• Title/Summary/Keyword: Fracture reduction

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Dorsal Short-Segment Fixation for Unstable Thoracolumbar Junction Fractures

  • Kim, Kwan-Sik;Oh, Sung-Han;Huh, Ji-Soon;Noh, Jae-Sub;Chung, Bong-Sub
    • Journal of Korean Neurosurgical Society
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    • v.40 no.4
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    • pp.249-255
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    • 2006
  • Objective : This study is to evaluate the efficacy of dorsal short-segment fixation in unstable thoracolumbar junction fractures. Methods : The cases of 20 patients who underwent dorsal short-segment fixation were reviewed retrospectively. Clinical outcomes were analysed using Sonntag's pain level, work status, and neurological scale according to the modified Frankel classification. Radiological outcomes were analysed using Mumford's anterior body compression[%], canal compromise ratio, and Cobb's kyphotic angle. Results : At the latest clinical follow-up [average=14.6 months]. there were 19 [95.0%] in group I and 1 patient [5.0%] in II in pain level. The postoperative work status were 17 [85.0%] in group I, 2 patients [10.0%] in II, and 1 patient [5.0%] in V. Surgery brought to improve the neurologic status. In success group [19 cases, 95%], the average canal compromise ratio was reduced from 0.57 [${\pm}0.07$] to 0.05 [${\pm}0.08$] [P<005], the average anterior body compression [%] was reduced from 41% [${\pm}17$] to 18% [${\pm}14$] [P<0.05], and the average preoperative kyphotic angle was $20.0^{\circ}$ [${\pm}9.0$], and corrected to $5.7^{\circ}$ [${\pm}7.1$] postoperatively, and progressed to $7.8^{\circ}$ [${\pm}6.2$] at the latest follow-up. There was a case of implantation failure in an elderly osteoporotic patient. Conclusion : Although there are limitations in the patient number and follow-up period, the present study favors dorsal short-segment fixation for selective cases in unstable thoracolumbar junction fractures.

The Effect of Postural Correction and Subsequent Balloon Inflation in Deformity Correction of Acute Osteoporotic Vertebral Fractures

  • Liu, Hai-Xiao;Xu, Cong;Shang, Ping;Shen, Yue;Xu, Hua-Zi
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.337-342
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    • 2014
  • Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. Results : Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and $5.34^{\circ}$ compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by $8.32^{\circ}$ (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). Conclusion : In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.

Flexural Behavior of RC Beams Using High-Strength Reinforcement for Ductility Assessment (고강도 철근을 활용한 휨 부재의 연성거동에 관한 연구)

  • Kwon, Soon-Beom;Yoon, Young-Soo
    • Journal of the Korean Society of Hazard Mitigation
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    • v.2 no.1 s.4
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    • pp.119-126
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    • 2002
  • This paper presents the appropriateness for using high strength reinforcement according to the use of high strength concrete. Nine flexural tests were conducted on full-scale beam specimens according to the concrete strength, reinforcement strength and reinforcement ratio as main variable. The structural behavior was analyzed due to the flexural strength, stress-strain curve, deflections at yielding and fracture point, crack appearance and ductility factor. The member with high-strength reinforcements showed large deflection at yielding point and this was analyzed as a main cause to decrease the ductility factor. Structural behavior after yielding point, however, showed similarity to behavior of members with normal strength reinforcements of same stiffness. It was found that in the case of using reinforcements of $5500kgf/cm^2$ strength, the combination with concrete of $800kgf/cm^2$ strength demonstrated the great appropriateness which can increase the flexural capacity without any reduction of maximum reinforcement ratio.

Calculation for of Strength Reduction Factor for Concrete Beam reinforced with GFRP rebars (GFRP rebar로 보강된 콘크리트보의 휨 강도감소계수 보정식 제안)

  • Sim, Jong-Sung;Park, Cheol-Woo;Park, Sung-Jae;Kang, Tae-Sung;Kwon, Dong-Wook;Lee, Yong-Taek
    • Proceedings of the Korea Concrete Institute Conference
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    • 2008.11a
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    • pp.137-140
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    • 2008
  • If the flexural member of concrete is designed using the FRP rebar, suddenly brittleness destruction resulted from the fracture of FRP rebar is generated in the extreme situation because of brittleness characteristics of FRP rebar and concrete when designed to be less than balanced reinforcement ratio, so it is recommended to design the flexural member of concrete to be more than balanced reinforcement ratio. In ACI 440.1R-06 proposes the different bending strength decrease coefficient according to destructive form of concrete flexural member using the FRP rebar. However, ACI 440.1R-06 applies the same strength decrease coeffient to all FRP rebars made of diverse materials. If the same strength decrease coefficient is applied to all FRP rebars, effect of increasing the reinforcement ratio and selection of FRP rebar will be considerably limited. In this regard, we are to propose the formula to calculate the bending strength decrease coefficient in consideration of change in characteristics of FRP rebar and L/D through the reliability analysis in this paper.

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Delayed-Onset Methicillin-Resistant Staphylococcus aureus Infection at 18 Months after Absorbable Plate Fixation for Zygomaticomaxillary Complex Fracture

  • Lee, Hyun Rok;Shin, Hea Kyeong;Lee, Dong Lark;Jung, Gyu Yong
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.229-232
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    • 2016
  • None of the reports of delayed infection mentioned a latent period exceeding 13 months. we report an infection that developed 18 months after implantation of an absorbable plate. A 16-year-old adolescent girl had undergone reduction and fixation with an absorbable plate for Lefort I and zygomaticomaxillary complex fractures 18 months prior at our hospital. In her most recent hospital visit as an outpatient, abscess was observed in periocular area. Computed tomography revealed sinusitis with an abscess above the infraorbital rim. Wound culture yielded methicillin-resistant Staphylococcus aureus. Despite conservative treatments, wound state did not improve. Therefore, our department decided to perform surgery. Absorbable plate had been mostly absorbed but remained a bit. Bony depression of infraorbital rim and mucosal exposure of maxillary sinus anterior wall were observed. After the surgery, the patient recovered. We believe that the reason the wound infection and sinusitis manifested at the same time is because of several factor such as alcohol abuse, smoking, and mucosal exposure of maxillary sinus anterior wall. Absorbable plate takes 9 months to 3 years to be completely absorbed, thus we suggest studies with a follow-up of at least 3 years be undertaken to determine the outcomes of patients with many risk factors.

Microstructure, Mechanical and Wear Properties of Hot-pressed $Si_3N_4-TiB_2$ Composite

  • Kim, Hyun-Jin;Lee, Soo-Whon;Tadachika Nakayama;Koichi Niihara
    • The Korean Journal of Ceramics
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    • v.5 no.4
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    • pp.324-330
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    • 1999
  • $Si_3N_4$-$TiB_2$ with 2 wt% $Al_2O_3$ and 4 wt% $Y_2O_3$ additives was hot pressed in a flowing $N_2$ environment with varying $TiB_2$ content from 10 to 50 vol%. Variations of mechanical (hardness, fracture toughness, and flexual strength), and tribological properties as a function of $TiB_2$ content were investigated. As the content of $TiB_2$ increased, relative density decreased due to the chemical reaction of $TiB_2$in $N_2$ environment. The reduction of density causes mechanical properties to be degraded with an increase of $TiB_2$ in $Si_3N_4$. Tribological properties were dependent of microstructure as well as mechanical properties, however, they were degraded strongly by the chemical reaction of $Si_3N_4$-$TiB_2$ during hot pressing in $N_2$ environment. SEM and TEM observations, and X-ray diffraction analysis that the chemical reaction products at the interface are TiCN, Si, and $SiO_2$. Also, the comparison of XRD patterns of the $Si_3N_4$-40 vol% $TiB_2$ composites hot pressed at $1,750^{\circ}C$ for 1 hour between in $N_2$ and in Ar gas was made. The XRD peaks of Si and $SiO_2$ were not found in Ar, but still a weak peak of TiCN was presented.

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The Size of Calcaneus in Koreans (한국인의 종골 크기)

  • Kim, Jin-Su;Cho, Hun-Ki;Hwang, Sae-Min;Lee, Keun-Woo;Young, Ki-Won;Lee, Kyung-Tai
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.143-149
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    • 2013
  • Purpose: Open reduction and internal fixation of calcaneal fracture using plate has been used. While numerous plates have been manufactured, most of the conventional plates are designed for westerners, realistically the size is larger for Korean. The domestic products, on the other hand, often have the undesirable screw holes and path. Therefore, we measured the radiologic parameter of Korean calcaneus for providing the plate and screw hole placements. Materials and Methods: We measured the outer lines and angles with over the 20 years old 291 females and 322 males. A: Length of inferior plane of calcaneus, B: Length of anterior plane of calcaneus, C: Length from line A to sinus tarsi, D: Length from line A to posterior point of posterior facet, E: Length from line A to calcaneal tuberosity, F: Length of posterior facet, G: Length from anterior point of line A to C, H: Length from line C to line D, a: Angle between A and B, b: Gissane angle, c: Bohler angle, d: Calcaneal pitch angle using Marosis m-view$^{(R)}$. Results: Mean A, B, C, D, E, F, G, H were 63.6, 26.4, 23.2, 43.7, 40.5, 26.9, 12.8, 18.1 mm. Mean a, b, c, d angle were 105.8, 122.4, 32.4, $20.5^{\circ}$. Male's calcaneus is significantly bigger than female's (p<0.001). Conclusion: AP calcaneus length 63.6 mm, maximal height 43.7 mm is considered to be helpful in making the Korean calcaneal plate.

Three-dimensional FE analysis of headed stud anchors exposed to fire

  • Ozbolt, Josko;Koxar, Ivica;Eligehausen, Rolf;Periskic, Goran
    • Computers and Concrete
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    • v.2 no.4
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    • pp.249-266
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    • 2005
  • In the present paper a transient three-dimensional thermo-mechanical model for concrete is presented. For given boundary conditions, temperature distribution is calculated by employing a three-dimensional transient thermal finite element analysis. Thermal properties of concrete are assumed to be constant and independent of the stress-strain distribution. In the thermo-mechanical model for concrete the total strain tensor is decomposed into pure mechanical strain, free thermal strain and load induced thermal strain. The mechanical strain is calculated by using temperature dependent microplane model for concrete (O$\check{z}$bolt, et al. 2001). The dependency of the macroscopic concrete properties (Young's modulus, tensile and compressive strengths and fracture energy) on temperature is based on the available experimental database. The stress independent free thermal strain is calculated according to the proposal of Nielsen, et al. (2001). The load induced thermal strain is obtained by employing the biparabolic model, which was recently proposed by Nielsen, et al. (2004). It is assumed that the total load induced thermal strain is irrecoverable, i.e., creep component is neglected. The model is implemented into a three-dimensional FE code. The performance of headed stud anchors exposed to fire was studied. Three-dimensional transient thermal FE analysis was carried out for three embedment depths and for four thermal loading histories. The results of the analysis show that the resistance of anchors can be significantly reduced if they are exposed to fire. The largest reduction of the load capacity was obtained for anchors with relatively small embedment depths. The numerical results agree well with the available experimental evidence.

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

  • Altintas, Burak;Yildiz, Fatih;Uzer, Gokcer;Kapicioglu, Mehmet;Bilsel, Kerem
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.59-67
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    • 2017
  • Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

Analysis of Thermo-Acoustic Emission from Damage in Composite Laminates under Thermal Cyclic Loading (열하중을 받는 복합재료 적층판의 손상에 대한 열-음향방출해석)

  • Kim, Young-Bok;Min, Dae-Hong;Lee, Deok-Bo;Choi, Nak-Sam
    • Journal of the Korean Society for Nondestructive Testing
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    • v.21 no.3
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    • pp.261-268
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    • 2001
  • An investigation on nondestructive evaluation of thermal stress-nduced damage in the composite laminates (3mm in thickness and $[+45_6/-45_6]_s$ lay-up angles) has been performed using the thermo-acoustic emission technique. Reduction of thermo-AE events due to repetitive thermal load cycles showed a Kaiser effect. An analysis of the thermo-AE behavior determined the stress free temperature of composite laminates. Fiber fracture and matrix cracks were observed using the optical microscopy, scanning electron microscopy and ultrasonic C-sean. Short-Time Fourier Transform of thermo-AE signals offered the time-frequency characteristics which might classily the thermo-AE as three different types to estimate the damage processes of the composites.

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