• The Journal of Korean Academy of Prosthodontics
• /
• v.48 no.2
• /
• pp.94-100
• /
• 2010

Purpose: The purpose of this study was to compare the fracture strength of the zirconia ceramic crowns according to tooth position. Material and methods: After 10 metal dies were made for each group, the zirconia ceramic crowns were fabricated using CAD/CAM system ($Lava^{TM}$ All-Ceramic System) and each crown was cemented on each metal die with resin cement (Rely $X^{TM}$ Unicem). The cemented zirconia ceramic crowns mounted on the testing jig were inclined with 30 degrees to the long axis of the tooth and the universal testing machine was used to measure the fracture strength. Results: 1. The fracture strength of the zirconia ceramic crown in the lower 1st molar (2963 N) had the highest and that in the lower central incisor (1035 N) had the lowest. 2. The fracture strength of zirconia ceramic crown was higher than that of the IPS Empress crowns in all tooth position. 3. The fracture mode of the crowns was similar. Most of fracture lines began at the loading area and extended through proximal surface perpendicular to the long axis of the crowns. 4. There were no significant differences on the fracture strength of the zirconia ceramic crowns according to tooth position except in premolar group. Conclusion: Within the limitations of this study, the results suggested that strength of zirconia ceramic crown is satisfactory for clinical use.

• The Journal of Korean Academy of Prosthodontics
• /
• v.33 no.4
• /
• pp.611-633
• /
• 1995

The pupose of this study was to compare the fracture strength of five kinds of all-ceramic crowns(Vintage, Dicor Empress-staining, Empress-layering, In-Ceram) luted with glass ionomer cerment and composite resin cement and to evaluate the effect of cements on the fracture stregth of all ceramic crowns. Five groups of twelve uniform sized all-ceramic crown specimens were fabricated. Six specimens of each group were cemented with glass ionomer cement(Fuji G.I. Cement) and the remaining six specimens of each group were etched, silane-treated, and cemented with composite resin cement(Bistite resin cement). The crowns were stored in water$(37^{\circ}C)$ for 1 day prior to loading in an Instron, using a steel ball(diameter 4mm) at a crosshead speed of 0.5mm/min. The crowns were angled $30^{\circ}$, so the steel ball contacted with the crowns 2mm lingual from the mid-incisal edge. The results obtained were summarized as follows ; 1. With G.I. cement, mean fracture load(Kg) Were : Intage : $18.33{\pm}1.47$ ; Empress-staining : $23.92{\pm}6.67$ ; Dicor : $24.0{\pm}5.81$ ; Empress-layering : $26.92{\pm}2.80$ ; In-Ceram : $51.58{\pm}6.87$ ; ANOVA revealed a significant difference existed(p<0.05) between the group A(Vintage, Dicor, Empress-staining, Empress-layering) and group B(In-Ceram). 2. With Resin cement, mean fracture load(Kg) were : Intage : $22.75{\pm}4.97$ ; Dicor : $42.75{\pm}7.07$ ; Empress-staining : $44.08{\pm}7.99$ ; Empresslayering : $50.42{\pm}5.43$ ; In-Ceram : $52.58{\pm}6.51$ ; ANOVA revealed a significatnt difference existed(p<0.05) between the group A(Vintage) and B(Dicor, Empress-staining Empress-alyering, In-Ceram). 3. Resin cement significantly increased the fracture strength of the all-ceramic crowns for Dicor(156%), Empress-staining(185%), Empress-alyering(187%)(p<0.05); but did not increase the fracture strength of Vintage(128%) and In-Ceram(101%)(p>0.05). 4. Majority of the all-ceramic crowns show a wedge fracture extending through proximal surfaces to an apex, usually apical third(with G.I. cement) or middle third(with Resin cement) of the facial surface.

• Clinics in Shoulder and Elbow
• /
• v.18 no.2
• /
• pp.68-74
• /
• 2015

Background: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. Methods: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. Results: At the final follow-up, the mean Korean Showlder Society score and Constant scores were $88.96{\pm}12.1$ and $86.6{\pm}11.9$, respectively, in group A and $86.21{\pm}11.8$ and $85.3{\pm}11.7$, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was $1.6^{\circ}$ in group A and $4.8^{\circ}$ in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). Conclusions: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.

• Clinics in Shoulder and Elbow
• /
• v.2 no.2
• /
• pp.187-198
• /
• 1999

Purpose: The authors compared the results of Ender nailing for the proximal humerus fractures with those of the conservative methods radiographically. Materials and Method: Nine patients(mean age: 69 years.) received Ender nailing, and the other nine patients, conservative treatments(mean age: 73 years). All fractures were 2 part fractures. The Ender nails were inserted either through posterior elbow approach or transepicondylar approach. A simple Velpeau bandage was applied to the conservative treatment group. The average follow-up was 15 months. Results: The initial status of the anatomical reduction, i.e., the values of the medial shift, overlapping and the varus agulation, were little changed at follow-up radiographs in both the Ender nailing group and the conservative treatment group. There was no significant difference for the status of anatomical reduction between the Ender nailing group and the conservative treatment group. The stability of fixation by Ender nails, i.e., the degree of fanning out of the nails was poor in most cases. Not a few problems/complications happened in cases of Ender nailing group; back­ing out of the nail in three cases, penetration of the nails into the humeral heads in 3, fractures or cracking of the humerus around the nail insertion area in 4 and reduction loss in one. Conclusion: We could not get better results with the use of Ender nail. We use no longer Ender nails for the proximal humerus fractures. Further studies are needed for the better option for the proximal humerus fractures.

• Investigative Magnetic Resonance Imaging
• /
• v.21 no.3
• /
• pp.177-182
• /
• 2017

Schwannomas are benign nerve sheath tumors that are typically located in soft tissue. Occasionally, schwannomas involve osseous structures. These intraosseous schwannomas are generally benign neoplasms that account for less than 0.2% of primary bone tumors. Schwannomas are very rarely observed in long bones. We present a case of a schwannoma affecting the proximal femur with a coincident subchondral fracture of the femoral head. A 38-year-old-male presented with left hip pain without deteriorating locomotor function. Plain film radiographs displayed a lobulating contoured lesion within the intertrochanteric portion of the femur. The magnetic resonance imaging (MRI) scans showed a tumor occupying the intertrochanteric region. Diffuse bone marrow edema, especially in the subchondral and head portions of the femur that was possibly due to the subchondral insufficiency fracture was also noted. The lesion was surgically excised and bone grafting was performed. Histologically, there was diffuse infiltrative growth of the elongated, wavy, and tapered cells with collagen fibers, which are findings that are characteristic of intraosseous schwannoma. Although very rare, intraosseous schwannoma should be included in the differential diagnosis of radiographically benign-appearing, non-aggressive lesions arising in the femur. The concomitant subchondral fracture of the femoral head confounded the correct diagnosis of intraosseous schwannoma in this case.

• Clinics in Shoulder and Elbow
• /
• v.19 no.4
• /
• pp.223-228
• /
• 2016

Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

• Journal of Mechanical Science and Technology
• /
• v.15 no.7
• /
• pp.1072-1076
• /
• 2001

A biomechanical study was conducted in this study to investigate if in-line skating wrist guards can effectively reduce the impact forces so as to protect the wrist from fracture. The forearm specimens with and without wrist guards were dropped using a specially designed sled to simulate the impact on the wrist while falling. A force plate was used to measure the total impact force on the dropping weight whereas a load cell was attached to the proximal end of the specimen and used to quantify the impact transmitted through the wrist joint. From the non-destructive tests, mean peak force measured from a force plate showed no difference between the guarded and unguarded groups whereas mean impulse of the guarded group was significantly greater than that of the unguarded group (p<0.01). Comparing the peak force and impulse measured from the load cell, the peak force of the guarded group was significantly less than that of the unguarded group (p<0.001), while the impulse values were similar. When the specimens were dropped from a higher position (2.5ft ve. 1ft), all unguarded specimens had severe wrist fractures whereas fracture was found in three out of 5 guarded specimens. Comparison of mean peak forces and impulses showed as significant difference between the guarded and unguarded groups only in the mean impulse measured from the force plate. These results suggest that the wrist guard may protect the wrist by attenuating the peak force transmitted to radius and ulnar although it may not be effective when the wrist is subjected to an impact sufficiently large to cause fractures.

• Parasites, Hosts and Diseases
• /
• v.62 no.1
• /
• pp.131-138
• /
• 2024

Halicephalobus gingivalis is a free-living nematode that occasionally causes infections in horses. We report a rare case of limb fracture of horse caused by infection with H. gingivalis. An 8-year-old mare was referred to the Veterinary Hospital of the Federal University of Lavras with claudication grade 5 of the right hind limb, that had been started 3 months ago. The patient had aseptic arthritis in the tarsal joint and edema that extended to the quartile. The radiographic examination showed punctate osteolysis with exacerbation of bone trabeculation along the calcaneus, talus, proximal epiphysis of the third metatarsal and distal epiphysis of the tibia. Treatment for arthritis was initiated, and the animal showed a slight improvement in limb function. However, 21 days after hospitalization, due to a comminuted fracture of the tibia, it was euthanized. At necropsy, yellowish masses were found from the metatarsal to the tibia, and around the tarsal bones and joint. Similar masses were also found in the left kidney. Numerous nematodes compatible with H. gingivalis were identified. This is the first description of a pathological fracture caused by H. gingivalis infection in an equine limb.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.7 no.2
• /
• pp.98-104
• /
• 2014

Purpose: To evaluate the incidence of deep vein thrombosis (DVT) before hip fracture by duplex color Doppler ultrasonography. Materials and Methods: From June 2013 to May 2014, 27 patients who had agreed to perform color Doppler ultrasonography before hip fracture surgery were evaluated for the incidence of DVT. Patients who had history of DVT were excluded. Five patients were men and 19 patients were women. The mean age was 74.3 years old (41-87). There were 15 cases of femoral neck fracture, 11 cases of intertrochanteric fractures and one case of acetabular fracture. Surgical intervention underwent within 48 hours from admission and duplex color Doppler ultrasonography was carried out at the day of admission. Results: DVT occurred in six cases (22.2%). Four cases (14.8%) occurred in proximal deep vein and two cases (7.4%) occurred in distal deep vein. The mean period of immobilization was longer in patients who had DVT. But there was no significant difference. The mean age was 79 years old (75-87) in patients who had DVT and 72 years old (65-86) in patients who had not. There was significant difference (p=0.038). Conclusion: The incidence of DVT which was diagnosed by duplex color Doppler ultrasonography before hip fracture surgery was relatively high (22.2%). So it is necessary to undergo duplex color Doppler ultrasonography more aggressively to rule out DVT before hip fracture surgery.

• Journal of Veterinary Clinics
• /
• v.22 no.1
• /
• pp.60-64
• /
• 2005

A 6year-old intact male hound cross dog, weighing 23 kg, was presented to the Teaching Animal Hospital, Chonbuk National University with the history of gunshot wound at the left elbow joint. Survey radiographs of the affected elbow revealed the presence of a metallic bullet caudal to the olecranon processes and comminuted fracture of the proximal radius and ulna. The first treatment strategy included removal of the bullet and fixation of the radius and ulna using separate bone plates, bone screw, K-wire and surgical wire, was failed. The second treatment strategy included olecranon osteotomy and rigid immobilization of the elbow joint with a bone plate applied to the caudal aspect of the humerus and ulna along with autogenous bone grafts collected from the 13th rib. The optimal angle of the joint following arthrodesis of this case appeared to be 130°. This resulted in improving the case but after 60 weeks the plate was bent and there was exudation from the wound. The third treatment strategy was the same with the second except for that the bone autografts were collected from the proximal metaphyses of the ipsilateral humerus. This resulted in a successful arthrodesis 6 weeks after the surgery. Elbow arthrodesis with bone autograft resulted in acceptable function, but abnormal gait remained in the dog due to mechanical interference with the movement of the joint.