• 제목/요약/키워드: Fracture index

검색결과 254건 처리시간 0.031초

3축 가력시스템에 의한 박스형 암거의 파괴거동 분석 (Analysis of Failure Behavior of the Box Culvert with 3-Axes Loading System)

  • 우상균;권용길;조준형;한상훈
    • 한국구조물진단유지관리공학회 논문집
    • /
    • 제13권5호통권57호
    • /
    • pp.142-148
    • /
    • 2009
  • 이 논문에서는 3축 가력상태에 놓인 박스형 암거의 극한파괴실험을 실시하고 박스형 암거의 파괴거동 특성을 파악하고 하중증가에 따른 균열폭의 변화를 측정하였다. 현실적인 외압상태를 모사하기 위해 상부 및 좌,우측부에서 동시에 가력할 수 있는 3축 가력시스템을 이용하여 하중을 재하 하였다. 하중 증가에 따른 상부슬래브 및 좌,우측 벽체에서의 균열양상을 관찰하였으며 상부슬래브에서의 균열폭 증가량을 정량적으로 측정하였다. 이를 통해 균열폭 증가에 따른 구조손상도를 실험적으로 정량화시켜 박스형 암거의 구조내력저하지수를 실험적으로 추정하였다.

구강내 외과적 창상 치유에서 0.2% hyaluronic acid gel의 유효성에 대한 이중 맹검 연구 (APPLICATION OF 0.2% HYALURONIC ACID GEL IN ORAL SURGICAL WOUND : A RANDOMIZED DOUBLE-BLIND STUDY)

  • 김재윤;이진용;배광학;이종호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제34권2호
    • /
    • pp.157-165
    • /
    • 2008
  • The aim of this study was to evaluate the efficacy of a topical 0.2% hyaluronic acid (HA) preparation in the management of wound after removal of arch bar for facial bone fracture and a suture site after orthognatic, oral cancer or oral surgery. Forty patients participated in a randomized, placebo controlled, double-blind trial to evaluate the efficacy of the topical HA and preparation. HA topically applied to the wound after removal of arch bar or stitch out, 3 times a day for 4 weeks. Evaluation is performed once a week for 4 weeks. For subjective evaluation, relative pain reduction in visual analog scale (VAS) and existence of heat sensation was accessed. For objective evaluation, gross evaluation, papilla index, existence of wound dehiscence, redness and swelling was checked. The same evaluation was performed in each arch bar group and suture group. For whole subject, 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy. Same findings were seen other weeks but there was no significancy. 0.2% HA group had better result than placebo in objective evaluation (papilla index, wound dehiscence, redness and swelling), but in gross evaluation placebo had better result than 0.2% HA group with no significancy. Subject was divided into suture group and arch bar group. Same aspect was seen, but only suture group had significancy not arch bar group in pain reduction score. 0.2% HA group resulted higher reduction than placebo group in pain of site in first week with significancy, especially in suture group. It reveals topical application of HA in wound especially suture site reduced pain in early stage. And 0.2% HA group had better result than placebo in papilla index, redness and swelling with no statistical significancy. In conclusion, HA has effect of pain reduction and healing promotion in the mucosal wound after oral surgery.

Steri-Oss 임플랜트의 임상 결과에 관한 연구 (A STUDY OF CLINICAL RESULTS ON STERI-OSS ENDOSSEOUS IMPLANTS)

  • 민영규;권혁신;정재헌
    • 대한치과보철학회지
    • /
    • 제36권2호
    • /
    • pp.258-272
    • /
    • 1998
  • This investigation evaluated patients who received Steri-Oss implants from the Dental Hospital of Chosun University during the period from March 1989 to August 1997. 346 fixtures of 127 patients were included in this study. The results were as follows ; 1.The follow-up period was defined as the period between the surgical placement of the implants and the last follow-up examination. The mean follow-up period was $2.17{\pm}1.21$ years. 2.The period between fixture installation and second surgery was $0.71{\pm}0.44$ years in the maxilla and $0.46{\pm}0.21$ years in the mandible. 3.The number of fixtures which were installed in the upper jaw(112) was less than that in the lower jaw(234) and in the posterior region(260) was more than in the anterior region(86). 4.The length of fixture which was most frequently used was 12 mm and least was 8mm. Screw implants were installed more than cylindrical implants. 3.8mm implant was the most common implans, followed by 4.5mm and 3.25mm. 5.The number of augmentation cases was more than that of non-augmentation cases and the rate of augmentation cases in the maxilla was more than that in the mandible. 6.Implant restorations for partial edentulos patients(94cases) were more than single- tooth implant restorations(33cases) or implant restorations for complete edentulos patients(10cases). 7.Free-standing prostheses for partially edentulous patients were more commom than any other type of connection between implants and natural teeth. 8.Plaque Index($0.95{\pm}0.74$) and Gingival Index($0.31{\pm}0.52$) were very similar around the natural teeth and reflected an acceptable level of plaque and gingivitis control. Mean value for keratinized mucosa index($1.93{\pm}1.20$) remained fairly constant around level 2(1-2 mm keratinized epithelium). 9.Patients were generally satisfied with implant in terms of comfort, function, speech and esthetics. 10.There was not a statistically significant differences in overall survial rate between implants placed in the maxilla (91.5%) and those placed in the mandible (93.8%). Fourteen implants lost before the prosthetic rehabilitation and eleven implants lost following variable periods in function after the prosthetic phase of the treatment. 11.Cause of implant failures was exfoliation or removal of fixture due to non-osseointegration before the prosthetic rehabilitation or due to fracture of fixture, masticatory pain after the prosthetic rehabilitation. 12.The survival rate of Steri-Oss implants using the Kaplan-Meier statistical analysis was 93.8% at 2 year and 86.6% at 5 year, In all cases, implant losses occured predominantly in the healing period. There was a steep decline in the rate of implant loss after the first year. 13.The survival rate of Steri-Oss implants in the anterior region was 94.8% at 2 year and 94.8% at 5 year and that in the posterior region was 92.8% at 2 year and 75.9% at 5 year. In conclusion, this study revealed a number of parameters and guidelines for achieving an optimal success rate in osseointegration.

  • PDF

낭산일대에 분포하는 화강섬록암 암석자원의 열극체계 및 물리적 특성 (Fracture Pattern and Physical Property of the Granodiorite for Stone Resources in the Nangsan Area)

  • 윤현수;홍세선;박덕원
    • 암석학회지
    • /
    • 제16권3호
    • /
    • pp.144-161
    • /
    • 2007
  • 낭산지역 일대의 쥬라기 흑운모 화강섬록암은 담회색, 치밀조직을 이루는 중립질암이다. 암체에 대한 광역적인 열극체계 분석결과는 다음과 같다. 열극의 주향은 빈도등급에 의하여 크게 세 방향으로 분류가 가능하다. 이들 열극은 빈도등급에 의하여 (1) $N80^{\circ}{\sim}90^{\circ}E$ (1st-order)>(2) $N70^{\circ}{\sim}80^{\circ}E$ (2nd-order)>(3) $NS{\sim}N10^{\circ}E$ (3rd-order)의 순으로 나타난다. 특히 이들 열극의 간격은 200 cm 미만의 것들이 대부분을 차지한다. 따라서 분석된 열극체계 및 간격으로 미루어 낭산일대에서는 규격석보다 비규격석의 산출이 훨씬 많아 쇄석자원의 잠재성이 더 클 것으로 해석된다. 특히 밀집하는 기존 석산의 수직상 채석면의 방향도 빈도등급에 의하여 두 그룹으로 분류되어, (1) $N14^{\circ}W{\sim}N16^{\circ}E$ (1st-order)와 (2) $N78^{\circ}E{\sim}N88^{\circ}E$ (2nd-order)에서 뚜렷이 우세하다. 상기한 두 그룹의 수직상 채석면의 방향은 광역적 열극체계와는 다소 차이가 있다. 이와 같은 현상은 단위 석산에서 발달하는 미세균열의 배향성과 크게 관련되는 것으로 볼 수 있다. 낭산지역의 물성 중에서 비중, 흡수율, 공극률, 압축강도, 인장강도와 마모경도는 각각 2.65, 0.28%, 0.73%, $1,628kg/cm^2,\;100kg/cm^2$ 및 31의 평균값을 가진다. 공극률의 경우와는 달리, 낭산 및 속리산지역의 화강암류는 상호 유사한 마모경도를 가진다. 이는 마모저항의 지표로 간주되는 석영과 알칼리장석의 모우드 값의 차이로 설명될 수 있다. 한편 낭산지역의 연구를 통하여 규명된 수직상 채석면의 방향 및 각종 물성특성의 전반적인 이해는 차후 이 지역의 암석자원 활용 시주요 정보로 활용될 것으로 기대된다.

압박 긴장대 방법을 이용한 구상 돌기 골절의 견고한 고정과 조기 운동을 통한 주관절 기능의 향상 (Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique)

  • 류인혁;서보건;김형진;정재익;김경철
    • Clinics in Shoulder and Elbow
    • /
    • 제12권2호
    • /
    • pp.159-166
    • /
    • 2009
  • 목적: 압박 긴장대 방법을 이용한 작은 구상 돌기 골절의 견고한 고정과 주관절의 조기 운동을 통한 기능의 향상 및 그 결과를 분석하고자 한다. 재료 및 방법: 주관절 내측접근법으로 K-강선과 철선을 이용하여 고정된 8예의 구상돌기 골절을 대상으로 하였다. 분류상 8예 모두 Regan-Morrey type 2였으며 O'Driscoll 분류12)로는 tip형(subtype 2)가 예, anteromedial 형 (subtype 2, 1예 그리고 subtype 3, 2예)3예였다. 동반 손상으로는 측부인대 파열이 6예, 요골두 및 경부골절이 4예였으며 모두 함께 치료하였다. 술 후 5~7일간의 고정 치료 후 경첩 보조기 (hinge brace)을 착용한 상태에서 술후 6주까지 능동적 운동을 허용하였다. 술 후 통증의 여부, 관절 운동 범위, Mayo elbow performance score(MEPS)을 이용한 기능적 평가 방법을 이용하여 치료 결과를 분석하였다. 평균 11 (6~28)개월 추시 하였으며 척골 신경 증상에 대해서도 함께 조사하였다. 결과: 모든 구상돌기 골절은 내고정용 도구의 실패 없이 모두 유합되었다. 평균 2.2 (2~4)개의 K-강선이 사용되었다. 관절운동 범위에 대해 신전은 평균 $3^{\circ}(0^{\circ}\sim25^{\circ})$, 굴곡는 평균 $137^{\circ}(130^{\circ}\sim140^{\circ})$, 회내전은 평균 $69^{\circ}(45^{\circ}\sim90^{\circ})$, 회외전은 $78^{\circ}(45^{\circ}\sim90^{\circ})$이였다. MEPS는 평균 96 (65~100) 이였다. 척골 신경 증상은 terrible triad 1예에서 첫 수술 (index operation)후 요골두를 절제하고 내측 측부 인대의 기능 부전이 있는 1예에서 관찰되었다. 결론: 쉽게 구할 수 있으며 가격이 저렴한 K-강선과 철선을 이용한 압박 긴장대 방법은 충분히 견고하여 조기에 능동적 운동을 허용할 수 있어 주관절의 기능 향상을 가져올 수 있었다. 이 방법은 특히 다발성 소형 구상 돌기 골절의 경우 유용한 하나의 고정 방법으로 생각된다.

발목 골절 및 탈구 혹은 경골 천정 골절 환자들의 수술에 있어 경종골핀을 이용한 발목 외고정 장치를 적용했을 때의 임상적 효용성 (Efficacy of Temporal Fixation Using Threaded Trans-Calcaneal Pin in Patients with Ankle Fracture-Dislocation or Tibia Pilon Fractures)

  • 박대현;곽희철;김정한;이창락;권용욱;추혜정;박철순
    • 대한족부족관절학회지
    • /
    • 제24권2호
    • /
    • pp.81-86
    • /
    • 2020
  • Purpose: Ankle fractures with dislocations and pilon fractures at the distal tibia are usually associated with soft tissue damage caused by high-energy damage. Recently, a two-stage operation to perform internal fixation after the application of external fixation devices for stabilizing soft tissues has been accepted as the treatment of choice. This paper reports the clinical result of these injuries treated with threaded trans-calcaneal pin external fixation devices. Materials and Methods: Thirty-three patients diagnosed with ankle fractures with dislocations or tibial pilon fractures without open wounds. They underwent surgical treatment with threaded trans-calcaneal pin external fixation from January 2008 to February were enrolled in this study. This study evaluated the visual analogue scale (VAS), foot function index (FFI), and Olerud & Molander score as well as whether complications occurred. Results: The average VAS showed a meaningful decrease (p<0.001) from 7.4 before surgery to 2.6 after application of the external fixation device, and 1.4 at 12 months after surgery. The FFI also decreased significantly from 84.3 preoperatively to 20.3 at 12 months postoperatively (p<0.001). The Olerud & Molander score averaged 71.4 points, showing good clinical results. Complete bone union was observed in all patients. One patient each underwent debridement due to wound necrosis and infection in the pin insertion site. At the final follow-up, seven patients had posttraumatic ankle joint arthritis, according to a radiological examination. Conclusion: Manual reduction and external fixation using a threaded trans-calcaneal pin is a suitable surgical technique that is easy to perform and shows good clinical outcomes in stabilizing soft tissue damage in fractures and dislocations of ankle fracture or tibia pilon fractures in foot and ankle injury.

Is the Agricultural Work a Risk Factor for Koreans Elderly Spinal Sagittal Imbalance?

  • Hong, Jong-Hwan;Han, Moon-Soo;Lee, Seul-Kee;Lee, Jung-Kil;Moon, Bong Ju
    • Journal of Korean Neurosurgical Society
    • /
    • 제63권5호
    • /
    • pp.623-630
    • /
    • 2020
  • Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

소 족지 단중족증의 치료결과 - 합병증을 중심으로 - (The Outcome of the Treatment of Lesser toe Brachymetatarsia - focus on complications -)

  • 이호승;윤준오;박수성;김유진
    • 대한족부족관절학회지
    • /
    • 제7권1호
    • /
    • pp.13-20
    • /
    • 2003
  • Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.

  • PDF

압열인장시험을 이용한 화강암의 지연파괴특성 및 장기안정성 평가 (Estimation of the Characteristics of Delayed Failure and Long-term Strength of Granite by Brazilian Disc Test)

  • 정용복;천대성;박의섭;박찬;이윤수;박철환;최병희
    • 터널과지하공간
    • /
    • 제24권1호
    • /
    • pp.67-80
    • /
    • 2014
  • 본 연구에서는 임계하균열성장 변수를 구하기 위해 제안된 Wilkins의 시험법을 압열인장시험과 결합하여 화강암의 인장강도, Mode I 파괴인성과 임계하균열성장지수를 동시에 구하였으며 이를 사용하여 암석의 장기거동을 평가하였다. 또한 내부압력을 받는 압축공기저장(CAES) 공동에 대한 장기안정성을 수치해석코드인 FRACOD를 사용하여 해석하였다. 시험 결과 화강암의 임계하균열성장지수(n)는 29.39로 결정되었으며 5 ~ 6 MPa의 내압은 저장공동의 장기안정성에 큰 영향을 미치지 않는 것으로 나타났다. 또한 시험 과정에서 측정한 미소파괴음을 분석한 결과 암석내의 미소균열 생성 및 전파에 따른 암석의 손상을 정량적으로 기술할 수 있었다. 만약, 실내와 동일한 조건으로 현장에서 AE 모니터링을 수행할 경우 AE 모니터링을 통해서 하중을 받는 암석의 현재 상태를 정량적으로 평가하는 것이 가능할 것으로 판단된다.

대퇴 경부 골절의 임상적 고찰 (A Clinical Study of Femur Neck Fractures)

  • 구환모;안면환;인주철
    • Journal of Yeungnam Medical Science
    • /
    • 제7권1호
    • /
    • pp.69-80
    • /
    • 1990
  • 본 영남의대 정형외과학 교실에서는 1984년 1월 부터 1988년 5월 까지 입원 치료한 대퇴 경부 골절 환자 중 최근까지 2년 이상 추적 조사가 가능 하였던 23명의 24례를 대상으로 하여 고찰한 결과를 요약하면 다음과 같다. 1. 총 23명중 여자가 19명, 65세 이상의 노년층의 환자가 11명으로 노년층의 여자에서 호발하였다. 2. 18례에서 경도의 외력에 의한 것이었고 65세 이상의 12례 중 전례에서 경도의 외력에 의해 골절되었고 8례에서 심각한 골조송증을 보였다. 3. 24례 중 14례에서 전위된 골두하 골절이었고 6례에서 전위된 횡경부 골절이었으며 4례에서 전위되지 않은 횡경부 골절이었다. 4. 치료는 14례에서 도수 정복후 내고정을 10례에서 일차적 관절 치환술을 시행하였고 내고정한 14례중 4례에서 대퇴 골두 괴사로 이차적 관절 치환술을 시행하였다. 5. 내고정을 시행한 14례 중 7례에서 합병증을 관찰할 수 있었고 무혈성 괴사가 6례, 불유합 2례, Pin 이동 3례, 내고정물 부전이 1례였다. 6. 관절 치환술을 시행한 14례에서 수술 직후의 대퇴경의 수술적 접합률이 대퇴경의 해리와 관계가 있었다.(r=-0.68. p<0.01) 대퇴 경부 골절의 치료시에 합병증의 발생은 대개 골절의 양상 및 치료시기, 정복의 정도에 의해 결정되며 치료의 지연, 정복의 불가능, 과내반 교정, 병적 골절일 경우에는 일차적 고관절 치환술이 환자의 조기 거동과 사망률의 감소를 위해 바람직할 것으로 사료된다.

  • PDF