• Journal of Korean Tunnelling and Underground Space Association
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• v.12 no.1
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• pp.95-103
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• 2010

In this paper, a new soft ground tunneling technique termed the PNT method(Pre-Nailed Tunneling Method) is studied. Mechanism of the method is investigated in terms of theoretical and numerical approaches. The pre-nailing effects are validated by performing two dimensional numerical analyses. It is identified that the method is successful in soft grounds, and greatly efficient in reducing the ground deformation by nailing the ground. To develop the design guidelines of the method, numerical parametric analyses on the installation range and angle were also carried out.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.1-11
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• 2003

Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

• Journal of the Korean Geotechnical Society
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• v.26 no.7
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• pp.117-133
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• 2010

A hybrid system of soil-nailing and compression anchor is proposed in this paper; the system is composed of an anchor bar (installed at the tip) with two PC strands and a steel bar. After drilling a hole, installing proposed hybrid systems, and filling the hole with grouting material, prestress is applied to the anchor bar to restrict the deformation at the head and/or to prevent shallow slope failures. However, since the elongation rate of PC strand is much larger than that of steel bar, yield at the steel bar will occur much earlier than at the PC strand. It means that the yield load of the hybrid system will be overestimated if we simply add yield loads of the two - anchor bar and PC strands. It might be needed to try to match the yielding time of the two materials by applying the prestress to the anchor bar. It means that the main purpose of applying prestress to the anchor bar should be two-fold: to restrict the deformation at the nail head; and more importantly, to maximize the design load of the hybrid system by utilizing load transfer mechanism that transfers the prestress applied at the tip to the head through anchor bar. In order to study the load transfer mechanism in a systematic way, in-situ pullout tests were performed with the following conditions: soil-nailing only; hybrid system with the variation of prestress stresses from 0 kN to 196 kN. It was found that the prestress applied to the anchor system will induce the compressive stress to the steel bar; it will result in decrease in the slope of load-displacement curve of the steel bar. Then, the elongation at which the steel bar will reach yield stress might become similar to that of PC strands. By taking advantage of prestress to match elongations at yield, the pullout design load of the hybrid system can be increased up to twice that of the soil-nailing system.

• Journal of the Korean Geotechnical Society
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• v.24 no.4
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• pp.101-114
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• 2008

Pressurized grouting is a common technique in geotechnical engineering applications to increase the stiffness and strength of the ground mass and to fill boreholes or void space in a tunnel lining and so on. Recently, the pressurized grouting has been applied to a soil-nailing system which is widely used to improve slope stability. Because interaction between pressurized grouting paste and adjacent ground mass is complicated and difficult to analyze, the soil-nailing design has been empirically performed in most geotechnical applications. The purpose of this study is to analyze the ground behavior induced by pressurized grouting paste with the aid of laboratory model tests. The laboratory tests are carried out for four kinds of granitic residual soils. When injecting pressure is applied to grout, the pressure measured in the adjacent ground initially increases for a while, which behaves in the way of the membrane model. With the lapse of time, the pressure in the adjacent ground decreases down to a value of residual stress because a portion of water in the grouting paste seeps into the adjacent ground. The seepage can be indicated by the fact that the ratio of water/cement in the grouting paste has decreased from a initial value of 50% to around 30% during the test. The reduction of the W/C ratio should cause to harden the grouting paste and increase the stiffness of it, which restricts the rebound of out-moved ground into the original position, and thus increase the in-situ stress by approximately 20% of the injecting pressures. The measured radial deformation of the ground under pressure is in good agreement with the expansion of a cylindrical cavity estimated by the cavity expansion theory. In-situ test revealed that the pullout resistance of a soil nailing with pressurized grouting is about 36% larger than that with regular grouting, caused by grout radius increase, residual stress effect, and/or roughness increase.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.133-140
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• 2019

Purpose: This study examined the radiological and clinical outcomes of tibiotalocacalcaneal arthrodesis using retrograde intramedullary nailing in a severe hindfoot deformity and ankle/subtalar arthritis. Materials and Methods: A total of 22 patients (22 cases) with a severe hindfoot deformity and arthritis underwent tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. The average age was 57.4 years (22-82 years) and the mean follow-up was 29.6 months (12-74 months). The radiological outcomes included an assessment of the preoperative and postoperative coronal ankle alignment, hindfoot alignment, sagittal alignment, and postoperative union time. The clinical outcomes were evaluated using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and postoperative complications. The results were analyzed statistically by dividing the patients into two groups based on a 10° angle of deformity. Results: Regarding the preoperative coronal ankle alignment, 14 patients had a mean varus deformity of 17.8°±14.5° and six had a mean valgus deformity of 8.1°±6.6°. Postoperatively, a satisfactory postoperative coronal ankle alignment of less than 5° was obtained in all patients. Regarding the preoperative hindfoot alignment, 12 patients showed a mean varus deformity of 15.2°±10.5° and six had a mean valgus deformity of 8.1°±4.2°. In total, 94.4% (17 patients) had satisfactory postoperative hindfoot alignment of less than 5°. Radiological union was achieved in 90.9% at an average of 19.2 weeks (12-32 weeks) and there were 2 cases of nonunion. The clinical outcomes showed improvement in the mean VAS and AOFAS scores (p<0.001, p<0.001, respectively). Even a preoperative severe deformity more than 10° showed a significant deformity correction of coronal ankle alignment and hindfoot alignment, postoperatively (p<0.001, p<0.001, respectively). No significant differences were found between the patients with a preoperative coronal ankle deformity more than 10° and those less than 10° regarding the mean postoperative coronal ankle alignment (p=0.162). Conclusion: Tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is an acceptable technique for achieving satisfactory deformity correction, high union rate with minimal complications, and improvement of the clinical outcomes. In addition, tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is considered an effective treatment option, particularly in severe ankle and hindfoot deformities.

• Journal of Korean Tunnelling and Underground Space Association
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• v.18 no.6
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• pp.569-579
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• 2016

In order to ensure the stability of tunnel portal slope, reinforcement method such as anchors, soil nails and rock bolts have been used in Korea. When selecting slope reinforcement methods in tunnel portal area such as reinforcement arrangement and length, trial and error method can be very time-consuming and it was also not easy to verify the selection of an optimum condition. In this study, using the FISH language embedded in the finite difference code FLAC3D program, the optimization technique was developed with the Differential Evolution Algorithm (DEA). After building a database on the soil nailing method in tunnel portal area, this system can be selected to an optimum arrangement plan based on the factor of safety through the FLAC3D analysis. Through the results of numerical analysis, it was confirmed that the number of analysis was decreased by about 8 times when DEA based optimization technique was used compared to the full combination (FC). In case of the design of slope reinforcement in tunnel portal area, if this built-system is used, it is expected that the selection of an optimum arrangement plan can be relatively easier.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.388-399
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• 1993

The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993, 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft fractures. 3. The Interlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of fracture and then made early joint motion exercise and ambulation.

• Journal of the Korean Geotechnical Society
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• v.28 no.1
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• pp.55-66
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• 2012

The load transfer mechanism of hybrid model of soil-nailing and compression anchor is studied in this paper. The hybrid model is composed of an anchor bar (installed at the tip) with two PC strands and a steel bar. It can make active behavior of skin friction by applying the pre-stress. In this paper, the load transfer mechanisms of soil-nailings, compression anchors, and hybrid models, respectively, are obtained from skin friction theory and load transfer theory. Field pullout tests are performed to identify the load transfer mechanism and experimental results are compared with analytical solution. In case of soil-nailings, the tension load is transferred from face to tip, however, in case of compression anchors, the compression load is transferred from tip to face. The experimental behavior of the hybrid model is similar to that of compression anchor when only pre-stress is applied. If the pullout test is performed by simultaneously pulling out the anchor and the nail, the compression load is dominant at the tip and tension load is dominant at the face. The load transfer mechanism of the hybrid model shows the combined behavior of soil-nailings with compression anchors.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.326-333
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• 2021

Purpose: A retrograde intramedullary nail is commonly used to treat femoral shaft and distal femur fractures. The authors analyzed the treatment results and the factors affecting the period of bone union for thirty-five patients treated with a retrograde intramedullary nail. Materials and Methods: Thirty-five patients who could be followed up for more than twelve months after the treatment with retrograde intramedullary nailing were analyzed retrospectively. The treatment results and the relationship between the period of bone union and the patient's age, sex, comminution of fracture, presence of open fracture, location of the fracture, and accompanying fractures were evaluated. Results: The average bone union time was 4.50 months. The period of bone union was unaffected by the age, sex, location, and presence of open fractures but was affected by the presence of comminution and accompanying fractures. Conclusion: Retrograde intramedullary nailing is effective for distal and shaft of fractures of the femur. The period of bone union is affected by the presence of comminution and accompanying fractures.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.93-98
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• 2023

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.