• Title/Summary/Keyword: Fracture reduction

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CONSERVATIVE TREATMENT OF INTRA-ALVEOLAR ROOT FRACTURE OF PRIMARY INCISORS USING RESIN WIRE SPLINT : CASE REPORT (레진 강선 고정을 이용한 유전치 치근 파절의 보존적 치료 : 증례 보고)

  • Jung, Ji Hyun;Park, Jae-Hong;Kim, Kwang Chul;Choi, Yeong Chul;Choi, Sung Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.1
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    • pp.53-59
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    • 2013
  • In an intra-alveolar root fracture (IARF) of a primary tooth with severe mobility and displacement, extraction and periodic-follow-up is the choice of recommended treatments because of the fear of aspiration of the mobile tooth and the possibility of damage in the permanent succeeding tooth. However, repositioning and splinting are presented as a fresh proposal recently. In case of extracting a primary incisor, many problems occur; esthetic problems; functional problems such as pronunciation and mastication; space loss; and psychological and social problems. Therefore, the best treatment is conservation of the primary tooth. The aim of this report was to suggest the conservative treatment of an Intra-alveolar root fracture of the primary central incisors with severe mobility and displacement based on two cases that describe the diagnoses, treatments and follow-ups (mean period: 27-month). All cases have been treated by reduction and immobilization by resin wire splint (RWS) (mean period: 6-week). Both cases were followed up until the successors were erupted. There have been no complications such as pain, pulp necrosis, periapical lesion, displacement of permanent tooth germ, eruption disturbance and etc.

Operative Treatment of Distal Clavicle Fracture Nonunion (원위 쇄골 불유합의 수술적 치료)

  • Kang, Ho-Jung;Yoon, Hang-Seob;Hahn, Soo-Bong;Kim, Sung-Jae
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.220-226
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    • 2007
  • Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.

Biomechanical Comparison of Inter-fragmentary Compression Pressures : Lag Screw versus Herbert Screw for Anterior Odontoid Screw Fixation

  • Park, Jin-Woo;Kim, Kyoung-Tae;Sung, Joo-Kyung;Park, Seong-Hyun;Seong, Ki-Woong;Cho, Dae-Chul
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.498-503
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    • 2017
  • Objective : The purpose of the present study was to compare inter-fragmentary compression pressures after fixation of a simulated type II odontoid fracture with the headless compression Herbert screw and a half threaded cannulated lag screw. Methods : We compared inter-fragmentary compression pressures between 40- and 45-mm long 4.5-mm Herbert screws (n=8 and n=9, respectively) and 40- and 45-mm long 4.0-mm cannulated lag screws (n=7 and n=10, respectively) after insertion into rigid polyurethane foam test blocks (Sawbones, Vashon, WA, USA). A washer load cell was placed between the two segments of test blocks to measure the compression force. Because the total length of each foam block was 42 mm, the 40-mm screws were embedded in the cancellous foam, while the 45-mm screws penetrated the denser cortical foam at the bottom. This enabled us to compare inter-fragmentary compression pressures as they are affected by the penetration of the apical dens tip by the screws. Results : The mean compression pressures of the 40- and 45-mm long cannulated lag screws were $50.48{\pm}1.20N$ and $53.88{\pm}1.02N$, respectively, which was not statistically significant (p=0.0551). The mean compression pressures of the 40-mm long Herbert screw was $52.82{\pm}2.17N$, and was not statistically significant compared with the 40-mm long cannulated lag screw (p=0.3679). However, 45-mm Herbert screw had significantly higher mean compression pressure ($60.68{\pm}2.03N$) than both the 45-mm cannulated lag screw and the 40-mm Herbert screw (p=0.0049 and p=0.0246, respectively). Conclusion : Our results showed that inter-fragmentary compression pressures of the Herbert screw were significantly increased when the screw tip penetrated the opposite dens cortical foam. This can support the generally recommended surgical technique that, in order to facilitate maximal reduction of the fracture gap using anterior odontoid screws, it is essential to penetrate the apical dens tip with the screw.

Effect of Mechanical and Toughening Characteristics of Epoxy/Carbon Fiber Composite by Polyamide 6 Particles, CTBN Addition Technology (Polyamide 6 입자 및 CTBN 첨가 기술에 따른 에폭시/탄소섬유 복합재의 강인화 효과 및 기계적 특성)

  • Sung-Youl Bae;Kyo-Moon Lee;Sanjay Kumar;Ji-Hun Seok;Jae-Wan Choi;Woo-Hyuk Son;Yun-Hae Kim
    • Composites Research
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    • v.36 no.5
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    • pp.355-360
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    • 2023
  • Epoxy-based carbon fibers reinforced plastic (CFRP) exhibit limitations in their suitability for industrial applications due to high brittleness characteristics. To address this challenge, extensive investigations are underway to enhance their toughness properties. This research focuses on evaluating the toughening mechanisms achieved by Polyamide 6 particles(p-PA6) and Carboxyl-Terminated Butadiene-Acrylonitrile (CTBN) elastomer, with a specific emphasis on utilizing minimal additive quantities. The study explores the impact of varying concentrations of p-PA6 and CTBN additives, namely 0.5, 1, 2.5, and 5 phr, through comprehensive Mode I fracture toughness and tensile strength analyses. The inclusion of p-PA6 demonstrated improvements in toughness when introduced at a relatively low content of 1phr. This improvement manifested as a sustained fracture behavior, contributing to enhanced toughness, while simultaneously maintaining the material's tensile strength. Furthermore, the investigation revealed that the incorporation of p-PA6 affected in particle aggregation, thus influencing the overall toughening mechanism. Incorporation of CTBN, an elastomeric modifier, exhibited a pronounced increase in fracture toughness at higher concentrations of 2.5 phr and beyond. However, this increase in toughness was accompanied by a reduction in tensile strength, resulting in fracture behavior similar to conventional CFRP exhibiting brittleness. The synergy between pPA6, CTBN and CFRP appeared to marginally enhance tensile strength under specific content conditions. As a result of this study, optimized conditions for the application of the p-PA6, CTBN toughening technology have been identified and established.

A follow-up study on extracorporeal fixation of condylar fractures using vertical ramus osteotomy

  • Park, Sung Yong;Im, Jae Hyoung;Yoon, Seong Hoe;Lee, Dong Kun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.76-82
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    • 2014
  • Objectives: The aim of this study is to report the results of extracorporeal fixation in patients with mandibular condylar fractures and compare them with the clinical results of conservative treatment. Materials and Methods: The medical records of 92 patients (73 male [M] : 19 female [F], age 13-69 years, mean 33.1 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery in Sun Dental Hospital (Daejeon, Korea) from 2007 to 2012 were reviewed. Patients were divided into three groups: group A (23 patients; M : F=18 : 5, age 21-69 years, mean 32.6 years), treated with extracorporeal fixation; group B (30 patients; M : F=24 : 6, age 16-57 years, mean 21.1 years), treated by conventional open reduction; and group C (39 patients; M : F=31 : 8, age 16-63 years, mean 34.4 years), treated with the conservative method ('closed' reduction). Clinical and radiographic findings were evaluated and analyzed statistically. Results: Occurrence of postoperative condylar resorption correlated with certain locations and types of fracture. In this study, patients in group A (treated with extracorporeal fixation) did not demonstrate significant postoperative complications such as malocclusion, mandibular hypomobility, temporomandibular disorder, or complete resorption of condyle fragments. Conclusion: In superiorly located mandibular condyle fractures, exact reconstruction of condylar structure with the conventional open reduction technique can be difficult due to the limited surgical and visual fields. In such cases, extracorporeal fixation of the condyle using vertical ramus osteotomy may be a better choice of treatment because it results in anatomically accurate reconstruction and low risk of complications.

Modification of Strain-dependent Hydraulic Conductivity with RMR (RMR에 따른 변형률 의존 수리전도도 변화 해석)

  • 윤용균
    • Tunnel and Underground Space
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    • v.13 no.1
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    • pp.44-51
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    • 2003
  • Changes of the hydraulic conductivity resulting from the redistribution of stresses by underground excavation are examined using the strain-dependent hydraulic conductivity modification relation, where the modulus reduction ratio and induced strain are the major parameters. The modulus reduction ratio is defined in terms of RMR(Rock Mass Rating) to represent the full gamut of rock mass condition. Though shear dilation has the effect on the modification of hydraulic conductivity, the extent of it depends on RMR When the extensional strain is applied to a fracture, the hydraulic conductivity increases with the decrease of RMR Loading configuration has the effect on the modification of hydraulic conductivity, where the differential stress mode with a magnitude of the minimum principal stress $($\sigma$_x)$ fixed and a magnitude of the maximum principal stress $($\sigma$_y)$ varied is found to exert the greatest effect on the change of hydraulic conductivity.

Efficacy and Safety of Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Body Compression Fractures : Compared with Vertebroplasty

  • Yi, Won-Jae;Lee, Jung-Ho;Lee, Hyuk-Gee;Ryu, Kee-Young;Kang, Dong-Gee;Kim, Sang-Chul
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.112-117
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    • 2007
  • Objective : Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. Methods : Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. Results : The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. Conclusion : Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.

Clinical Significance of Lateral Ankle Radiograph after the Reduction of a Syndesmosis Injury (원위경비인대결합 손상 정복 후 관찰된 측면 방사선 영상의 임상적 중요성)

  • Suh, Jae Wan;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.128-134
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    • 2017
  • Purpose: To introduce reliable and newly developed radiographic measures based on a lateral ankle radiograph to assess a syndesmotic reduction after screw fixation and to compare with the radiographic measures based on the anteroposterior (AP) and mortise radiographs. Materials and Methods: The postoperative ankle radiographs of 34 ankle fracture cases after screw fixation for concurrent syndesmosis injury were reviewed. Two radiographic parameters were measured on each AP and mortise radiograph; tibiofibular clear space (TFCS) and tibiofibular overlap (TFO). Five radiographic parameters were measured on the true lateral radiographs; the anteroposterior tibiofibular (APTF) ratio, anterior tibiofibular ratio (ATFR), posterior tibiofibular ratio (PTFR), distances of intersection of the anterior fibular border and the tibial plafond to anterior cortex of the tibia (AA'), and the intersection of posterior fibular border and tibial plafond to the tip of the posterior malleolus (BB'). In addition, the distance (XP) between the fibular posterior margin (X) crossing tibial plafond or the posterior malleolus and posterior articular margin (P) of the tibial plafond was measured on the lateral view. Results: Using TFCS and TFO in the AP and mortise radiographs, malreductions of syndesmosis were estimated in 17 of 34 cases (50.0%). Using the introduced and developed radiographic measures in the lateral radiographs, syndesmotic malreductions were estimated in 16 out of 34 cases (47.1%). Seventeen cases (50.0%) showed no evidence of postoperative diastasis using the radiographic criteria on the AP and mortise view, 10 cases (58.8%) of whom showed evidence of a malreduction on the lateral radiograph. The newly developed measurements, XP, were measured 0 in 11 out of 34 cases (32.4%). Conclusion: The reduction of syndemosis after screw fixation can be accurately assessed intraoperatively with a combination of several reliable radiographic measurements of the lateral radiograph and traditional radiographic measurements of the AP and mortise radiograph.

Fabrication and Evaluation of 5 vol%CNT/Al Composite Material by a Powder in Sheath Rolling Method (분말시스압연법에 의한 5 vol%CNT/Al 복합재료의 제조 및 평가)

  • Hong, Dongmin;Kim, Woo-Jin;Lee, Seong-Hee
    • Korean Journal of Materials Research
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    • v.23 no.11
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    • pp.607-612
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    • 2013
  • A powder in sheath rolling method was applied to the fabrication of a carbon nano tube (CNT) reinforced aluminum composite. A 6061 aluminum alloy tube with outer diameter of 31 mm and wall thickness of 2 mm was used as a sheath material. A mixture of pure aluminum powder and CNTs with a volume content of 5% was filled in the tube by tap filling and then processed to an 85% reduction using multi-pass rolling after heating for 0.5 h at $400^{\circ}C$. The specimen was then further processed at $400^{\circ}C$ by multi-pass hot rolling. The specimen was then annealed for 1 h at various temperatures that ranged from 100 to $500^{\circ}C$. The relative density of the 5vol%CNT/Al composite fabricated using powder in sheath rolling increased with increasing of the rolling reduction, becoming about 97% after hot rolling under 96 % total reduction. The relative density of the composite hardly changed regardless of the increasing of the annealing temperature. The average hardness also had only slight dependence on the annealing temperature. However, the tensile strength of the composite containing the 6061 aluminum sheath decreased and the fracture elongation increased with increasing of the annealing temperature. It is concluded that the powder in sheath rolling method is an effective process for fabrication of CNT reinforced Al matrix composites.

Combined Percutaneous and Minimal on Internal Fixation of Calcaneal Fractures Using Extensile Lateral Approach (광범위 외측 도달법을 이용한 종골 골절의 경피적 및 최소 내고정술)

  • Yu, Sun-O;Kim, Joo-Sung;Kim, Jong-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.201-207
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    • 2002
  • Purpose: To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach. Materials and Methods: From March 2000 to February 2002, thirty-eight displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type IV of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative care, all fractures healed without secondary displacement except 1 case on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed. Conclusion: Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.

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