• 대한치과보철학회지
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• 제33권1호
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• pp.98-129
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• 1995

The purpose of this study was to evaluate how mandibular implant-supported fixed complete prosthesis, implant and mandible responded mechanically, according to curvature of arch, number and location of fixture, and amounts of load. The shape of mandibular arch was tapered or square form and, 4 or 6 fixtures were implanted in each arch model. A vertical load of 10kg was applied at the center of prosthesis and a vertical load of 20kg was applied at the location of the 10mm or 20mm cantilever posterior to the most distal implant. Three-dimensional finite element analysis was performed for stress distribution and deflection using commercial software(ABAQUS program) for Sun-SPARC Workstation. The results were as follows : 1. The case square arch form was more stable to compare with that of tapered arch form in respect of stress distribution and displacement under vertical load on the center of prosthesis. 2. 6-implants cases were more stable than 4-implants cases for decreasing bending torque under vertical load on the center of prosthesis. 3. Under vertical load on cantilever extension, the case of 10mm long cantilever was more stable than that of 20mm long cantilever in respect of stress distribution and displacement. 4. Under vertical load on cantilever extension, 6-implants cases had a tendency to reduce displacement and to increase the reaction force of supporting point due to increasing of the bending stiffness of the prosthesis than 4-implant case. 5. When the ends of 10mm or 20mm long cantilever were loaded, the most distal implant was under compressive stress but the second most distal implant was under the highest tensile stress and the remaining implants were under varying tensile stress. 6. Because 6-implants cases had smaller displacement than 4-implants cases, 6-implants cases were more favorable in respect of prevention of screw loosening under repeated loadings.

• 대한정형도수물리치료학회지
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• 제1권1호
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• pp.65-74
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• 1995

There is no line of demarcation between the shoulder and elbow regions. Pain In the arm may originate at the shoulder with reference downwards or less often at the elbow with reference upwards. Most pains indicated by the patient at the elbow or forearm have a local origin, since at the more distal part of the upper limb the capacity for correct localization is good. Once it is clear that the elbow region is at fault, the joint and the muscles about it are tested by ten movements. 1. Four. Passive extension, flexion, pronation, supination-full range, LOM, painful, painless. 2. Four. Resisted extension, flexion, pronation, supination-strong, weak, painful, painless. 3. Two. Resisted flexion, extension at the wrist-painful, painless. The muscles that perform theses two movements arise from the humeral epicondyles and a lesion in either often causes pain felt at the elbow although the tissuse affected is not functionally a part of the elbow (i. e. Tennis elbow and Golfer's elbow).

• 대한치과보철학회지
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• 제36권1호
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• pp.150-165
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• 1998

For the purpose of evaluating the effect of both direct retainer design and bony absorption degree around abutment of indirect retainer on the supporting tissue of abutment of indirect retainer, dislodging force was transmitted to unilateral distal extension RPD bases. Analysis of stress distributed within the supporting tissue around abutment of indirect retainer was carried out. Using three-dimensional photoelastic stress analysis method and the conclusion is a follows. 1. According to the extent of force which the direct retainer of the most distal abutment tooth, the amount of force transmitted to the abutment tooth of indirect retainer was small. 2. Of all the cases, Mandibular first premolar which was used abutment tooth of indirect retainer, buccal, mesial and distal sides represented compression stress and lingual side represented tensile stress. 3. The more bone resorption of abutment tooth of indirect retainer, the more distortion of buccal and distal side of abutment tooth was existed and the extent of compression stress which was existed and distal side to abutment tooth was large. 4. When the alveolar bone around the abutment with indircet retainer is normal. The amount of force transmitted on abutment with indirect retainer was small in the order of Akers clasp, RPA clasp, RPI clasp. 5. When the alveolar bone around the abutment with indirect retainer has been absorbed 20% and 30%, the amount of force transmitted on abutment with indirect retainer was small in the order of RPA calsp, RPI clasp, Akers clasp. 6. When denture is displaced, shape of the direct retainer reciprocating abutment affect much the function of indirect retainer.

• 대한치과보철학회지
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• 제33권3호
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• pp.413-439
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• 1995

The purpose of this study was to evaluate the stress distribution developed in the supporting structures by mandibular distal extension removable partial dentures with 2 different direct retainer designs and with or without indirect retainer and abutment splinting. The examined direct retainers on the second bicuspid abutment tooth were Akers clasp and RPA clasp, the indirect retainer was located on the mesial fossa of the first bicuspid, and the first and second bicuspid were splinted in case of tooth splinting. Total 8 cases were compared and analyzed with 3-dimensional finite element method. 150N were applied vertically on the artificial teeth of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows : 1. The forces transmitted to the abutment tooth were primarily from the occlusal rests. 2. The abutment tooth was displaced distally when the force was applied. The compressive stress was observed at the distal root surface of the abutment tooth and the tensile stress, at the mesial root surface. 3. The denture base was displaced posteriorly and inferiorly when the force was applied. At the more distal portion of the denture base, the greater displacement was observed.And the anterior portion of the major connector was displaced superiorly. 4. The occlusal rest placed on the distal part of the abutment tooth tended to tip the tooth more posteriorly than did one on the mesial part of that tooth. 5. Severe superior displacement was observed at the anterior portion of the major connector in case of removable partial dentures without indirect retainer. 6. In case of tooth-splinting, the stress was distributed through all the root surface of both abuments. In case of no tooth-splinting, the stress was concentrated on the distal root surface of the primary abutment.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.20-26
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• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.94-99
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• 2020

Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion-extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

• 대한치과보철학회지
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• 제23권1호
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• pp.97-112
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• 1985

The purpose of this study was to evaluate the stress patterns developed in supporting structures by removable partial denture with attachment retainers. The attachments tested were Dalbo(miniature) attachment, resilient Ceka attachment, rigid Ceka attachment, precision and sleeve attachment, and R.P.I. clasp as a contrast. 3-dimensional photoelastic stress analysis was used to record the isochromatic and isoclinic fringe patterns and to calculate principal stress components at measuring points. The results showed that: 1. The maximum compressive stress on residual ridge was produced under the loading point with Dalbo and resilient Ceka attachment, distal to the loading point with rigid Ceka and precision and sleeve attachment, and mesial to the loading point with R.P.I. clasp. 2. The Dalbo attachment produced the most stress on residual ridge, and the least stress on abutment teeth. and resilient Ceka attachment showed favorable stress distribution. 3. Rigid Ceka attachment produced higher compressive stress on buccal. alveolar crest, and precision and sleeve attachment produced higher compressive stress on distal alvelolar crest and mesial surface of the root apex in abutment teeth. 4. R.P.I. clasp produced higher compressive stress on mesial alveolar crest.

• 대한족부족관절학회지
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• 제21권2호
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• pp.55-60
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• 2017

Purpose: Stiffness in the first metatarsophalangeal joint after surgery for hallux valgus has been reported. The goal of this study was to test the efficacy of releasing plantar aponeurosis for improving the range of extension in the first metatarsophalangeal joint that was limited after hallux valgus surgery. Materials and Methods: Thirteen patients (1 man, 12 women [17 feet]; median age, 54.4 years; range, 44~69 years) with limited first metatarsophalangeal joint extension after hallux valgus surgery, who underwent an additional procedure of plantar aponeurosis release between March 2015 and August 2015, were included. Subsequently, the passive range of extension in the first metatarsophalangeal joint was evaluated via knee extension and flexion positions. Hallux valgus angle, inter-metatarsal angle, distal metatarsal articular angle, and talo-first metatarsal angle were measured on weightbearing dorsoplantar and lateral radiographs of the foot preoperatively. Results: The mean range of extension for the first metatarsophalangeal joint improved significantly, from $2.5^{\circ}$ to $40.9^{\circ}$ in the knee extension position (p<0.00). The mean extension range for the first metatarsophalangeal joint also improved, from $18.2^{\circ}$ to $43.2^{\circ}$ in the knee flexion position (p<0.00). In all patients, congruence of the first metatarsophalangeal joint was recovered. Conclusion: Plantar aponeurosis release is an effective additional procedure for improving the extension range of the first metatarsophalangeal joint after hallux valgus surgery.

• 한국운동역학회지
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• 제15권4호
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• pp.131-142
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• 2005

This study was investigated the stability of the AK amputee gait through analysing the variability on kinematic variables between the sound leg and the prosthetic limb. The one male, AK amputee who could walk for himself with his prosthetic limb was participated in this study. Six cameras of the MCU 240 and the QTM(Qualisys Track Manager) software were used for data collecting in this study. The relative angle of both segments was the difference between the absolute angle of the distal segment and the absolute angle of the proximal segment. The coupling angles between the prosthetic limb and the sound leg were caculated on the thigh Flexion/Extension in relative to the shank Flexion/Extension and the shank Flexion/Extension n relative to the foot Flexion/Extension. In order to evaluate the variability of segment and joint angle, C.V. was used, and to evaluate the variability for coupling angles, the Relative motion calculated by vector coding method of the continuous methods was used. As stated, the gait pattern of the prosthetic limb was almost similar gait pattern of the sound leg, but the prosthetic limb showed that the gait pattern of the sound leg and the prosthetic limb were not stable against the sound leg.

• 대한치과보철학회지
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• 제56권4호
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• pp.375-383
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• 2018

완전 무치악 환자에서 임플란트를 이용한 보철 수복을 계획하는 경우 임상의는 많은 어려움과 직면하게 된다. 임플란트를 이용한 고정식 보철물로 수복하려는 경우 높은 치료 비용과 장기간의 치료 기간뿐만 아니라 고도로 흡수된 치조골로 인해 추가적인 수술을 동반해야 하는 경우가 많다. 또한 임플란트 피개의치 제작 시에는 수복물을 위한 악간 공간의 부족이 문제가 될 수 있다. 본 연구에서는 최근 연구되고 있는 임플란트를 지대치로 이용한 가철성 수복 증례의 하나로, 상악 완전 무치악 환자에서 전치부의 소수 임플란트 식립 후 이를 지대치로 하는 후방 연장 국소의치 수복을 수행하였다. 이는 치조골 이식 등의 부가적인 수술 가능성을 줄여 치료 기간을 단축시키며, 고령의 환자에게도 비교적 받아들이기 쉬운 치료법이 될 수 있다. 본 증례에서 이를 이용하여 환자에게 기존의 보철물 양식과 유사한 보철 수복을 제공하여 빠른 적응과 저작 효율 및 심미성을 회복하였으며, 만족할만한 치료 결과를 보여주었다.