• Clinics in Shoulder and Elbow
• /
• v.25 no.4
• /
• pp.288-295
• /
• 2022

Background: There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment. Methods: Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography. Results: Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis. Conclusions: Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.

• Clinics in Shoulder and Elbow
• /
• v.19 no.3
• /
• pp.143-148
• /
• 2016

Background: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. Methods: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. Results: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. Conclusions: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.3
• /
• pp.201-206
• /
• 2005

Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.

• Journal of the Korean Society for Precision Engineering
• /
• v.27 no.2
• /
• pp.137-144
• /
• 2010

In general, spinal fusion surgery takes pressure off the pain induced nerves, by restoring the alignment of the spine. Therefore spinal fixation system is used to maintain the alignment of spine. In this study, a biomechanical study was performed comparing the SROM(Spinal Range Of Motion) of three types of system such as Rigid, Dynesys, and Fused system to analyze the behavior of spinal fixation system inserted in vertebra. Dynesys system, a flexible posterior stabilization system that provides an alternative to fusion, is designed to preserve inter-segmental kinematics and alleviate loading at the facet joints. In this study, SROM of inter-vertebra with spinal fixation system installed in the virtual vertebra from L4 to S1 is estimated. To compare with spinal fixation system, a simulation was performed by BRG. LifeMOD 2005.5.0 was used to create the human virtual model of spinal fixation system. Through this, each SROM of flexion, extension, lateral bending, and axial rotation of human virtual model was measured. The result demonstrates that the movement of Dynesys system was similar to normal condition through allowing the movement of lumbar.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.2
• /
• pp.120-125
• /
• 2012

Objective : To investigate the feasibility of C1 lateral mass screw and C2 pedicle screw with polyaxial screw and rod system supplemented with miniplate for interlaminar fusion to treat various atlantoaxial instabilities. Methods : After posterior atlantoaxial fixation with lateral mass screw in the atlas and pedicle screw in the axis, we used 2 miniplates to fixate interlaminar iliac bone graft instead of sublaminar wiring. We performed this procedure in thirteen patients who had atlantoaxial instabilities and retrospectively evaluated the bone fusion rate and complications. Results : By using this method, we have achieved excellent bone fusion comparing with the result of other methods without any complications related to this procedure. Conclusion : C1 lateral mass screw and C2 pedicle screw with polyaxial screw and rod system supplemented with miniplate for interlaminar fusion may be an efficient alternative method to treat various atlantoaxial instabilities.

• Proceedings of the KSME Conference
• /
• 2008.11a
• /
• pp.664-667
• /
• 2008

Since the advent of pedicle screw fixation system, posterior spinal fusion has markedly increased This intemal fixation system has been reported to enhance the fusion rates, thereby becoming very popular procedure in posterior spinal arthrodesis. Although some previous studies have shown the complications of spinal instruments removal, i.e. loss of correction and spinal collapse in scoliosis or long spine fusion patients, there has been no study describing the benefit or complications in lumbar spinal fusion surgery of one or two level. In order to clarify the effect of removal of instruments on mechanical motion profile, we simulated a finite element model of instrumented posterolateral fused lumbar spine model, and investigated the change of mechanical motion profiles after the removal of instrumentation.

• Archives of Plastic Surgery
• /
• v.50 no.2
• /
• pp.142-147
• /
• 2023

Some of Asian eyelids have double fold and some do not. Many people tend to prefer double eyelid in aesthetic and functional reasons. Since the mechanism of double eyelid is bonding the eyelid skin to the eye-opening tissue, the principle of double eyelid surgery is also connecting the eyelid skin to levator component. Double eyelids are differentiated by their shape according to the height and curvature. The double eyelid surgery procedure is divided into incision method and nonincision method. And the incision method is subdivided into double fold line design, skin and oculi muscle incision or excision, pretarsal or preaponeurotic soft tissue excision, fixation of posterior lamella to anterior lamella, and skin suture. The nonincision method is to connect the posterior lamella and the anterior lamella as a thread only without an incision. A successful double eyelid surgery creates a fold well-balanced in height, curvature, and depth of the fold based on patient's preference. In this article, the author's own methods of performing surgery are described, with a step-by-step guide and surgical tips.

• Proceedings of the KSME Conference
• /
• 2008.11a
• /
• pp.1527-1532
• /
• 2008

45% of the sports accidents is the knee damage and the representative case is the damage of an Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament(PCL). Although the past different views of ACL reconstruction comes to an agreement, the disputes of PCL is remained yet. The most important engineering approach for these various surgery techniques is accurately to understand and to evaluate the fatigue behavior depending on the stress flow and the stress distribution under the allotted load and the cyclic load, which are caused by the graft fixing device, the proximal tibia of the PCL reconstructing structure. Therefore, this study is the basic research of these above facts. The current transtibial tunnel surgery using the cadaveric Achilles tendon grafts is chosen for the various PCL reconstruction. The relationships between the slippage, the extension ratio, and the slippage ratio by the heel bone fixing method and the soft tissue fixing method of the Achilles tendon were also defined. This research will be the essential data to help the resonable operating techniques for the next PCL reconstruction.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.6
• /
• pp.495-498
• /
• 2007

Fractures of lumbo-sacral junction involving bilateral sacral wings are rare. Posterior lumbo-sacral fixation does not always provide with sufficient stability in such cases. Various augmentation techniques including divergent sacral ala screws, S2 pedicle screws and Galveston rods have been reported to improve lumbo-sacral stabilization. Galveston technique using iliac bones would be the best surgical approach especially in patients with bilateral comminuted sacral fractures. However, original Galveston surgery is technically demanding and bending rods into the appropriate alignment is time consuming. We present a patient with unstable lumbo-sacral junction fractures and comminuted U-shaped sacral fractures treated by lumbo-sacro-pelvic fixation using iliac screws and discuss about the advantages of the iliac screws over the rod system of Galveston technique.

• Journal of Korean Foot and Ankle Society
• /
• v.9 no.2
• /
• pp.193-196
• /
• 2005

A posterior 3-portal arthroscopic approach with the patient in the prone position provides a novel and optimal approach for isolated subtalar arthrodesis. This approach facilitates access to the posterior talocalcaneal facet and facilitates safe access with regard to the posteromedial neuromuscular bundle. The technique involves prone positioning, establishment of two posterolateral portals and one posteromedial portal, arthroscopic posterior talocalcaneal facet debridement, percutaneous morcellized bone grafting and internal screw fixation. Preliminary results have shown high patient satisfaction, an excellent fusion rate and less postoperative morbidity than open subtalar arthrodesis.