• Title/Summary/Keyword: Head fixation

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Dorsal Wedge Osteotomy Using Bioabsorbable Pins for the Treatment of Freiberg's Disease (중족골두 무혈성 괴사에서 생체흡수성 핀으로 고정한 배측 쐐기 절골술)

  • Gong, Hyun-Sik;Baek, Goo-Hyun;Kim, Ji-Hyeong;Chung, Moon-Sang
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.59-63
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    • 2005
  • Purpose: To present the procedure and results of dorsal wedge osteotomy fixated by bioabsorbable polyglycolide pins for the treatment of symptomatic Freiberg's disease. Materials and Methods: From January 1997 to December 2002, six patients with Freiberg's disease underwent dorsal wedge osteotomy of the metatarsal neck to bring the healthy plantar part of the metatarsal head into articulation. Bioabsorbable polyglycolide pins were used for the fixation and short-leg walking cast was applied for 4 weeks. Results: All patients returned to full daily activities without pain in three months after the operation. Radiographically, solid healing of the osteotomy was observed at average ten weeks. The active range of motion of the metatarsophalangeal joint increased by a mean gain of 30 degrees, and no complication such as displacement, osteolysis or sinus formation was observed. Conclusion: Dorsal wedge osteotomy fixated by bioabsorbable pins for patients with symptomatic Freiberg's disease is effective procedure that provides relatively early range of motion exercise and avoids second procedure for implant removal.

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Design of Performance Evaluation System and Measurement of Dynamic Behavior for Fluid Hydrodynamic Bearing in HDD (HDD용 유체동압베어링 성능평가 시스템 설계 및 동적거동 측정)

  • Kang, Jung-Woo;Lee, Tae-Whi;Lee, Hyoung-Wook;Park, Sung-Jun
    • Journal of the Korean Society for Precision Engineering
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    • v.28 no.10
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    • pp.1159-1165
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    • 2011
  • The recording density of HDD is increasing in ratio of 100% each year. Because the increasing of recording density requires the feature of high rotation, fixation and low-noise, fluid hydrodynamic bearing(FDB) has been paid attention to overcome a limitation in ball bearing. Most of researches related to improving performance of FDB have been studied in Japan which has 80% more market share of HDD spindle motor assembly. Main subject of studies are about for the design of the groove shape, manufacturing process of fluid dynamic bearing, performance evaluation and measurement. In HDD, non-repeatable runout(NRRO) is most important parameter which determines the performance of HDD spindle system because NRRO is unpredictable that cannot be compensated in head/slider servo system. In this study, performance evaluation system can measure dynamic behaviors were designed and methodology for calculating imbalance, RRO, and NRRO were proposed.

The necessity for education on endotracheal intubation through video laryngoscope - A focused on paramedic students - (비디오 후두경을 통한 기관내 삽관 교육의 필요성 - 응급구조과 학생을 중심으로 -)

  • Ham, Young-Lim;Kim, Jin-Hwa;Lee, Jae-Gook
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.1
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    • pp.7-17
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    • 2019
  • Purpose: The aim of this study was to verify the necessity of endotracheal intubation through video laryngoscope and to provide basic data to inform the provision of video laryngoscope education. Methods: Eighty paramedic students participated in this study. A survey was conducted from November 5, 2018 to December 7, 2018. Data were analyzed with independent t-tests, and the chi-squared test. Results: The video laryngoscope is a highly usable instrument that can easily be applied during training. The instrument provides better visual evaluation of the normal airway (p=.004), the airway in case of cervical collar and head fixation (p=.000), and the airway in case of tongue edema (p=.000). The time of endotracheal intubation in the normal airway was significantly less with the video laryngoscope compared with the direct laryngoscope. The success rate of tracheal intubation was significantly higher in the video laryngoscope group than in the direct laryngoscope. Conclusion: This study suggests the necessity of education on endotracheal intubation through video laryngoscope in the professional airway maintenance training course of emergency department students. The video laryngoscope is easier to apply than the direct laryngoscope in cases of intubation in various clinical situations.

Biomechanical investigation of arm position on deforming muscular forces in proximal humerus fractures

  • Christen E. Chalmers;David J. Wright;Nilay A. Patel;Hunter Hitchens;Michelle McGarry;Thay Q. Lee;John A. Scolaro
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.282-287
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    • 2022
  • Background: Muscular forces drive proximal humeral fracture deformity, yet it is unknown if arm position can help mitigate such forces. Our hypothesis was that glenohumeral abduction and humeral internal rotation decrease the pull of the supraspinatus and subscapularis muscles, minimizing varus fracture deformity. Methods: A medial wedge osteotomy was performed in eight cadaveric shoulders to simulate a two-part fracture. The specimens were tested on a custom shoulder testing system. Humeral head varus was measured following physiologic muscle loading at neutral and 20° humeral internal rotation at both 0° and 20° glenohumeral abduction. Results: There was a significant decrease in varus deformity caused by the subscapularis (p<0.05) at 20° abduction. Significantly increasing humeral internal rotation decreased varus deformity caused by the subscapularis (p<0.05) at both abduction angles and that caused by the supraspinatus (p<0.05) and infraspinatus (p<0.05) at 0° abduction only. Conclusions: Postoperative shoulder abduction and internal rotation can be protective against varus failure following proximal humeral fracture fixation as these positions decrease tension on the supraspinatus and subscapularis muscles. Use of a resting sling that places the shoulder in this position should be considered.

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

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Kim, Hyung-Jin;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.159-166
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    • 2009
  • Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

Evaluation of Setup When Using C-Rad System in Radiotherapy (방사선치료 시 C-Rad system을 이용한 셋업의 평가)

  • Park, Eun-Tae;Ko, Seong-Jin;Choi, Seok-Yoon;Kim, Jung-Hoon;Kim, Chang-Soo;Kim, Dong-Hyun;Kang, Se-Sik
    • The Journal of the Korea Contents Association
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    • v.12 no.5
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    • pp.303-310
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    • 2012
  • In radiotherapy, accurate patient positioning and set up are important factor that treatment can influence success. In generally, the 3-laser system is used when the patient set up. But today the body surface scanning system(C-Rad system) is trying to use. Compare and evaluate the C-Rad system and the 3-laser system to check availability. Head and neck that are no movement of internal organs and easy to apply fixation device are limited. Alderson Rando anthropomorphic phantom and 10 patients who have lesions of head and neck are targeted. C-RAD system's setup error mean and standard deviation are the X axis($0.55{\pm}0.51mm$), Y axis($-0.2mm{\pm}0.523mm$), Z axis($-0.85{\pm}0.587mm$) in the phantom study, and in the patient study X axis($-0.05{\pm}0.621mm$), Y axis($0.075{\pm}0.755mm$) Z axis($-1.025{\pm}0.617mm$). So C-RAD system is better than 3-laser system mostly, but C-RAD system's error rate is a little worse than 3-laser system in the Z axis. When radiation treatment of head and neck, body surface contour scanning system contribute to correct positioning and minimize the set up error.

Influence of Fertilization Treatment using Organic Amendment based on Soil Testing on Plant Growth and Nutrient use Efficiency in Cabbage (토양검정에 의한 유기자원 시비처방이 양배추의 생육 및 양분이용효율에 미치는 영향)

  • Lim, Jin-Soo;Lee, Bang-Hyun;Kang, Seung-Hee;Lee, Tae-Guen
    • Korean Journal of Environmental Agriculture
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    • v.39 no.2
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    • pp.95-105
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    • 2020
  • BACKGROUND: In this study, in order to verify the effects of supplemented organic amendment fertilizers recommended by the soil testing on cabbages, we used various amounts of organic amendment fertilizers. The amount of organic amendment fertilizers was decided by calculating each ratio of inorganic nitrogen, phosphorus, and potassium based on the recommended fertilizer composition. METHODS AND RESULTS: The cabbages subjected to treatments 1 and 2 showed similar or greater leaf colors (SPAD values), head heights, head widths, head weight, soil organic matter content, nitrate-nitrogen level, and conductivity after harvest, when compared with cabbages treated with chemical fertilizers. The phosphorus and potassium fixation in the soil were higher in the plot where cabbages were treated with chemical fertilizers, and the nutrient use efficiency was greater in the plots with organic amendments and mineral addition. CONCLUSION: The treatments 1 and 2 that were supplemented with 180-200% of nitrogen, 100-130% of phosphorus, and 185-250% of potassium in comparison to chemical fertilizers, applied by the inorganic ratios of nitrogen, phosphorus, and potassium can be used as organic amendment fertilizers for cabbages.

Open versus closed treatment for extracapsular fracture of the mandibular condyle

  • Lee, Junyeong;Jung, Hee-Yeoung;Ryu, Jaeyoung;Jung, Seunggon;Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.5
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    • pp.303-308
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    • 2022
  • Objectives: Selection of treatment methods for mandibular condylar fractures remains controversial. In this study, we investigated treatment methods for condylar fractures to determine the indications for open or closed reduction. Patients and Methods: Patients >12 years of age treated for mandibular condylar fractures with a follow-up period of ≥3 months were included in this study. The medical records of enrolled patients were reviewed for sex, age, fracture site, treatment method (open or closed reconstruction), postoperative intermaxillary fixation period, operation time, and complications. Radiological analysis of fracture fragment displacement and changes in ramal height difference was performed using computed tomography and panoramic radiography. Results: A total of 198 patients was investigated, 48.0% (n=95) of whom underwent closed reduction and 52.0% (n=103) underwent open reduction. There was no significant correlation between reduction method and patient sex, age, or follow-up period. No statistically significant difference between the incidence of complications and treatment method was observed. None of the patients underwent open reduction of condylar head fracture. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. There was no statistically significant correlation between the groups and fracture fragment displacement. However, there was a significant difference between the treatment groups in amount of change in ramal height difference between the fractured and the non-fractured sides during treatment. Conclusion: No significant clinical differences were found between the open and closed reduction methods in patients with mandibular condylar fractures. According to fracture site, closed reduction was preferred for condyle head fractures. There was no significant relationship between fracture fragment displacement and treatment method.

Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years (65세 이상의 상완골 근위부 골절 환자에서 다축 각안정 잠김 압박 금속판을 이용한 내고정술)

  • Lee, Ki-Won;Choi, Young-Joon;Ahn, Hyung-Sun;Kim, Chung-Hwan;Hwang, Jae-Kwang;Kang, Jeong-Ho;Choo, Han-Ho;Park, Jun-Seok;Kim, Tae-Kyung
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.25-31
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    • 2012
  • Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

Effects of Screw Configuration on Biomechanical Stability during Extra-articular Complex Fracture Fixation of the Distal Femur Treated with Locking Compression Plate (잠김 금속판(LCP-DF)을 이용한 대퇴골 원위부의 관절외 복합골절 치료시 나사못 배열에 따른 생체역학적 안정성 분석)

  • Kwon, Gyeong-Je;Jo, Myoung-Lae;Oh, Jong-Keon;Lee, Sung-Jae
    • Journal of Biomedical Engineering Research
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    • v.31 no.3
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    • pp.199-209
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    • 2010
  • The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.