRS score for lower back pain decreased from 7 to 3, and the ODI score decreased from 51.11 to 22.22. Range of motion (ROM) increased meaningfully in flexion(from 30 to 60), Left/Right lateral bending(from 10/30 to 30/45), Left/Right rotation (from 10/30 to 30/45), and the EQ-5D score also increased from 0.506 to 0.677. Conclusion: The results indicate that Korean medical treatment may be effective for managing patients' acute compression fractures.
The Geo-Reservoir Experimental Analogue Technology (GREAT) cell was designed to recreate the thermal-hydro-mechanical conditions of deep subsurface in the laboratory. This apparatus can generate a polyaxial stress field using lateral loading elements, which rotate around the longitudinal axis of a sample and is capable of performing a fluid flow test for samples containing fractures. In the present study, numerical simulations were carried out for triaxial compression tests using the GREAT cell and the mechanical behavior of samples under different conditions of lateral loading was investigated. We simulated an actual case, in which triaxial compression tests were conducted for a polymer sample without fractures, and compared the results between the numerical analysis and experiment. The surface strain (circumferential strain) of the sample was analyzed for equal and non-equal horizontal confining pressures. The results of the comparison showed a good consistency. Additionally, for synthetic cases with a fracture, we investigated the effect of the friction and type of fracture surface on the deformation behavior.
This paper investigated computationally and experimentally the interaction here between a notch as well as a micropore under uniaxial compression. Brazilian tensile strength, uniaxial tensile strength, as well as biaxial tensile strength are used to calibrate PFC2d at first. Then, uniaxial compression test was conducted which they included internal notch and micro pore. Experimental and numerical building of 9 models including notch and micro pore were conducted. Model dimensions of models are 10 cm × 10 cm × 5 cm. Joint length was 2 cm. Joints angles were 30°, 45° and 60°. The position of micro pore for all joint angles was 2cm upper than top of the joint, 2 cm upper than middle of joint and 2 cm upper than the joint lower tip, discreetly. The numerical model's dimensions were 5.4 cm × 10.8 cm. The fractures were 2 cm in length and had angularities of 30, 45, and 60 degrees. The pore had a diameter of 1 cm and was located at the top of the notch, 2 cm above the top, 2 cm above the middle, and 2 cm above the bottom tip of the joint. The uniaxial compression strength of the model material was 10 MPa. The local damping ratio was 0.7. At 0.016 mm per second, it loaded. The results show that failure pattern affects uniaxial compressive strength whereas notch orientation and pore condition impact failure pattern. From the notch tips, a two-wing fracture spreads almost parallel to the usual load until it unites with the sample edge. Additionally, two wing fractures start at the hole. Both of these cracks join the sample edge and one of them joins the notch. The number of wing cracks increased as the joint angle rose. There aren't many AE effects in the early phases of loading, but they quickly build up until the applied stress reaches its maximum. Each stress decrease was also followed by several AE effects. By raising the joint angularities from 30° to 60°, uniaxial strength was reduced. The failure strengths in both the numerical simulation and the actual test are quite similar.
After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Kim, Woo Youn;Hong, Eun Seok;Hong, Jung Seok;Ahn, Ryeok;Hwang, Jae Cheol;Kim, Sun Hyu
Journal of Trauma and Injury
/
v.21
no.1
/
pp.46-52
/
2008
Purpose: This study was to evaluate the effect of arterial embolization on survival in patients with pelvic bone fractures and arterial bleeding. Methods: From January 2001 to December 2007, in all, 18 patients with pelvic bone fractures that had been treated with interventional arterial embolization were included in this retrospective study. The Injury Severity Score (ISS), the Revised Trauma Score (RTS), the initial hemodynamic status, the blood gas analysis, blood transfusion data, and mortality were the main outcome measurements. Results: Pelvic bone fractures were classified into lateral compression (LC), antero-posterior compression (APC), vertical shear (VS), and combined (CM) type according to the Young-Burgess classification. The Survivor group included 11 patients (61.1%), and the non-survivor group included 7 patients (38.9%). The mean ages for the survivor and the non-survivor groups were 40.0 and 45.6 years (p=0.517). The types of pelvic bone fractures were LC 11 (61.1%), APC 6 (33.3%), and VS 1 (5.6%): LC 7 (63.6%), and APC 4 (36.4%) in the survivor group and LC 4 (57.1%), APC 2 (28.6%), and VS 1 (14.3%) in the non-survivor group. The internal iliac artery was the predominant injured vessel among both the survivors (n = 5, 45.5%) and the non-survivors (n = 4, 57.1%). No differences in initial blood pressures, ISS, and RTS existed between the two groups, but the arterial pH was lower in the non-survivor group (pH 7.09 (${\pm}0.20$) vs 7.30 (${\pm}0.08$), p=0.018). The number of transfused 24-hour units of packed RBC was greater in the non-survivor group ($24.1{\pm}12.5$ vs $14.4{\pm}6.8$, p=0.046). Conclusion: No differences in initial blood pressure and trauma scores existed between survivors and non-survivors with pelvic bone fractures, who had been treated with arterial embolization, but arterial pH was lower the in non-survivors.
Lee, Sang Won;Kim, Sun Hyu;Hong, Eun Seog;Ahn, Ryeok
Journal of Trauma and Injury
/
v.25
no.1
/
pp.1-6
/
2012
Purpose: This study analyzed the characteristics of unstable pelvic bone fractures associated with intra-abdominal solid organ injury. Methods: Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality. Results: The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group. Conclusion: A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.
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.
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