• 제목/요약/키워드: Head fixation

검색결과 147건 처리시간 0.021초

Cement Augmentation of Dynamic Hip Screw to Prevent Screw Cut Out in Osteoporotic Patients with Intertrochanteric Fractures: A Case Series

  • Rai, Avinash Kumar;Goel, Rajesh;Bhatia, Chirag;Singh, Sumer;Thalanki, Srikiran;Gondane, Ashwin
    • Hip & pelvis
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    • 제30권4호
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    • pp.269-275
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    • 2018
  • Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson's scoring system. Results: More patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be $-2.506{\pm}0.22$ (mean${\pm}$standard deviation); all patients were within the range of -2.0 to -2.8. The duration of radiological union was $13.67{\pm}1.77$ weeks. Salvati and Wilson's scoring at 12 months of follow up was $30.96{\pm}4.97$. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out. Conclusion: Bone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.

The Treatment of Gunshot Wound with Maxillofacial Fracture in a Dog

  • Kim, Young-ung;Lee, Dong-bin;Heo, Su-young;Kim, Nam-soo
    • 한국임상수의학회지
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    • 제35권5호
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    • pp.215-217
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    • 2018
  • A one-year-old, intact male, 24 kg, mixed breed dog was referred to the Animal Medical Center, Iksan, Chonbuk, Korea for treatment of a gunshot wound to the head. Physical examinations revealed bilateral nasal bleeding and open-mouth breathing. Radiographic examination showed fracture of the right maxilla bone and multiple fractures of the nasal bone. A $1cm{\times}1cm{\times}1.8cm$ region of mineral opacity material was observed in the right-cranial ventralnasal cavity and a $6mm{\times}6mm{\times}9mm$ region of mineral opacity material was present in the left-cranial dorsal-nasal cavity. The surgical procedure involved removal of bone fragments and the lodged bullet as well as the installation of three intraosseous wires. At two weeks after surgery, the patient exhibited no complications and had a good prognosis.

흉골 골절에 대한 임상적 고찰 (A Clinical Observation of the Traumatic Sternal Fracture)

  • 심재영
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.916-921
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    • 1990
  • Clinical observations were performed on 17 cases of the traumatic sternal fracture, those were admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 6 years 5months period from January 1983 to May 1989. Obtained results were as follows: 1. The frequency was about 4.8% of the nonpenetrating chest trauma. 2. The ratio of male to female was 16: 1 in male predominance and age distribution was from 24 to 62 years old. 3. The common cause were high decelerating injury [impact of the steering column] and falling down[more than 3 m in high]. 4. The most common fracture site was sternal body and next was sternomanubrial junction. 5. Associated intrathoracic organ injuries were cardiac contusion [6 cases], hemopneumothorax[1 Case], mediastinal bleeding[1 case], and thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture, and long bone fracture. 6. Abnormal EGG findings were sinus bradycardia[1 case], bundle branch block [2 cases], and sinus tachycardia[3 cases]. 7. The operative reduction and fixation was necessary in only one case and the others were treated with conservative treatment.

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하악골 비대칭 환자의 양측성 하악골 시상분할 골절단술 후 하악과두의 위치 변화 (POSTOPERATIVE POSITIONAL CHANGE OF CONDYLE AFTER BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY ASSOCIATED WITH MANDIBULAR ASYMMETRY)

  • 이성근;김경욱;김철환
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권5호
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    • pp.359-367
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    • 2004
  • Purpose: After the surgical correction with sagittal split ramus osteotomy, the position of the mandibular condyle in the glenoid fossa and the proximal segment of the mandible change because of bony gap between proximal and distal segment, especially in case of mandibular setback asymmetrically. In this study, positional changes in the condyle and proximal segment after BSSRO were estimated in the mandibular asymmetry patient by analyzing the in submentovertex view and P-A cephalogram for identification of ideal condylar position during surgery. Patients and Methods: The 20 patients were selected randomly who visit Dankook Dental Hospital for mandibular asymmetry. Bilateral sagittal split ramus osteotomy with rigid fixation was performed and P-A cephalogram and submentovertex view was taken at the time of preoperative, immediate postoperative, 3 month postoperative period. Results: Intercondylar length and transverse condylar angle was increased due to inward rotation of proximal segment and anteromedial rotation of lateral pole of condyle head. The condylar position had a tendency to return to the preoperative state and after 3 months return up to about half of the immediate post-operative changes, and all the results showed more changes in asymmetry patient and deviated part of the mandible. Conclusion: Based on all these results above, surgeon should make efforts to have a precise preoperative analysis and to have a ideal condylar position during rigid fixation after BSSRO.

Management of Unilateral Facet Dislocation of the Cervical Spine

  • Baek, Geum-Seong;Lee, Woo-Jong;Koh, Eun-Jeong;Choi, Ha-Young;Eun, Jong-Pil
    • Journal of Korean Neurosurgical Society
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    • 제41권5호
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    • pp.295-300
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    • 2007
  • Objective : Unilateral facet dislocation of the cervical spine occurs by flexion and rotation injuries and cannot be easily reduced by axial traction. We analyzed 14 consecutive patients with unilateral facet dislocation of the cervical spine to increase knowledge about anatomical reduction of locked facet and factors for successful reduction. Methods : Fourteen patients [10 men and 4 women] with unilateral facet dislocation of the cervical spine were retrospectively analyzed. Plain X-ray, computerized tomography scan, and magnetic resonance imaging were performed. All patients underwent manual reduction and surgery with anterior interbody fusion and plate fixation. The manual reduction was performed by neck flexion and rotation to the opposite side of dislocation, followed by rotation and flexion of the head toward the side of dislocation and extension with relaxation of traction. Mean follow-up period was 17 months. The level of spine, amount of subluxation, combined facet fracture, and time from injury to initial reduction were analyzed using the data obtained from medical records. Results : Thirteen [93%] patients were reduced successfully. Immediate reduction was achieved in 7 patients but failed in 7 patients. Seven patients underwent delayed closed reduction under general anesthesia, and successful reduction was achieved in 6 patients. Only one patient with bone chips between articular facets failed to achieve anatomical reduction. Conclusion : In order to reduce the locked facet more easily and safely, we recommend manipulative traction with anterior interbody fusion and plate fixation under general anesthesia after being aware of spinal cord injury with magnetic resonance imaging.

군견 안부위에 기생한 동양안충에 대한 주사전자현미경적 관찰 소견 (Scanning Electron Microscopy of Thelazia callipaeda Railliet and Henry, 1910 in the Eye of a Dog)

  • Yong-Suk Ryang;Kyu-Je Lee;Dong-Hyun Lee;Yoon-Kyung Cho;Jee-Aee Im;Ju-Youn Park;Hee-Sang Han
    • 대한의생명과학회지
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    • 제5권1호
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    • pp.41-49
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    • 1999
  • 저자들은 1999년 5월에 경기도 남양주군 군부대에서 사육하고 있는 한 마리의 군견 오른쪽 안부 위에서 7마리 (암놈 4마리, 수놈 3마리)의 동양안충을 검출하였다. 이 중 일부는 고정과 lactophenol 액으로 봉입한 후 광학현미경으로 관찰하였으며 일부는 glutaraldehyde액 에 고정하여 주사전자현미경으로 관찰하였다. 충체의 암놈 및 수놈의 두부와 꼬리부위의 형태 특징 그리고 충체 표피의 각질, 암놈 음문의 위치 등을 관찰한 결과 동양안충으로 동정하였다.

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상완골 경부 이분 골절에서 T형 금속판을 이용한 치료 (Treatment of Two-Part Fracture of Humerus Neck Using T Plate Fixation)

  • 남일현;안길영;윤호현;김재철;문기혁
    • Clinics in Shoulder and Elbow
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    • 제9권1호
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    • pp.34-41
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    • 2006
  • Purpose: This study is to analyze the result and complications of internal fixation with T-plate for two-part fracture of the neck of the humerus. Materials and Methods: The clinical results of fourteen patients who had been performed with this method mentioned above were reviewed. Their average age was 49.6. Postoperative mean follow up period was 24.1 months. Radiological evaluation was done by Kronberg's and shoulder function by Neer's. Results: By Kronberg evaluation, nine cases were good, two cases acceptable and three cases poor. By Neer's, mean score of shoulder function was 77.6 and 4 cases were excellent, one satisfactory, five unsatisfactory and four failure. The complications were the sfiff shoulder, loss of reduction and avascular necrosis of humeral head. Conclusion: In this study, there were differences according to the age. And we obtained an unsatisfactory result in patients over 50 years old. We consider that in patients over 50 years old, the differences were due to the muscle weakness through wide surgical approaches, postoperative implant loosening or the stiffness caused by poor rehabilitation.

편도와 접근을 통한 측방인두간극 이물제거의 치험 증례 (REMOVAL OF FOREIGN BODY IN THE LATERAL PHARYNGEAL SPACE VIA TRANSTONSILLAR APPROACH)

  • 김성민;김한석;김지혁;권광준;박영욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권5호
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    • pp.567-571
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    • 2007
  • Lateral pharyngeal space is one of potential fascial planes of head and neck, that may become involved by various pathological processes, such as infection, inflammation and neoplasm. The calcified stylohyoid ligament with styloid process is also located in this space, so this space is more acquainted with Eagle's syndrome in oral and maxillofacial field. During the mandibular transbuccal fixation procedures of 29-year old female patient who had right condylar neck and left parasymphysis fracture, we had lost one 10.0 mm miniscrew. After confirming the location of the lost miniscrew from different angled plain skull radiographies, we tried to find it in the lateral pharyngeal space via transtonsillar approach at the time of plate removal operation. This case report is aimed to share our valuable experience of the effective approach way to the lateral pharyngeal space, which has many advantages, such as short operative time, minimal bleeding, fast post-operative recovery, and less morbidity. The related literature is also reviewed.

A Study of Evaluating Eye Movement Based on Ocular Motor Score for Children with Spastic Cerebral Palsy

  • Jeong, Seo-Young;Oh, Tae-Young
    • The Journal of Korean Physical Therapy
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    • 제32권6호
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    • pp.341-347
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    • 2020
  • Purpose: The purpose of this study is to introduce a tool for evaluating eye movement and analyze the reliability of measurement based on 10 cases of evaluating the oculomotor function of children with spastic cerebral palsy Methods: The participants were selected by 6 medical and welfare institutions in Busan as GMFCS grade 1-3 among spastic diplegia and hemiplegia. Seven examiners evaluated 3 children for the evaluation of inter-rater agreement of Ocular Motor Score (OMS) and evaluated the condition of the ocular motor of 10 children using OMS, a re-examination was performed at six weeks after the initial examination. SPSS ver.25.0 was used to calculate the interclass correlation coefficient and Wilcoxon's signed-rank test, Mann Whitney-U test. Results: The inter-rater agreement of OMS was 0.89. Second mean values were decreased compared first examination in motility/ductions/version, saccades and smooth pursuit, but there was no significant difference. Children under 6 years old had a high mean value of saccades in first examination and the motility/ductions/version, fixation, saccades in second examination, but there was no significant difference. Spastic diplegia children's mean values were higher in head posture, fixation in 8 gaze directions than hemiplegia children in both first and second examination, but there were no significant differences. Conclusion: Ocular motor function in 10 children of spastic children who participated in the study and could see that the scores was differed depending on age, type, grade of cerebral palsy. OMS may be available for this purpose.

자기공명영상검사장비의 세균오염도 측정 및 소독에 관한 연구 (A Study on the Measurement of Bacterial Contamination of MRI Examination Equipment and Disinfection Conditions)

  • 정성운;임청환;유인규
    • 디지털융복합연구
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    • 제11권12호
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    • pp.665-672
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    • 2013
  • 영상의학과에는 다양한 질병을 가진 환자들이 검사를 받는 곳으로 병원감염의 교차 오염이 될 가능성이 큰 부서이다. 특히 자기공명영상(MRI)검사는 다른 검사에 비해 검사시간이 오래 걸려 교차오염에 더욱더 노출이 될 수 있다. 이에 본 연구는 MRI검사장비의 소독실태를 파악하고, 환자와 접촉이 가장 많은 Head coil, 환자 고정용 Block, 밀폐된 공간인 Bore에서의 세균분포도를 파악 하였다. MRI 검사장비의 소독실태는 MRI실 근무자 150명을 대상으로 설문을 실시하였으며, 세균분포의 파악은 10 곳의 의료기관에서 측정하였다. MRI 장비의 세균 분포도결과 Staphylococcus, 등의 다양한 세균들이 발견되었다. MRI실 소독실태 파악결과 Head coil, Block, Bore의 소독은 잘 시행되는 것으로 나타났으며, 소독의 시기는 아침에 1회 소독을 가장 많이 시행 하는 것으로 나타났다. 또한 감염관리자에 따른 소독의 유, 무와 소독의 시기에서는 MRI실 검사자가 감염관리 할 때 잘 시행되는 것으로 나타났다. 환자를 검사한 후 교차오염을 방지하기 위하여 바로 적절한 소독제로 소독을 실시하여 교차오염을 방지하여야 할 것이다.