• Journal of Trauma and Injury
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• v.37 no.2
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• pp.161-165
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• 2024

Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.234-239
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• 2018

Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

• The Korean Journal of Emergency Medical Services
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• v.20 no.1
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• pp.7-15
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• 2016

Purpose: There are few studies on the quality of cardiopulmonary resuscitation (CPR) performed by a single rescuer using a bag-valve-mask device. The aim of this study is to compare CPR quality outcomes according to the rescuer's position or mask fixation grip method and to determine the optimal means of achieving therapeutic goals. Methods: The three CPR methods were defined as over-the-head, lateral-superior, and lateral-inferior, depending on the rescuer's position or mask fixation hand placement. CPR quality was estimated for 83 paramedic students who performed 5 minutes of CPR in a randomized sequence on a manikin using each of the three methods. Results: The over-the-head method showed no advantage for cardiac compression and ventilation quality, but minimized the rescuer's fatigue score. Conclusion: In contrast to previous studies or prevailing beliefs, the lateral-superior position is optimal for achieving therapeutic goals with moderate or minimal rescuer fatigue.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.1
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• pp.30-36
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• 2014

There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.99-103
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• 2011

Purpose: Head movement during brain perfusion SPECT (Diamox) scan is a one of important issues which decreases image quality. It also causes repeated scans. This study was designed to evaluate variable factors causing scan failures. Materials and Methods: 676 patients (359 men, 317 women, age average $54.5{\pm}18.4$) for brain perfusion SPECT (Diamox) scan from March, 2010 to Feb. 2011 were used as a subject. Age data and the kind of disease(Moyamoya disease (MMD), None moyamoya disease (NMMD), Cerebral infarction (CI)), test performance outcome (success,failure) were collected. The head movement factors(gender, disease, age, head fixation device) were evaluated by chi-square test and logistic regression analysis Results: The result showed that men had higher scan failure rate than women. Seniors in seventies(men 3.4%, women 1.5%) showed the most highest failure rate. Using head fixation device increased scan success rate up to 94.4~97.7%. The scan success rate is dependent upon gender, head fixation device by chi-square test(${\chi}^2$=3.8 (df=1, p<0.05), ${\chi}^2$=10.4 (df=1, p<0.001)) Gender, disease(CI), head fixation device showed very effective result in logistic regression analysis.(Wald=3.3 (p<0.07), Wald=3.7 (p<0.05), Wald=9.3 (p<0.05) Conclusion: It is demonstrated that gender, disease, using head fixation device is statistically very useful factors. Especially, head fixation device is a main key minimizing repeated scan.

• Asian Spine Journal
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• v.12 no.6
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• pp.1053-1059
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• 2018

Study Design: Retrospective review. Purpose: To detect the effect of cannulated (poly-axial head) and solid (mono-axial head) screws on the local kyphotic angle, vertebral body height, and superior and inferior angles between the screw and the rod in the surgical management of thoracolumbar fractures. Overview of Literature: Biomechanics studies showed that the ultimate load, yield strength, and cycles to failure were significantly lower with cannulated (poly-axial head) pedicle comparing to solid core (mono-axial head). Methods: The medical charts of patients with thoracolumbar fractures who underwent pedicle screw fixation with cannulated or solid pedicle screws were retrospectively reviewed; the subjects were followed up from January 2011 to December 2015. Results: Total 178 patients (average age, $36.1{\pm}12.4years$; men, 142 [84.3%]; women, 28 [15.7%]) with thoracolumbar fractures who underwent surgery and were followed up at Hamad Medical Corporation were classified, based on the screw type as those with cannulated screws and those with solid screws. The most commonly affected level was L1, followed by L2 and D12. Surgical correction of the local kyphotic angle was significantly different in the groups; however, there was no significant difference in the loss of correction of the local kyphotic angle of the groups. Surgical correction of the reduction in the vertebral body height showed statistical significance, while the average loss of correction in the reduction of the vertebral body height was not significantly different. The measurement of the angles made by the screws on the rods was not significantly different between the cannulated (poly-axial head) and solid (mono-axial head) screw groups. Conclusions: Solid screws were superior in terms of providing increased correction of the kyphotic angle and height of the fractured vertebra than the cannulated screws; however, no difference was noted between the screws in the maintenance of the superior and inferior angles of the screw with the rod.

• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.345-349
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• 2005

Objective: Anterior screw fixation provides the best anatomical and functional results for type II odontoid process fracture (type II-A, II-N, and II-P) with intact transverse ligament. The purpose of this study is to evaluate the usefulness of the 4.5mm diameter, cannulated Herbert screw in anterior screw fixation. Methods: From Jan. 2003 to Feb. 2004, consecutive 10cases of type II odontoid process fractures were treated with anterior screw fixation using a Herbert screw. The Herbert screw has double threads, with different pitches on the distal and proximal ends. It has no head, so it can be inserted through articular cartilage and buried below bone surface. It was originally developed for treating scaphoid fractures. Results: There were 8male and 2female patients whose ages ranged from 15 to 67years (mean 42.1years). The fracture type was type II-A in 4patients, II-N in 3 patients, and II-P in 3 patients. The fracture line was oblique downward and backward in 6cases, oblique downward and forward in 1 case, and horizontal in 3cases. The range of follow-up was 5 to 18months (mean 12months). Bone fusions were achieved in all cases without any instrumental failures or postoperative complications. Conclusion: The Herbert screw is very useful in anterior fixation for type II odontoid process fracture. This series showed successful results also in type II-A odontoid fracture when treated with the Herbert screw, but further more studies are required.

• Journal of Veterinary Clinics
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• v.24 no.4
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• pp.631-635
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• 2007

Luxation of the hip is the most common luxation seen in small animals. Luxations are classified by the direction in which the femoral head lies in relation to the acetabulum and craniodorsal luxations are the most common type. Recommendations for treatment are based on the presence of preexisting disease, the type and duration of luxation and severity of concurrent injuries. In this study modified external skeletal fixation was used for craniodorsal coxofemoral luxation in 5 dogs. Luxated head Joint was reduced and fixator pins were applied into the greater trochanter, the middle point of iliac body and the lateral surface of sacroiliac joint in a closed fashion. Reduction was successful in 4 of the 5 operated limbs. Complications noted in this study included pin tract drainage, pin loosening and secondary fracture at the pin insertion site.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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• pp.442-446
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• 2001

Purpose : This study evaluated clinical and radiographic results after open reduction and lag-screw fixation of mandibular condyle fractures. Patients and Methods : 26 patients had been treated by lag-screw fixation for madibular condyle fracures via submandibular approach and follow up for over 6 months. The lag-screw used in this study was designed by Eckelt. Results : Radiographically, resorption of the condyle head found in 4 cases (15%) and minimal displacement of the condyle head was found in 3 cases (12%). Post-operative infection were not found in all cases. Clinically, All patiens had a stable occlusion and normal mouth opening (over 40mm). TMD problems with crepitus or some discomfort encountered in 4 patients but tolerable to the patients. Conclusion : Lag screw fixation can be a good option especially high level condylar fractures, however this procedure must be used in cautiously because of slipping of the fragments and possible to resorption of the fragments.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.95-99
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• 1991

Several authors have proposed techniques and devices by which the correct position of the proximal segment can be maintained both during fixation and postoperatively. Schendel, Epker, Lake, Worms, Ive and Poulton have been discussed the problem of condylar distration in mandibular orthognathic surgery. This study described have showed the some advantages forward repositioning of the condyle head in vertical ramus osteotomy which used with the Mini-Hoffmann sets in external skeletal pin fixation extraorally in 19 cases.