• Title/Summary/Keyword: Ideal insertion position

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Ideal Insertion Position of Ankle Syndesmosis Screw (경비 인대 결합 나사못의 이상적인 삽입부위)

  • Park, Hong-Gi;Moon, Seon-Sang
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.60-65
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    • 2002
  • Purpose: The purposes of the present study were to find the ideal insertion position syndesmosis screw and relation to the surrounding anatomical structures when indirectly inserting the screw anteriorly at a 30 angle at 3 cm proximal portion of the ankle join t. Materials and Methods: We performed computed tomography from the axial view in 20 normal individuals at 3 cm proximal portion of the ankle joint and divided the lateral side of the fibula into 4 sections. We drew a line from the middle of each of these 4 sections to the posterolateral tibia at a 30 angle and determined the relationship between each of these lines and the surrounding anatomical structures and confirmed the site at which each of these 4 lines passed through the posterolateral tibia which divided into 3 sections and the site of the fibula at which each of these lines passed through the middle 1/3 portion of the tibia. Results: The posterior 3/4 portion of the fibula that passed through the middle 1/3 portion of the posterolateral tibia in 18 cases. The portion did not approach the surrounding anatomical structures(Peroneal vessels and the muscular portion of FHL). Conclusion: The ideal insertion position of syndesmosis screw at 3 cm proximal portion of the ankle joint at a 30 angle is the posterior 3/4 portion of the lateral side of the fibula, and injury to the surrounding anatomical structures could be avoided when the screw passes through the middle 1/3 portion of the posterolateral tibia.

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Radiographic Evaluation of Femoral Tunnel Placement During ACL Reconstruction (전방 십자 인대 재건술시 대퇴 터널의 위치에 대한 방사선학적 평가)

  • Chung, Hyun Kee;Choi, Choong Hyeok;Lee, Joong Hak
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.80-84
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    • 1998
  • The isometric position for the graft is important in the anterior cruciate ligament reconstruction surgery. It is well known that the femoral position is more critical than tibial side. But, there is few deciding method of proper graft position after the anterior cruciate ligament reconstruction surgery. So we planned to evaluate the ideal femoral isometric position with 6 adult cadavaric femurs and exact radiographs. After the insertion of femoral interference screw on ideal isometric position, we obtained roentgenograms of true lateral view and 10, 20, 30, 45 degree internal and external rotation views. Then we measured the shortest distance from the posterior cortical margin of lateral femoral condyle to posterior border of interference screw on the radiographs. We also measured true distance between posterior cortical margin of lateral femoral condyle to the posterior margin of femoral tunnel after cutting of distal femur. Based on this study, we could not determine the permissible rotation degree of radiographs. But we concluded that if the distance between posterior cortical margin of lateral femoral condyle and posterior border of interference screw ranges 4.5-6.5mm on the lateral view, the femoral position is considered as a relatively ideal isometric good position.

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Orthodontic correction of bialveolar protrusion by interproximal reproximation and water-soluble tubes bonded with deflection-based bonding technique: A case report (인접면 삭제와 변위-기반 접착술로 부착한 수용성 튜브를 이용한 절치 돌출의 교정 치료: 증례보고)

  • Roh, Yu-Yeon;Lim, Sung-Hoon;Jeong, Seo-Rin
    • The Journal of the Korean dental association
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    • v.55 no.12
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    • pp.850-860
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    • 2017
  • Orthodontic treatment with premolar extraction is usually performed to correct bialveolar protrusion. These methods require the use of stiff rectangular working archwire which requires lengthy alignment and leveling before insertion. In this case report, interproximal reproximation was performed instead of extraction. To establish clearance between the archwire and resin domes fixing the archwire, an archwire was inserted into a water-soluble tube before fabricating resin domes. This tube is solved away by the saliva. During fabrication of resin domes, the archwire was deflected intentionally reflecting the displacement of teeth from their ideal position. This can be called as deflection-based bonding (DBB) technique. DBB is different from conventional method of positioning the brackets on its ideal position and then inserting an archwire to align the brackets. Because the orthodontic force of the archwire comes from its deflection from passive configuration, deflecting an archwire as needed can move the teeth more predictably than just bonding brackets on its ideal position. Also, areas with good alignment before orthodontic treatment can be maintained simply by not deflecting the archwire during bonding in these areas. After initial alignment, interproximal reproximation was performed to create 4.8 mm space in the maxillary arch and 4.2 mm space in the mandibular arch. These spaces were closed using orthodontic mini-implant anchorage thus retracting the maxillary incisors 4 mm posteriorly accompanied with 0.7 mm and 0.3 mm distal movement of right and left molars. By using interproximal reproximation and water-soluble tube with DBB, mild bialveolar protrusion was successfully treated without extraction.

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Three Dimensional Measurement of Ideal Trajectory of Pedicle Screws of Subaxial Cervical Spine Using the Algorithm Could Be Applied for Robotic Screw Insertion

  • Huh, Jisoon;Hyun, Jae Hwan;Park, Hyeong Geon;Kwak, Ho-Young
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.376-381
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    • 2019
  • Objective : To define optimal method that calculate the safe direction of cervical pedicle screw placement using computed tomography (CT) image based three dimensional (3D) cortical shell model of human cervical spine. Methods : Cortical shell model of cervical spine from C3 to C6 was made after segmentation of in vivo CT image data of 44 volunteers. Three dimensional Cartesian coordinate of all points constituting surface of whole vertebra, bilateral pedicle and posterior wall were acquired. The ideal trajectory of pedicle screw insertion was defined as viewing direction at which the inner area of pedicle become largest when we see through the biconcave tubular pedicle. The ideal trajectory of 352 pedicles (eight pedicles for each of 44 subjects) were calculated using custom made program and were changed from global coordinate to local coordinate according to the three dimensional position of posterior wall of each vertebral body. The transverse and sagittal angle of trajectory were defined as the angle between ideal trajectory line and perpendicular line of posterior wall in the horizontal and sagittal plane. The averages and standard deviations of all measurements were calculated. Results : The average transverse angles were $50.60^{\circ}{\pm}6.22^{\circ}$ at C3, $51.42^{\circ}{\pm}7.44^{\circ}$ at C4, $47.79^{\circ}{\pm}7.61^{\circ}$ at C5, and $41.24^{\circ}{\pm}7.76^{\circ}$ at C6. The transverse angle becomes more steep from C3 to C6. The mean sagittal angles were $9.72^{\circ}{\pm}6.73^{\circ}$ downward at C3, $5.09^{\circ}{\pm}6.39^{\circ}$ downward at C4, $0.08^{\circ}{\pm}6.06^{\circ}$ downward at C5, and $1.67^{\circ}{\pm}6.06^{\circ}$ upward at C6. The sagittal angle changes from caudad to cephalad from C3 to C6. Conclusion : The absolute values of transverse and sagittal angle in our study were not same but the trend of changes were similar to previous studies. Because we know 3D address of all points constituting cortical shell of cervical vertebrae. we can easily reconstruct 3D model and manage it freely using computer program. More creative measurement of morphological characteristics could be carried out than direct inspection of raw bone. Furthermore this concept of measurement could be used for the computing program of automated robotic screw insertion.

Study of the relationship between the indication rod of stent on implant CT and the real path of implant fixture insertion considering residual ridge (임플란트 CT에서 방향 표시자의 방향과 잔존골을 고려한 임플란트 식립 방향의 관계에 관한 연구)

  • Kim Do-Hoon;Heo Min-Suk;Lee Sam-Sun;Oh Sung-Ook;Choi Hang-Moon;Jeon In-Seong;Choi Soon-Chul
    • Imaging Science in Dentistry
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    • v.33 no.2
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    • pp.79-83
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    • 2003
  • Purpose : To assess the relationship between the direction of the indicating rod of the radiographic stent for ideal prosthetic design and the actual possible path of implant fixture placement when residual ridge resorption is considered. Materials and Methods: The study materials consisted of 326 implant sites (male 214 cases and female 112 cases) from a total of 106 patients (male 65 patients and female 41 patients) who desired implant prostheses. Computed tomography of patients were taken and reformatted using ToothPix/sup (R)/ software. Bony defects, bony sclerosis, the change of the direction of indicating rod, and root proximity of the adjacent teeth were examined on the CT-derived images. Results: The rate of the irregular crestal cortex was relatively high on premolar and molar area of maxilla. Mandibular molar area showed relatively high rate of focal sclerosis on the area of implant fixture insertion. The position of the indicating rods were relatively acceptable on the molar areas of both jaws. However, the position of the indicating rods should be shifted to buccal side with lingual rotation of the apical end on maxillary anterior teeth and premolar area. Conclusion: Clinically determined rod direction and position of the indicating rod for implant placement was not always acceptable for insertion according to the reformatted CT images. The pre-operative treatment plan for implant should be determined carefully, considering the state of the alveolar bone using the reformatted CT images.

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Finite element analysis of maxillary incisor displacement during en-masse retraction according to orthodontic mini-implant position

  • Song, Jae-Won;Lim, Joong-Ki;Lee, Kee-Joon;Sung, Sang-Jin;Chun, Youn-Sic;Mo, Sung-Seo
    • The korean journal of orthodontics
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    • v.46 no.4
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    • pp.242-252
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    • 2016
  • Objective: Orthodontic mini-implants (OMI) generate various horizontal and vertical force vectors and moments according to their insertion positions. This study aimed to help select ideal biomechanics during maxillary incisor retraction by varying the length in the anterior retraction hook (ARH) and OMI position. Methods: Two extraction models were constructed to analyze the three-dimentional finite element: a first premolar extraction model (Model 1, M1) and a residual 1-mm space post-extraction model (Model 2, M2). The OMI position was set at a height of 8 mm from the arch wire between the second maxillary premolar and the first molar (low OMI traction) or at a 12-mm height in the mesial second maxillary premolar (high OMI traction). Retraction force vectors of 200 g from the ARH (-1, +1, +3, and +6 mm) at low or high OMI traction were resolved into X-, Y-, and Z-axis components. Results: In M1 (low and high OMI traction) and M2 (low OMI traction), the maxillary incisor tip was extruded, but the apex was intruded, and the occlusal plane was rotated clockwise. Significant intrusion and counter-clockwise rotation in the occlusal plane were observed under high OMI traction and -1 mm ARH in M2. Conclusions: This study observed orthodontic tooth movement according to the OMI position and ARH height, and M2 under high OMI traction with short ARH showed retraction with maxillary incisor intrusion.

Analysis of junction site between T-DNA and plant genome in Lissorhoptrus oryzophilus resistance GM rice (벼물바구미 (Lissorhoptrus oryzophilus) 내충성 GM 벼에서 T-DNA와 게놈의 인접부위 분석)

  • Lee, Jin-Hyoung;Shin, Kong-Sik;Suh, Seok-Cheol;Rhim, Seong-Lyul;Lim, Myung-Ho;Woo, Hee-Jong;Qin, Yang;Kweon, Soon-Jong;Park, Soon-Ki
    • Journal of Plant Biotechnology
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    • v.41 no.3
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    • pp.127-133
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    • 2014
  • Four transgenic rice lines harboring insect-resistant gene cry3A showed ideal field performances characterized by high considerable resistance to rice water weevil (Lissorhoptrus oryzophilus Kuschel). In this study, we estimated the insertion number of foreign genes, and analyzed the flanking sequences of T-DNAs in rice genome. As a result, T-DNA of BT12R1 line was inserted in exon region of rice chromosome 10. Two copies of T-DNAs were inserted in line BT12R2. BT12R3 line was analyzed at only left border flanking sequence. BT12R4 line was confirmed one copy of foreign gene insertion at the position 24,516,607 ~ 24,516,636 of rice chromosome 5, accompanied by a deletion of 30 bp known genomic sequences. This intergenic position was confirmed none of expressed gene and any deletion/addition of T-DNA sequence. In conclusion, these molecular data of rice water weevil resistant Bt rice would be used to conduct the biosafety and environment risk assessment for GM crop commercialization.

Buttock Augmentation with Elastomer Implants (엘라스토머 임플란트를 사용한 엉덩이 확대 성형술)

  • Park, Bong-Kwon;Kim, Youn-Hwan;Ahn, Hee-Chang
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.182-188
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    • 2011
  • Purpose: The buttocks region has been associated with allure and sex appeal for centuries. Gluteal implants enable buttocks remodeling in a way that is not possible in other methods. One of the reasons that render gluteal implant surgeries unpopular is the fear of complications, the main problems being seroma, wound dehiscence, extrusion, and a visible or palpable implant. The authors present the XYZ technique, which provides anatomical reference points to guide the intramuscular dissection procedure in a feasible and safe way, resulting in a lower complication rate. Methods: The XYZ procedure was done for buttock augmentation on 8 patients from December 2009 to June 2010. Patient's ages ranged from 27 to 44 with a mean age of 36. Seven patients were applied the 250cc sized Elastomer implants with one patient 290cc sized implant. Preoperative marking was done with the patients in the standing position. Bisection of the gluteus maximus muscle was done at the midpoint thickness to create a plane for implant insertion, which is called the sandwich plane. Results: The 8 cases were performed safely without major complications. However one patient had minor wound dehiscence, and was managed with conservative treatment. Another patient had a discomfort on the buttocks for a long time. The patients were followed up for average 6 months. All patients were satisfied with the aesthetic results. Conclusion: In performing the XYZ technique for gluteal augmentation, the surgeon must split the muscle into two equal halves with anatomical reference points to guide the muscle detachment in a symmetrical way at an adequate depth. This method provides a guideline for the surgeon in determining the ideal plane during intramuscular dissection and gives predictable results with low complication rates. Intramuscular gluteoplasty with gluteal implants offers predictable, aesthetically pleasing results without contour irregularities and only a low incidence of major complications.

Posterior Lumbar Interbody Fusion Using Posterolateral Placement of A Single Cylindrical Threaded Cage and Two Regular Cages : A Biomechanical Study (단일 나사형 Cage를 이용한 후방 요추체간 융합술과 두개의 나사형 Cage를 이용한 PLIF의 생체 역학적 비교)

  • Park, Choon Keun;Hwang, Jang Hoe;Ji, Chul;Kwun, Sung Oh;Sung, Jae Hoon;Choi, Seung Jin;Lee, Sang Won;Kim, Moon Kyu;Park, Sung Chan;Cho, Kyeung Suok;Park, Chun Kun;Yuan, Hansen;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.883-890
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    • 2001
  • Objectives : An in vitro biomechanical study of posterior lumbar interbody fusion(PLIF) with threaded cage using two different approaches was performed on eighteen functional spinal units of bovine lumbar spines. The purpose of this study was to compare the segmental stiffnesses among PLIF with one long posterolateral cage, PLIF with one long posterolateral cage and simultaneous facet joint fixation, and PLIF with two posterior cages. Methods : Eighteen bovine lumbar functional spinal units were divided into three groups. All specimens were tested intact and with cage insertion. Group 1(n=12) had a long threaded cage($15{\times}36mm$) inserted posterolaterally and oriented counter anterolaterally on the left side by posterior approach with left unilateral facetectomy. Group 2(n=6) had two regular length cages($15{\times}24mm$) inserted posteriorly with bilateral facetectomy. Six specimens from group 1 were then retested after unilateral facet joint screw fixation in neutral(group 3). Likewise, the other six specimens from group 1 were retested after fixation with a facet joint screw in an extended position(group 4). Nondestructive tests were performed in pure compression, flexion, extension, lateral bending, and torsion. Results : PLIF with a single cage, group 1, had a significantly higher stiffnesses than PLIF with two cages, group 2, in left and right torsion(p<0.05). Group 1 showed higher stiffness values than group 2 in pure compression, flexion, left and right bending but were not significantly different. Group 3 showed a significant increase in stiffness in comparison to group 1 for pure compression, extension, left bending and right torsion(p<0.05). For group 4, the stiffness significantly increased in comparison to group 1 for extension, flexion and right torsion(p<0.05). Although there was no significant difference between groups 3 and 4, group 4 had increased stiffness in extension, flexion, right bending and torsion. Conclusion : Posterior lumbar interbody fusion with a single long threaded cage inserted posterolaterally with unilateral facetectomy enables sufficient decompression while maintaining a majority of the posterior elements. In combination with a facet joint screw fixation, adequate postoperative stability can be achieved. We suggest that posterolateral insertion of a long threaded cage is biomechanically an ideal alternative to PLIF.

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