• Clinics in Shoulder and Elbow
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• v.23 no.3
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• pp.156-158
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• 2020

PHILOS plate fixation in osteoporotic proximal humerus fracture of old age is well-known for high complication rate, especially metal failure, providing various augmentation techniques, such as calcium phosphate cement, allogenous or autologous bone graft. We report a case of polymethyl methacrylate augmentation to provide appropriate reduction with a significant mechanical support. This can be a treatment option for displaced unstable osteoporotic proximal humerus fracture with marked bony defect.

• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.270-275
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• 2012

There may be complications after comminuted or intraarticular calcaneal fracture regardless of the initial treatment. Transcalcaneal talonavicular dislocation is rarely reported severe form of calcaneal fracture. We experienced a neglected transcalcaneal talonavicular subluxation case, who had been treated for intraarticular calcaneal fracture conservatively. Subtalar distraction bone block fusion was done for calcaneal malunion with talonavicular subluxation. Inspite of successful subtalar fusion, pain was persisted because of talonavicular re-subluxation with arthritis and calcaneocuboid arthritis. So, second operation, the talonavicular and calcaneocuboid fusion, was done. After union achieved, the patient's foot pain was improved. Calcaneal malunion combined with talonavicular subluxation and unstable transverse tarsal joint, such as this case, initial triple arthrodesis could be considered.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.61-65
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• 2021

A Morel-Lavallée lesion is a closed degloving injury caused by traumatic separation of the skin and subcutaneous tissue from the underlying fascia. However, since physicians tend to focus on treating the bone fracture, hemodynamic instability accompanying a Morel-Lavallée lesion can sometimes be overlooked. We report the case of a hemodynamically unstable 73-year-old man who had a Morel-Lavallée lesion of the thigh, but no femur fracture. Angiography showed active bleeding from the muscular branch of the right deep femoral artery, which was then successfully embolized.

• Structural Engineering and Mechanics
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• v.90 no.5
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• pp.481-492
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• 2024

This research examined the mechanical behavior of fiber-reinforced concrete at unstable environmental conditions. Concrete composites with varying percentages of steel and glass fibers were analyzed. Compressive, indirect tensile, and fracture toughness properties were evaluated using the Edge Notched Disc Bend (ENDB) test under freezing-thawing and acidic environments and the results were compared with normal conditions. Steel fibers decreased the strength in the specified cycles, while glass fibers showed a normal strength trend. The compressive, tensile and fracture toughness of the samples containing 1.5 vol.% fibers showed a 1.28-, 2.13- and 4.5-fold enhancement compared to samples without fibers, after 300 freezing-thawing cycles, respectively.

• Journal of the Korea Concrete Institute
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• v.14 no.5
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• pp.689-697
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• 2002

The dynamic loads and load-point displacements of concrete three-point bend (TPB) specimens had been measured. The average crack velocities measured with strain gages were 0.16 ㎜/sec ∼ 66 m/sec. The fracture energy for crack extension was determined from the difference of the kinetic energy for the load-point velocity and the strain energy without permanent deformation from the measure external work. For all crack velocities, there were micro-cracking for 23 ㎜ crack extension, stable cracking for 61 ㎜ crack extension at the maximum strain energy, and then unstable cracking. The unstable crack extension was arrested at 80 ㎜ crack extension except the tests of 66 m/sec crack velocity. The tests less than 13 ㎜/sec crack velocity and faster than 1.9 m/sec showed static and dynamic fracture behaviors, respectively. In spite of much difference of the load and load-point displacement relations for the crack velocities, the crack velocities of dynamic tests did not affect on fracture energy rate during the stable crack extension due to the reciprocal action of kinetic force, crack extension and strain energy. During stable crack extension, the maximum fracture resistances of the dynamic tests was 147％ larger than that of the static tests.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.272-275
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• 2015

Pelvic bone fracture with unstable vital signs is a life-threatening condition demanding proper diagnosis and immediate treatment. Unlike long bones, the pelvic bone is a three dimensional structure with complex holes and grooves for vessels and nerves. Because of this complexity, a pelvic bone fracture can lead to complicated and serious bleeding. We report a case of a fifty-year-old male suffering from a pelvic bone fracture due to a fall. An imaging study showed fractures of both the superior and the inferior ramus of the pubic bone, with contrast extravasation underneath them, resulting in a large preperitoneal hematoma. He was sent for angiography, which revealed a hemorrhage from a branch of the left obturator artery. Embolization was done with a glue and lipiodol mixture. The patient recovered without complication, and was discharged at four weeks after admission.

• Journal of Trauma and Injury
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• v.27 no.2
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• pp.29-32
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• 2014

Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.178-182
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• 2020

Isolated fractures of lower sacrum are commonly treated conservatively in most cases because of low energy damage and stable fracture. However, surgical treatment is required in displaced unstable fracture. But the surgical technique is not established and even case reports are not common. We reported a case of displaced transverse fracture of the lower sacrum that was treated with an open reduction and dual plate fixation.

• Asian Spine Journal
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• v.12 no.6
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• pp.967-972
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• 2018

Study Design: Biomechanical study. Purpose: To investigate the relative stiffness of a new posterior pelvic fixation for unstable vertical fractures of the sacrum. Overview of Literature: The reported operative fixation techniques for vertical sacral fractures include iliosacral screw, sacral bar fixations, transiliac plating, and local plate osteosynthesis. Clinical as well as biomechanical studies have demonstrated that these conventional techniques are insufficient to stabilize the vertically unstable sacral fractures. Methods: To simulate a vertically unstable fractured sacrum, 12 synthetic pelvic models were prepared. In each model, a 5-mm gap was created through the left transforaminal zone (Denis zone II). The pubic symphysis was completely separated and then stabilized using a 3.5-mm reconstruction plate. Four each of the unstable pelvic models were then fixed with two iliosacral screws, a tension band plate, or a transiliac fixation plus one iliosacral screw. The left hemipelvis of these specimens was docked to a rigid base plate and loaded on an S1 endplate by using the Zwick Roell z010 material testing machine. Then, the vertical displacement and coronal tilt of the right hemipelves and the applied force were measured. Results: The transiliac fixation plus one iliosacral screw constructions could withstand a force at 5 mm of vertical displacement greater than the two iliosacral screw constructions (p=0.012) and the tension band plate constructions (p=0.003). The tension band plate constructions could withstand a force at $5^{\circ}$ of coronal tilt less than the two iliosacral screw constructions (p=0.027) and the transiliac fixation plus one iliosacral screw constructions (p=0.049). Conclusions: This study proposes the use of transiliac fixation in addition to an iliosacral screw to stabilize vertically unstable sacral fractures. Our biomechanical data demonstrated the superiority of adding transiliac fixation to withstand vertical displacement forces.

• Clinics in Shoulder and Elbow
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• v.21 no.2
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• pp.95-100
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• 2018

Background: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures. Methods: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications. Results: At the removal, the pain VAS was $2.69{\pm}1.30$ and $4.10{\pm}2.14$ in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was $9.59{\pm}1.60$ and $7.81{\pm}2.67$ in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant. Conclusions: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.