• Title/Summary/Keyword: Orthopaedics

Search Result 188, Processing Time 0.03 seconds

A Finite Element Analysis of Stress on the Femoral Stem with Resorption of Proximal Medial Femur after Total Hip Replacement (대퇴골 근위부 골흡수가 인공 고관절 대퇴 stem에 미치는 응력에 관한 연구-FEM을 이용한 분석)

  • 김성곤
    • Journal of Biomedical Engineering Research
    • /
    • v.15 no.2
    • /
    • pp.183-188
    • /
    • 1994
  • In clinical orthopaedics, bone resoption in the cortex is often seen post operatively on X-rays or bone densitometry after total hip replacement (THR) in the form of cortical osteoporosis or atropy. Stress shielding of bone occurs, when a load, normally carried by the bone alone, is shared with an implant as a result, the bone stresses are abnormal and with remodelling analysis this may cause extensive proximal bone resoption, possibly weakening the bone bed to the point of failure. The author made finite element models of the cemented and non-cemented type implanted femoral stem with bone resorption of the proximal medial femur and studied the feed back effect of the various degree of bone resoption to THR system by parametric analysis on the stress of the femoral stem and interface. The results of the present finite element analysis implied that the extent of proximal bone resorption has the effect of more increasing stress on the distal stem tip, cement mantle and interface in both type of femoral stem and this high distal stress possibly can cause the mechanical failure of loosening or failure after THR.

  • PDF

Dilemmas pertaining to three canals in the mesiobuccal root of a maxillary second molar: a case report

  • Arora, Ankit;Acharya, Shashi Rashmi;Saraswathi, Muliya Vidya;Sharma, Padmaja;Ather, Amber
    • Restorative Dentistry and Endodontics
    • /
    • v.38 no.3
    • /
    • pp.172-177
    • /
    • 2013
  • The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for the presence of a third canal. The root canal configuration of 3-2-1 was confirmed for the mesiobuccal root using information gained from clinical, radiographic, and multidetector computed tomography (MDCT) scan findings. This case demonstrates the need for efforts to locate extra canals in the mesiobuccal root of the maxillary molars as their internal anatomy remains a mystery.

Repeatable calibration of Hounsfield units to mineral density and effect of scanning medium

  • Crookshank, Meghan;Ploeg, Heidi-Lynn;Ellis, Randy;MacIntyre, Norma J.
    • Advances in biomechanics and applications
    • /
    • v.1 no.1
    • /
    • pp.15-22
    • /
    • 2014
  • Computed tomography (CT) is being utilized in orthopaedics and related research to estimate bone strength. These applications benefit from calibration of Hounsfield units to mineral density typical of long bone, up to $1750mg/cm^3$. This study describes a method for establishing repeatable calibration of Hounsfield units to density, and determines the effects of imaging medium on calibration accuracy. Four hydroxyapatite standards were imaged in air on 7 occasions over 19 weeks using a helical multi-slice CT scanner. Each standard was scanned 5 times in different media: porcine soft tissue, water, and air. Calibrated densities were highly repeatable (CV<3.5%). No difference in density was observed between water and soft tissue conditions (p>0.08). This work provides a model for determining repeatable scanner-specific density calibration, demonstrates that the linear relationship between Hounsfield units and density extends to values typical of cortical bone, and supports the practice of imaging calibration standards in an environment similar to that of the target bone.

Complications of olecranon osteotomy in the treatment of distal humerus fracture

  • Spierings, Kimberley E;Schoolmeesters, Bram J;Doornberg, Job N;Eygendaal, Denise;van den Bekerom, Michel PJ
    • Clinics in Shoulder and Elbow
    • /
    • v.25 no.2
    • /
    • pp.163-169
    • /
    • 2022
  • Distal humerus fractures (DHFs) are challenging to treat due to the locally complex osseous and soft tissue anatomy. Adequate exposure of the articular surface of the distal humerus is crucial when performing an anatomical reconstruction of the elbow. Even though "triceps-on" approaches are gaining popularity, one of the most commonly used surgical treatments for DHF is olecranon osteotomy. The incidence of complications related to this approach is unclear. This review was performed to assess the type and frequency of complications that occur with the olecranon osteotomy approach in the treatment of DHF. A literature search was conducted in the PubMed/Medline, Embase, and Cochrane Library digital databases up to February 2020. Only English articles describing complications of olecranon osteotomy in the treatment of DHF were included. Data on patient and surgical characteristics and complications were extracted. Statistical analysis was performed using SPSS. A total of 41 articles describing 1,700 osteotomies were included, and a total of 447 complications were reported. Of these 447 complications, wound infections occurred in 4.2% of osteotomies, of which 1.4% were deep infections and 2.8% were superficial. Problems related with union occurred in 3.7% of osteotomies, 2% of which represented non-union and 1.7% delayed union. The high risk of complications in olecranon osteotomy must be considered in the decision to perform this procedure in the treatment of DHF.

Survey of Areas Underserved by Plastic Surgery in Japan

  • Sato, Makoto
    • Archives of Plastic Surgery
    • /
    • v.49 no.2
    • /
    • pp.215-220
    • /
    • 2022
  • Background In Japan, there is a large regional disparity in plastic surgery availability. In order for plastic surgery to be widely available for all citizens, it is essential for at least one plastic surgery facility to be located in each secondary medical zone. Methods Using the Japan Society of Plastic and Reconstructive Surgery homepage and some databases, we extracted data on secondary medical zones that do not have a plastic surgery facility. The national and regional coverage rates were calculated. The coverage rate for each group divided by the degree of population concentration was also calculated. Results We found that 147 of 344 secondary medical zones did not have a plastic surgery facility, and the area coverage rate was found to be 57.27% nationwide. The coverage rate in terms of population was 87.07% (correlation coefficient of area and population coverage = 0.983). The area coverage rates in Hokkaido-Tohoku, Kanto, Chubu, Kansai, Chugoku-Shikoku, and Kyushu-Okinawa districts were 47.46, 72.15, 76.47, 62.79, 52.08, and 32.81%, respectively. The corresponding population coverage rates were 79.92, 91.62, 94.27, 90.59, 80.68, and 69.54%, respectively. The area coverage rates in metropolitan areas, provincial cities, and rural areas were 98.08, 75.90, and 15.87%, respectively. In contrast, the area coverage rate of dermatology was 62.79% and that of orthopaedics was 97.09%. Conclusion Unfortunately, it is estimated that more than 40% of secondary medical zones are underserved by plastic surgery, and 13% of the population is not able to fully benefit from this specialty in Japan.

Effect of Pore Structures of a Ti-49.5Ni (at%) Alloy on Bone Cell Adhesion (Ti-49.5Ni (at%)합금의 다공성 구조가 뼈 세포 흡착에 미치는 영향)

  • Im, Yeon-Min;Choi, Jung-Il;Khang, Dong-Woo;Nam, Tae-Hyun
    • Korean Journal of Materials Research
    • /
    • v.22 no.2
    • /
    • pp.66-70
    • /
    • 2012
  • Ti-Ni alloys are widely used in numerous biomedical applications (e.g., orthodontics, cardiovascular science, orthopaedics) due to their distinctive thermomechanical and mechanical properties, such as the shape memory effect, superelasticity and low elastic modulus. In order to increase the biocompatibility of Ti-Ni alloys, many surface modification techniques, such as the sol-gel technique, plasma immersion ion implantation (PIII), laser surface melting, plasma spraying, and chemical vapor deposition, have been employed. In this study, a Ti-49.5Ni (at%) alloy was electrochemically etched in 1M $H_2SO_4$+ X (1.5, 2.0, 2.5) wt% HF electrolytes to modify the surface morphology. The morphology, element distribution, crystal structure, roughness and energy of the surface were investigated by scanning electron microscopy (SEM), energy-dispersive Xray spectrometry (EDS), X-ray diffractometry (XRD), atomic force microscopy (AFM) and contact angle analysis. Micro-sized pores were formed on the Ti-49.5Ni (at%) alloy surface by electrochemical etching with 1M $H_2SO_4$+ X (1.5, 2.0, 2.5) wt% HF. The volume fractions of the pores were increased by increasing the concentration of the HF electrolytes. Depending on the HF concentration, different pore sizes, heights, surface roughness levels, and surface energy levels were obtained. To investigate the osteoblast adhesion of the electrochemically etched Ti-49.5Ni (at%) alloy, a MTT test was performed. The degree of osteoblast adhesion was increased at a high concentration of HF-treated surface structures.

Age and Survival of Cervical Cancer Patients with Bone Metastasis

  • Nartthanarung, Adisak;Thanapprapasr, Kamolrat;Udomsubpayakul, Umaporn;Thanapprapasr, Duangmani
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.19
    • /
    • pp.8401-8404
    • /
    • 2014
  • Background: To determine survival times of cervical cancer patients with bone metastasis related to the effect of age at the time of cervical cancer diagnosis, we performed the retrospectively analytical study. Methods: A total of 68 cervical cancer patients with bone metastasis were treated at a single hospital, during January 1998 to December 2010. Fifty-two medical records were identified and collected, the remaining sixteen medical records were not found. Main outcome measures were patient characteristics, clinical information, duration from cervical cancer diagnosis to bone metastasis diagnosis, survival time after bone metastasis and overall survival time. Results: Among fifty-two cervical cancer patients with bone metastasis, there were 13 patients who were less than 45 years old, and 39 patients were 45 years old or more at the time of cervical cancer diagnosis. The younger group had less median overall survival than the older group, with a statistically significant difference (21 months, 95% CI 19.93-22.06; 34 months, 95% CI 23.27-44.72, p = 0.021). However, they were comparable in the duration from cervical cancer diagnosis to bone metastasis diagnosis and the survival time after bone metastasis. Conclusion: Young patients with bone metastasis aged less than 45 years old at the time of cervical cancer diagnosis have a poorer prognosis than the elderly patients. Impact: To improve survival and quality of life, more intensive and novel multimodal treatments at the time of cervical cancer diagnosis should be considered in patients less than forty-five years, who can tolerate the side effects better.

Increased Osteoblast Adhesion Densities on High Surface Roughness and on High Density of Pores in NiTi Surfaces

  • Im, Yeon-Min;Gang, Dong-U;Kim, Yeon-Uk;Nam, Tae-Hyeon
    • Proceedings of the Materials Research Society of Korea Conference
    • /
    • 2009.11a
    • /
    • pp.39.1-39.1
    • /
    • 2009
  • NiTi alloy is widely used innumerous biomedical applications (orthodontics, cardiovascular, orthopaedics, etc.) for its distinctive thermomechanical and mechanical properties such as shape memory effect, super elasticity, low elastic modulus and high damping capacity. However, NiTi alloy is still a controversial biomaterial because of its high Ni content which can trigger the risk of allergy and adverse reactions when Ni ion releases into the human body. In order to improve the corrosion resistance of the TiNi alloy and suppress the release of Ni ions, many surface modification techniques have been employed in previous literature such as thermal oxidation, laser surface treatment, sol-gel method, anodic oxidation and electrochemical methods. In this paper, the NiTi was electrochemically etched in various electrolytes to modify surface. The microstructure, element distribution, phase composition and roughness of the surface were investigatedby scanning electron microscopy (SEM), energy-dispersive X-ray spectrometry(EDS), X-ray diffractometry (XRD) and atomic force microscopy (AFM). Systematic controlling of nano and submicron surface features was achieved by altered density of hydro fluidic acid in etchant solution. Nanoscale surface topography, such as, pore density, pore width, pore height, surface roughness and surface tension were extensively analyzed as systematical variables.Importantly, bone forming cell, osteoblast adhesion was increased in high density of hydro fluidic treated surface structures, i.e., in greater nanoscale surface roughness and in high surface areas through increasing pore densities.All results delineate the importance of surface topography parameter (pores) inNiTi to increase the biocompatibility of NiTi in identical chemistry which is crucial factor for determining biomaterials.

  • PDF

Design and manufacture of supersonic waves system that there is no invasion that there is no stimulation of embedded base for crush bone fracture patient's treatment (II) (파쇄 골절환자의 치료를 위한 임베디드 기반의 무자극, 무침습 초음파 시스템의 설계 및 제작(II))

  • Kim, Whi-Young
    • Journal of the Korea Computer Industry Society
    • /
    • v.7 no.5
    • /
    • pp.583-590
    • /
    • 2006
  • BT technology, medical treatment engineering technology is offering important role and grow by creative technology. Specially, bone fracture treatment can achieve very important role in research of bone, physiology and dynamics of bone is very useful patient's diagnostic and treatment in presence at a sickbed. <중략>Furthermore embedded base of in administration aspect as well as if supersonic waves curer is treatment innocuously and without invasion very efficient tell. If apply supersonic waves in bone fracture treatment, can reduce curer about 40%. Operation frequency through bone fracture treatment supersonic waves curer of embedded base designs and manufactured 1m Hz, 1.2mHz, 1.3mHz, 1.4mHz, supersonic waves origination that have 1.5mHz's tranducer, and embodied protocol in PDA base in this research, and did so that is interfaced to general PC. If is using but supplement research water that see clinically by diagnosis in city, is seen to become convenient medical treatment assistance mounting to bone fracture patient's treatment and courtesy call. Specially, tried to approach basic form after modeling processing if may be applied variously to physiotherapy, orthopaedics patient who gouge late, and study standardization special quality little more.

  • PDF

Review of Acute Traumatic Closed Mallet Finger Injuries in Adults

  • Botero, Santiago Salazar;Diaz, Juan Jose Hidalgo;Benaida, Anissa;Collon, Sylvie;Facca, Sybille;Liverneaux, Philippe Andre
    • Archives of Plastic Surgery
    • /
    • v.43 no.2
    • /
    • pp.134-144
    • /
    • 2016
  • In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed. Tubiana's classification takes into account the size of the bony articular fragment and DIPJ subluxation. We propose to stage subluxated fractures as stage III if the subluxation is reducible with a splint and as stage IV if not. Left untreated, mallet finger becomes chronic and leads to a swan-neck deformity and DIPJ osteoarthritis. The goal of treatment is to restore active DIPJ extension. The results of a six- to eight-week conservative course of treatment with a DIPJ splint in slight hyperextension for tendon lesions or straight for bony avulsions depends on patient compliance. Surgical treatments vary in terms of the approach, the reduction technique, and the means of fixation. The risks involved are stiffness, septic arthritis, and osteoarthritis. Given the lack of consensus regarding indications for treatment, we propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which we treat with extra-articular pinning.