• 제목/요약/키워드: Tissue fixation

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Surgical Treatment of Olecranon Fractures

  • Koh, Kyoung-Hwan;Oh, Hyoung-Keun
    • Clinics in Shoulder and Elbow
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    • v.20 no.1
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    • pp.49-56
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    • 2017
  • Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.

Posterior Cervical Fixation with a Nitinol Shape Memory Loop for Primary Surgical Stabilization of Atlantoaxial Instability : A Preliminary Report

  • Kim, Duk-Gyu;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.21-26
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    • 2012
  • Objective : To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury. Methods : We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients' neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications. Results : Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period. Conclusion : Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

Proximal Symphalangism and Congenital Stapes Fixation (기부지절유합증을 동반한 선천성등골고정증)

  • 이철희;박영원;김종선;노관택
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.41.1-41
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    • 1981
  • The combination of congenital stapes fixation and proximal symphalangism has been described in several kindreds. It exhibits autosomal dominant inheritance. A patient, 11-year-old female, visited department of otolaryngology of SNUH in December, 1980. Her complaint was bilateral hearing loss since birth. Physical examination revealed fusion of proximal interphalangeal joints of both 4th and 5th fingers. Tympanic membrane was normal. Temporal bone X-ray was normal. Pure tone audiogram revealed about 60 dB conductive loss with horizontal curve. On exploratory tympanotomy of right side, bony fixation of stapedial footplate was found. So, stapedectomy with connective tissue wire prosthesis was performed. As a result, marked improvement of hearing was obtained with 5 dB A-B gap on operated side.

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Factors Affecting the Healing of Radial Fractures Using Acrylic Pin External Fixation in Small Breed Dogs

  • Chun, Bong-Su;Lee, Seoung-Jin;Seok, Seong Hoon;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.93-97
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    • 2019
  • Healing of 48 cases of radial fractures in small breed dogs treated with acrylic pin external fixation was evaluated retrospectively to investigate the factors affecting the healing of radial fractures. The mean age of the subjects was 15.02 months, the mean body weight was 3.48 kg, and the mean maximum length of the radius (MLR) was 90.77 mm. External skeletal fixation frames type 1a, 2a, and 3 were used; among them type 2a was used most frequently (75%). The mean time to clinical union (TCU) was 67.17 days, and the success rate was 95.8%. Age, bodyweight, MLR, and occurrence of complications increased TCU significantly. Among complications, pin loosening, swelling of the operated forelimb tissue for more than 2 weeks, and coexistence of two or more complications increased TCU significantly (p < 0.05). There was no relationship between location of the fracture and TCU. The results of this study may be useful to predict the prognosis of radial fractures in small dogs.

Ankle Salvage Procedure without Internal Fixation for Large Bone Defect after Failed Total Ankle Arthroplasty: A Case Report (실패한 족관절 인공관절 치환술 후 큰 골결손에서 내고정 없이 시행한 족관절 구제술: 증례 보고)

  • Park, Man-Jun;Eun, Il-Soo;Jung, Chul-Young;Ko, Young-Chul;Yoo, Chong-Il;Kim, Min-Woo;Hwang, Keum-Min
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.76-79
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    • 2014
  • In treatment of failure in ankle joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation, treatment of large bone defects is considerably important for ankle joint stability and union, therefore, the choice of treatment for large bone defects is use of femoral head or iliac crest bone graft and rigid internal fixation. Because first generation total ankle arthroplasty performed for the first time using a cemented fixation technique requires a large amount of bone resection during re-surgery and there is some possibility of a larger bone defect after removal of implants, in cases where prosthesis for the defect is needed, performance of palliative femoral head or iliac crest bone graft and rigid internal fixation can be difficult. We report on a case of a 48-year-old woman who had experienced ankle pain for 25 years since undergoing total ankle arthroplasty. Because the patient had little ankle motion and rigid soft tissue despite a large bone defect caused by aseptic loosening, a good outcome was obtained only for the femoral cancellous bone graft using allo femoral head without internal fixation.

Combined Percutaneous and Minimal on Internal Fixation of Calcaneal Fractures Using Extensile Lateral Approach (광범위 외측 도달법을 이용한 종골 골절의 경피적 및 최소 내고정술)

  • Yu, Sun-O;Kim, Joo-Sung;Kim, Jong-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.201-207
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    • 2002
  • Purpose: To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach. Materials and Methods: From March 2000 to February 2002, thirty-eight displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type IV of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative care, all fractures healed without secondary displacement except 1 case on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed. Conclusion: Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.

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Transposition Lateral Arm Flap for Coverage of the Elbow Defects (전이형 외측 상완 피판술을 이용한 주관절 연부조직 결손의 피복)

  • Song, Joo-Hyoun;Lee, Yoon-Min;Lee, Joo-Yup
    • Archives of Reconstructive Microsurgery
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    • v.17 no.2
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    • pp.82-86
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    • 2008
  • Purpose: Soft tissue defect can occur on the posterior aspect of the elbow after trauma or fracture fixation. To cover the defect and maintain elbow functions, various flap surgeries including latissimus dorsi muscle flap, lateral arm flap and radial forearm flap can be performed. We present the clinical results of transposition lateral arm flap for coverage of the elbow defect and discuss the cause of posterior soft tissue necrosis after fracture fixation. Materials and Methods: Two patients who had posterior soft tissue defect of the elbow after open reduction of the fractures around the elbow were treated with transposition lateral arm flap. The mean size of skin defect was 20 $cm^2$. The flap was elevated with posterior radial collateral artery pedicle and transposed to the defect area. Donor defect was covered with split thickness skin graft. The elbow was immobilized for 1 week in extended position and active range of motion was permitted. Results: All two cases of transposition lateral arm flap survived without marginal necrosis. The average range of motion of the elbow was 10~115 degrees. Mayo elbow performance score was 72 and Korean DASH score was 23. Conclusion: When elbow fractures are fixed with three simultaneous plates and screws, skin necrosis can occur on the posterior aspect of the elbow around olecranon area. If the size of skin defect is relatively small, transposition lateral arm flap is very useful option for orthopaedic surgeons without microsurgical technique.

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Assessment of neovascularization during bone healing using contrast-enhanced ultrasonography in a canine tibial osteotomy model: a preliminary study

  • Jeon, Sunghoon;Jang, Jaeyoung;Lee, Gahyun;Park, Seungjo;Lee, Sang-kwon;Kim, Hyunwook;Choi, Jihye
    • Journal of Veterinary Science
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    • v.21 no.1
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    • pp.10.1-10.12
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    • 2020
  • Blood perfusion of skeletal muscle and callus was evaluated using contrast-enhanced ultrasonography (CEUS) in a canine osteotomy model to determine the applicability of CEUS in the assessment of neovascularization during fracture healing and to compare the vascular signals on CEUS between external skeletal fixation and cast-applied dogs. In 6 Beagle dogs, a simple transverse osteotomy was performed at the left tibial shaft and external skeletal fixation (n = 3) or a cast (n = 3) was applied. Radiography, power Doppler ultrasonography (power Doppler), and CEUS were performed until complete union was achieved. On CEUS, vascular changes were quantitatively evaluated by measuring peak intensity (PI) and time to PI in the soft tissue and callus and by counting the vascular signals. Vascular signals from the soft tissue were detected on power Doppler and CEUS on day 2. Significantly more vascular signals were detected by CEUS than by power Doppler. On CEUS, PI in the surrounding soft tissue was markedly increased after the fracture line appeared indistinctively changed on radiography in all dogs. In the cast-applied dogs, vascular signals from the periosteal and endosteal callus were detected on CEUS before mineralized callus was observed on radiography. CEUS was useful in assessing the vascularity of soft tissue and callus, particularly in indirect fracture healing, and provided indications of a normally healing fracture.

EXPERIMENTAL STUDY ON EFFECTS OF PULP CAPPING AGENTS THAT ARE USED IN VITAL PULPOTOMY TO PULP TISSUE (생활치수절단술에 사용되는 복탁제가 치수에 미치는 영향에 관한 실험적 연구)

  • Cha, Moon-Ho
    • The Journal of the Korean dental association
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    • v.9 no.4
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    • pp.157-160
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    • 1971
  • To compare the effects of various pulp capping agents that are usually applied to human pulp tissue, adult dogs were bred for a certain period and each capping agent was applied experimentally to pulp tissue after vital pulpotomy. Histological observations are as follows. 1) In comparison between methods of vital pulpotomy, one and two appointment method, different courses of healing were observed. In one appointment method, the granulation tissue formation at the amputation sur face of pulp tissue had a tendency to be transformed to scar tissue formation. In two appointment method, more transformation than that of one appointment method from scar tissue to dentin matrix formation were observed. 2) Histologic changes that have appeared in pulp tissue are a) fixation at outer layer b) degeneration at middle layer c) hyperemia and round cell infiltration at inner layer 3) With use of formocresol mixed zinc oxide powder in two appointment method complete formation of dentin matrix were observed. 4) Among the methods and aagents described above formocresol mixed zinc oxide powder in two appointment method appeared to be relatively effective.

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STUDIES ON BLOOD GROUP SPECIFIC SUBSTANCE IN THE DENTAL HARD TISSUE -IDENTIFICATION OF A. B. O. BLOOD GROUPS FROM DENTAL HARD TISSUE LEFT STANDING UNDER VARIOUS CONDITIONS- (치아편조직의 혈형물질 검출에 관한 실험적 연구 -제매장조건하의 치아경조직에서 혈액형판정-)

  • Kim, Chong-Youl
    • The Journal of the Korean dental association
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    • v.19 no.5 s.144
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    • pp.449-461
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    • 1981
  • The author studied on the blood groups by the elution tests with teeth left standing under various conditions, and the following results were obtained. 1) The blood group identification with dental hard tissue proved to be possible. 2) In the cases of teeth left under various conditions-formalin fixation, standing in air, soil embedding and immersing in water-the identification of blood groups was possible in every case without any difference on difficulties. 3) The reaction of agglutination was somewhat more obvious in dentin substance than in enamel. 4) About 10 mg of dental hard tissue was recommendable for blood grouping.

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