• 터널과지하공간
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• 제10권3호
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• pp.378-386
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• 2000

본 논문은 통계적 기법에 의한 균열망 해석 프로그램 (NAPSAC)을 사용하여 암반의 수리특성을 평가하기 위해 시도되었다. 암반내 존재하는 절리의 방향성을 고려한 투수계수를 산정하기 위해 마북리 시험터널 주위의 시추자료와 막장 자료로부터 얻어진 균열에 대한 정보로부터 대상지역의 등가 투수계수를 추정하였다. 대상지역의 관찰자료 (균열망에 대한 자료, 수리지질학적 자료 )로부터 통계적 균열망 해석을 위한 입력자료를 결정하여 해석모델의 신뢰성을 확보하였다. 구현된 모델로부터 모델의 크기를 증가함에 따라서 이방성 투수계수 및 투수계수의 변화를 계산하였다. 해석결과 대상지역의 투수성은 균열군의 방향성에 의해 강한 이방성을 보였다.

• 대한족부족관절학회지
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• 제21권2호
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• pp.70-74
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• 2017

Fractures and fracture-dislocations of the ankle are caused by a variety of mechanisms. In addition to fractures, injuries of soft tissue, such as ligaments, tendons, nerves, and muscles may also occur. Among these, a tibialis posterior tendon injury is difficult to be identified due to swelling and pain at the fracture site. It is difficult to observe tibialis posterior tendon injury on a simple radiograph; it is usually found during surgery by accident. There are some studies regarding irreducible ankle fracture-dislocations due to interposition of the tibialis posterior tendon; however, to the best of our knowledge, there has not been any report about interposition of injured tibialis posterior tendon. Herein, we report a case of an irreducible fracture-dislocation of the ankle due to injured tibialis posterior tendon interposition that was observed intraoperatively, interrupting the reduction of ankle fracture-dislocation. We obtained satisfactory clinical result after reduction of the trapped tendon, fracture reduction, and internal fixation; therefore, we are willing to report this case with the consent of the patient. This study was conducted with an approval from the local Institutional Ethics Review Board.

• 대한기계학회논문집A
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• 제31권2호
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• pp.166-173
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• 2007

Fatigue fracture behavior of a hybrid bolted joint was evaluated in comparison to the case of static fracture. Two kinds of specimens were fabricated for the mechanical tests; a hybrid bolted joint specimen for the shear test and a hybrid joint part specimen applied in the real tilting car body for the bending test. Characteristic fracture behaviors of those specimens under cyclic toads were obviously different from the case under static loads. For the hybrid bolted joint specimen, static shear loading caused the fracture of the bolt body itself in a pure shear mode, whereas cyclic shear loading brought about the fracture at the site of local tensile stress concentration. For the hybrid joint part specimen, static bend loading caused the shear deformation and fracture in the honeycomb core region, while cyclic bend loading did the delamination along the interface between composite skin and honeycomb core layers as well as the fracture of welded joint part. Experimental results obtained by static and fatigue tests were reflected in modifications of design parameters of the hybrid joint structure in the real tilting car body.

• 한국임상수의학회지
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• 제20권4호
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• pp.458-466
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• 2003

The bone regeneration effects of copper oxide on experimentally induced fibular fracture were examined in 36 New Zealand white male rabbits. They were divided into two groups: non-treated group (control group) and copper oxide treated group (treatment group). A fibular fracture was created by an osteotomy in the middle of the fibula and 62.5 mg/kg of copper oxide was orally administrated during 7 days after operation in the treatment group. Radiological findings, histopathological examinations and hematoserological findings were observed to evaluate the bone regeneration effects of copper oxide on fibula fracture during 9 weeks. In radiological findings, the area of bone regeneration at the fracture site of the treatment group was significantly wider from 3 weeks to 6 weeks after administration of copper oxide than those of the control group (p < 0.05). In histopathological examinations, fracture healing in treatment group was faster than in control group. Also, histopathological responses of thick bony trabeculae and new bone marrow formation were shown in the treatment group, whereas many fibrous tissues and cartilages were mainly observed in the control group. No specific effects of copper oxide on the body was found in hematological and serological test during experimental period. These results showed that the copper oxide had a potential therapeutic application in the treatment of fracture and bone trauma.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.455-461
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• 2018

Background: Surgical-site, multimodal drug injection has recently evolved to be a safe and useful method for multimodal pain management even in patients with musculoskeletal trauma. Methods: Fifty consecutive patients who underwent plating for mid-shaft and distal clavicular fractures were included in the study. To evaluate whether surgical-site injections (SIs) have pain management benefits, the patients were divided into two groups (SI and no-SI groups). The injection was administered between the deep and superficial tissues prior to wound closure. The mixture of anesthetics consisted of epinephrine hydrochloride (HCL), morphine sulfate, ropivacaine HCL, and normal saline. The visual analogue scale (VAS) pain scores were measured at 6-hour intervals until postoperative hour (POH) 72; stress biomarkers (dehydroepiandrosterone sulfate [DHEA-S], insulin, and fibrinogen) were measured preoperatively and at POH 24, 48, and 72. In patients who wanted further pain control or had a VAS pain score of 7 points until POH 72, 75 mg of intravenous tramadol was administered, and the intravenous tramadol requirements were also recorded. Other medications were not used for pain management. Results: The SI group showed significantly lower VAS pain scores until POH 24, except for POH 18. Tramadol requirement was significantly lower in the SI group until POH 24, except for POH 12 and 18. The mean DHEA-S level significantly decreased in the no-SI group ($74.2{\pm}47.0{\mu}g/dL$) at POH 72 compared to that in the SI group ($110.1{\pm}87.1{\mu}g/dL$; p = 0.046). There was no significant difference in the insulin and fibrinogen levels between the groups. The correlation values between all the biomarkers and VAS pain scores were not significantly different between the two groups (p > 0.05). Conclusions: After internal fixation of the clavicular fracture, the surgical-site, multimodal drug injection effectively relieved pain on the day of the surgery without any complications. Therefore, we believe that SI is a safe and effective method for pain management after internal fixation of a clavicular fracture.

• 대한족부족관절학회지
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• 제17권3호
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• pp.182-188
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• 2013

Purpose: We evaluate clinical manifestations and radiologic features of ankle fracture & dislocation, as well as the usefulness of computed tomography on posterior ankle fracture & dislocation to study factors contributing to ankle fracture & dislocation. Material and Methods: Ankle dislocation was defined as the center of talar body being translated over the cortex of tibia on AP or lateral view on simple X-ray. Surgical treatments of 30 patients from January 2007 to March 2012 were categorized according to the injury mechanism, the direction of dislocation and fracture site. Joint involvement of posterior malleoalr fracture was evaluated through simple x-ray and computed tomography. We treated surgically if posterior malleolus fracture involves more than 25% of dital tibial articular surface. Thereafter, clinical outcomes were identified through radiographs and by using the AOFAS score. Results: The mean age was 42(13-78) years old, and slip down was the most common injury mechanism (13 cases). Car accident (6 cases) and fall accident (4 cases) were the next frequently found injury mechanisms. As for the types of ankle fracture, posterior fracture and dislocation (21 cases, 43.3%) was most commonly found. Out of these 21 cases, 15 cases involved trimalleolar fracture, and 19 cases were associated with posterior malleolar fracture. Danis-weber type B and C patients were 11 cases and 10 cases respectively. Articular involvement of posterior malleolar fracture turned out to be average 27.9%(5.1%~49.1%) on simple x-ray. The rate was evaluated as average 31.7%(12.6%~55.3%) on computed tomography which was conducted 15 times, and led us to more meaningful data. Conclusion: Anterolateral fracture and dislocation often accompanied open dislocation. Posterior fracture dislocation was most commonly found. Posterior malleolus was an important factor that ensures posterior stability of the ankle joint. Computed tomograph is useful to evaluate the articular involvement of posterior malleolar fracture.

• 대한두개안면성형외과학회지
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• 제19권2호
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• pp.102-107
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• 2018

Background: Nasal fracture and orbital blowout fracture often occur concurrently in cases of midface blunt trauma. Generally, these multiple fractures treatment is surgery, and typically, the nasal bone and orbit are operated on separately. However, we have found that utilizing a transconjunctival approach in patients with concurrent nasal bone fracture and orbital blowout fracture is a useful method. Methods: The participants in the present study included 33 patients who visited the Plastic Surgery outpatient department between March 2014 and March 2017 and underwent surgery for nasal fracture and orbital blowout fracture. We assessed patients' and doctors' satisfaction with surgical outcomes after indirect open reduction via a transconjunctival approach for the treatment of nasal bone fracture with associated orbital blowout fracture. Results: According to the satisfaction scores, both patients and doctors were satisfied with transconjunctival approach. Conclusion: We presented here that our method enables simultaneous operation of nasal fracture accompanied by orbital blowout fracture, rather than treating the two fractures separately, and it allows precise reduction of the nasal fracture by direct visualization of the fracture site without any additional incisions or difficult surgical techniques. Also, by preventing the use of excessive force during reduction, this method can minimize damage to the nasal mucosa, thereby reducing the incidence of nasal bleeding.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.389-392
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• 2004

It is clinically well known that pre-tension of wires increases the fracture stability in ring or hybrid external fixation. In some cases, additional half pin should be necessary to increase the stability when soft tissue impalement occurs during fixation. In this paper, the fracture stability of a hybrid external fixator system with different pre-tension effects and additional half-pins was analysed using FEM to investigate the effects of these pre-tension and half pin on the system stability quantitatively. 3-D finite element models of five different fixator frames were developed using by beam elements. In axial compression analysis, the fracture stiffness was increased maximally 62％ as the pre-tension increased. In torsion analysis, in the other hand, there is little variations in the fracture stiffness. Additional half pin increased the system stiffness about 200 ％. From the results, proper pre-tension and additional half pin would provide good methods to increase the fracture stability of the hybrid external fixator and provide more surgical options to minimize soft tissue damage at the fracture site.

• 대한핵의학회지
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• 제21권1호
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• pp.39-46
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• 1987

The stress fracture is a disease caused by and abnormal stress to the normal bone with constant, repeated pull. Early detection of stress fracture plays an important role in treatment and prevention of its complication. Bone scintigraphy was performed to evaluate 18 patients with stress fracture of the lower extremities from May, 1985 to April, 1987, in the Department of Internal Medicine of National Police Hospital. The results were as follows: 1) Seventeen of the 18 cases showed positive bone scans at the initial study performed from 1 week to S months after the onset of symtom. 2) Ten of the 18 patients had findings of stress fracture at the initial X-ray film. Two out of 8 negative case revealed positive findings in the follow-up studies. 3) The bone scans in the 2 cases taken 5 months after the onset of symton; the one showed only slightly increased radiouptake, the other showed no abnormal findings. In conclusion, bone scanning is a more sensitive indicator of early stress fracture than radiologic study. The healing phase is characterized by a gradual decline in radioactivity at the fracture site in concordance with subsidence of symptom.

• 대한족부족관절학회지
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• 제18권4호
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• pp.217-221
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• 2014

Fracture and fracture-dislocation of the ankle may be caused by a variety of mechanisms. In addition to the fracture, injury of soft tissue such as ligaments, tendons, nerves, and muscles may occur. Among these, tibialis posterior tendon injury is difficult to identify due to swelling and pain at the fracture site. There is no clear finding in radiological examination, therefore, it is found during surgery. In this case, irreducible fracture-dislocation of the ankle due to tibialis posterior tendon interposition was observed after the primary operation. The authors obtained satisfactory results in performance of a secondary operation assisted with arthroscopy.