• 제목/요약/키워드: Failure of fixation

검색결과 161건 처리시간 0.022초

Factors Associated with the Stability of Two-part Mini-implants for Intermaxillary Fixation

  • Kim, Seong-Hun;Seo, Woon-Kyung;Lee, Won;Kim, In-Soo;Chung, Kyu-Rhim;Kook, Yoon-Ah
    • Journal of Korean Dental Science
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    • 제2권2호
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    • pp.24-30
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    • 2009
  • Two component orthodontic C-implants have been introduced as intermaxillary fixation (IMF) screws in cases of periodontal problems with bone loss, severely damaged teeth, or short roots. This retrospective research sought to investigate the complications and risk factors associated with the failure of two-part C-implants for IMF cases and to show the possible indications compared to one-component mini-implants. The study sample consisted of 46 randomly selected patients who had a total of 203 implants. Pearson chi-square tests of independence were used to test for associations among categorical variables. At least 19 of the total 203 implants failed (9.3%). There was no significant difference in implant failure due to gender, oral hygiene, and placement, although a significant difference due to soft tissue characteristics and root contact was observed. The two-component design of the mini-implant is reliable for difficult IMF cases. Note, however, that the factors influencing implant failure were found to be age, root damage, and condition of soft tissues.

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견봉쇄골탈구와 원위쇄골골절에서 소절개를 이용한 Wolter금속판 내고정술 (Minimal incision Wolter Plate Fixation on the Displaced Lateral End Fracture of the Clavicle and the Acromioclayicular Dislocation)

  • 고상훈
    • Clinics in Shoulder and Elbow
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    • 제5권1호
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    • pp.23-28
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    • 2002
  • Purpose Displaced lateral end fracture of clavicle and acromioclavicular dislocation type Ⅲ∼Ⅵ may be required surgical treatment. Material and Methods : From May 1998 to March 2001, we operated with Welter plate with minimal incision by one surgeon. Immediately, pendulum and passive exercise was initiated after surgery. The shoulder function was evaluated using UCLA score. Average follow up was on 28(12∼45) months. Results : All 11 patients were regained satisfactory function. Average UCLA score was 31.9(29~35) at last follow up. Conclusion . The merit of Welter plate fixation with minimal incision is simple technique, reduced surgical time, smaller scar than large plate, strong fixation, early exercise, reduced implant failure. The disadvantage is expensive, skin irritatatation by long hook. But Welter plate fixation with minimal incision is a good method of internal fixation and excellent clinical result in surgical treatment of type H displaced lateral end fracture of the clavicle and type Ⅲ∼Ⅵ acromioclavicular dislocation.

무지외반증에서 생체흡수성 나사못으로 고정한 변형 마우 절골술의 결과 (Results of Modified Mau Osteotomy Fixed with Bioabsorbable Screws in Hallux Valgus)

  • 김상환;윤영필
    • 대한족부족관절학회지
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    • 제19권3호
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    • pp.97-101
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    • 2015
  • Purpose: The purpose of this study was to analyze the clinical results of application of bioabsorbable screws in hallux valgus surgery using modified Mau osteotomy. Materials and Methods: We retrospectively reviewed medical records of 25 patients. Operations were performed between May 2013 and January 2014. We performed 33 modified Mau osteotomies and fixed using bioabsorbable screws. Mean age of patients was 52 years (range 19 to 71). Mean follow up duration was 13.2 months (range 12.3 to 18.9). The clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and satisfaction score. Weight bearing anteroposterior radiographs were taken for measurement of hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA). All radiographs were evaluated in order to detect complications related to bioabsorbable screws such as osteolysis, cyst formation, and fixation failure. Results: The mean pre- and postoperative pain VAS scores were 4.0 and 1.7 (p<0.05). The mean AOFAS score improved from 52.6 to 82.8 (p<0.05). Preoperative HVA and IMA were 31.2 and 13.9, respectively. Postoperative HVA and IMA were 5.2 and 6.2 (p<0.05). The DMAA increased from 7.8 to 9.9 (p<0.05). There was one case of superficial wound infection and one loss of correction, and no case of osteolysis, cystic formation around the screw, or deep infection. All patients showed union without fixation failure. Conclusion: The clinical and radiological evaluation of this study demonstrates reliable results without fixation failure or allergic reaction. The use of bioabsorbable screw appears not to be inferior to metal screw fixation in hallux valgus surgery.

성인의 상완골 과상부 골절의 도수 정복 후 경피적 고정 방식의 치료 결과 (Results of Closed Reduction and Percutaneous Fixation of the Supracondylar Fractures of the Humerus in Adults)

  • 박진수
    • Clinics in Shoulder and Elbow
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    • 제5권2호
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    • pp.102-109
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    • 2002
  • Purpose: To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods in adults Materials and Methods: Seven patients, aged 55 to 52 years (average,69 years), were reviewed after a mean follow-up of 37 months (range, 11-65 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). Six patients underwent closed reduction and one patient, open reduction after failure of closed reduction. Percutaneous fixation with cannulated screws was performed to the 4 patients, per- cuta)leous fixation with Kirschner wires in 3 patients. All except one patients have associated medical problems. The results were assessed based on the Mayo Elbow Performance Score. Results: All the patients with cannulated screw fixation had stable bony union with excellent ranges of motion (mean: 5-125 degrees). All the three patients who received percuatnaous smooth K-wire fixation had nonunion with poor results, one of them had changed into cannulated screw. and then had good result. Conclusion: Although simple supracondylar fracture is similar to the pediatric fracture in nature, it should be firmly fixed with the method such as threaded cannualted screw rather than the simple fixation with K-wires.

무지 외반증에서 Akin 절골술 내측 횡 봉합사 고정술의 결과 (The Results of Medial Horizontal Suture Fixation of Akin Osteotomy in Hallux Valgus)

  • 윤영필;김정훈
    • 대한족부족관절학회지
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    • 제21권1호
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    • pp.1-6
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    • 2017
  • Purpose: The purpose of this study was to analyze the clinical results of medial horizontal suture fixation of Akin osteotomy in hallux valgus and present its advantages. Materials and Methods: This study was based on 48 cases of 35 patients with Akin osteotomy, who underwent surgery of hallux valgus between December 2014 and July 2015, and with at least 12 months of follow-up. The mean age of patients was 46.9 years (range, 16~71 years). The mean follow-up duration was 15.9 months (range, 12~18 months). Clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS hallux metatarsophalangeal interphalangeal scale) score, and satisfaction score. Weightbearing anteroposterior radiographs were taken to measure the distal articular set angle (DASA) of the hallux. Radiographic bone union at 6 months follow-up was regarded as a success, while a loss of reduction and nonunion was regarded as a failure. Results: The mean pre- and postoperative pain VAS scores were 4.27 and 1.67, respectively (p<0.05). The mean AOFAS score improved from 59.7 to 80.5 (p<0.05). The DASA was improved from 8.15 to -2.57 (p<0.05). There was no case of skin irritation, cortical breakage, inflammation from the knot, and infection. All patients showed union without fixation failure. Conclusion: The clinical and radiological evaluations in this study demonstrate reliable results without complication. The medial horizontal suture fixation of the Akin osteotomy was effective, and the advantage of this procedure was unnecessity of the material removal, preservation of the joint, and no skin irritation.

나사 파단 예방을 위해 새로 디자인한 경비 인대 결합 나사의 효용성: 생역학 연구 (The Efficacy of Newly Designed Screw for Prevention of the Screw Breakage in Syndesmosis Fixation: Biomechanical Study)

  • 이동오;송상헌
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.94-97
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    • 2020
  • Purpose: Fatigue breakage of cortical screws sometimes occurs after syndesmosis fixation, regardless of the period of screw retention. This study compared the fatigue strength of a novel screw design to conventional cortical screws in the fixed state of syndesmosis. Materials and Methods: Twelve sawbone models were tested mechanically to determine the fatigue strength of three screw designs. The first group was composed of cortical screws, while the second and third groups were newly-designed screws. The second group was composed of screws with a 2.4-mm diameter thread-free portion of the mid-shank while the third group had a 2.0-mm diameter thread-free mid-shank. A 400 N load was applied repetitively to a fibula model and the number of cycles until screw failure was recorded. Four screws from each group were tested, giving a total of 12 fatigue tests. Results: The average cycles until screw failure for groups 1, 2, and 3 were 8,134, 63,186, and 2,581, respectively. The second group showed the highest fatigue strength (p=0.018). The other two screw designs showed similar fatigue strength (p=0.401). Conclusion: New screw designs with a thread-free portion in the mid-shank could reduce the occurrence of fatigue breakage after syndesmosis fixation.

나사못을 이용한 제 1 중족 족지 관절 유합술 (The First Metatarsophalangeal Arthrodesis with Screws Fixation)

  • 서우영;성일훈;조현중
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.142-145
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    • 2009
  • Purpose: The aim of this study was to retrospectively evaluate the clinical and radiological results of the first metatarsophalangeal joint arthrodesis with two crossed screws fixation. Materials and Methods: We treated 23 patients (24 cases) with arthrodesis of the first metatarsophalangeal joint using two crossed screws fixation between December 2000 and May 2005. There were 3 male patients and 20 female patients. Ages ranged from 28 to 74 years (mean, 50 years). Follow-up ranged from 4.1 to 8.2 years (mean, 6.5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) score and their satisfaction was evaluated clinically, foot anteroposterior and lateral radiograph, radiologically. Results: Of the 24 cases, 6 had surgery for dorsal plate and screws fixation because of failure to acquire firm fixation with two crossed screws fixation. All 6 cases acquired bony union. Fusion of the hallux first metatarsophalangeal joint occurred in 16/18 cases (89%). Nonunion occurred in 2 cases (11%) and was asymptomatic. At last follow-up, hallux valgus angle ranged from 11 to 25 degrees(mean, 17.7 degrees), dorsiflexion ranged from 15 to 25 degrees (mean, 22 degrees).The mean preoperative AOFAS score of 37 points(range, 28 to 45 points) improved to a mean of 77 points (range, 65~90 points) postoperatively. The result of the procedure as rated subjectively by the patient was excellent for 5 cases, good for 11 cases and fair for 2. Conclusion: Comparatively, the arthrodesis of the first metatarsophalangeal joint with crossed screws fixation showed a satisfactory clinical results, we thought that require technical attention for firm fixation in operation.

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척추고정장치의 피로성능 평가와 향상 (Enhancement and Evaluation of Fatigue Resistance for Spine Fixation System)

  • 김현묵;김성곤
    • 한국정밀공학회지
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    • 제26권8호
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    • pp.142-147
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    • 2009
  • Spinal fixation systems provide surgical versatility, but the complexity of their design reduces their strength and fatigue resistance. There is no published data on the mechanical properties of such screws. Screws were assembled according to a vertebrectomy model for destructive mechanical testing. A group of two assemblies was tested in static compression. One group was applied to surface a grit blasting method and another group was applied to surface a bead blasting method. Modes of failure, yield, and ultimate strength, yield stiffness, and cycles to failure were determined for six assembles. Static compression 2% offset yield load ranges was from 327 to 419N. Fatigue loads were determined two levels, 37.5% and 50% of the average load from static compression ultimate load. An assembly of bead blasting treatment only achieved 5 million cycles at 37.5% level in compression bending.

Obtaining Maximal Stability with a Septal Extension Technique in East Asian Rhinoplasty

  • Jeong, Jae Yong
    • Archives of Plastic Surgery
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    • 제41권1호
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    • pp.19-28
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    • 2014
  • Recently, in Korea, the septal extension graft from the septum or rib has become a common method of correcting a small or short nose. The success rate of this method has led to the blind faith that it provides superior tip projection and definition, and to the failure to notice its weaknesses. Even if there is a sufficient amount of cartilage, improper separation or fixation might waste the cartilage, resulting in an inefficient operation. Appropriate resection and effective fixation are essential factors for economical rhinoplasty. The septal extension graft is a remarkable procedure since it can control the nasal tip bidirectionally and three dimensionally. Nevertheless, it has a serious drawback since resection is responsible for septal weakness. Safe resection and firm reconstruction of the framework should be carried out. Operating on the basis of the principle of "safe harvest" and rebuilding the structures is important. Further, it is important to learn several techniques to manage septal weakness, insufficient cartilage quantity, and failure of the rigid frame during the surgery.

리스프랑 관절 손상 수술 중 시행하는 프리어 검사법 (Freer Test for an Intraoperative Evaluation of a Lisfranc Joint Injury: A Technical Report)

  • 양기원;이홍섭;박성철;정구민
    • 대한족부족관절학회지
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    • 제24권4호
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    • pp.165-167
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    • 2020
  • Failure to achieve stable fixation during surgery for a Lisfranc joint injury leads to subtle instability that causes dysfunction and posttraumatic osteoarthritis. Therefore, it is important to check for appropriate fixation during surgery. This paper reports a test that evaluates the joint instability dynamically during the open reduction of the Lisfranc joint and checks the stability after fixation. a Freer elevator was inserted into the interosseous area between the medial cuneiform and second metatarsal base, and a twisting force was applied to evaluate the dynamic instability of the Lisfranc joint. After fixation of the Lisfranc joint, the stability of the fixation could be tested by trying this maneuver with the Freer elevator. Overall, the Freer test can be considered a valuable test in open surgery for a Lisfranc joint injury.