• Title/Summary/Keyword: Failure of fixation

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Sciatic Nerve Injury Following a Delayed Surgical Procedure for the Hamstring Muscle Avulsion from the Ischial Tuberosity - A Case Report - (슬근 좌골 결절 견열 손상의 지연 수술후 발생한 좌골신경 손상 - 증례 보고 -)

  • Kim Hui Taek;Yoo Chong Il;Yun Pyung Ju;Lee Jong Seo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.75-78
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    • 2002
  • Avulsion of the hamstring tendon from the ischial tuberosity is common in many sports, especially with younger athletes. The injury results from a sudden forceful flexion of the hip joint when the knee is extended and the hamstring muscles powerfully contracted. Early diagnosis and surgical repair with reattachment of avulsed muscles to the ischial tuberosity restore function and correct deformity. But, a delay in the diagnosis and treatment leads to a poor result functionally and clinically. Complication, such as heterotopic ossification and failure of the fixation, etc., were reported following a surgical procedure for this injury. However, sciatic nerve injury has not been reported in the literature. We report our experience of a sciatic nerve palsy after surgery that was performed three months after that the initial injury.

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Cement Augmentation of Dynamic Hip Screw to Prevent Screw Cut Out in Osteoporotic Patients with Intertrochanteric Fractures: A Case Series

  • Rai, Avinash Kumar;Goel, Rajesh;Bhatia, Chirag;Singh, Sumer;Thalanki, Srikiran;Gondane, Ashwin
    • Hip & pelvis
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    • v.30 no.4
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    • pp.269-275
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    • 2018
  • Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson's scoring system. Results: More patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be $-2.506{\pm}0.22$ (mean${\pm}$standard deviation); all patients were within the range of -2.0 to -2.8. The duration of radiological union was $13.67{\pm}1.77$ weeks. Salvati and Wilson's scoring at 12 months of follow up was $30.96{\pm}4.97$. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out. Conclusion: Bone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.

New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail (골수정을 이용한 대퇴골 전자간 골절의 새로운 치료 경향)

  • Kim, Junyoung;Choi, Kihong;Yang, Kyu Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.193-199
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    • 2020
  • A gamma nail has been used to treat intertrochanteric fractures since 1988. Although such cephalomedullary nails have mechanical advantages over extramedullary fixation devices, such as sliding hip screw, their beneficial effects on treating the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 fractures are still controversial. During their 30-year history, many problems have been overcome, and new types of cephalomedullary nails have been introduced in clinical practice. New cephalomedullary nail systems facilitate nailing procedures and enhance the purchase capability of the femoral head by a lag screw. On the other hand, the failure rate still depends on the hands of the orthopedic surgeons. This review article focused on the basic principle of medial support and restoration of a medial buttress during the treatment of trochanteric fractures using a cephalomedullary nail.

Treatment Results of Hallux Valgus Deformity by Parallel-Shaped Modified Scarf Osteotomy (무지 외반증 환자에서 평행 변형 스카프 절골술을 이용한 치료 결과)

  • Park, Hyun-Woo;Kim, Sung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.123-127
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    • 2012
  • Purpose: The purpose of this study was to evaluate the clinical and radiographic results of the parallel-shaped modified Scarf osteotomy which is performed the Scarf osteotomy parallel to the shaft of the 1st metatarsal bone for hallux valgus deformities. Materials and Methods: We retrospectively reviewed 43 patients who had been treated by the parallel-shaped modified Scarf osteotomy for hallux valgus deformities between January 2006 and March 2011. We evaluated the results after this Scarf osteotomy with respect American Orthopaedic Foot & Ankle Society (AOFAS) scores, radiologic results by comparing intermetatarsal angle between 1stand 2nd metatarsal bones and hallux valgus angle. Results: We checked out the pre-operational and post-operational radiologic evaluation of intermetatarsal angle and hallux valgus angle between 1st and 2nd metatarsal bones. The mean AOFAS scores improved from 63.5 to 88.5. At final follow up, The hallux valgus angle improved from $31.4^{\circ}$ (16-52) to $9.0^{\circ}$ (3-13) and the intermetatarsal angle improved from $18.6^{\circ}$ (12-30) to $9.3^{\circ}$ (6-12) postoperatively. There was no case of major complications included recurrence of valgus deformity, correction or fixation failure and stress fractures. Conclusion: Our results suggest the our parallel-shaped modified Scarf osteotomy produces improved AOFAS scores, and effective correction of hallux valgus deformities. Our Scarf technique of osteotomy which is performed in parallel to the metatarsal bone minimizes the need for skill while more reliable and obtaining good correction and avoids associated complications.

A Historical Study on the Joseon Government's Attempt to Recover the Tariff Autonomy during the Period of Port Opening (개항기 조선정부의 관세자주권 회복 시도)

  • Yun, Kwang-Woon
    • Korea Trade Review
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    • v.44 no.1
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    • pp.301-319
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    • 2019
  • This study is to review the Joseon government's attempt to recover the tariff autonomy lost in the course of entering into the unequal treaty with then-Japan government, as well as the practical effort to realize such an attempt. Among other attempts, the Joseon government ① began imposing tariffs starting September 1878 by establishing Dumopo Customs Office in Busan, ② dispatched on April 1881 a group of investigators to the competent authorities to review and look back the Joseon's tariff system against Japan and ③ entered into a tariff negotiation with then-Japan government on September 1881 with the emissary (Susinsa) Byeong-ho Jo representing the Joseon government. A series of these attempts, in line with each other, represents the Joseon government's ceaseless, constant effort to recover the tariff autonomy, which is what this study intends to review from the modern-day perspectives. Authored by Byeong-ho Jo to capture an advantageous position in the 1881's tariff negotiation against then-Japan government, 「Joilseui」 successfully represented the Joseon government's position on matters of ① the Japanese tax-autonomous district in Korea, ② defining tariff rates, ③ use of Japanese Yen for payment of tariffs, ④ effective period of the treaty and ⑤ export restrictions on grains. Failure of the Joseon government's attempt to recover the Tariff autonomy was attributable not only to, as 「Joilseui」 defined, ① governments' non-cooperative attitudes on the negotiation table, ② lack of authorities that the entrusted bodies had, ③ import tariffs defined high and ④ export restrictions on grains and red ginseng, but also to loss of the tariff autonomy in 1876 and the 1881's negotiation broken down that were plotted by then-Japan government's invasive policy.

Residual foreign body inflammation caused by a lumber beam penetrating the facial region: a case report

  • Jun Ho Choi;Sang Seong Oh;Jae Ha Hwang;Kwang Seog Kim;Sam Yong Lee
    • Archives of Craniofacial Surgery
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    • v.24 no.1
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    • pp.37-40
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    • 2023
  • Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.

Estimating Fatigue Life of APD Electronic Equipment for Activation of a Spaceborne X-band 2-axis Antenna (2축 짐벌식 X-band 안테나 구동용 전장품 APD 제어보드의 피로수명 평가)

  • Jeon, Young-Hyeon;Oh, Hyun-Ung
    • Journal of Aerospace System Engineering
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    • v.11 no.1
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    • pp.1-7
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    • 2017
  • While a satellite is carried into orbit by a launch vehicle, it is exposed to the severe launch environment with random vibrations and shock. Accordingly, these vibration sources affect electronic equipment, particularly the printed circuit board (PCB) in the satellite. When the launch load impacts the PCB, it causes negative behavior. This causes perpendicular bending around the boundary of fixation points that finally leads to the failure of solder joints, lead wires, and PCB cracks. To overcome these issues, the electronic equipment design must meet reliability requirements. In this paper, Steinberg's method is used to derive allowable and maximum deflection to verify design from a life perspective concerning the control board of the Antenna Pointing Driver (APD) mounted on KOMPSAT-3.

Arthroscopic Rotator Cuff Repair by Single Row Technique (회전근 개 파열에 대한 관절경적 봉합술 중 일열 봉합술의 유용성)

  • Yum, Jae-Kwang
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.77-81
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    • 2008
  • The goal of rotator cuff repairs is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading and optimize the biology of the tendon-bone interface until the cuff heals biologically to the bone. Single row repairs are least successful in restoring the footprint of the rotator cuff and are most susceptible to gap formation. Double row repairs have an improved load to failure and minimal gap formation. Transosseous equivalent repairs (suture bridge technique) have the highest ultimate load and resistance to shear and rotational forces and the lowest gap formation. Even though the superior advantages of double row and transosseous equivalent repairs, those techniques take longer surgical time and are more expensive than single row repairs. Therefore single row repairs can be useful in bursal side partial thickness or small size full thickess rotator cuff tear.

Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique (압박 긴장대 방법을 이용한 구상 돌기 골절의 견고한 고정과 조기 운동을 통한 주관절 기능의 향상)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Kim, Hyung-Jin;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.159-166
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    • 2009
  • Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

Anterior Instability of the Knee after Arthroscopic Treatment for Tibial Spine Fractures (경골극 골절의 관절경적 치료 후 슬관절의 전방 불안정성)

  • Choi, Chong-Hyuk;Kim, Sung-Hwan;Joo, Jong-Hwan;Kim, Hyung-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.26-32
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    • 2006
  • Purpose: We evaluated the result of the degree of reduction and anterior instability after arthroscopic treatment of tibial spine fractures. Materials and Methods: Thirty-two cases of tibial spine fractures treated with arthroscopic procedure could be evaluated and the mean follow-up period was $18\;(12{\sim}48)$ months. Evaluations included Lachman test, rotatory instability examination and side to side difference (SSD) using KT-2000 arthrometer. The degree of radiologic reduction was classified as accurate reduction, anterior elevation and reduction failure, according to which the degree of anterior instability was measured. Results: There were twenty three cases (71%) of accurate duction, eight cases (25%) of anterior elevation and one case (4%) of education failure. Eight (29%) of twenty eight cases with pull-out method showed anterior elevation. The SSDs of the accurate reduction and the anterior elevation group were 2.0 mm and 2.8 mm, respectively showing no significant difference. However, the percent age of grade 0 Lachman test and SSD less than 3 mm of the accurate reduction group were significantly higher. Conclusion: Accurate reduction is important in reducing anterior instability especially in unstable fractures. Therefore, arthroscopic pull-out method should be performed with great caution to avoid anterior elevation of the fracture fragment.

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