• Title/Summary/Keyword: Failure of fixation

검색결과 161건 처리시간 0.019초

지상작전의 원칙 측면에서 미 제1해병사단의 장진호 연결작전 고찰 (From the point of view of ground operations principle, Chosin Link-up operation discussion of the US 1st Marine Division)

  • 김규빈;최영렬
    • 안보군사학연구
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    • 통권13호
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    • pp.1-41
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    • 2016
  • US 8th Army in the attack on the Western Front was a situation that was frustrated by the 13th Corps Communist army. To this time support this, goals that have been granted to the US 1st Marine Division that initiated the attack in Mupyonri direction, lack the potential to achieve was not decisive. It was a operation specific erroneous judgment that occurred because there was no one accurately grasp the battlefield of the situation the wrong UN Forces Command. Tactical victory can be to maximize the operation outcomes. However, there is no possible failure of the operation is to expand the tactical success. This is because the failure of the operation, because directly linked to the success or failure of the war. Tactical victory can be to maximize the operation outcomes. However, operation specific failure is not it possible to expand the tactical victory. Therefore tactical success of the US 1st Marine Division, can not compensate for operation specific failure of the United Nations Forces Command. However, Chinese Communist Army 9th Corps is obsessed only victory of tactics to annihilate the US 1st Marine Division, by being fixation to the Chosin whole area, it was not possible to run a operational operation. Therefore tactical success df the US 1st Marine Division, Chinese Communist Army 9th Corps is to extinguish the ability to increase the number of the 13th Corps of the Western Front, 8th Army US have contributed to have escaped the crisis. In addition, the US 10th Corps while maintaining the combat force, by an important role to withdraw through the sea, was able to complement the misjudgment of the operation.

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원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과 (Clinical Features of Distal Tibial Fractures and Treatment Results of Minimally Invasive Plate Osteosynthesis)

  • 김원유;지종훈;권오수;박상은;김영율;길호진;정재중
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.94-100
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    • 2012
  • Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

견봉 쇄골 관절 탈구에 대한 견봉 쇄골 관절의 관혈적 정복술 (Open Reduction of Acromioclavicular Joint for the Acromioclavicular Joint Dislocations)

  • 송현석;최남용;한석구;나기호;남원식;양혁재;박성진
    • Clinics in Shoulder and Elbow
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    • 제9권2호
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    • pp.189-195
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    • 2006
  • Purpose: To analyze the result of the accurate open reduction of acromioclavicular (AC) joint and pin fixation, coracoclavicular (CC) screw fixation without CC ligament repair for AC joint injuries. Materials and Methods: Between January 2000 and December 2003, seventeen cases with at least one year follow-up among twenty-one cases underwent operation for AC-CC ligament injuries. A transverse incision approximately 5 cm in length was made over the clavicle, and the AC joint was reduced accurately. Under the image intensifier, a cannulated screw and washer were inserted for the CC ligament. Two Steinman pins were inserted for the AC joint and the AC ligament was repaired with nonabsorbable suture. Gentle passive range of motion was begun postoperative 2 weeks. The pins were removed at $6{\sim}8$ weeks and the screw was removed at $10{\sim}12$ weeks. The results were evaluated by a distance between AC and CC joints on plain films and ASES score at last follow-up. Results: At the last follow-up, there was no limitation of motion and average ASES score was 96($86{\sim}100$ points). There was no failure showing over 5 mm difference of distance compared to opposite side on the plain films. Seven cases had the skin damages and local infection due to pin migration and three cases showed the loosening of CC screw. Conclusion: We could have satisfactory results by accurate reduction of AC joint and simple pins and screw fixation for AC-CC ligament injuries.

성공적인 전방십자인대 재건술을 위한 적절한 이식건의 선택 (Graft Considerations for Successful Anterior Cruciate Ligament Reconstruction)

  • 경희수
    • 대한정형외과학회지
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    • 제56권1호
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    • pp.14-25
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    • 2021
  • 성공적인 전방십자인대 재건술을 얻기 위해 수술 전 계획, 수술수기, 수술 후 재활 등 여러 가지 요소가 관여한다. 그리고 좋은 결과를 얻기 위해서 수술 중 이식건의 선택, 고정, 처리 방법, 성숙, 본체골에 병합, 장력 등을 고려해야 한다. 이식건을 선택할 때 이식건의 강도, 이식건의 고정방법, 고정부위 치유, 공유 부위 이환, 이식건의 표면적 크기 등을 고려해야 한다. 이식건에는 자가건과 동종건의 두 가지가 있다. 자가 슬개건, 슬괵건, 대퇴사두건 등 사용할 수 있는 자가건은 여러 가지가 있으며 각각의 장·단점을 가지고 있다. 최근 국내에서 동종건의 사용빈도가 높아지고 있는데 공여부의 이환이 없고, 수술 시간이 짧고, 수술 후 통증이 적고, 재료가 다양한 장점이 있다. 하지만 동종건이 자가건보다 장기간 추적 결과가 더 좋다는 보고는 없다. 동종건은 골과의 합병이 오래 걸리고, 불완전하며, 인대 재형성이 늦고, 생역학적으로 자가건보다 강도가 낮으며, 면역반응의 위험성이 높고, 질병 전파의 가능성 등 원초적인 제한점을 가지고 있다. 그래서 장기간 결과에서 실패율이 높고 이식건의 성숙도가 자가건보다 좋지 않다. 그러므로 동종건은 자가건의 대용이 될 수 있지만 자가건을 사용할 수 없을 때, 여러 가지 인대 재건술이 필요한 경우를 제외하고 자가건을 사용하도록 하는 것이 좋다. 만약 적절한 크기와 굵기의 자가건을 얻을 수 있다면 자가건을 사용한 적절한 고정방법을 선택하고 수술 후 재활을 하면 동종건을 사용한 결과보다 우수한 결과를 얻을 것으로 생각된다.

대퇴골 간부 골절시 사용한 금속물의 금속부전(Metal failure)의 기전에 대한 연구 (A study of the cause of metal failure in treatment of femur shaft fracture - Fractographical and clinical analysis of metal failure-)

  • 전춘배;서재성;안면환;안종철;인주철
    • Journal of Yeungnam Medical Science
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    • 제7권1호
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    • pp.81-93
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    • 1990
  • 1983년 5월부터 1989년 9월까지 본 영남의료원 정형외과에 대퇴골 간부골절시 사용한 금속 내 고정물의 금속 부전으로 입원한 경우 중 부전된 금속의 표면관찰이 가능한 8례에 대한 임상적 고찰 및 부전된 금속 파손 표면의 관찰을 통해 확인한 파손 원인을 요약하면 다음과 같다. 1. 금속 부전이 발생 내고정물의 종류는 압박금속판 5례, Jewett nail 1례, Rowe plate screw 1례, interlocking nail 1례였다. 2. 금속 부전의 임상적 추정에 의한 원인으로는 반대편 피질골 결손 5례, 부적절한 위치선정 1례 및 부적절한 금속선택 1례였다. 3. 금속 내고정후 금속 부전이 되기까지의 기간을 보면, 4개월이 1례, 6개월에서 12개월 사이가 6례, 3년이 1례였다. 4. 부전된 내고정물의 파손면 관찰을 통해 확인한 금속부전의 원인을 보면, 첫째, impact failure 1례 둘째, fatigue failure 6례 machining mark가 있어 이것이 stress riser로서 역할을 한 것으로 보이는 경우가 4례였으며, 이의 형태는 low consistent cyclic fatigue failure와 irregular cyclic fatigue failure의 형태를 관찰할 수 있었다. 셋째, Stress corrosion crack 1례를 관찰할 수 있었다. 5. 316L Stainless Steel은 내부식성이 좋은 금속이지만 fretting에 의해 특유의 부동태 피막이 손상되면 pitting corrosion을 일으키며 경우에 따라서는 파손의 기점으로 작용되어 failure의 주요 원인이 되기도 한다. 6. screw hole의 가공시 기계에 의한 손상 및 기구(implant) 제조 과정중 손상이 plate의 failure를 유발하는 중요한 원인이 될 수도 있다. 기계에 의한 손상은 응력을 집중시키므로 plate가 파손되기 쉽게 한다. 이상의 결과 임상적 추정에 의한 원인 이외에도 부전된 금속파손면 관찰을 통해 중요한 다른 원인을 찾을 수 있었으므로, 금속부전의 예방을 위해 앞으로 이 방향으로의 계속적인 연구가 필요할 것으로 사료된다.

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전방십자인대 재건술의 합병증 (Complications of Anterior Cruciate Ligament Reconstruction)

  • 송은규;김종석
    • 대한정형외과스포츠의학회지
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    • 제2권1호
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    • pp.15-19
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    • 2003
  • Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

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폐쇄성 족관절 골절에 동반된 후경골건 파열 - 1예 보고 - (Ruptured Posterior Tibial Tendon in Closed Ankle Fracture - A Case Report -)

  • 최중근;우승한
    • 대한족부족관절학회지
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    • 제6권1호
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    • pp.92-95
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    • 2002
  • Traumatic ruptures of tibialis posterior tendon are much less common and consequently have received little attention. A tibialis posterior tendon rupture associated with a closed medial malleolar fracture occured in a 32 years old man due to slip down. The tendon rupture was not diagnosed before surgery but was recognized at the time of open operation. The treatment was open reduction and internal fixation at the bony fragments with primary repair of the tendon. This tendon injury, although rare, should be considered in the management of ankle fracture because the tendon rupture could easily have been overlooked and failure to recognize this at the time of injury may result in poor long - term ankle function despite a well- healed fracture.

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유한요소법을 이용한 인공고관절 주대형태의 개선에 대한 연구 (A Study for Improvement of the Femoral Stem Type using the Finite Element Analysis)

  • 윤경렬;원예연;이수훈
    • 한국CDE학회논문집
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    • 제5권2호
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    • pp.122-126
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    • 2000
  • A major mechanical problem with total hip replacement is the loosening of the femoral component. The loss of proximal support, with firm fixation distally, has been thought to be a major caused of fatigue failure of femoral stems. While many causes have been proposed, the most frequently suggested cause of the calcar resorption is the disuse atrophy of the cortex of the calcar due to the stress shielding of the proximal bone by the metal femoral stem. In this research, the new-designed stem(modified collar stem) was considered which made a hole inside stem and had a 3 mm thickness. Using the 3-dimensional finite element methods, the common collar stem and the modified colla stem was modeled and analysed. Also, the two models was compared. The results showed that the modified collar stem decreased the stress-shielding and it made a effective load transfer at the entire femoral region.

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Anterolateral Mini-open Fixation with a Patch Augmentation for Latissimus Dorsi Tendon Transfer in Irreparable Rotator Cuff Tears: Technical Note

  • Kim, Du-Han;Kim, Dong-Hu;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • 제18권4호
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    • pp.269-271
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    • 2015
  • Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.

일본(日本)에 있어서의 사방공학연구(砂防工學硏究)의 동향(動向) (The Trend and Achievements of Erosion Control Research in Japan)

  • 우보명
    • 한국산림과학회지
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    • 제20권1호
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    • pp.51-60
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    • 1973
  • The trend and achievments of soil erosion control research in Japan were investigated through observation tours and reference work and following facts were found to be important aspects which should be considered in the soil erosion control research program in Korea. Experiments on forest and water relations, and ground water phenomena at the water source zone in Tokyo University. Studies on land-slides and erosion control dam in Kyoto University. Studies on mud-flow and snow avalanches in Hokkaido University. Studies on sanddune fixation and disaster damage prevention forests in Kyushu University. Studies on forest denudations in Nagoya University. Studies on Greening-works and soil erosion prevention chemicals in Tokyo Agriculture University. Training on planning of erosion control works and prevention of disaster damages in Forest Research Institute. Experiments on soil erosion phenomena and infiltration in Tohoku Branch, FRI. Experiments on erosion and surface stratum failure of steep slopes and their prevention methods in Railway Technical Research Institute.

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