• Clinics in Shoulder and Elbow
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• 제22권3호
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• pp.149-153
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• 2019

We experienced acromial erosion and subsequent fracture after the treatment of Rockwood type V acromioclavicular dislocation with hook plate and coracoclavicular ligament augmentation. It was treated by using a surgical technique to address an acromial fracture and subsequent losses of reduction in acromioclavicular joint with two trans-acromial cortical screws (crossbar technique). The reduction state of acromioclavicular joint could be maintained by these two screws. Our crossbar technique could be considered as a good salvage procedure for the reduction loss caused by cutout or significant erosion of acromion after insertion of clavicular hook plate.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.288-295
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• 2022

Background: There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment. Methods: Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography. Results: Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis. Conclusions: Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.

• 대한족부족관절학회지
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• 제1권2호
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• pp.112-118
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• 1997

Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.70-73
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• 2023

The hip is a stable ball-and-socket joint. Bilateral anterior dislocations of the native hip joints account for fewer than 1% of all dislocations. We present a unique case of a bilateral anterior dislocation in a patient who presented to our institution within 6 hours of trauma. The dislocations were promptly reduced under propofol anesthesia in the operating room. The patient did not suffer a concurrent fracture. After the procedure, we performed regular X-ray examinations for 2 years to rule out the development of avascular necrosis of the head of the femur. The course of the patient was unremarkable.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.27-30
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• 2020

Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.

• 열처리공학회지
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• 제23권3호
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• pp.131-136
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• 2010

The LCF (low cycle fatigue) behavior and the serration phenomena in the plastically deformed and non-deformed 5052 Al alloy were investigated. The plastic deformation was performed by 1 pass or 4 passes in ECAP (equal channel angular pressing) followed by annealing. Only cyclic hardening continued from the beginning until fracture at all strain amplitudes during LCF in the non-deformed alloy, which was caused by the increase in dislocation density during fatigue. Slight cyclic hardening followed by plateau until fracture was observed during LCF in the ECAPed alloy, which was caused by the slight increase in dislocation density in the beginning and then keeping constant in dislocation density afterward until fracture by forming subgrains in this stage of fatigue. The serrations on the stress-strain curves of this alloy were observed, which indicate that the dynamic strain aging (DSA) is occurring during plastic deformation. The variation in amplitudes of serration was studied by changing the strain rate in tensile or fatigue tests.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.168-171
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• 2016

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

• 세라미스트
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• 제9권6호
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• pp.49-55
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• 2006

Intra-type alumina-based nanocomposites, in which second-phase nanoparticles are embedded within alumina grains, use dislocation activities to enhance strength and fracture toughness. The dislocations are generated around the nanoparticles by residual stresses during cooling process. In this paper, first, we explain strengthening and toughening mechanisms of alumina-based nanocomposites based on dislocation activities. Second, we propose a soaking method to construct the intra-type nanostructure and fabricate alumina/nickel and alumina/silver nanocomposites. The nanocomposites are then annealed in order to enhance the fracture toughness of the materials. Finally, we discuss the relation between the strength, fracture toughness, and critical frontal process zone size of the materials.

• Clinics in Shoulder and Elbow
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• 제3권1호
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• pp.20-25
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• 2000

Purpose : To evaluate functional results and study factors influencing results after humeral hemiarthroplasty for comminuted fractures of the proximal humerus. Materials and Methods: We reviewed 12 patients with average follow-up period of 23 months(12 to 42). The proximal humeral fractures consisted of one anatomical neck fracture, five three-part and six four-part fractures or fracture-dislocations. Constant score and Compito et al' evaluation system were used for clinical assessment. Statistical analysis was done with the Wilcoxon test. Results: Six cases of anatomical neck, three-part fractures or fracture-dislocations showed 61 points on the average Constant score and three unsatisfactory results on the Compito et al' evaluation; Six of four-part fractures or fracture-dislocations showed 51 points and three unsatisfactory results. There were 59(two unsatisfactory) for five non-associated dislocation and 53(four unsatistactory) for seven associated dislocation; 66(one unsatisfactory) for three under 60 years and 41(five unsatisfactory) for nine over 60 years; 67(two unsatisfactory) for seven tuberosity union and 41(four unsatisfactory) for five tuberosity non-union or resorption; 58(four unsatisfactory) for ten early operation within two weeks and 43(all unsatisfactory) for two delayed operation; and 18(unsatisfactory) for one case of a accompanied rotator cuff tear. Conclusion: We concluded that tuberosity union was important factor influencing the results. Also, we thought that age, timing of operation and accompanied rotator cuff tear could be influenced to results.

• 대한족부족관절학회지
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• 제6권2호
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• pp.178-180
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• 2002

Authors report one patient of concurrent fracture of medial malleolus and rupture of deltoid ligament. To the author's knowledge, combined failure of both structures has not been previously reported in Korea. Injury mechanism was classified into pronation -abduction type according to Lauge-Hansen classification. Plain radiograph revealed trimalleolar fracture and posterior ankle dislocation. MRI showed complete rupture of both deep and superficial layer of the deltoid ligament. In conclusion, therefore, concurrent rupture of deltoid ligament should be considered for the surgical treatment in trimalleolar ankle fracture with posterior ankle dislocation resulted from pronation-adduction injury.