• Title/Summary/Keyword: Fixed Joint

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Mid to Long - Term Results of Meniscal Allograft Transplantation (동종 반월상 연골 이식술 후 중장기 추시 결과)

  • Chun, Churl-Hong;Kweon, Seok-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.19-25
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    • 2009
  • Purpose: We report mid to long - term results of meniscal transplantation and evaluate the important factors for successful outcomes. Materials and Methods: Between December 1999 and September 2002, 25 meniscal transplantations were performed using fresh frozen allograft. The lateral meniscus was transplanted in 19 cases and medial meniscus in 6 cases. The mean age was 34 years (range, 17~50 years) and the mean follow up was 54.8 months (range, 6~85 months). Preoperative measurements were made using a ruler graded in millimeters. Lateral meniscus was fixed by keyhole technique and medial meniscus was fixed by double bone plug technique with suturing the periphery of the meniscal transplant. All patients were evaluated with Knee Assessment Scoring System (KASS), Lysholm knee score, and Tegner activity scale for daily activity. Results: Symptoms improved in all cases. The average KASS score increased from 61.7 preoperatively to 83.8 postoperatively. The average Lysholm knee score increased from 77.7 preoperatively to 87.7 postoperatively (excellent in 3 cases, good in 17 cases, fair 4 cases, poor 1 case). But painful swellings were 3 cases, numbness in 1 case, and granuloma due to non-absorbable suture material in 1 case. Peroneal nerve palsy in 1 case was recovered after 6 weeks postoperatively. Conclusion: Meniscal allograft transplantation after subtotal or total menisectomy can significantly relieve pain and improve function of the knee joint. The exact preoperative sizing and secure fixation are essential for successful outcomes.

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Operative Treatment with Anatomically Preshaped Locking Compression Plate in Distal Fibular Fracture (해부학적 잠김 압박 금속판을 이용한 원위 비골 골절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.130-135
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    • 2013
  • Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

MECHANICAL PROPERTIES OF LASER-WELDED CAST TITANIUM AND TITANIUM ALLOY (원심 주조된 타이타늄과 타이타늄 합금의 레이저 용접 특성)

  • Yun, Mi-Kyung;Kim, Hyun-Seung;Yang, Hong-So;Vang, Mong-Sook;Park, Sang-Won;Park, Ha-Ok;Lee, Kwang-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.44 no.5
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    • pp.642-653
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    • 2006
  • Purpose : The purpose of this study was to investigate the effect of the output energy(voltage) of laser welding on the strength and properties of joint of cast titanium(CP Gr II) and titanium alloy(Ti-6Al-4V). Material and method : Cast titanium and its alloy rods(ISO6871) were prepared and perpendicularly cut at the center of the rod. After the cut halves were fixed in a jig, and the joints welded with a laser-welding machine at several levels of output voltage of $200V{\sim}280V$. Uncut specimens served as the non-welded control specimens The pulse duration and pulse spot size employed in this study were 10ms and 1.0mm respectively. Tensile testing was conducted at a crosshead speed of 0.5mm/min. The ultimate tensile strength(MPa) was recorded, and the data (n=6) were statistically analyzed by one-way analysis of variance(ANOVA) and Scheffe's test at ${\alpha}$=0.05. The fracture surface of specimens investigated by scanning electron microscope (SEM). Vickers microhardness was measured under 500g load of 15seconds with the optimal condition of output voltage 280V. Results : The results of this study were obtained as follows, 1. When the pulse duration and spot size were fixed at 10ms and 1.0mm respectively, increasing the output energy(voltage) increased UTS values and penetration depth of laser welded to titanium and titanium alloy. 2. For the commercial titanium grade II, ultimate tensile strength(665.3MPa) of the specimens laser-welded at voltage of 280V were not statistically(p>0.05) different from the non-welded control specimens (680.2MPa). 3. For the titanium alloy(Ti-6Al-4V), ultimate tensile strength(988.3MPa) of the specimens laser-welded at voltage of 280V were statistically(p<0.05) different from the non-welded control specimens (665.0MPa). 4. The commercial titanium grade II and titanium alloy(Ti-6Al-4V) were Vickers microhardness values were increased in the fusion zone and there were no significant differences in base metal, heat-affected zone.

Synergistic Effect of Azadirachta Indica Extract and Iodide Ions on the Corrosion Inhibition of Aluminium in Acid Media (Azadirachta Indica엑스와 요드화이온이 산성매체에서 Al 부식방지에 대한 Synergistic 효과)

  • Arab, S.T.;Al-Turkustani, A.M.;Al-Dhahiri, R.H.
    • Journal of the Korean Chemical Society
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    • v.52 no.3
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    • pp.281-294
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    • 2008
  • synergistic action caused by iodide ions on the corrosion inhibition of aluminium (Al) in 0.5 M HCl in the presence of Azadirachta Indica (AZI) plant extract has been investigated using potintiodynamic polarization and impedance techniques. It is found that AZI extract inhibits the corrosion of aluminium in 0.5 M HCl. The inhibition efficiency increases with the increase in AZI extract concentration, until 24% v/v of AZI extract, then Inh.% is decreased with father increase in AZI extract concentration. The adsorption of this extract in the studied concentration is found to obey Frewendlish adsorption isotherm. The addition of iodide ions enhances the inhibition efficiency to a considerable extent. The increase in Inh.% values in presence of fixed concentration of iodide ions indicates that AZI extract forms an insoluble complex at lower AZI extract concentrations by undergoing a joint adsorption. But at higher concentrations of AZI extract, competitive adsorption is found between iodide ions and the formed complex leading to less Inh.%.The Inh.% decreased in presence of iodide ions with AZI extract than in presence of AZI extract alone at all studied iodide concentrations. The synergism parameter Sq is defined and calculated from surface coverage values. This parameter in the case of AZI extract is found to be more than unity, indicating that the enhanced inhibition efficiency caused by the addition of iodide ions.

The Effect of Total Patellectomy in the Prosthetic Replacement of Proximal Tibia (경골 근위부 종양에서 인공 삽입물 사용시 슬개골 전적출술이 관절기능 회복에 미치는 영향)

  • Park, Il-Hyung;Kim, Jae-Do;Ihn, Joo-Chul;Chun, In-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.8-17
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    • 1996
  • The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

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HISTOLOGIC CHANGE OF THE POSTERIOR ATTACHMENT IN ANTERIOR DISC DISPLACEMENT OF THE TEMPOROMANDIBULAR JOINT-A NEW MODEL OF INTERNAL DERANGEMENT IN RABBITS (실험가토의 악관절원판 변위시 후방부착조직의 변화)

  • Kim, Tae-Woo;Ko, Jea-Seung;Chang, Young-il
    • The korean journal of orthodontics
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    • v.23 no.4 s.43
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    • pp.503-527
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    • 1993
  • This paper describes a new method to create an animal model for TMJ internal derangement in the New Zealand white rabbits and the light and electron microscopical changes of posterior attachment of them. Twenty six rabbits(2.5-3.0kg), four normal and twenty two experimental, were used. The right disc of experimental animal was displaced anteriorly without sectioning the posterior attachment and tied to the zygomatic arch with nylon not to be reduced to the original position. The left TMJ was sham-operated to be compared with its right experimental one. Normal animals were sacrificed one day and eight weeks after experiment. Experimental animals were sacrificed one day, ten days, three weeks, five weeks and eight weeks after surgery respectively. They were fixed intravenously with $2\%$ glutaldehyde under general anesthesia and the samples of them were processed for light and electron microscopic examination. The purpose of this experiment is to make a suitable animal model of disc displacement without reduction for studying and understanding the cellular and morphologic events in posterior attachment of TMJ including early changes which were difficult to be observed in human TMJs. The results of this investigation suggest the following conclusions : 1. Authors induced anterior disc displacement surgically in rabbits with new method to examine histologic changes of posterior attachment. Tissue reactions of this model seem to be similar to those observed in human disc displacement. We think this animal model for anterior disc displacement may be used to explore and evaluate objectively the effects of many treatment modalities in disc displacements. 2. The animal disease model showed inflammation at early stage(one and ten days). At this stage there were mild-to-severe mononuclear inflammatory cell infiltration, numerous newly formed vessels, vessel dilatation and engormement and many fibroblasts. 3. At middle stage(three weeks), fibrosis occurred, where fibroblasts decreased in number, but their cytoplasm was profuse indicating high activity. Collagen fibers increased in number and the tissue looked more dense. 4. At late stage(five weeks and eight weeks) showed degenerative changes including perforation of posterior attachment, disintegration of collagen fiber bundles, degeneration of fibroblasts, metastatic ossification, and dystrophic calcification.

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A Directional Distance Function Approach on the Efficiency of Chinese Commercial Banks (방향성거리함수를 이용한 중국의 상업은행 효율성 분석)

  • Hwang, Ryeon-Hee;Kim, Seong-Ho;Lee, Dong-Won;Nam, Doo-Woo
    • Journal of Korea Society of Industrial Information Systems
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    • v.17 no.2
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    • pp.81-94
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    • 2012
  • On December 11, 2001, China joined the WTO and became one of the member countries and the Chinese financial markets had to be open in 5 years. So, the Chinese government transformed national commercial banks into joint-stock banks. The purpose of this paper is to investigate the validity of this decision by the Chinese government. In order to measure the efficiency of banks, the directional distance function (DDF) methodology is used, which analyzes whether a bad output exists in the outputs. In the empirical analysis, the number of staffs, the fixed assets, and the equity capital are used as inputs, while the loans and the non-performing loans ratio are used as a good output and a bad output, respectively. The non-performing loans ratio is included in output since it could affect the efficiency of banks. If it isn't considered in the analysis, a distortion might occur in analyzing the efficiency of banks. The results show that the efficiency of the major commercial banks was improved, and that the efficiency of joint-stocks banks was higher for 2002-2003 while the efficiency of national commercial banks was higher for 2004-2006. It was due mainly to the foreign exchanges reserve funds injected into national commercial banks by the Chinese Ministry of Finance, and as a result bad assets were eliminated.

Ventral Fixation of Atlantoaxial Joint under Fluoroscopic Guidance Using Screws in a Chihuahua Dog (환축추 아탈구 견에서 투시기 유도를 통한 복측 나사 고정술)

  • Lee, Jae-Hoon;Yang, Hee-Taek;Yang, Wo-Jong;Chung, Dai-Jung;Kang, Eun-Hee;Eom, Ki-Dong;Choi, Chi-Bong;Chang, Hwa-Seok;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.25 no.2
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    • pp.131-135
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    • 2008
  • A 5-year-old Chihuahua dog was evaluated for a tetraparesis. The dog was presented with a non-ambulatory tetraparesis and neck pain. Radiography demonstrated an atlantoaxial (AA) subluxation and increased distance between the dorsal arch of the C1 and the dorsal spinous process of the C2. The AA joint was fixed with ventral transarticular fixation using two screws under fluoroscopic guidance. Neck brace was applied during 3 weeks post-operation. After 4 weeks, the dog was fully ambulatory with improved neurological function. Postoperative radiographs confirmed reduction of the luxation and no migration of screws. The dog showed complete resolution of clinical signs without signs of recurrence till 4 months after operation. Proper angulations of screws provided under fluoroscopic guidance, enabled adequate stabilization of the AA joints using ventral transarticular screw fixation which improved neurologic outcome of the patient.

The Volar Plating of Fracture of the Coronoid Process - Report of Two Cases - (구상돌기 골절에서 내측 접근법을 통한 전방 금속판 고정술 - 2예 보고 -)

  • Jung, Gu-Hee;Cho, Chul-Hyun;Jang, Jae-Ho;Kim, Jae-Do
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.260-265
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    • 2010
  • Purpose: To report the clinical results of two cases of coronoid process fractures that were treated with volar plating through a medial approach. Materials and Methods: Two fractures of the coronoid process that needed to be fixed were managed with open reduction and internal fixation through a medial approach using 2.4 mm locking compression plates (Compact Hand set$^{(R)}$, Synthes, Switzerland). The patients were followed up for 14 months and 17 months and were evaluated using the Mayo Elbow Performance Score (MEPS). Results: The MEPS was 95 for Case 1 and 100 for Case 2. Active elbow joint motions were $5^{\circ}-120^{\circ}$ (Case 1) and $0^{\circ}-130^{\circ}$ (Case 2). Supination and pronation fully recovered. Conclusion: Satisfactory results can be obtained in cases of coronoid process fractures because volar plating through a medial approach allows sound fixation and early mobilization of the elbow joint.

Three-dimensional finite element analysis for the effect of retentive groove design on joint strength of casting connection (유지구 설계가 주조연결강도에 미치는 영향에 관한 삼차원 유한요소법적 연구)

  • Kim, Jung-Woo;Jeong, Chang-Mo;Jeon, Young-Chan;Yun, Mi-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.1
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    • pp.29-38
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    • 2009
  • Statement of problem: A casting connection technique is widely used for repair, correction and addition to base metal framework. However, a casting connection technique may increase the risk of failure in clinical situations when high stresses exist. Purpose: The purpose of this study was to investigate the mechanical retentive groove design comparatively to increase the joint strength by using the three-dimensional finite element analysis model of a 3-unit fixed partial denture. Material and methods: Ten finite element models were constructed. (Model A: One retentive groove, Model B: Two retentive grooves, Model C: Three retentive grooves, Model D: Four retentive grooves, Model E: One horizontal groove and two vertical grooves, Model F: Two horizontal grooves and one vertical groove, Model G: One groove with the enlarged dimension, Model H: Two grooves with the enlarged dimension, Model I: One groove with the increased height, Model J: One groove with the increased width of base). The vertical force was applied to the mesial and the distal fossa to the casting connection of mandibular first molar. Results: The main factors, affecting joint strength of casting connection were both the retention between the primary cast and the secondary cast and the thickness of the primary cast remaining after preparing retentive groove. The increase of retentive force, according to the numbers and the dimension of retentive groove had an effect on distributing stress. However, in some cases, the increase of retentive force resulted in the increase of stress by reducing thickness of the primary cast in the connection area. Conclusion: The design of retentive groove that limits number of retentive groove for metal thickness and increases the depth of retentive groove for retention is highly recommended.