• Title/Summary/Keyword: Head fixation

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Results of radial head resection after Mason type 3 or 4 fracture of the elbow

  • Mebouinz, Ferdinand Nyankoue;Kasse, Amadou;Sy, Mouhamadou Habib
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.131-135
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    • 2020
  • Background: Resection of the radial head is a surgical indication for comminuted radial head fracture in which internal fixation is inaccessible. Some complications from the surgery can alter the function of the patient's elbow. The objective of this study was to assess functional outcome of the elbow after resection of the radial head. Methods: A retrospective longitudinal study was performed with patients who underwent radial head resection between 2008 and 2018. Elbow function was assessed by the Mayo Elbow Performance Index (MEPI) for 11 patients comprising three women and eight men. The mean follow-up was 47.6 months. The mean age was 41±10.3 years. Results: Nine patients had a stable and painless elbow. The mean extension-flexion arc was 97.73°±16.03°. The mean values of pronation and supination were 76.8° and 74.5°, respectively. The mean MEPI score was 83.2 points, and restoration of overall function was achieved in 81% of the cases. Poor function was noted in one in 10 that presented with a terrible triad. Conclusions: Resection of the radial head restored elbow functionality at a rate of 81%, which was a good outcome for patients.

Broken Mayfield Head Clamp

  • Lee, Tae-Hoon;Kim, Sang-Jin;Cho, Do-Sang
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.306-308
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    • 2009
  • The Mayfield head clamp is the most frequently used head clamp system in the field of neurosurgery. In many cases, surgery is performed with complete reliance on the safety of the MHC. However, we experienced an extremely rare case in which the MHC accidentally broke while installing this system for immobilization of the head and neck. This is a case report with a brief review of the literature. The patient was a 58-year-old female who was scheduled to undergo cervical laminoplasty under the diagnosis of degenerative spondylotic cervical stenosis. In an attempt to install an MHC, we fixed three pins in the scalp; however, the arm of the MHC system broke when force was applied from both directions. Fortunately, the patient remained in a stable position and did not sustain an injury to the head or neck. Fixation was performed using another MHC, and the surgery was performed successfully. The patient was discharged after surgery with no specific complications related to the MHC system. The authors experienced an extremely rare case of MHC breakage during application and report the importance of properly managing and maintaining the instruments in order to prevent fatal injury.

Development of A Fractionated Stereotactic Radiotherapy System (분할 정위방사선 치료 시스템 개발 연구)

  • 이동한;지영훈;이동훈;조철구;김미숙;유형준;류성렬
    • Progress in Medical Physics
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    • v.13 no.1
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    • pp.9-14
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    • 2002
  • We invented the newly developed Fractionated Stereotactic Radiotherapy(F.S.R.T) system using combined techniques of couch mounting and pedestal mounting system. Head fixation frame consists of a milled alluminium alloy(duralumin) and is placed to the couch. This frame immobilized patient head using the dental bite, 3.2 mm frontal and occipital thermoplastic mask. To evaluate the coordinate of target isocenter, Brown-Revert-Walls C.T localizer can be attached to this frame. And also, we developed the frame mounting system by developing the modification of pedestal mounting system. This system is fixed to couch floor and can be used to evaluate the isocenteric accuracy of gantry, couch and collimator in Q.A procedure. In order to measure the relocation accuracy, the acrylic phantom and the accurate pointers have been made. The repositioning of the targets in the phantom were estimated by comparing C.T coordinates and E.C.L portal films taken with anterior-posterior and right-left direction. From the results of experiments, the average distance errors between the target isocenter and its mean position were 0.71$\pm$0.19 for lateral, 0.45$\pm$0.15 for inferior-superior, 0.63$\pm$0.18 for anterior-posterior. And the maximum distance error was less than 1.3 mm. The new head fixation frame and frame mounting system were non-invasive, accurately relocatable, easy to use, very light and well tolerable by the results of phantom tests. The major advantage of using this frame mounting system is complete access to any point in the Patients cranium especially posterior direction

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Operative Treatment of Unstable Fracture of the Proximal Humerus (상완골 근위부 불안정성 골절의 수술적 치료)

  • Kim Young-Kyu;Jang Young-Hun;Kim Keon-Beom
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.198-204
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    • 1998
  • Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

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A Case of Interarytenoid Scar Disguising Bilateral Vocal Cord Palsy (양측성 성대 마비로 오인된 피열간 반흔 1예)

  • Shin, Dong-Hyuk;Kim, Yong Won;Lee, Yongsik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.1
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    • pp.36-38
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    • 2014
  • The patient suffered cardiac arrest 8 months before presentation. She has been suffering hoarseness and exertional dyspnea and nocturnal stridor. Upon flexible laryngoscopy, her vocal cords showed no motion and fixed in paramedian position. There was no causal finding on neck CT. EMG showed some muscular activity. Under the suspicion of crico arytenoid fixation, we performed suspension laryngoscopy, and found the arytenoid cartilage was fixed with short and stout scar, which was removed with scissors. Just after surgery she regained her voice and respiration.

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Unusual Isolated Complete Tear of Subscapularis and Biceps Long Head Tendon Associated with Heterotopic Ossification

  • Sohn, Hoon-Sang;Baek, Duck In;Shon, Min Soo
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.127-133
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    • 2014
  • Heterotopic ossification (HO) within the substance of the subscapularis tendon is a rare lesion which remains a poorly described condition with little known of the exact mechanisms involved. Furthermore, its clinical importance remains still unclear. To our knowledge, there are no studies present to data regarding HO within the substance of the subscapularis tendon, even with resultant isolated complete tear of the subscapularis tendon. Here we present a case of huge HO associated with unusual isolated complete tear of subscapularis tendon concomitant with tear of biceps long head tendon. After arthroscopic debridement for the complete tear site of biceps long head tendon, mini-open excision of the ossification and subscapularis repair with suture anchor fixation were performed. The patient showed complete recovery of strength and function of the subscapularis at subsequent 24 months follow up.

Analysis of Criteria Regarding Frontal and Side Impacts of Wheelchair Occupant in Vehicle by Computer Simulation Method (컴퓨터 시뮬레이션 방법을 이용한 휠체어 탑재 차량의 전방/측방충돌 시 휠체어 탑승자의 위험도 분석)

  • Kim, S.M.;Lee, M.P.;Park, S.Y.
    • Journal of Biomedical Engineering Research
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    • v.27 no.6
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    • pp.365-369
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    • 2006
  • According to the IIHS (Insurance Institute fur Highway Safety), side impacts are made up 30% of all accidents (reported 1998). In the case of auto accidents, head and neck injuries were most common as 58%, injuries to the body's trunk equaled 32%, and injuries to the abdomen were 21%. Therefore in this study, injury of wheelchair occupant in frontal and side impact of wheelchair loaded vehicle was analyzed using computer simulation method. The occupant was restrained at the rear of wheelchair by the lap belt. The detailed fixation and restrain conditions of the wheelchair occupant are referred to SAR J2249's recommendation. We estimated HIC(Head Injury Criteria) and HNIC (Head and Neck Injury Criteria) based on measured data.

Single oblique osteotomy for correction of congenital radial head luxation with concurrent complex angular limb deformity in a dog: a case report

  • Kim, Junhyung;Song, Jaeyong;Kim, Sun-Young;Kang, Byung-Jae
    • Journal of Veterinary Science
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    • v.21 no.4
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    • pp.62.1-62.7
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    • 2020
  • A 5-month old Shih Tzu was diagnosed with congenital elbow luxation and uniapical complex angular deformity of the radius. Single radial oblique and dynamic ulnar osteotomies were performed, using patient-specific 3D-printed osteotomy guide. External skeletal fixation was maintained for three weeks to prevent re-luxation of elbow joint. Three months after the surgery, objective gait analysis indicated markedly improved limb function. In addition, radiograph showed improved congruity of elbow joint and appropriate bone healing. In dogs with congenital radial head luxation and concurrent complex angular deformity, a single oblique osteotomy might be a viable option to preserve bone length and correct the luxation of elbow joint.

TWO PART MINI-IMPLANT AS AN EFFICIENT TOOL FOR INTERMAXILLARY FIXATION (분리형 미니 임플란트를 이용한 효과적인 악간고정법의 소개)

  • Lee, Won;Kim, In-Soo;Seo, Woon-Kyung;Heo, Hyun-A;Kim, Seong-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.5
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    • pp.477-482
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    • 2006
  • The new type of orthodontic mini-implant named C-implant can be an effective alternative to conventional one-component mini-implant in the intermaxillary fixation (IMF) cases because of its particular design. The small size, two-part design, efficiency, and low cost of the C-implant make it applicable to various types of IMF cases easily such as fracture reduction and orthognathic surgery. The two part design resists highly to the fracture or deformation during implantation and removal. The long span head allows the patient to easily attach intermaxillary elastics, so that the patient can apply intermaxillary elastics for traction easily. Through this article, we tried to show the possibility of this appliance as a good adjunct for the IMF screw.

A Case Report of Head and Neck Neurofibroma Cured with Transitional Flap (국소피판으로 치료한 $6{\times}7cm$ 크기의 두경부 신경섬유종 1례)

  • Do Jae-Woon;Park Sang-Woo;Jeong Joon-Hun;Kang Tae-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.1
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    • pp.36-39
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    • 2006
  • The Neurofibroma is a benign neoplasm originating from neural tissue such as Schwann cell, fibroblast and peripheral fibroblast, which rarely converts to malignancy. About 25-45% of neurofibroma are located in head and neck, and the most common sites are lateral cervical region and mouth. Because of its high vascularity and invasion to the adjacent organs, surgical resection may be confronted and limited, moreover large neurofibroma can cause large defect that needs various kinds of flap. The factors related to clinically suspected malignancy are painlessness, abrupt increase in size, firm fixation, and central ulceration, although the malignancy rate of neurofibroma is low. The complete resection was failed several times at local clinic, the patient was transferred to our hospital. We have successfully removed the retroauricular neurofibroma using transposition flap & free skin graft on its large defects.