• Title/Summary/Keyword: Leg fracture

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Fracture behavior modeling of a 3D crack emanated from bony inclusion in the cement PMMA of total hip replacement

  • Mohamed, Cherfi;Abderahmane, Sahli;Benbarek, Smail
    • Structural Engineering and Mechanics
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    • v.66 no.1
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    • pp.37-43
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    • 2018
  • In orthopedic surgery and in particular in total hip arthroplasty, the implant fixation is carried out using a surgical cement called polymethylmethacrylat (PMMA). This cement has to insure a good adhesion between implant and bone and a good load distribution to the bone. By its fragile nature, the cement can easily break when it is subjected to a high stress gradient by presenting a craze zone in the vicinity of inclusion. The focus of this study is to analyze the effect of inclusion in some zone of cement in which the loading condition can lead to the crack opening leading to their propagation and consequently the aseptic loosening of the THR. In this study, the fracture behavior of the bone cement including a strange body (bone remain) from which the onset of a crack is supposed. The effect of loading condition, the geometry, the presence of both crack and inclusion on the stress distribution and the fracture behavior of the cement. Results show that the highest stresses are located around the sharp tip of bony inclusion. Most critical cracks are located in the middle of the cement mantle when they are subjected to one leg standing state loading during walking.

Clinical Application of Instep Flap (내측 족저 동맥을 이용한 도피판술의 임상적 고찰)

  • Chung, Duke-Whan;Han, Chung-Soo;Kim, Yong-Hwan;Nam, Gi-Un;Kim, Jin-Won
    • Archives of Reconstructive Microsurgery
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    • v.2 no.1
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    • pp.46-52
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    • 1993
  • Soft-tissue deficits over the plantar forefoot, plantar heel, Achilles tendon, and distal parts of lower leg are often troublesome to cover with a simple graft or local flap due to limited mobility of surrounding skin and poor circulation in these area. Soft-tissue reconstruction in these regions should provide tissue components similar to the original lost tissue, supply durability and minimal protective pressure sensation and result in a donor site that is well tolerated and treated. We analysed 7 cases that were treated with the Instep flap due to soft-tissue defects over these regions from July of 1990 to July of 1993. All flaps were viable and successful at follow-up. 1. The age ranged from 9 years to 60 years, and 6 cases were male and 1 case female. 2. The sites of soft-tissue loss were the plantar forefoot(1 case), plantar heel(3 cases), Achilles tendon(2 cases), and distal parts of lower leg(1 case). 3. The causes of soft-tissue loss were simple soft-tissue crushing injury(1 case), crushing injury of the 1st toe(1 case) and posttraumatic infection and necrosis(5 cases). 4. The associated injury were open distal tibio-fibula, fracture(2 cases), medial malleolar fracture of the ankle(1 case), Achilles tendon rupture(2 case) and 1st metatarso-phalangeal disarticulation(1 case). 5. The size of flap was from $3{\times}4cm$ to $5{\times}10cm$(average $4{\times}5.6cm)$. 6. In 7 cases, we were not to find post-operative necrosis and infection, non-viability, limitation of ankle joint, and gait disturbance caused by the Instep flap surgery. 7. This study demonstrates that the Instep flap should be considered as another valuable technique in reconstruction of these regions.

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Effect of Intravenous Intraoperative Esmolol on Pain Management Following Lower Limb Orthopedic Surgery

  • Haghighi, Mohammad;Sedighinejad, Abbas;Mirbolook, Ahmadreza;Nabi, Bahram Naderi;Farahmand, Maral;leili, Ehsan Kazemnezhad;Shirvani, Masoumeh;Jahromi, Sina Khajeh
    • The Korean Journal of Pain
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    • v.28 no.3
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    • pp.198-202
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    • 2015
  • Background: Lack of proper control of acute postoperative pain often leads to lingering or chronic pain. Several studies have emphasized the role of beta-blockers in reducing postoperative pain. Esmolol is a selective short-acting beta-blocker that produces few side effects. The purpose of this study was to examine the effect of intravenous intraoperative esmolol on postoperative pain reduction following orthopedic leg fracture surgery. Methods: In a clinical trial, 82 patients between 20-65 years of age with tibia fractures and American Society of Anesthesiologists (ASA) physical status I & II who underwent surgery were divided into two groups. Group A received esmolol and group B received normal saline. Postoperative pain was measured at three time points: entering the recovery unit, and at 3 h and 6 h following surgery, using the Visual Analogue Scale (VAS). A P value of < 0.05 was considered significant. Results: Mean VAS scores at all three time points were significantly different between the two test groups (P = 0.02, P = 0.0001, and P = 0.0001, respectively). The consumption of pethidine was lower in group A than in group B (P = 0.004) and the duration of its effect was significantly longer in time (P = 0.026). Conclusions: Intravenous intraoperative esmolol is effective in the reduction of postoperative pain following leg fracture surgery. It reduced opioid consumption following surgery and delayed patient requests for analgesics.

Simple Identification of Symmetric Reduction in Unilateral Depressed Zygomatic Fracture (일측성 광대뼈골절 환자에서 수평계와 자를 이용한 변위 교정의 간단한 파악법)

  • Yi, Hyung-Suk;Lee, Kyung-Suk;Kim, Jun-Sik;Kim, Nam-Gyun
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.195-198
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    • 2010
  • Purpose: The zygoma is a key element which composes the facial contour. Zygomatic fracture induces facial asymmetry. We use radiologic evaluation or inspections mainly for identification of symmetry after reduction depressed zygomatic fracture. But the disadvantages of such methods are time-consuming and complicated process. So we tried to develop a new testing method with a ruler and a level. Methods: In unilateral depressed zygomatic fracture patient, parallel to the patient's head to make sure lay horizontaly. Put the leg of a ruler on the malar eminence so that it is at the same distance from the facial midline. Then take the level of malar eminence as put the level above the ruler. This process was performed before and after the reduction. Results: We were able to fix with plate and screw after checking the results of reduction fast and easily. Good results were obtained at post-operative radiologic evaluation. Conclusion: We can easily get the ruler and level around life. This method is not only simple but also shorttime process compared with other method-radiologic evaluation or inspection. And the operator can explain the results to the patients easily and objectively. Authors obtained the good results with this new method, and would introduce it for another method of identifying the result of reduction in depressed zygomatic fractures.

Leg Fracture Recovery Monitoring Simulation using Dual T-type Defective Microstrip Patch Antenna (쌍 T-형 결함 마이크로스트립 패치 안테나를 활용한 다리 골절 회복 모니터링 모의실험)

  • Byung-Mun Kim;Lee-Ho Yun;Sang-Min Lee;Yeon-Taek Park;Jae-Pyo Hong
    • The Journal of the Korea institute of electronic communication sciences
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    • v.18 no.4
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    • pp.587-594
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    • 2023
  • In this paper, we present the design and optimization process of an on-body microstrip patch antenna with a paired T-type defect for monitoring fracture recovery of human legs. This antenna is designed to be light, thin and compact despite the improvement of return loss and bandwidth performance by adjusting the size of the T-type defect. The structure around the applied human leg is structured as a 5-layer dielectric plane, and the complex dielectric constant of each layer is calculated using the 4-pole Cole-Cole model parameters. In a normal case without bone fracture, the return loss of the on-body antenna is -66.71dB at 4.0196GHz, and the return loss difference ΔS11 is 37.95dB when the gallus layer have a length of 10.0mm, width of 1.0mme, and height of 2.0mm. A 3'rd degree polynomial is presented to predict the height of the gallus layer for the change in return loss, and the polynomial has a very high prediction suitability as RSS = 1.4751, R2 = 0.9988246, P-value = 0.0001841.

Deterministic Fracture Mechanics Analysis of Nuclear Reactor Pressure Vessel Under Rot Leg Leak Accident (고온관 누설에 의한 가압열충격 사고시 원자로 용기의 건전성 평가를 위한 결정론적 파괴역학 해석)

  • Lee, Sang-Min;Choi, Jae-Boong;Kim, Young-Jin;Park, Youn-Won;Jhung, Myung-Jo
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.26 no.11
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    • pp.2219-2227
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    • 2002
  • In a nuclear power plant, reactor pressure vessel (RPV) is the primary pressure boundary component that must be protected against failure. The neutron irradiation on RPV in the beltline region, however, tends to cause localized damage accumulation, leading to crack initiation and propagation which raises RPV integrity issues. The objective of this paper is to estimate the integrity of RPV under hot leg leaking accident by applying the finite element analysis. In this paper, a parametric study was performed for various crack configurations based on 3-dimensional finite element models. The crack configuration, the crack orientation, the crack aspect ratio and the clad thickness were considered in the parametric study. The effect of these parameters on the maximum allowable nil-ductility transition reference temperature ($(RT_{NDT})$) was investigated on the basis of finite element analyses.

Mixed-Mode Fatigue Characteristics of Composite/Metal Interfaces (복합재료/금속 계면의 혼합모드 피로 특성)

  • Baek, Sang-Ho;Kim, Won-Seock;Jang, Chang-Jae;Lee, Jung-Ju
    • Composites Research
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    • v.23 no.4
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    • pp.21-27
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    • 2010
  • In most engineering structures, fracture often takes place due to fatigue. Therefore, many studies about the effect of the various mode-mixities on fatigue characteristics have been performed. However, most of the former studies only address metal/metal interfaces or delamination of composite. In this study, the fatigue characteristics of composite/metal interfaces are investigated. The fatigue tests were performed using single leg bending(SLB)specimens that comprise composite and steel bonded to each other using co-cure bonding method. This paper focuses on fatigue characteristics depending on different mode ratios$(G_{II}/G_T$. The overall results obtained in this study show that the crack propagation rate increases with the mode II loading component.

Electrical Acupuncture Combined Bee Venom Therapy for Pain and Disability Induced Intervertebral Herniated Disc of L-spine;A Pilot Study

  • Kwon, Young-Dal
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.3
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    • pp.703-707
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    • 2008
  • To examine the efficacy of electrical acupuncture combined bee venom in controlling low back with leg pain induced Herniated Intervertebral Disc (HIVD). 13 patients (men 8, women 5; age $41.30\;{\pm}\;17.27$) diagnosed as HIVD by CT or MRI had low back and leg pain as a chief complaint and diseases such as spinal tumor, infection and fracture were excluded. They were treated by electrical acupuncture (8 Hz) combined bee venom therapy three times a week in Wonkwang University Hospital, and pain intensity with VAS and functioning with Roland-Morris Disability Qestionnaire(RDQ) were measured at the baseline(B), and 4 weeks after treatment. The data were analyzed with Wilcoxon signed ranks test(SPSS12.0) and the level set for statistical significance was P<0.05. The pain was significantly reduced by two combined treatments (=0.002;$B7.69{\pm}2.06$,4Wks$4.70{\pm}2.72$). The function was also significantly improved by both treatments(=0.001;$B12.15{\pm}6.85$,4Wks$6.85{\pm}5.15$). The results suggest that a combination of acupuncture and bee venom therapy may be beneficial for low back pain from HIVD. In future, randomized clinical trials including follow-up are needed to examine the effects of these therapies.

Acute Shortening and Delayed Lengthening in Management of Lower Leg Amputation: A Case Report

  • Kang, Seung Hoon;Jung, Sung Won;Jin, Jin Woo;Kim, Dong Hee;Shin, Sung Jin;Jeong, Min;Eho, Yil Ju
    • Archives of Reconstructive Microsurgery
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    • v.25 no.2
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    • pp.65-68
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    • 2016
  • Acute bone shortening and delayed lengthening by Ilizarov surgery have been used to treat a wide range of soft tissue injuries including open fracture, osteomyelitis of the tibia and lower leg amputation. It has advantages such as bone lengthening as well as minimizing the loss of damaged tissues via tissue expansion. Here, we report a case of 52-year-old male with satisfactory results through acute bone shortening, replantation, and gradual bone lengthening after complete amputation of the ankle with related literature reviews.

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

  • Yoo, Jun-Il;Cha, Yong-Han;Kim, Kap-Jung;Kim, Ha-Yong;Choy, Won-Sik;Hwang, Sun-Chul
    • Hip & pelvis
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    • v.30 no.4
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    • pp.241-253
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    • 2018
  • Purpose: This study was conducted to compare cemented and cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures via meta-analysis and systematic review of relevant studies. Materials and Methods: Systematic review and meta-analysis were performed on 31 available clinical studies; 19 of these studies used cemented stems, 12 used cementless stems, one used both types of stems, and two studies involved a comparative analysis of both stem types. Results: There were statistically significant differences in rates of leg length discrepancy (LLD) greater than 1 cm between the cemented (event rate, 0.089) and cementless groups (event rate, 0.015 and 0.047; P=0.03). Conclusion: Cemented bipolar hemiarthroplasty and cementless bipolar hemiarthroplasty performed on elderly patients with unstable intertrochanteric fracture revealed similar mortality and complication rates; however, the rate of LLD greater than 1 cm was significantly higher in the cemented group compared with the cementless group.