• Title/Summary/Keyword: Early fixation

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Treatment of Carpal Scaphoid Fracture (주상골 골절의 수술적 치험례)

  • Beck, Won-Jin;Seo, Jae-Sung;Ahn, Jong-Chul;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.361-366
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    • 1986
  • Fracture of the carpal scaphoid bone is the most common fracture of the carpus. Unfortunately. nonunion are common since the symptoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Fracture of the scaphoid is a common condition whose management remains controversial. The conservative treatment has many complications, these include inability to work while in plaster, stiffness of the wrist afterwards, muscle wasting, weakness and malunion. So various operative treatments of scaphoid fracture have been developed. Open reduction by use of screws suggested by Maclaughlin first in 1954. In 1984 a new and simple operative technique has been developed to provide rigid internal fixation for all types of fractures of the scaphoid by T.J. Herbert. This involves the use of a double-treaded bone screw which provides good fixation that, after operation, a plaster cast is rarely required and most patients are able to return to work within a few weeks. Authors have experienced 10 cases of scaphoid fracture and accomplished good result in all cases by internal fixation using Herbert screw. The results are as follows : Of these 10 fractures, 2 were fresh fractures and 8 were non unions of scaphoid fracture. In nonunion cases, the time interval between fracture and operation was from 5 months to 5 years. The postoperative immobilization period was average of 4 weeks. Short period of immobilization achieved early functional recovery of the wrist. The bony unions in roentgenogram were seen from 3 months to 9 months after operation. In 2 cases the fracture gap was seen after 9 months. But in these cases the symptoms such as pain and range of motion of wrist were improved.

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THE LONG-TERM CONSERVATIVE DRAINAGE CARE OF EXTENSIVE OSTEOMYELITIS ASSOCIATED WITH MANDIBULAR COMPOUND FRACTURE : REPORT OF A CASE (장기간의 보존적 배농술로 치료된 하악 복합골절 관련 광범위 골수염 치험 : 증례보고)

  • Kim, Ha-Rang;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Mo, Dong-Yub;Lee, Chun-Ui
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.544-549
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    • 2009
  • Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.

Changes of Nitrogen-Fixation Activity and Environmental Factors of Growth in Lespedeza bicolor Turcz (싸리(Lespedeza bicolor Turcz.)의 공생 질소고정활성과 생육환경요인의 변화)

  • 송승달
    • Journal of Plant Biology
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    • v.35 no.4
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    • pp.317-322
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    • 1992
  • The nitrogen fixation activity and environmental factors of Lespedeza bicli!oy Turcz, forming annual root nodules by symbiotic Rhizobium sp. were analyzed in the field conditions during the growing period. Seasunal changes of $N_2-fixation$ activity showed the maximum value of $120\;\mu\textrm{M}\;C_2_H4{\cdot}noduie\;g\;fw^{-1}{\cdot}hr^{-1}$ during the active growing period (June) and varied significantly depending on the growth phase and environmental factors. The maximum activities were attained at the conditions of pH 7, $30^{\circ}C$ of temperature, 18 Kpa of oxygen partial pressure and inhibited by water stress and nitrogen sources. The habitat soil was weak acidic and poor in nitrogen, phosphorus and organic matter contents. The leaf area ratios and chlorophyll contents were ranged from 442 to $48;\textrm{cm}^2{\cdot}g\;dw^{-1}$ and from 33 to $38\;\mu\textrm{g}\;chI{\cdot}\textrm{cm}^2$. Nitrogen contents in each organ showed the maximum of 46, 19 and $11\;mg{\cdot}g\;dw^{-1}, respectively for leaf, rool and stem in the early period. The highest phosphorus contents were 4.2, 1.2 and $0.6\;mg{\cdot}g\;dw^{-1}$, respectively for leaf. root and stem in early growing period. The allocation ratios of nitrogen quantity showed 60% for leaves and 73% for roots during the active and late growth period, and 22% [or stems in average. The allocalion ralios o[ phosphorus quantity showed 58% for leaves during the most productive period, 70% for roots in the pre-growth stage and 26% for stems in average.verage.

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Studies on Varietal Differences in Growth, Nodulation and Nitrogen Fixation in Soybeans, Glycine max (L.) Merrill I. Changes in nitrogen fixation activity and dry weight of plant organs during reproductive stage (콩의 생육, 근류형성, 질소고정에 있어서 품종간 차이 I. 등숙단계별 각 기관 건물중 및 질소고정활성의 경시적 변화)

  • Eun-Hui Hong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.32 no.3
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    • pp.323-329
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    • 1987
  • Five soybean varieties of two early maturing Karikei73 and SS 79168, and three late maturing Tohoku76, Baegunkong and Jangbaegkong were used and evaluated in the study. Of the varieties examined, Karikei73 was characterized by the delayed leaf senescence. The varieties were planted in the pots of 1/3500 a filled with volcanic ash soil at the experimental fields of the National Institute of Agrobiological Resources in Japan. Major agronomic characteristics including the activity of nitrogen fixation for root nodules during the grain filling period were measured. Measurements during the stages were followed by the stage of development descriptions for soybeans made by Fehr and Carviness (1977). The acetylene reducing activity (ARA) per dry weight of root nodule measured using acetylene reduction assays was the highest at R4-R4.5 with decreasing trends thereafter for the early matruing varieties, while it continuously increased up to R6 but decreased rapidly thereafter for the late maturing varieties. The dry weights of root nodules and all parts of the host plant at each stage checked were greater in the late maturing varieties being the same in ARA per pot.

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Nitrogen Fixation of Legumes and Transfer to Grasses in Spring Paddy Soil (춘계답리작 토양에서 두과의 질소고정과 이의 화본과로의 이동)

  • Lee, Hyo-Won
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.27 no.3
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    • pp.167-172
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    • 2007
  • Manure recycle is an emerging issue in agriculture in Korea these days. Farmers are keeping eye on legume mixture with grasses for nitrogen fixation and transfer to companion crops by legumes. We had a trial to investigate the effect of different legume mixtures on nitrogen fixation and transfer in spring soil. The treatment was arranged in a randomized complete block design with three replications. Three different mixtures were used(rye+hairy vetch, Italian ryegrass+crimson clover, oat+pea) and sowed in pots with paddy soil from western part of Korea(Seo Chon County). Pots with rye+vetch were transplanted from field of RDA(rural development administration) in Suwon on 2 February 2007 and other mixture treatments were sowed on early March with different sowing rate(7:3=Italian:crimson, 6:4=oat:pea). $(^{15}NH_4)_2SO_4$ solution at. $99.8\;atom%^{15}N$ was applied to the each pot at the rate of $2kg\;N\;ha^{-1}$. Application was done on 6 April at rye+vetch pots and remainder were applied on April 16. Forage were harvested from each pot at ground level in heading stage and separated into legume and grass. Total N content and $^{15}N$ value were determined using a continuous flow stable isotope ratio mass spectrometry. DM yield of rye+vetch, Italian+crimson and oat+pea were 6,607, 3,213 and 4,312 kg/ha, respectively. Proportion of N from fixation was 0.73(rye+vetch), 0.42(Italian+crimson) and 0.93(oat+pea). The percentages of N transfer from legume to grass were from 61% to 24% in different method by treatment and -35% to 21% in isotope dilution method.

THE COMPARATIVE STUDY OF THE EFFECT OF THE SEMI RIGID AND RIGID FIXATIONS OF THE GROWTH OF THE CRANIOFACIAL SKELETON (반강성(半剛性) 및 강성고정(剛性固定)이 두개안면골(頭蓋顔面骨)의 성장(成長)에 미치는 영향(影響)에 관한 연구(硏究))

  • Lee, Sang-Chull;Kim, Yeo-Gab
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.157-170
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    • 1993
  • To prove the effct of semi-rigid fixation which utilize wire and rigid fixation which utilizes miniplate toward cranio-facial growth and development of growing children for teenagers, 28 rabbits-6 weeks, about 1.5kg-were experimented. They were classified three groups the semi-rigid group was 12 rabbits which were fixed with 26 gauge stainless steel wire to cross a fronto-nasal suture, the rigid group was the other 12 rabbits which were fixed with miniplate and screw, the control group was 4 rabbits which were get rid of only periosteum. The sample of fronto-nasal of rabbits which were sacrified after 2 weeks, 4 weeks, 8 weeks, and 12 weeks of the operation were investigated and made a comparative study with the light microscops. 1. At the control group, the central part of bony suture was connected with colagen bundle, the osteoblastic layer was investigated at the bony ending, new bone which covered the inside and outside faces of the bone suture was formed between periosteum. 2. Two weeks later from the experiment, ran slightly irregularly the collagen bundle which connects both bony endings of the rigid group. 3. Four weeks later from the experiment, collagen bundle of bone surface were arranged parally a little and comparing to the semi-rigid group, newly formed woven bone of surface of the adjacent bone was made obviously a little. 4. Eight weeks later from the experiment, collagen bundle which is located between both bony ending become close. Both the semi-rigid group and the rigid group showed significant formation of new bone at the periosteum and the bone surface. 12 weeks later from the experiment, both the semi-rigid group and the rigid group showed the regular running in the collagen bundle and smooth, dense periosteum. Then they assumed a similar aspect of the control group. I think that it does not give the influence to the cranio-facial growth of children or teenager to utilize a rigid fixation for a short period. Because as the time goes on, the surface of the bone suture was recovered and adjacent bone surface of the miniplate fixation showed compensatory growth, although both the semi-rigid group which utilized wire and rigid group which utilized a miniplate brought about the change of the area of the bone suture at the early period.

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Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP (잠김 압박 금속판(LCP)을 이용한 상완골 근위부 이분 및 삼분 골절의 치료)

  • Shin, Sung-Il;Song, Kyung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Rae;Hyun, Yoon-Suk;Park, Deok-Yong
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.204-211
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    • 2007
  • Purpose: To evaluate the result and complication of treatment using Locking Compression Plate (LCP) for fracture of proximal humerus. Materials and Methods: Between 2004 and 2006, 21 patients with two-part and three-part fractures of the proximal humerus were treated by LCP fixation. Their average age was 54.9 years. Postoperative mean follow-up period was 22.9 months. The reduction was qualified and complication were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. Results: By Neer's functional evaluation, mean score of shoulder function was 86.3 and 18 case (86%) had excellent or satisfactory results. There was one case of nonunion but no infection or avascular necrosis of the humeral head. No correlation was found between the final result and the type of fracture, age, gender or quality of reduction. Conclusion: We obtained satisfactory result of LCP fixation for fracture of proximal humerus in this study. LCP fixation for proximal humerus fracture is a reliable method to obtain satisfactory reduction, rigid fixation and early exercise.

Dual Plate Fixation for Periprosthetic Femur Fracture after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 대퇴골 삽입물 주위 골절의 이중 금속판 고정술)

  • Kim, Dong Hwi;Cha, Dong Hyuk;Ko, Kang Yeol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.26-33
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    • 2021
  • Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author's hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis-Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65-82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1-108 months). The mean follow-up period was 23 months (12-65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7-40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2-4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0-4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70-95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation.

The conservative care by early endodontic drainage of infected teeth in the line of a mandibular fracture: report of a case (조기 치근관 배농술을 이용한 하악 골절선상 감염치아들의 보존적 관리: 증례보고)

  • Mo, Dong-Yup;Yoo, Jae-Ha;Choi, Byung-Ho;Seol, Sung-Han;Kim, Ha-Rang;Lee, Chun-Ui
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.309-313
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    • 2010
  • The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

MAP Kinase-Mediated Negative Regulation of Symbiotic Nodule Formation in Medicago truncatula

  • Ryu, Hojin;Laffont, Carole;Frugier, Florian;Hwang, Ildoo
    • Molecules and Cells
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    • v.40 no.1
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    • pp.17-23
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    • 2017
  • Mitogen-activated protein kinase (MAPK) signaling cascades play critical roles in various cellular events in plants, including stress responses, innate immunity, hormone signaling, and cell specificity. MAPK-mediated stress signaling is also known to negatively regulate nitrogen-fixing symbiotic interactions, but the molecular mechanism of the MAPK signaling cascades underlying the symbiotic nodule development remains largely unknown. We show that the MtMKK5-MtMPK3/6 signaling module negatively regulates the early symbiotic nodule formation, probably upstream of ERN1 (ERF Required for Nodulation 1) and NSP1 (Nod factor Signaling Pathway 1) in Medicago truncatula. The overexpression of MtMKK5 stimulated stress and defense signaling pathways but also reduced nodule formation in M. truncatula roots. Conversely, a MAPK specific inhibitor, U0126, enhanced nodule formation and the expression of an early nodulation marker gene, MtNIN. We found that MtMKK5 directly activates MtMPK3/6 by phosphorylating the TEY motif within the activation loop and that the MtMPK3/6 proteins physically interact with the early nodulation-related transcription factors ERN1 and NSP1. These data suggest that the stress signaling-mediated MtMKK5/MtMPK3/6 module suppresses symbiotic nodule development via the action of early nodulation transcription factors.