• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.384-386
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• 2020

This report describes osteotomy and iliac bone graft for malunion caused by failed mandibular fracture reduction. A 27-year-old man was referred 3 months after a motor vehicle accident. At another hospital, two operations had been performed for symphyseal fracture using two resorbable plates. Malocclusion was noted, and panoramic radiography and computed tomography revealed a misaligned dental arch, with a 9.37-mm gap between the central and the lateral incisor of the left mandible. A wafer was made from the patient's dental model, and a maxillary arch bar was applied. Through a lower gingivolabial incision, osteotomy was performed between the malunited symphyseal fracture segments. Both segments were reduced to their original position using the wafer and fixed with titanium miniplates via intermaxillary fixation (IMF). The intersegmental gap was filled with cancellous bone from the iliac crest. The gingival defect was covered with a mucosal transposition flap from the gingivolabial sulcus. IMF and the wafer were maintained for 5 and 9 weeks, respectively. At postoperative week 13, the screws were removed from the mandible and satisfactory occlusion was noted. His mouth opening improved from 2.5 to 3 finger breadths (40 mm). This case demonstrates the need for sufficient IMF when using resorbable plates.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.173-183
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• 1998

$TGF-{\beta}$ is one of growth factors that may be involved in the formation of bone and cartilage. Multiple studies demonstrate that $TGF-{\beta}$ is involved in regulating cell proliferation, differentiation and matrix synthesis, events observed in frature healing. The apperance of $TGF-{\beta}$ in the fracture during healing was evaluated by immunohistologic localization of $TGF-{\beta}$ using antibody. Twenty Sprauge-Dawley strain white male rats, each weiging about 150grams were used and divided two groups. The one group, the $2{\times}2mm$ bony defect was formed in the right femur. The other group, $4{\times}2mm$ bony defect was formed in right femur. Both group were sacrificed at 3day, 1, 2, 3, 4 week and femur were harvested, paraffin sections were stained with H & E, MT stain, immunihistochemical staining with $TGF-{\beta}$ antibody and observed under light microscope. The result were as follows: 1. New bone formation and cartilagenous tissue was seen at 3day. And in the $2{\times}2mm$ bony defect group, $TGF-{\beta}$ stained the cell surounding new bone. 2. The osteoclast and trabecular was seen at 1week. $TGF-{\beta}$ stained the osteoblast and in the $2{\times}2mm$ bony defect group was stained more than $4{\times}2mm$ bony defect group. 3. The lamella bone and trabecule was seen from 3, 4week, and $TGF-{\beta}$ stained almost negative. From the above finding, we could concluded that $TGF-{\beta}$ stained the osteoblast at early stage and 1week, the peak stain was seen from 1week, and then decreased, almost negative stain was seen at 3, 4week.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.125-132
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• 2007

Introduction: Ulna is nearly equal to radius in function and bony architecture and strength in forearm. But in lower extremity, fibula is 1/5 of tibia in anatomic and functional point so we can find fibula transposition is commonly used in defect of tibia. We cannot find other article about segmental forearm bone transposition in man. The purpose of this study was to report our clinical and functional result of undergoing segmented transposition of ipsilateral ulna with its own vascular supply in defect of radius in 6 cases. Material and method: From June 1994 to October 2007, 7 segmented bone transpositional grafts in forearm were performed in Kyung Hee Medical Center. The distribution of age was from 20 years old to 73 years old. There was male in 6 cases and female in 1 case. The causes of operation were giant cell tumor in 1 case and traumatic origin in 6 cases; it was nonunion in 2 cases and fracture with severe comminution in 4 cases. Ipsilaterally segmented ulna keeping its own vascular supply was transported to defect of radius in severe traumatic patients and one patient whose tumor in radius had been excised. Transported ulna was fixed to proximal and distal radius remnants by plate and screw. In one case with giant cell tumor, transported ulna was connected to radius across wrist joint as wrist joint fusion. Joint preserving procedures were performed in 6 cases with crushing injury of radius. Results: We could obtain solid bony union in all cases and good functional results. The disadvantage was relative shortening of forearm, but we could overcome this problem. Conclusion: We think that ipsilateral segmented ulna transposition keeping its own vascular supply to radius can be perfomed with one of procedures in cases with wide defect in radius.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.50-55
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• 2010

Injury of the musculocutanous nerve can be associated with a proximal humeral fracture or shoulder dislocation, and injury of the brachial plexus. However, injury of this nerve associated with a humeral shaft fracture has rarely been reported. Diagnosis of the musculocutaneous nerve injury is difficult because its sensory loss is ill-defined, and examination of elbow flexion is difficult when it is associated with fractures. We report an unusual case of musculocutaneous nerve injury in a 27 years old woman who had multiple injuries including a humerus shaft fracture, an ipsilateral radius shaft fracture, and an associated radial nerve laceration. Diagnosis of the musculocutaneous nerve injury was delayed because combined fractures of the humerus and radius prevented proper examination of the elbow motion and nerve grafting of the radial nerve delayed early elbow motion exercise. Delayed exploration of the musculocutaneous nerve 6 months after trauma showed complete rupture of the nerve at its entry into the coracobrachialis muscle and the defect was successfully managed by sural nerve graft.

• 농업과학연구
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• 제42권2호
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• pp.125-129
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• 2015

This study was conducted to investigate the incidence of bone-fracture from pig carcass slaughtered in eight processing plants located in Daejeon and Chungnam area, Korea, during the year 2013 and 2014, and to evaluate the quality of semimembranous muscle from bone-fractured carcasses. Twenty semimembranous muscles were collected from bone-fractured carcasses and none bone-fractured (control) ones, respectively, after storage of pig carcass at $5^{\circ}C$ for 24 h. The pH, cooking loss, and color of semimembranous muscle were measured as quality parameters. In total 4,865,502 of pig carcasses, the occurrence of bone fracture was 0.328% (15,975 heads) and scored the highest defect (26.31%) in total abnormal carcasses. The pH and cooking loss of semimembranous muscle from bone-fractured carcasses were significantly lower than those of control (p<0.05). $L^*$ and $a^*$ values of semimembranous muscle were not significantly different between bone-fractured carcass and control whereas that of $b^*$ values was significantly higher in bone-fractured carcass than control (p<0.05). Eight out of twenty semimembranous muscle collected from bone-fractured carcasses were confirmed as PSE whereas only one in control. In conclusion, the incidence of bone-fracture pre- and during slaughter of pig may cause serious defects in final meat quality. Therefore, the proper handling and treatment should be implicated to avoid and/or decrease the incidence of bone-fracture of pigs.

• 대한기계학회논문집A
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• 제35권9호
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• pp.1119-1129
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• 2011

쇼트피닝(shot-peening) 처리를 한 베어링강의 고사이클 피로거동을 연구하였다. 열처리한 베어링강(JISSUJ2) 시험편과 열처리 후 쇼트피닝 표면가공을 추가한 시험편을 사용해 회전굽힘피로시험을 수행하고 파단 된 시험편의 파면을 분석하였다. 시험편의 피로파괴는 표면 결함에서 비롯된 표면 파괴와, 내부의 비금속개 재물에서 비롯된 내부형 파괴의 두 종류로 발생하였다. 내부 파괴의 경우 비금속 개재물 주변에 어안(fisheye) 모양의 파괴양식이 관찰되었다. 개재물은 표면으로부터의 깊이와 형상에 따라 피로 수명에 큰 영향을 주었다. 쇼트피닝 가공을 한 베어링강은 저사이클 하중영역 및 고사이클 하중영역에서 모두 피로수명이 향상되었으며, 하중이 작아질수록 피로수명의 개선은 더욱 커졌다. 또한 2 모수 와이블(Weibull) 분포를 이용하여 베어링강의 확률-응력-수명 (P-S-N) 곡선을 구하여 신뢰도 높은 피로수명 예측을 하였다.

• 대한용접접합학회:학술대회논문집
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• 대한용접접합학회 2006년도 춘계 학술대회 개요집
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• pp.68-70
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• 2006

For the aluminum material of the thick-thickness more than 100mm Penetration depth Electron beam welding is effectively applicable with a characteristic of high energy intensity. But Al 6061 alloy has high crack sensitivity due to minor alloys, which are silicon, magnesium, copper etc. With a sample block of 135mm thickness EBW test was performed in vertical position. As tensile strength has $210{\sim}220N/mm^2$ with weld area broken. Bend test shows low ductility with fracture of partly specimens. Chemical contents of alloys show no difference between weld and base metal. Defect in middle weld area figures out typical hot crack due to low melting materials. Micro structure of weld area has some difference compare to HAZ and base metal. As a result of EBW test for Al 6061 alloy, it shows that weld defect could be occurred even though establishing of optimum weld parameter condition.

• Journal of Chest Surgery
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• 제52권3호
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• pp.162-164
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• 2019

A male patient weighing 2.5 kg was admitted for respiratory difficulty, and a large ventricular septal defect (VSD) was diagnosed. During care, sudden right leg swelling with a femur shaft fracture occurred. The patient's father had a history of recurrent lower extremity fractures; thus, osteogenesis imperfecta was considered. The patient's respiratory difficulty became aggravated, and VSD repair in the neonatal period was therefore performed with gentle sternal traction and great vessel manipulation under total intravenous anesthesia to prevent malignant hyperthermia. The patient was discharged without notable problems, except minor wound dehiscence. Outpatient genetic testing revealed that the patient had a COL1A1/COL1A2 mutation.

• Archives of Reconstructive Microsurgery
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• 제24권2호
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• pp.41-49
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• 2015

Free or pedicled vascularized fibular grafts (VFG) are useful for the reconstruction of large skeletal defects, particularly in cases of scarred or avascular beds, or in patients with combined bone and soft tissue defects. Compared to non-VFG, VEG, which contains living osteocytes and osteoblasts, maintains its own viability and serves as good osteoconductive and osteoinductive graft. Due to its many structural and biological advantages, the free fibular osteo- or osteocutaneous graft is considered the most suitable autograft for the reconstruction of long bone defects in the injured extremity. The traditional indication of VFG is the long bone and soft tissue defect, which cannot be reconstructed using a conventional operative method. Recently, the indications have been widely expanded not only for defects of midtibia, humerus, forearm, distal femur, and proximal tibia, but also for the arthrodesis of shoulder and knee joints. Because of its potential to allow further bone growth, free fibular epiphyseal transfer can be used for the hip or for distal radius defects caused by the radical resection of a tumor. The basic anatomy and surgical techniques for harvesting the VFG are well known; however, the condition of the recipient site is different in each case. Therefore, careful preoperative surgical planning should be customized in every patient. In this review, recently expanded surgical indications of VFG and surgical tips based on the author's experiences in the issues of fixation method, one or two staged reconstruction, size mismatching, overcoming the stress fracture, and arthrodesis of shoulder and knee joint using VFG are discussed with the review of literature.

• Archives of Reconstructive Microsurgery
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• 제24권2호
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• pp.68-74
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• 2015

Purpose: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. Materials and Methods: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. Results: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. Conclusion: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.