• 대한족부족관절학회지
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• 제14권2호
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• pp.140-145
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• 2010

Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.17-22
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• 2011

Objective : In the present study, authors retrospectively reviewed the clinical outcomes of halo-vest immobilization (HVI) versus surgical fixation in patients with odontoid fracture after either non-surgical treatment (HVI) or with surgical fixation. Methods : From April 1997 to December 2008, we treated a total of 60 patients with upper cervical spine injuries. This study included 31 (51.7%) patients (22 men, 9 women; mean age, 39.3 years) with types II and III odontoid process fractures. The average follow-up was 25.1 months. We reviewed digital radiographs and analyzed images according to type of injury and treatment outcomes, following conservative treatment with HVI and surgical management with screw fixation. Results : There were a total of 31 cases of types II and III odontoid process fractures (21 odontoid type II fractures, 10 type III fractures). Fifteen patients underwent HVI (10 type II fractures, 5 type III fractures). Nine (60%) out of 15 patients who underwent HVI experienced successful healing of odontoid fractures. The mean period for bone healing was 20.2 weeks. Sixteen patients underwent surgery including anterior screw fixation (6 cases), posterior C1-2 screw fixation (8), and transarticular screw fixation (2) for healing the odontoid fractures (11 type II fractures, 5 type III fractures). Fifteen (93.8%) out of 16 patients who underwent surgery achieved healing of cervical fractures. The average bone healing time was 17.6 weeks. Conclusion : The overall healing rate was 60% after HVI and 93.8% with surgical management. Patients treated with surgery showed a higher fusion rate and shorter bony healing time than patients who received HVI. However, prospective studies are needed in the future to define better optimal treatment and cost-effective perspective for the treatment of odontoid fractures.

• Hip & pelvis
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• 제30권4호
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• pp.254-259
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• 2018

Purpose: Internal fixation using compression hip screws (CHS) and traction tables placing patients in the supine position is a gold standard option for treating intertrochanteric fractures; however, at our institution, we approach this treatment with patients in a lateral decubitus position. Here, the results of 100 consecutive elderly (i.e., ${\geq}45$ years of age) patients who underwent internal fixation with CHS in lateral decubitus position are analyzed. Materials and Methods: Between March 2009 and May 2011, 100 consecutive elderly patients who underwent internal fixation with CHS for femoral intertrochanteric fracture were retrospectively reviewed. Clinical outcomes (i.e., Koval score, Harris hip score [HHS]) and radiographic outcomes (i.e., bone union time, amount of sliding of lag screw, tip-apex distance [TAD]) were evaluated. Results: Clinical assessments revealed that the average postoperative Koval score decreased from 1.4 to 2.6 (range, 0-5; P<0.05); HHS was 85 (range, 72-90); and mean bone union time was 5.0 (range, 2.0-8.2) months. Radiographic assessments revealed that anteroposterior average TAD was 6.95 (range, 1.27-14.63) mm; lateral average TAD was 7.26 (range, 1.20-18.43) mm; total average TAD was 14.21 (range, 2.47-28.66) mm; average lag screw sliding was 4.63 (range, 0-44.81) mm; and average angulation was varus $0.72^{\circ}$(range, $-7.6^{\circ}-12.7^{\circ}$). There were no cases of screw tip migration or nonunion, however, there were four cases of excessive screw sliding and six cases of varus angulation at more than $5^{\circ}$. Conclusion: CHS fixation in lateral decubitus position provides favorable clinical and radiological outcomes. This technique is advisable for regular CHS fixation of intertrochanteric fractures.

• 대한족부족관절학회지
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• 제16권2호
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• pp.116-122
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• 2012

Purpose: Subtalar arthrodesis has been the gold standard for the painful subtalar joint disorders. Successful subtalar arthrodesis requires fusion of the 3 facet joints. The purpose of the study is to compare the clinical outcome of the posterior fixation (P2) and anterior-posterior (A1P1) fixation technique for subtalar arthrodesis which enhance anterior and middle facet fixation. Materials and Methods: The study is based on the 20 feet (19 patients) of the subtalar arthrodesis utilizing cannulated screws from September 2006 to September 2009 with at least 1-year follow-up. Two fixation techniques were utilized for the subtalar arthrodesis: 1) posterior fixation only (P2, 7 feet, 35%) and 2) anterior-posterior (A1P1) fixation method (13 feet, 65%). Visual Analog Scale Pain (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score (maximum: 94 points), the time for returning to daily living and the patient satisfaction were also evaluated. Results: Average follow-up period were 13.2 months (12-3 mo). The AOFAS score improved from preoperative average 45 (0-68) to 81.6 (62-94), while VAS score was decreased from average 8.0 (3-10) to 1.8 (0-5) at final follow-up. Ninety-five percent of the patients were satisfied with surgery. All the patients returned to daily living at average 7.2 months (2-15 mo) post-surgery. Radiographically, 2 techniques both showed 100% fusion of the posterior compartment of the subtalar joint. Postoperative complications were 1 case of low grade infection and 1 case of sural nerve neuralgia. Conclusion: The subtalar arthrodesis using A1P1 fixation technique showed better fusion rate of the anterior compartment of the subtalar joint compared to P2 fixation technique although the 2 techniques both showed similar favorable clinical outcome. Therefore the A1P1 fixation technique is found to be a viable option to address chronic painful subtalar joint disorders to enhance the anterior compartment fixation.

• 한국임상수의학회지
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• 제36권2호
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• pp.93-97
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• 2019

Healing of 48 cases of radial fractures in small breed dogs treated with acrylic pin external fixation was evaluated retrospectively to investigate the factors affecting the healing of radial fractures. The mean age of the subjects was 15.02 months, the mean body weight was 3.48 kg, and the mean maximum length of the radius (MLR) was 90.77 mm. External skeletal fixation frames type 1a, 2a, and 3 were used; among them type 2a was used most frequently (75%). The mean time to clinical union (TCU) was 67.17 days, and the success rate was 95.8%. Age, bodyweight, MLR, and occurrence of complications increased TCU significantly. Among complications, pin loosening, swelling of the operated forelimb tissue for more than 2 weeks, and coexistence of two or more complications increased TCU significantly (p < 0.05). There was no relationship between location of the fracture and TCU. The results of this study may be useful to predict the prognosis of radial fractures in small dogs.

• 한국잠사곤충학회지
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• 제27권1호
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• pp.42-46
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• 1985

반응성 염료의 하나인 vinylsulfone계 염료로 견섬유에 날염하여 증열시간, 호료의 점도, 알카리 농도에 의한 염료량 및 고착량의 변화를 측정하여 반응성 염료의 견에 대한 날염 특성을 검토하고 연구한 결과를 다음과 같이 요약한다. 1) 증열 시간과 더불어 염착량 및 고착량은 증가하였으며 염착량과 고착량은 비례관계를 나타내고 있다. 2) 고착율은 80% 이상으로 높은 고착율을 나타내고 있다. 3) 호료의 점도에 따라 염착량과 고착량이 달라지며 적당한 점도가 요구됨을 시사한다. 4) 알카리 농도는 염착량과 고착량의 변화에 큰 영향을 주는 요인이었으며 적당량의 알카리 첨가가 필요함을 나타낸다. 5) 세탁 견뢰도와 일광 견뢰도가 뛰어났으며 실용상 매우 우수한 염료임이 입증되었다. vinylsulfone계 염료는 우수한 발염성과 견뢰도를 가지고 있어서 견질물의 염색분야에 충분한 응용을 기할 수 있다.

• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.163-166
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• 2011

Objective : Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. Methods : Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. Results : Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. Conclusion : In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.18-25
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• 2011

Purpose: In the process of replantation of the amputated fingertips, the primary concern was given to survival of the amputees, while the functional aspect of digits after the surgery has been easily neglected. Although an internal fixation with a K-wire is often a part of replantation of the amputated fingertips, little consideration had been given to the study of relationship between distal interphalangeal joint fixation and post operative range of motion. A comparative study in relation to post operative range of motion was done on two different groups, one group with K-wire insertion and the other group without a K-wire insertion at the distal interphalangeal joint. Materials and Methods: The study was done on the cases of a single digit amputation conducted at our institute (the age in the range of 10 to 60) in about four-year of time span from March of 2005 to March of 2009. The cases with a thumb replantation, osteomyelitis or articular surface injury have been excluded from this study. The cases of both head and shaft fracture, except the insertion site of tendon, of distal phalanx of internal fixation with a single K-wire were reviewed for this study. A group of 24 cases without distal interphalangeal joint fixation in comparison to a group of 22 cases with distal interphalangeal joint fixation was reviewed to assess the postoperative range of motion at distal interphalangeal joint on the 6th week after the surgery. And, on the 30th month after the surgery, a group of 10 cases without distal interphalangeal joint fixation in comparison to a group of 10 cases with joint fixation was reviewed. A K-wire was removed in about 5 weeks after the fracture was reunited under the radiographic image, immediately followed by a physical therapy. Result: The active range of motion for a group without interphalangeal joint fixation was measured $49.0^{\circ}$ on average, while $28.6^{\circ}$ was measured for a group with interphalengeal fixation on the 6th week after the surgery. On the 30th month after the surgery, the active range of motion was measured $52.0^{\circ}$ and $55.0^{\circ}$ on average for a group without and with interphalangeal fixation respectively. Conclusion: In the process of replantation of the amputated fingertips, short-term(on the 6th week) improvement of postoperative active motion of range can be expected in the cases without distal interphalangeal fixation in comparison to the cases of interphalangeal joint fixation with a K-wire. However, there seems to be no difference on motion of range in a long-term (on the 30th month) follow up period.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.171-179
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• 1995

The conservative treatment of the condylar fracture has been used for a long time because of its simplicity, good prognosis and less complication. Traditionally the conservative treatment has been carried out by maxillomandibular fixation using arch bar and wire. But a simplified technique of maxillomandibular fixation introduced here is a procedure that 4 bone screws are placed above the apecies of the maxillary and mandibular canines and then ipsilaterally placed maxillary and mandibular bone screws are linked by a loop of wire each other. This procedure has several advantages compared with the traditional maxillomandibular fixation method. 1) it provides simplicity for the operators. 2) it sustains maxillomandibular fixation more rigidly compared with arch bar technique. 3) it keeps stable maxillomandibular fixation in the region of the anterior teeth so that anterior open bite tendency can be remarkably minimized. 4) it does not injure the periodontal tissue because the teeth are not engaged and causes less discomfort to the patient. 5) it decreases the possibility of operator's AIDS infection through inadvertent skin puncture. 6) it is highly recommended for the patients whose teeth are available for maxillomandibular fixation. The two male patients were diagnosed as bilateral condylar and symphyseal fracture of the mandible. They restored stable occlusion and functional mandibular movement only by a simplified technique of maxillomandibular fixation.

• 대한족부족관절학회지
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• 제6권1호
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• pp.54-59
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• 2002

Purpose: To compare the clinical results between the screw fixation and modified tension band wiring in the treatment of medial malleolar fracture. Materials and Methods: From September 1998 to April 2002, 52 patients were treated by screw fixation and 43 patients were treated by modified tension band wiring for medial malleolar fracture. Results: Accoding to Lauge- Hansen classification, there were 28 cases of supination-external rotation type (53.8%), 9 of supination-adduction type (17.3%), 8 of pronation -external rotation type (15.4 %), 7 of pronation -abduction type (13.5 %) in screw fixation group and 21 (48.9%),11 (25.6%), 7 (16.3%) 4 (9.3%) of each type in tension band wiring group. The average time to union was 15.7 weeks in screw fixation group and 12.8 weeks in tension band wiring group.(p<0.05) In the functional outcome (according to Meyer and Kumler), 29 patients treated (76.2 %) with screw fixation showed excellent results and 34 patients (86.6%) treated with tension band wiring had excellent results (p<0.05). Conclusion: We concluded that more satisfactory result could be obtained with modified tension band wiring compared with screw fixation in the treatment of the medial malleolar fracture.