• Title/Summary/Keyword: delayed fracture

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Subtalar Arthrodesis using Cannulated Screws and Morselized Bone Graft (유관 나사와 분쇄 골이식을 사용한 거골하 관절 유합술)

  • Ahn, Jae-Hoon;Kim, Kap-Jung;Choy, Won-Sik;Na, Kyu-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.66-70
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    • 2006
  • Purpose: To analyze the clinical and radiological outcome of subtalar arthrodesis using cannulated screws and morselized bone graft. Materials and Methods: Twenty one patients with follow-up of more than 1 year after subtalar arthrodesis were included in this study. Mean age was 40.8 years, and mean follow-up duration was 38 months. Underlying diseases were 19 cases of posttraumatic arthritis (18 calcaneal fractures and 1 talar fracture) and 2 cases of tarsal coalition. Clinically AOFAS ankle-hindfoot score, operation time, complication and satisfaction of patients were analyzed. Radiologically time to union, arthritis of surrounding joints, preoperative and postoperative talar declination angle were analyzed. Results: AOFAS ankle-hindfoot score was improved from preoperative 33 points to postooperative 79 points. Eighteen patients (86%) were satisfied with the results. Mean operation time was 91 minutes. All cases were fixed with 1-2 cannulated screws and morselized bone graft. Mean time to radiologic union was 12.1 weeks. There was 1 case of delayed union. There was no significant perioperative changes in talar declination angles. Conclusion: Subtalar arthrodesis using cannulated screws and morselized bone graft seems to be relatively simple and effective treatment method for subtalar arthritis.

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Operative Treatment of Ipsilateral Fractures of Clavicle and Scapula (동측에 발생한 쇄골 골절과 견갑골 골절의 수술적 치료)

  • Park Jung Ho;Suh Seung Woo;Park Sang Won;Lee Kwang Suk
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.46-50
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    • 1998
  • The superior shoulder suspensory complex is composed of glenoid fossa, coracoid process, coracoclavicular ligament, distal clavicle, acromioclavicular ligament, acromion. Traumatic double disruptions of this complex lose its suspensory action on the shoulder joint and result in functional loss and deformity. Careful radiologic evaluation and appropriate management are required for injuries to this complex. Ipsilateral fractures of clavicle and scapula create unstable anatomic situation on shoulder joint. Conservative treatment usually fails to achieve good functional recovery due to rotator cuff weakness, nonunion, delayed union, malunion and neurovascular injury. Authors studied the result of operative treatment of ipsilateral clavicle and scapular fractures to prevent such complications. Seven cases were treated with open reduction and internal fixations of clavicle alone or clavicle and scapula simultaneously and followed up for nineteen months(twelve months - thirty-eight months). All but one patient showed good or excellent functional result according to the scoring system of Rowe. Poor result was developed in the case which had brain injury. Rigid fixations of clavicle alone or clavicle and scapular fractures both can achieve stable reduction of the fractures and prevent sequelae. We concluded that operative treatment of ipsilateral fractures of clavicle and scapula is safe and yields predictable good results.

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Free Vascularized Osteocutaneous Fibular Graft to the Tibia (경골에 시행한 유리 생비골 및 피부편 이식)

  • Lee, Kwang-Suk;Han, Seung-Beom;Lee, Byung-Taek;Kim, Hyeong-Sik
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.1-10
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    • 2002
  • Purpose : To analyze the clinical results of free vascularized osteocutaneous fibula graft to tibial defect combined with soft tissue defect and infection. Materials and Methods : In the retrospective study of 51 consecutive cases of vascularized osteocutaneous fibular graft, the length of the grafted fibula, size of the skin flap, anastomosed vessels, ischemic time of the flap, time for union, hypertrophy of fibula and the complications were evaluated. Results : Initial bony union of the grafted fibula was obtained at 3.74 months after operation, except 4 cases of nonunion and delayed union. The weight bearing without external supports was possible at 18 months after operation in average. The fracture of grafted fibula was most common complication(16 cases). Conclusion : The vascularized osteocutaneous fibula graft provided satisfactory bony union and functional results in the cases not responsible for conventional treatment methods.

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A Blunt Traumatic Vertebral Artery Injury: A Case Report

  • Lee, Min A;Choi, Kang Kook;Lee, Gil Jae;Yu, Byung Chul;Ma, Dae Sung;Jeon, Yang Bin;Chung, Min;Lee, Jung Nam
    • Journal of Trauma and Injury
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    • v.29 no.1
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    • pp.28-32
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    • 2016
  • Blunt traumatic vertebral artery injury (TVAI) is relatively rare, but it may frequently be associated with head and neck trauma. TVAI is difficult to diagnose with diverse outcomes, thus it is a clinical challenge. There are no widely accepted guidelines for treatment and diagnosis, so that the diagnosis of TVAI can be easily delayed. Therefore, any clinical suspicion from clues on the initial imaging is important for diagnosis of TVAI. The authors report on the case of a patient diagnosed as having a TVAI with a transverse foramen fracture.

Review of Formability and Forming Property for Stainless Steel (스테인레스 강판의 가공특성과 성형성에 관한 고찰)

  • Kim, Y.S.;Park, J.G.;Ahn, D.C.;Kim, Y.H.
    • Transactions of Materials Processing
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    • v.20 no.3
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    • pp.193-205
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    • 2011
  • Because of its rustproof property, stainless steel is widely used in kitchen appliances, building materials, electronics, chemical plants and automobile exhausts. In addition, the utilization of stainless steel for fuel cell application is growing. As the demand for this material increases, it is necessary to study the basic properties of stainless steel such as corrosion resistance, heat transfer, formability, cutting or shearing ability and weldability. In this article, the mechanical properties, formability and press forming performance of stainless steel are reviewed. Since temperature and strain rate affect the press forming performance of STS304(austenitic) stainless steel, the influence of these parameters on the plastic behavior should be investigated. Moreover, measures for the prevention of ridging of STS430(ferritic) and delayed fracture of STS430, which respectively appear during and after press forming, should be considered. Recently, stainless steel sheets with a thickness lower than 0.2 mm have been widely used in applications for mobile phone, digital camera and fuel cell separator. Therefore, there is a growing interest of studying the grain size effect and plasticity at the crystal scale in order to understand the anisotropic behavior and micro forming ability of thin sheets. This review paper was written with the objective of helping engineers and researchers to understand the forming characteristics of stainless steel and to establish standards in plastic forming techniques.

Surgical Experience of Acute Traumatic Posterior Fossa Subdural Hematoma : Study of 6 Cases and Review of the Literatures

  • Park, Jong-Tae;Kim, Dae-Won
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.441-444
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    • 2006
  • Objective : The goal of this study is to evaluate the clinical results in six patients who underwent surgical decompression for the acute subdural hematomas[ASDH] of posterior cranial fossa. Methods : Six patients [five males and one female] who had undergone surgery for ASDH of posterior cranial fossa between 2000 and 2005, were evaluated retrospectively with regard to clinicoradiological findings and surgical outcomes. The mean age was 45.8 years [range $9{\sim}67\;years$]. Results : Preoperative computed tomography showed ASDH on cerebellar hemisphere in four patients and on midline in two. All patients had the associated lesions such as subarachnoid hemorrhage, epidural or subdural hematoma, intraventricular hemorrhage, contusion or pneumocephalus in supratentorial area. Fracture of occipital bone was noted in two patients. Of the four patients who had 13 to 15 of Glasgow coma scale score at the time of admission, three were deteriorated within 24 hours after trauma. Of these three patients, delayed subdural hematoma developed 1 hour after initial normal CT finding in one patient and increased in thickness in another one. Postoperative outcome showed good recovery in three patients and moderate disability in one. Two patients were expired. Conclusion : This study supports that early diagnosis based on strict observation and prompt surgery in the patients with ASDH in posterior fossa will lead to the best results.

Mitigation of seismic drift response of braced frames using short yielding-core BRBs

  • Pandikkadavath, Muhamed Safeer;Sahoo, Dipti Ranjan
    • Steel and Composite Structures
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    • v.23 no.3
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    • pp.285-302
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    • 2017
  • Buckling-restrained braced frames (BRBFs) are commonly used as the lateral force-resisting systems in building structures in the seismic regions. The nearly-symmetric hysteretic response and the delayed brace core fracture of buckling-restrained braces (BRBs) under the axial cyclic loading provide the adequate lateral force and deformation capacity to BRBFs under the earthquake excitation. However, the smaller axial stiffness of BRBs result in the undesirable higher residual drift response of BRBFs in the post-earthquake scenario. Two alternative approaches are investigated in this study to improve the elastic axial stiffness of BRBs, namely, (i) by shortening the yielding cores of BRBs; and (ii) by reducing the BRB assemblies and adding the elastic brace segments in series. In order to obtain the limiting yielding core lengths of BRBs, a modified approach based on Coffin-Manson relationship and the higher mode compression buckling criteria has been proposed in this study. Both non-linear static and dynamic analyses are carried out to analytically evaluate the seismic response of BRBFs fitted with short-core BRBs of two medium-rise building frames. Analysis results showed that the proposed brace systems are effective in reducing the inter-story and residual drift response of braced frames without any significant change in the story shear and the displacement ductility demands.

Radicular Pain due to Subsidence of the Nitinol Shape Memory Loop for Stabilization after Lumbar Decompressive Laminectomy

  • Son, Byung-Chul;Kim, Deog-Ryeong
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.61-64
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    • 2015
  • A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.

A case of traumatic pseudoaneurysm of the internal carotid artery accompanying massive epistaxis: treated with detachable Coil (비출혈을 동반한 외상성 내경동맥 가성동맥류 1례 : Detachable Coil에 의한 색전술)

  • Park, Dong-Jin;Lee, Jun-Ho;Kim, Sun-Gon
    • Korean Journal of Bronchoesophagology
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    • v.12 no.2
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    • pp.35-41
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    • 2006
  • Traumatic pseudoaneurysm of the intracavernous internal carotid artery(ICA) is extremely rare, but it is life threatening condition because of massive recurrent epistaxis. Unfortunately, the prompt diagnosis and treatment of this disease are frequently delayed due to its rarity and variable latent period, so this disease is regarded as a challenge to clinicians. Optimal therapy for this diseases demands rapid suspicion for it and is essential in order to give the best functional outcome with minimizing its morbidity and mortality. The authors present a case of male patient with traumatic pseudoaneurysm of intracavernous ICA accompanying severe epistaxis. This patient was a 37-year-old male with unilateral blindness and recurrent massive epistaxis after suffering trauma to head. Computed tomography, MRI and carotid artery angiogram showed pseudoaneurysm of intracavernous ICA with sphenoid bone fracture. The patient was effectively managed with occlusion of the pseudoaneurysmal circulation by endovascular interventional embolization technique utilizing mechanically detachable tungsten coils.

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Delayed Aortic Injury Caused by a Posterior Rib Fracture: A Case Report (늑골 골절에 의해 발생한 지연성 대동맥 손상에 대한 치험 1례)

  • Kim, Chang-Wan;Choi, Seon Uoo;Kim, Seon Hee;Kim, Jae Hun;Hwang, Jung Joo;Cho, Hyun Min;Song, Seung Hwan;Cho, Jeong Su
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.31-33
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    • 2015
  • Traumatic aortic injury is well recognized as a primary cause of instantaneous death in victims of thoracic blunt trauma presenting with an aortic rupture or dissection, particularly after a deceleration injury. However, a direct aortic injury caused by a fractured rib segment after blunt thoracic trauma is extremely rare. We report the case of a 43-year-old male patient who experienced an aortic injury caused by the sharp edge of a fractured rib after multiple rib fractures due to blunt thoracic trauma.

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