• 제목/요약/키워드: Screw joint

검색결과 204건 처리시간 0.028초

천장관절융합술 후 기능 회복에 대한 추나요법을 포함한 한의복합치료 증례보고 1례 (A Case Report of Complex Korean Medicine Treatment Application Including Chuna Manual Therapy for Functional Recovery After Sacroiliac Joint Fusion)

  • 한윤희;박신혁;우현준;하원배;이정한
    • 척추신경추나의학회지
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    • 제17권2호
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    • pp.63-72
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    • 2022
  • Objectives This case study aimed to investigate the effect of complex Korean medicine treatment including Chuna manual therapy on sacroiliac joint (SIJ) pain status post SIJ fusion with sacroiliac screw fixation. Methods Complex Korean medicine treatments including Chuna manual therapy were provided to patients with SIJ widening due to a traffic accident trauma. Measurement of range of motion and manual muscle test to evaluate functional activities of daily living was conducted before and after treatment. Moreover, outcome estimates were performed using the numeric rating scale, pain disability index, and EuroQol 5-dimension five-level questionnaire. Results After complex treatment, functional activities of daily living improved. Sacroiliac joint pain decreased and the quality-of-life score improved. Conclusions This study suggests that treatment with complex Korean medicine treatment including Chuna manual therapy may improve traumatic SIJ widening status post SIJ fusion. A postoperative rehabilitation protocol based on accumulated research results considering a multidisciplinary approach should be prepared to ensure holistic treatment.

Novel computational approaches characterizing knee physiotherapy

  • Kim, Wangdo;Veloso, Antonio P.;Araujo, Duarte;Kohles, Sean S.
    • Journal of Computational Design and Engineering
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    • 제1권1호
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    • pp.55-66
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    • 2014
  • A knee joint's longevity depends on the proper integration of structural components in an axial alignment. If just one of the components is abnormally off-axis, the biomechanical system fails, resulting in arthritis. The complexity of various failures in the knee joint has led orthopedic surgeons to select total knee replacement as a primary treatment. In many cases, this means sacrificing much of an other-wise normal joint. Here, we review novel computational approaches to describe knee physiotherapy by introducing a new dimension of foot loading to the knee axis alignment producing an improved functional status of the patient. New physiotherapeutic applications are then possible by aligning foot loading with the functional axis of the knee joint during the treatment of patients with osteoarthritis.

Clinical Outcome of Modified Cervical Lateral Mass Screw Fixation Technique

  • Kim, Seong-Hwan;Seo, Won-Deog;Kim, Ki-Hong;Yeo, Hyung-Tae;Choi, Gi-Hwan;Kim, Dae-Hyun
    • Journal of Korean Neurosurgical Society
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    • 제52권2호
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    • pp.114-119
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    • 2012
  • Objective : The purpose of this study was 1) to analyze clinically-executed cervical lateral mass screw fixation by the Kim's technique as suggested in the previous morphometric and cadaveric study and 2) to examine various complications and bicortical purchase that are important for b-one fusion. Methods : A retrospective study was done on the charts, operative records, radiographs, and clinical follow up of thirty-nine patients. One hundred and seventy-eight lateral mass screws were analyzed. The spinal nerve injury, violation of the facet joint, vertebral artery injury, and the bicortical purchases were examined at each lateral mass. Results : All thirty-nine patients received instrumentations with poly axial screws and rod systems, in which one hundred and seventy-eight screws in total. No vertebral artery injury or nerve root injury were observed. Sixteen facet joint violations were observed (9.0%). Bicortical purchases were achieved on one hundred and fifty-six (87.6%). Bone fusion was achieved in all patients. Conclusion : The advantages of the Kim's technique are that it is performed by using given anatomical structures and that the complication rate is as low as those of other known techniques. The Kim's technique can be performed easily and safely without fluoroscopic assistance for the treatment of many cervical diseases.

Detection and Quantification of Screw-Home Movement Using Nine-Axis Inertial Sensors

  • Jeon, Jeong Woo;Lee, Dong Yeop;Yu, Jae Ho;Kim, Jin Seop;Hong, Jiheon
    • The Journal of Korean Physical Therapy
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    • 제31권6호
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    • pp.333-338
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    • 2019
  • Purpose: Although previous studies on the screw-home movement (SHM) for autopsy specimen and walking of living persons conducted, the possibility of acquiring SHM based on inertial measurement units received little attention. This study aimed to investigate the possibility of measuring SHM for the non-weighted bearing using a micro-electro-mechanical system-based wearable motion capture system (MEMSS). Methods: MEMSS and camera-based motion analysis systems were used to obtain kinematic data of the knee joint. The knee joint moved from the flexion position to a fully extended position and then back to the start point. The coefficient of multiple correlation and the difference in the range of motion were used to assess the waveform similarity in the movement measured by two measurement systems. Results: The waveform similarity in the sagittal plane was excellent and the in the transverse plane was good. Significant differences were found in the sagittal plane between the two systems (p<0.05). However, there was no significant difference in the transverse plane between the two systems (p>0.05). Conclusion: The SHM during the passive motion without muscle contraction in the non-weighted bearing appeared in the entire range. We thought that the MEMSS could be easily applied to the acquisition of biomechanical data on the knee related to physical therapy.

잠김 금속판(LCP-DF)을 이용한 대퇴골 원위부의 관절외 복합골절 치료시 나사못 배열에 따른 생체역학적 안정성 분석 (Effects of Screw Configuration on Biomechanical Stability during Extra-articular Complex Fracture Fixation of the Distal Femur Treated with Locking Compression Plate)

  • 권경제;조명래;오종건;이성재
    • 대한의용생체공학회:의공학회지
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    • 제31권3호
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    • pp.199-209
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    • 2010
  • The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.

임플랜트 지대주 나사의 텅스텐 카바이드/탄소 코팅이 전하중 및 조임회전각에 미치는 영향 (Influence of Tungsten Carbide/Carbon Coating on the Preload and Tightening Torque of Implant Abutment Screws)

  • 신현모;조욱;정창모
    • 구강회복응용과학지
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    • 제25권1호
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    • pp.53-59
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    • 2009
  • 본 연구는 external butt joint 연결 형태를 가진 임플랜트 시스템에서 티타늄 합금 나사와 텅스텐 카바이드와 탄소로 코팅한 나사의 압축력 및 조임 회전각 측정을 통해 동일한 전하중을 얻는 데 있어 코팅나사 사용이 갖는 임상적 효율성을 간접적으로 비교해 보고자 하였다. 본 연구에서는 Osstem Implant의 US II 시스템 고정체(${\phi}=4mm$)와 Cemented abutment를 사용하여 티타늄 합금(Ta) 지대주 나사 및 텅스텐 카바이드와 탄소로 표면 처리한(WC/CTa) 지대주 나사에 30Ncm의 조임 회전력을 적용한 후 압축력 및 조임 회전각을 측정하였다. 다음 WC/CTa 지대주 나사에서 측정된 압축력의 평균값을 계산하고 이를 Ta 지대주 나사에 적용하여 동일한 압축력이 가해질 때의 조임 회전력 값을 측정하였다. 그리고 실험결과 측정된 조임 회전력의 평균값을 Ta 나사에 적용한 후 조임 회전각을 측정하여 비교해 본 결과 다음과 같은 결론을 얻었다. 30Ncm의 조임 회전력에서 텅스텐 카바이드/탄소 코팅 나사가 티타늄 합금 나사보다 압축력과 회전각이 더 높게 나타났다. 텅스텐 카바이드/탄소 코팅 나사에 30Ncm의 조임 회전력을 적용하여 발생한 압축력을 얻기 위해서는 티타늄 합금 나사의 경우 55.6Ncm의 조임 회전력이 필요하였으며, 회전각에는 두 나사 간에 차이가 없었다.

임플란트와 상부구조물 사이의 micromotion에 관한 연구 (A study on the micromotion between the dental implant and superstructure)

  • 김지혜;송광엽;장태엽;박주미
    • 구강회복응용과학지
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    • 제19권1호
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    • pp.17-25
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    • 2003
  • Treatment with implants of single tooth missing cases is both functional and esthetic. Although the success rate of single-tooth implant treatments is increasing, sometimes it makes some problems. Problems with single-tooth implant treatments include soft tissue complications, abutment screw fracture, and most commonly, abutment screw loosening, and these involve the instability of the dental implant-superstructure interface. This study investigated and compared dental implant screw joint micromotion of various implant system with external connection or internal connection when tested under simulated clinical loading, Six groups (N=5) were assessed: (1) Branemark AurAdapt (Nobel Biocare, Goteborg, Sweden), (2) Branemark EsthetiCone (Nobel Biocare, Goteborg, Sweden), (3) Neoplant Conical (Neobiotec, Korea), (4) Neoplant UCLA (Neobiotec, Korea), (5) Neoplant 5.5mm Solid (Neobiotec, Korea), and (6) ITI SynOcta (Institute Straumann, Waldenburg, Switzerland). Six identical frameworks were fabricated. Abutment screws were tightened to 32-35 Ncm and occlusal screw were tightened to 15-20 Ncm with an electronic torque controller. A mechanical testing machine applied a compressive cyclic load of 20kg at 10Hz to a contact point on each implant crown. Strain gauge recorded the micromotion of the screw joint interface once a second. Data were selected at 1, 500, 5,000, 10,000, 20,000, 30,000, 40,000 and 50,000 cycle and 2-way ANOVA test was performed to assess the statistical significance. The results of this study were as follows; The micromotion of the implant-superstructure in the interface increased gradually through 50,000 cycles for all implant systems. In the case of the micromotion according to cycle increase, Neoplant Conical and Neoplant UCLA system exhibited significantly increasing micromotion at the implant-superstructure interface (p<0.05), but others not significant. In the case of the micromotion of the implant-superstructure interface at 50,000 cycle, the largest micromotion were recorded in the Branemark EsthetiCone, sequently followed by Neoplant Conical, Neoplant UCLA, Branemark AurAdapt, ITI SynOcta and Neplant Solid. Internal connection system showed smaller micromotion than external connection system. Specially, Neoplant Solid with internal connection system exhibited significantly smaller micromotion than other implant systems except ITI SynOcta with same internal connection system (p<0.05). In the case of external connection, Branemark EsthetiCone and Neoplant Conical system with abutment showed significantly larger micromotion than Branemark AurAdapt without abutment (p<0.05).

THE ASSESSMENT OF ABUTMENT SCREW STABILITY BETWEEN THE EXTERNAL AND INTERNAL HEXAGONAL JOINT UNDER CYCLIC LOADING

  • Lee, Tae-Sik;Han, Jung-Suk;Yang, Jae-Ho;Lee, Jae-Bong;Kim, Sung-Hun
    • 대한치과보철학회지
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    • 제46권6호
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    • pp.561-568
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    • 2008
  • STATEMENT OF PROBLEM: Currently, many implant systems are developed and divided into two types according to their joint connection: external or internal connection. Regardless of the connection type, screw loosening is the biggest problem in implant-supported restoration. PURPOSE: The purpose of this study is to assess the difference in stability of abutment screws between the external and internal hexagonal connection types under cyclic loading. MATERIAL AND METHODS: Each of the 15 samples of external implants and internal abutments were tightened to 30 N/cm with a digital torque gauge, and cemented with a hemispherical metal cap. Each unit was then mounted in a $30^{\circ}$ inclined jig. Then each group was divided into 2 sub-groups based on different periods of cyclic loading with the loading machine (30 N/ cm - 300 N/cm,14 Hz: first group $1{\times}10^6$, $5{\times}10^6$ cyclic loading; second group $3{\times}10^6$, $3{\times}10^6$ for a total cyclic loading of $6{\times}10^6$) The removal torque value of the screw before and after cyclic loading was checked. SPSS statistical software for Windows was used for statistical analysis. Group means were calculated and compared by ANOVA, independent t-test, and paired t-test with ${\alpha}$=0.05. RESULTS: In the external hexagonal connection, the difference between the removal torque value of the abutment screw before loading, the value after $1{\tims}10^6$ cyclic loading, and the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was not significant. The difference between the removal torque value after $3{\times}10^6$ cyclic loading and after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. In the internal hexagonal connection, the difference between the removal torque value before loading and the value after $1{\times}10^6$ cyclic loading was not significant, but the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was reduced and the difference was significant (P < .05). In addition, in the internal hexagonal connection, the difference between the removal torque value after $3{\times}10^6$ cyclic loading and the value after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. CONCLUSION: The external hexagonal connection was more stable than the internal hexagonal connection after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading (t = 10.834, P < .001). There was no significant difference between the two systems after $3{\times}10^6$, and additional $3{\times}10^6$ cycles.

족관절 삼과 골절에서 전후방 유관나사 후과 고정술의 2년 추시 결과 (Two-Year Follow-up Results of Anteroposterior Cannulated Screw Fixation of Posterior Malleolar Fragment in the Trimalleolar Fracture)

  • 정성윤;이명진;정영훈
    • 대한족부족관절학회지
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    • 제20권2호
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    • pp.67-72
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    • 2016
  • Purpose: The purpose of this study was to assess the 2-year follow-up results of patients with a trimalleolar fracture, who had undergone an anterior incision cannulated screw fixation of the posterior malleolar fragment, which had more than 25% of articular involvement or had no cortical continuity with the distal tibia. Materials and Methods: Among 28 patients with a trimalleolar fracture who had undergone fixation of the posterior malleolar fragment between February 2005 and February 2010, 14 patients, who underwent an anterior incision cannulated screw fixation of posterior malleolar fragment and were followed-up for more than 2 years, were selected. The postoperative clinical and radiological findings immediately and at the 1- and 2-year follow-up were compared. The clinical findings were evaluated as American Orthopaedic Foot and Ankle Society (AOFAS) score. The radiological assessment was evaluated as the maintenance of reduction, period to bone union, and the presence of nonunion, malunion, and complications. Results: The clinical outcome by mean AOFAS score revealed 83.0 points in the group with preoperative displacement below 2 mm and 80.7 points in the group with preoperative displacement above 2 mm postoperatively. The mean AOFAS score was 91.7 and 93.1 points in the group with preoperative displacement below 2 mm on 1- and 2-year follow-up, respectively, and 89.8 and 91.7 points in group with the preoperative displacement above 2 mm on 1- and 2-year follow-up, respectively. After a 2-year follow-up among 14 cases selected for this study, 13 cases showed an excellent reduction state and only 1 case (7.1%) showed a displacement of more than 2 mm. No complication were encountered in the group with preoperative displacement below 2 mm. On the other hand, among 8 patients in the group with preoperative displacement above 2 mm, there were 3 with limitations of the range of motion of the ankle joint (37.5%) and 1 post-traumatic arthritis (12.5%) at the 2-year follow-up. Conclusion: Anterior incision cannulated screw fixation of the posterior malleolar fragment could be a valuable method for the treatment of trimalleolar fractures that provides satisfactory results.