• Title/Summary/Keyword: Head fracture

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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.

Characteristics of temporomandibular joint structures after mandibular condyle fractures revealed by magnetic resonance imaging

  • Kim, Bong Chul;Lee, Yoon Chang;Cha, Hyung Seok;Lee, Sang-Hwy
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.24.1-24.7
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    • 2016
  • Background: This study aimed to evaluate the structural changes of temporomandibular joint immediately after condylar fractures with magnetic resonance imaging (MRI). Method: We evaluated 34 subjects of condylar fractures with MRI. The position, shape, and signal intensity of the condyle, disc, and retrodiscal tissue were analyzed with MR images. Results: Immediately after trauma, the disc was displaced with the fractured segment in almost all cases. And, the changes of signal intensity at the retrodiscal tissue were found but less related to the degree of fracture displacement. And, the high signals were observed almost at all fractured joint spaces and even at some contralateral joints. Conclusions: The displaced disc as well as the increased signal intensity of the joint space, condylar head, and retrodiscal tissue demands more attention to prevent the possible sequela of joint.

Iliac Bone Graft for Recurrent Posterior Shoulder Instability with Glenoid Bone Defect

  • Ko, Sang-Hun;Cho, Yun-Jae
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.190-193
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    • 2014
  • Recurrent posterior shoulder instability is a debilitating condition that is relatively uncommon, but its diagnosis in young adults is increasing in frequency. Several predisposing factors for this condition have been identified, such as the presence of an abnormal joint surface orientation, an osteochondral fracture of the humeral head or glenoid cavity, and a postero-inferior capsuloligamentary deficit, but their relative importance remains poorly understood. Whilst, conservative treatment is effective in cases of hyperlaxity or in the absence of bone abnormality, failure of conservative treatment means that open or arthroscopic surgery is required. In general, soft-tissue reconstructions are carried out in cases of capsulolabral lesions in which bone anatomy is normal, whereas bone grafts have been required in cases where posterior bony Bankart lesions, glenoid defects, or posterior glenoid dysplasia are present. However, a consensus on the exact management of posterior shoulder instability is yet to be reached, and published studies are few with weak evidence. In our study, we report the reconstruction of the glenoid using iliac bone graft in a patient suffering recurrent posterior shoulder instability with severe glenoid bone defect.

A Blunt Traumatic Vertebral Artery Injury: A Case Report

  • Lee, Min A;Choi, Kang Kook;Lee, Gil Jae;Yu, Byung Chul;Ma, Dae Sung;Jeon, Yang Bin;Chung, Min;Lee, Jung Nam
    • Journal of Trauma and Injury
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    • v.29 no.1
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    • pp.28-32
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    • 2016
  • Blunt traumatic vertebral artery injury (TVAI) is relatively rare, but it may frequently be associated with head and neck trauma. TVAI is difficult to diagnose with diverse outcomes, thus it is a clinical challenge. There are no widely accepted guidelines for treatment and diagnosis, so that the diagnosis of TVAI can be easily delayed. Therefore, any clinical suspicion from clues on the initial imaging is important for diagnosis of TVAI. The authors report on the case of a patient diagnosed as having a TVAI with a transverse foramen fracture.

Surgical Experience of Acute Traumatic Posterior Fossa Subdural Hematoma : Study of 6 Cases and Review of the Literatures

  • Park, Jong-Tae;Kim, Dae-Won
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.441-444
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    • 2006
  • Objective : The goal of this study is to evaluate the clinical results in six patients who underwent surgical decompression for the acute subdural hematomas[ASDH] of posterior cranial fossa. Methods : Six patients [five males and one female] who had undergone surgery for ASDH of posterior cranial fossa between 2000 and 2005, were evaluated retrospectively with regard to clinicoradiological findings and surgical outcomes. The mean age was 45.8 years [range $9{\sim}67\;years$]. Results : Preoperative computed tomography showed ASDH on cerebellar hemisphere in four patients and on midline in two. All patients had the associated lesions such as subarachnoid hemorrhage, epidural or subdural hematoma, intraventricular hemorrhage, contusion or pneumocephalus in supratentorial area. Fracture of occipital bone was noted in two patients. Of the four patients who had 13 to 15 of Glasgow coma scale score at the time of admission, three were deteriorated within 24 hours after trauma. Of these three patients, delayed subdural hematoma developed 1 hour after initial normal CT finding in one patient and increased in thickness in another one. Postoperative outcome showed good recovery in three patients and moderate disability in one. Two patients were expired. Conclusion : This study supports that early diagnosis based on strict observation and prompt surgery in the patients with ASDH in posterior fossa will lead to the best results.

CONDYLAR ANKYLOSIS : UNILATERAL POSTTRAUMATIC CONDYLAR PSEUDOANKYLOSIS (악관절 과두강직 : 편측성 과두강직을 동반한 안모비대칭 치료 증례)

  • Hong, Sung-Gyu;Hong, Sung-Joon
    • The korean journal of orthodontics
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    • v.23 no.3 s.42
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    • pp.427-445
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    • 1993
  • The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

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Reconstruction of the Extremity Injury using by Free Rectus Abdoninis Muscle or Myocutaneous Flap (유리 복직근 및 복직근피판술을 이용한 사지의 재건술)

  • Ahn, Ki-Young;Jang, Kyoung-Soo;Han, Dong-Gil
    • Archives of Reconstructive Microsurgery
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    • v.4 no.1
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    • pp.23-32
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    • 1995
  • Severe upper and lower extremity trauma may result in soft tissue loss with exposed bone and the subsequence of risk of chronic osteomyelitis or malunion of fracture fragments. Such injuries present a major reconstructive problem. But Since the introduction of microsugical technique, free muscle and myocutaneous flaps were employed to provide coverage of severely injured defects. Since Tai and Hasegawa(1974) first reported a breast reconstruction using by rectus abdominis myocuraneous flap, the free rectus myocutaneous flap has been widely employed for breast reconstuction, head and neck reconstruction, and extremity reconstruction in these days. The authors present their successful experience with free rectus abdominis muscle and rectus abdominis myocutaneous flaps for upper and low extremity reconstruction. From Nov. 94, to May 95, Five cases of severely injured extremites due to trauma or contact burn were treated with free rectus abdominis muscle flap or free rectus abdominis myocutaneous flap. All flaps except 1 case were survived without severe complications. As free muscle or myocutaneous flap, the free rectus abdominis flap has the advantages of a reliable pedicle, easy dissection, and an acceptable donor site, so it seems logical to apply the free rectus abdominis flap to apply in upper and lower extremity reconstruction.

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A Study on Dynamic Analysis and Fatigue Life of the Belt in the OHT Vehicle (OHT 차량 벨트 동특성 및 피로 수명에 관한 연구)

  • Jung Il-Ho;Kim Chang-Su;Cho Dong-Hyeob;Park Joong-Kyung;Park Tae-Won
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.29 no.8 s.239
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    • pp.1085-1092
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    • 2005
  • The OHT(Over Head Transportation) Vehicle transports heavy products quickly and repeatedly at the industrial workplace. The belt in the OHT vehicle is used to support the weight of the OHT Cage. The fatigue of the belt is caused by the dynamic load during the operation time. Since the fatigue fracture of the belt affects the safety at the workplace, the correct prediction of the dynamic load is necessary to calculate the fatigue life of the belt on the design step. In this paper a computer aided analysis method is proposed for the belt in the early design stage using dynamic analysis, stress analysis, belt tensile test, belt fatigue test and fatigue lift prediction method. From the dynamic load time histories and the stress of the belt FE model, a dynamic stress time history is produced. Using linear damage law and cycle counting method, fatigue life cycle is calculated. The method developed in this paper is used to reduce the time and cost for designing the OHT belt in different environment and condition.

Thoracic Endoscopic Sympatheitc Ganglion Cauterization on Reflex Sympathetic Dystrophy under One-Lung Ventilation (반사성 교감신경성 위축증환자에게 시행한 내시경적 흉부교감신경절 소작술 -증례 보고-)

  • Lee, Sang-Hun
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.210-214
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    • 1996
  • Thoracic sympathetic ganglion block(TSGB) with alcohol is a traditional method for treating a variety of disease at pain clinics. But it is a difficult block to perform requiring both skill and experience. Therefore, we performed a thoracic endoscopic cauterization to evaluate the efficacy of this method. A patient suffering sever forearm and hand pain due to radius fracture of the right arm, one and half years earlier, was referred to several different orthopaedic department of various hospitals with continued aggravated symptoms. He was then admitted to our hospital's orthopaedic department. Our diagnosis, confirmed by thermography, revealed reflex sympathetic dystrophy. Patients was therefore referred to the pain clinic where treatment consisted of endoscopic thoracic sympathetic cauterization under general anesthesia. Patient was intubated with Robertashow 37 Fr. double lumen tube left sided. Left lateral and slight head up position was applied to make lesion side up. Incisions were made to penetrate trocas 5 mm diamether on 4 th intercostal space along mid axillary line and midclavicular line. Negative pressure suction on ipsilateral lung and CO2 insufflation under 10 mmHg was applied to reduce lung size. Cauterization on thoracic sympathetic chain at T3 level was done under endoscoic guide. 24 Fr. chest tube was inserted. Patient's symptoms cleared and he was satisfied with the results of this treatment.

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Study on the Influence of Die Corner Radius for Deep Drawing of Elliptical Product of Automobile (자동차용 타원형 디프 드로잉 제품의 다이 반경에 관한 연구)

  • 허영민;박동환;강성수
    • Transactions of Materials Processing
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    • v.11 no.8
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    • pp.668-675
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    • 2002
  • The circles deform into various shape during deformation, the major and minor axes of which indicate the direction of the major and minor principal strains. Likewise, the measured dimensions are used to determine the major and minor principal strain magnitudes. This circular grid technique of measuring strains can be used to diagnose the causes of necking and fracture in industrial practice and to investigate whether these defects were caused by material property variation, changes in lubrication, of incorrect press settings. In non-axisymmetric deep drawing, three modes of forming regimes are found: draw, stretch, plane strain. The stretch mode for non-axisymmetric deep drawing could be defined when the major and minor strains are positive. The draw mode could be defined when the major strain is positive and minor strain is negative, and plane strain mode could be defined when the major strain is positive and minor strain is zero. Through experiments the draw mode was shown on the wall and flange are one of a drawn cup, while the plane strain and the stretch mode were on the punch head and the punch corner area respectively, We observed that the punch load of elliptical deep drawing was decreased according to increase of die corner radius and the thickness deformation of minor side was more large than major side.