• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.187-194
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• 2011

Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.

• Journal of Veterinary Clinics
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• v.36 no.5
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• pp.292-295
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• 2019

A 2-year-old, 440 kg, thoroughbred gelding showed a lameness grade of 3 out of 5, as well as swelling and heating on the proximal interphalangeal joint (PIPJ). Periarticular new bones due to the arthritis were observed on performing radiography and ultrasonography. PIPJ arthrodesis was performed under general anesthesia. With the PIPJ open, the articular cartilage was removed by using curette, chisel, and mallet. Arthrodesis was performed with a PIP plate and two additional transarticular cortex screws inserted in lag fashion. A cast was placed over the limb distal from the proximal metatarsal bone. At 6 months after surgery, complete union of the PIPJ was confirmed by radiography, and the incision site was well closed. Based on the outcome, a PIP plate with two additional transarticular cortex screws inserted in lag fashion is recommended as a method for treating osteoarthritis of the PIPJ in horses.

• The Journal of the Korean dental association
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• v.57 no.4
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• pp.204-212
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• 2019

Introduction : Patients with temporomandibular disorder may have various ear-related symptoms. If an excessive load is applied to the ear area due to the skeletal shape of the mandibular condyle or malposition of the disc, an auditory problems may occur. Case report : The patient was referred to our clinic due to the suspicion of temporomandibular disorder from the local otorhinolaryngology clinic. A few days ago, his right ear could not be heard. MRI showed that the left TMJ disc was anterior displacement with reduction, the right TMJ disc was anteromedial displacement without reduction. Also Right mandibular condyle showed sclerotic bone change, subchondral cyst and was compressing the frontal wall of the ear on MRI view. Right TMJ arthroplasty was done under the diagnosis of right TMJ osteoarthritis and osteochondroma. Postoperative intermaxillary fixation was done with SAS screw and elastics for 2 weeks. One month after the operation, hearing and TMJ discomfort were recovered without any complications. Conclusions As seen in this case, hearing loss due to benign tumor-like lesions of the temporomandibular joint should be treated surgically to restore the TMJ function and hearing.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.276-283
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• 2013

Purpose: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. Materials and methods: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (${\alpha}=.05$). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. Results: The pre-loading reverse torque values were $26.0{\pm}0.30Ncm$ (ready-made abutment; Transfer abutment) and $26.3{\pm}0.32Ncm$ (CAD-CAM custom-made abutment; CustomFit abutment) and $24.7{\pm}0.67Ncm$ (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. Conclusion: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

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

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.72-78
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• 2007

Purpose: This study is to analysis the outcome of patient with surgically treated Maisonneuve fracture and find out the factors that might influence the outcome. Material and methods: 20 patients who had surgical treatment due to Maisonneuve fracture between February, 2001 to March, 2005 were studied. The patients were followed for at least 1 year and average follow up period was 25 months. The average age was 41 years, 16 were male and 4 were female. Mechanism of injury according to Rouge-Hansen classification was supination-external rotation. In all cases, percutaneous screw fixation was applied proximal to tibiofibular syndesmosis. The screws were removed after 8 weeks under local anesthesis. Clinical, functional and radiographic results were evaluated. Results: 17 cases (85%) showed satisfying clinical and radiographic results. The mean functional score according to Ankle Scoring System was 91 (83 to 95). Complication occurred in 1 case with underlying systemic disease and 2 cases with initial ankle joint dislocation. Conclusion: Surgical treatment of Maisonneuve fracture showed relatively satisfying result. However, initial injury state and accompanying disease seem to have great effect on the result.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.176-180
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• 2003

We describe in this report the accurate reduction of a transverse displaced glenoid fracture through arthroscopic control . We used the lateral and superior (Neviaser portal) portal of the arthroscopic surgery in the shoulder joint for the U 4.0-mm titanium cannulated cancellous screw fixation. The advantages of this treatment are excellent intra-articular visualiBation, decreased soft tissue dissection ,less blood loss, shortened postoperative recovery and early ROM exercise. There(ore, we report the method of operation and the cases .

• Journal of Korean Foot and Ankle Society
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• v.21 no.3
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• pp.98-103
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• 2017

Purpose: The aim of this study was to analyze the factors related to nonunion in tibiotalar arthrodesis. Materials and Methods: Eighty cases of ankle arthritis treated with tibiotalar arthrodesis in our hospital from November 2008 to November 2015 with more than one year follow up were analyzed. Simple anteroposterior and lateral radiographs after 6 and 12 months of surgery were analyzed. Union was defined as more than 50% connection of the trabecular bone at the ankle joint surface in the anteroposterior and lateral radiographs. The nonunion group was defined as no signs of union with persistent pain 9 months after surgery. The surgical approach, type of used screw, preoperative and postoperative ankle alignment, body mass index (BMI), bone mineral density, and patients' prior history were compared between the two groups. Results: There were 69 union cases and 11 nonunion cases. In the patient factors, the gender and BMI was related to nonunion (p<0.05). The mean preoperative and postoperative ankle alignment in the nonunion group was $9.93^{\circ}{\pm}6.92^{\circ}$ and $5.43^{\circ}{\pm}3.35^{\circ}$ respectively, and $9.80^{\circ}{\pm}7.55^{\circ}$ and $5.63^{\circ}{\pm}3.45^{\circ}$ in the union group, respectively; the difference was not statistically significant (p>0.05). In the technical factors, the transfibular approach showed a better relationship but the association was not significant (p<0.05). In 40 cases of the transfibular approach, 12 cases used cancellous screws, and 4 cases showed nonunion due to screw breakage. Conclusion: Technical factors, such as the surgical approach and the type of screw used can be a risk factor in nonunion. In addition, patients' factors, such as gender and BMI, must be considered to reduce the nonunion rate.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.223-227
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• 2013

Objective : Although there is no consensus on the ideal treatment of the craniocervical instability, biomechanical stabilization and bone fusion can be induced through occipito-cervical fusion (OCF). The authors conducted this study to evaluate efficacy of OCF, as well as to explore methods in reducing complications. Methods : A total of 16 cases with craniocervical instability underwent OCF since the year 2002. The mean age of the patients was 51.5 years with a mean follow-up period of 34.9 months. The subjects were compared using lateral X-ray taken before the operation, after the operation, and during last follow-up. The Nurick score was used to assess neurological function pre and postoperatively. Results : All patients showed improvements in myelopathic symptoms after the operation. The mean preoperative Nurick score was 3.1. At the end of follow-up after surgery, the mean Nurick score was 2.0. After surgery, most patients' posterior occipito-cervical angle entered the normal range as the pre operation angle decresed from 121 to 114 degree. There were three cases with complications, such as, vertebral artery injury, occipital screw failure and wound infection. In two cases with cerebral palsy, occipital screw failures occurred. But, reoperation was performed in one case. Conclusion : OCF is an effective method in treating craniocervical instability. However, the complication rate can be quite high when performing OCF in patients with cerebral palsy, rheumatoid arthritis. Much precaution should be taken when performing this procedure on high risk patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2356-2363
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• 2015

This study deals the optimization design with the simulation based design of a coil spring inserted into the lock nut for preventing the screw thread from loosening at the bolted joint when the high-strength steel bolt with the property class of 10.9 is used and the screw torque of 640 to 800 (Nm) is applied. In this study, structural analysis of assembly composed of bolt, nut and coil spring is carried out to evaluate its safety factors on the basis of the equivalent stress with commercial finite element analysis software. And the design strategy to extract the design improvement from these simulation results is established. An iterative process performed with the proposed design strategy is also proposed for improving the performance of the existing design. At the proposed procedure, the feasible design parameters using response surface method are found, and then these parameters are verified to be optimal or not by comparing with the response values and the simulation results obtained from the feasible parameters.