• Advances in nano research
• /
• 제5권4호
• /
• pp.303-311
• /
• 2017

The continuum elasticity model is applied to investigate quantitatively the growth features and nucleation mechanism of quantum dots, nanopits, and joint QDs-nanopits structures in GaInAlN quasyternary systems. We have shown that for GaInAlN material system at the critical strain of ${\varepsilon}^*=0.039$ the sign of critical energy and volume is changed. We assume that at ${\varepsilon}={\varepsilon}^*$ the mechanism of the nucleation is changed from the growth of quantum dots to the nucleation of nanopits. Obviously, at small misfit (${\varepsilon}$ < ${\varepsilon}^*$), the bulk nucleation mechanism dominates. However, at ${\varepsilon}$ > ${\varepsilon}^*$, when the energy barrier becomes negative as well as a larger misfit provides a low-barrier path for the formation of dislocations, the nucleation of pits becomes energetically preferable. The free energy of mixing for $Ga_{1-x-y}In_xAl_yN$ quasiternary system was calculated and studied and its 3D sketch was plotted.

• Journal of Trauma and Injury
• /
• 제37권2호
• /
• pp.161-165
• /
• 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.

• 대한정형외과스포츠의학회지
• /
• 제2권2호
• /
• pp.77-81
• /
• 2003

목적: 슬관절 주위 골격의 기초과학을 생체역학을 중심으로 설명하고 빈도가 높은 스포츠 손상들에 대해 기술하고자 한다. 해부 밀 운동학: 슬관절은 순수한 경첩 관절이 아니며 적합하지 않으므로 여섯 방향의 운동이 가능하다. 경골대퇴간 운동역학: 슬관절의 굴곡-신전 축은 시상면에 수직이 아닐 뿐 아니라, 관상면상 관절선과 평행하지 않으므로, 경골대퇴관절은 굴곡 시 내반과 내회전이 동반되고 신전 시에는 외반과 외회전이 동반된다. 슬개대퇴 관절: 슬개대퇴 관절 압박력은 슬관절의 굴곡 각도와 사두고근력에 비례한다 슬개골은 신전기전의 moment arm을 증가시켜 신전기전의 효율을 증대시키고 지렛대 역할을 한다. 슬개골 골절: 비전위성 골절이면서 하지 직거상 운동이 보존된 경우에 비수술적 치료의 적응증이 되며 수술적 치료 시 고정 방법의 선택은 골절 양상에 따라 결정되겠으나 어느 술식을 선택하여도 신전지대의 봉합은 필수적이며 중요하다 슬개골 불안정성: 선행 해부학적 이상을 조사해야 하며 급성 탈구에서도 골연골 골절편이 있거나 재발의 위험이 높은 운동선수에서 인대 봉합을 고려할 수 있다. 비수술적 치료 및 재활에도 불수하고 계속되는 재발성 아탈구나 탈구는 수술이 필요하다 학령기 스포츠 손상: Idiopathic Adolescent Anterior Knee Pain, Osgood-Schlatter Disease, Sinding-Larsen-Johansson Disease 등이 흔하다

• Clinics in Shoulder and Elbow
• /
• 제9권1호
• /
• pp.50-59
• /
• 2006

Purpose: The nonoperative outcome of elbow dislocations with associated radial head and coronoid fractures are often unsatisfactory because of chronic instability and stiffness from proloned immobilization, Therefore we managed these injuries with well programed surgical appproaches. Method: Ten patients with this injury were evaluated retrospectively from May 1998 to June 2004 after a minimum of 12 months. These injuries include elbow dislocation and associated fractures of both the radial head and the coronoid process. All ten patients were treated by one clinic operatively with similar scheduled surgical methods which started on the lateral side and terminated on the medial side of the elbow. Radial head and neck fractures were classified Mason types, as two and three types respectively with six and four cases and six cases were fixated. Coronoid process were fixated with screws anteroposterior directly or anchor suture in all cases, each type was classified one, two and three. where were three type one, four type two, and three type three were according to Regan and Morrey classification. Results: The outcome was three resulting in excellent, four good, two normaland and the remaining case was one poor according to the Mayo Elbow Performance score. At a terminal follow up, the range of motion of the elbow averaged flection contracture, $6^{\circ}(0{\sim}20^{\circ})$ and further flection, $129^{\circ}(115{\sim}140^{\circ})$. Two patients had complications requiring additional care. One, displaced coronoid process which was repaired with capsule and the other patient experienced, palsy of ulnar nerve and contracted elbow joint. Conclusions: Usage of early operation as the minimum injury of medial ligaments complex and the rigid fixation of fractures to prompt motion with our scheduled management for elbow dislocations with associated radial head and coracoid fractures provided excellent results.

• Clinics in Shoulder and Elbow
• /
• 제13권1호
• /
• pp.92-98
• /
• 2010

목적: 견봉 쇄골 관절 손상의 치료 방법으로서 Clavicle hook plate를 이용한 고정술의 결과를 분석하였다. 대상 및 방법: 2008년 2월부터 2010년 4월까지 본원에서 견봉 쇄골 관절 탈구로 Clavicle hook plate를 이용한 고정술을 시행하였던 18예를 대상으로 하였다. 제 3형의 견봉 쇄골 관절 손상이 7예, 제 5형이 11예였으며, Clavicle hook plate는 수술 후 3개월 이후에 제거하였다. 치료 결과의 판정은 스트레스 부하 방사선 촬영을 하여 건측과 비교하였고 Korean shoulder scoring system 및 American shoulder elbow society score를 이용하여 견관절의 기능과 환자의 만족도를 평가하였다. 평균 추시 기간은 9개월이었다. 결과: 스트레스 부하 방사선 사진에서 오구 쇄골 간격이 건측에 비해 수술 전 평균 114% 증가되어 있었으나 수술 후 최종 추시 시 23%로 감소하였으며, Korean shoulder scoring system은 평균 80점이었고 American shoulder elbow society score는 평균 74점이었다. 결론: 견봉 쇄골 관절 손상의 Clavicle hook plate를 이용한 고정 시 충분한 관절 안정성으로 조기 재활이 가능하며, 방사선학적 및 기능적으로도 비교적 만족할만한 결과를 얻을 수 있어 수술적 치료에 있어 유용한 방법 중 하나라고 사료된다.

• Clinics in Shoulder and Elbow
• /
• 제13권2호
• /
• pp.194-201
• /
• 2010

목적: 오구 쇄골 인대를 봉합하지 않고 견봉 쇄골 관절의 관혈적 정복만 시행한 환자군에서의 임상적, 방사선학적 추시 결과를 확인하고자 하였다. 대상 및 방법: 1998년부터 2007년까지 변형 Phemister 술식과 갈고리 금속판 (AO hook 금속판, Wolter 금속판)을 사용하여 견봉 쇄골 관절 탈구로 수술 받은 환자 중 삽입물 제거한 53예를 대상으로 하였다. 변형 Phemister 술식을 사용한 군이 21명, 갈고리 금속판을 사용한 군이 32명 이였다. 임상적 평가는 Constant score를 이용하였으며, 양측 쇄골과 오구돌기 사이의 수직 거리를 비교하여 방사선적 평가를 하였다. 결과: Constant score는 변형 Phemister 술식을 사용한 군에서는 $87.59{\pm}7.8$, 갈고리 금속판을 사용한 군에서는 $89.35{\pm}5.3$로 통계학적 차이는 없었다. 두 군에서 수술 전 손상 부위의 쇄골 오구돌기의 평균 거리는 15.9 mm이였으며, 건측 견관절은 평균 8.0 mm이였다. 갈고리 금속판 환자군에서 건측과 비교하여 평균 1.0 mm, 변형 Phemister 환자군에서는 평균 1.2 mm의 수직 전위가 관찰되었으며 통계학적 차이는 없었다. 결론: 오구쇄골 인대를 복원 하지 않은 견봉 쇄골 관절 탈구의 관혈적 정복술 및 내고정술은 양호한 임상적, 방사선학적 결과를 보였다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제40권
• /
• pp.27.1-27.8
• /
• 2018

Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

• Clinics in Shoulder and Elbow
• /
• 제5권2호
• /
• pp.110-117
• /
• 2002

Purpose: We compared the results of open and arthroscopic Bankart repair in traumatic recurrent anterior dislocation ,3f the shoulder. Materials and methods: We analysed 7 cases underwent open Bankart repair (group I) and 13 cases underwent arthroscopic Bankart repair (group Ⅱ). The average follow-up period was 68.1 months (51-113 months) in group I and 41.1 months (16~57 months) in group Ⅱ. All patients in group I and Ⅱ were non-athletes. We analyzed statistically objective evaluation, such as the stability of shoulder joint, the range of motion, pain, impaired throwing, Bankart rating system by Rowe and subjective evaluation, visual analog scale (VAS) between two groups. Results: In terms of dominant and non-dominant shoulders, the age at initial episode of dislocation, the elapsed time from injury to surgery, the number of preoperative dislocations associated with susceptibility to apprehension. respectively, there was no statistically significant differences between two groups. In group I the average Rowe's scortls was 84.3 and 3 cases (43%) had excellent results,4 cases (S7cfo), good ones. In group H the average Rowe's scores was 87.3 and 7 cases (54%) had excellent results,6 cases, good ones. There was tendency to show more excellent results in group ll, but there was no statistically significant differences. The average VAS were 90.3 points in group I and 88 points in group Ⅱ, which showed also no statistically significant differences. Conclusion: Open and arthroscopic Bankart repairs had no significant difference and showed also good results in travinatic recurrent anterior dislocation of shoulder.

• 대한관절경학회지
• /
• 제5권1호
• /
• pp.41-44
• /
• 2001

정복되지 않는 슬관절 탈구 중 내측 광근에 의한 단추구멍 손상에 의한 경우는 매우 드문 경우로 이에 대한 신속한 정복이 지연된 슬관절 탈구로 발생할 수 있는 합병증을 줄일 수 있다. 저자들은 슬부의 후외방 전위와 대퇴골 내과의 돌출을 보이는 환자를 자기 공명 영상으로 진단하고 이에 대해 관절 절개술을 이용하여 정복술 및 양측 십자인대 복원술로 치료한 환자를 경험하였다. 술후 10개월에 환자는 경도의 후방 불안정이 있었으나 관절의 운동 범위는 정상으로 회복되었다.

• Clinics in Shoulder and Elbow
• /
• 제19권3호
• /
• pp.155-162
• /
• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.