• Title/Summary/Keyword: distal extension

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A Comparison of with and without in the Fixation of Distal Chevron Osteotomies for Hallux Valgus (무지 외반증 환자의 원위 갈매기형 절골술시 절골면 고정유무에 따른 치료결과 비교)

  • Yoo, Seong-Ho;Kim, Bu-Whan;Song, Moo-Ho;Ahn, Seong-Jun;Seo, Sang-Hyok
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.230-233
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    • 2006
  • Purpose: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. Materials and Methods: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). Results: On group A, the mean first MTP (metatarsophalangeal) angle corrected $17^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $20-37^{\circ}$) and the mean first IM (intermetatarsal) angle corrected $10^{\circ}$ pre-operatively to average $15^{\circ}$ (range; $9-18^{\circ}$). On Group B, the mean first MTP angle corrected $16^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $18-33^{\circ}$) and the mean first IM angle corrected $7^{\circ}$ pre-operatively to average $13^{\circ}$ (range; $9-16^{\circ}$) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. Conclusions: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.

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Is Adjacent Segment Disease More Frequent in Proximal Levels in Comparison with Distal Levels? Based on Radiological Data of at Least 2 Years Follow Up with More than 2 Level Thoracolumbar Fusions

  • Kim, Jung-Ho;Ryu, Dal-Sung;Yoon, Seung-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.603-609
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    • 2019
  • Objective : The purpose of this retrospective study was to determine which of the proximal adjacent segment disease (ASD) and distal ASD was more prevalent and what parameters is more related to ASD in proximal levels and distal levels after more than 2 levels fusions. Methods : The medical records were reviewed retrospectively for 856 cases. A total of 66 cases of ASD were enrolled. On preop magnetic resonance imaging, disc degeneration was measured at the upper and lower parts of surgically treated levels and confirmed by the commonly used Pfirrmann grade. Segmental flexibility in sagittal plane was embodied in segment range of motion (ROM) obtained through flexion and extension X-ray before surgery. Coronal angle was recorded as methods Cobb's angle including fusion levels preoperatively. For the comparison of categorical variables between two independent groups, the chi-square test and Fisher exact test were performed. Results : Proximal ASD and distal ASD were 37/856 (4.32%) and 29/856 (3.39%), respectively. The incidence of proximal ASD was relatively high but insignificant differences. In comparison between ASD group and non ASD group, proximal Pfirmman was higher in proximal ASD and distal Pfirmman was higher in distal ASD group (p=0.005, p<0.008, respectively). However, in the ROM, proximal ROM was higher in proximal ASD, but distal ROM was not different between the two groups (p<0.0001, p=0.995, respectively). Coronal angle was not quite different in both groups (p=0.846). Conclusion : In spite of higher frequency in ASD in proximal level in spinal fusion, it is not clear that incidence of ASD in proximal level is not higher than that of distal ASD group in more than 2 level thoracolumbar fusions. Not only Pfirrmann grade but also proximal segmental ROM is risk factor for predicting the occurrence of ASD in patients more than 2 level of thoracolumbar spine fusion operation excluding L5S1.

Repetitive Dorsiflexion Exercises in Ankles have Effects on the Active Range of Flexion and Extension Motion through Lumbar, Cervical Spine and Ankle, Wrist Joints (족관절의 반복적 배측굴곡 운동이 요.경추와 족.수관절의 능동 굴신 가동범위에 미치는 영향)

  • Moon, Sang-Eun;An, Sung-Jun;Jung, Dong-Sub
    • Journal of Korean Physical Therapy Science
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    • v.15 no.4
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    • pp.27-34
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    • 2008
  • Background: This study was designed to analyze Repetitive dorsiflexion exercises in ankles have effects on the active range of flexion and extension motion through lumbar, cervical spine and ankle, wrist joints. Methods: 30 female college students in their twenties who frequently wear high heels participated the number of the experimental group was 15 persons and the number of the control group was 15 persons. They did exercise at the physical therapy room in M college, from the 8th of March to the 11th of April 2007. The experimental group had used the model of dorsiflexion repetitive exercise three times per week, for 4 weeks, but the control group did not exercise at all. In the sagittal plane active ROM of the these spine and joints were measured before and after the experiment using a digital goniometer. The results of two groups were compared and analyzed using paired T-test. Results: The active range of flexion and extension motion of the vertebra(especially lumbar flexion) and distal joints were significantly different in exercise group(p<.05). Conclusion: The model of repetitive dorsiflexion exercise of the ankle joint had positive effects on improving the active range of flexion and extension motion of the lumbar vertebra and distal joints of limbs. The results suggest that the repetitive dorsiflexion exercise is useful and also effective therapy for improving motion in women usually wearing high-heel.

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A STUDY ON THE STRESS DISTRIBUTION OF ABUTMENT TEETH AND RESIDUAL RIDGE AREA BETWEEN TELESCOPIC AND CLASP TYPE RPD BY FEM METHOD (telescope형 및 Clasp형 유지장치를 이용한 국소의치 지지조직의 응력분포에 관한 삼차원 유한요소법적 연구)

  • Koak, Jai-Young;Kim, Kwang-Nam;Chang, Ik-Tae;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.1
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    • pp.104-126
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    • 1999
  • The purpose of this study was to compare and evaluate the stress distribution and displacement developed in the abutment teeth and residual ridge area by madibular unilateral distal extension removable partial denture with 2 different retainer designs. The retainers on right and left canine and right 2nd molar were Alters clasp in one model and telescopic crown in the other model. The stress distribution of abutment teeth and residual ridge area on two model were compared and analyzed with 3-dimensional finite element method. 150N and 400N forces were applied vertically, 30 degree and horizontally on the central fossa area of left 1st molar of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows 1. As the magnitude and angulation of applied force were increased, the magnitude of stress on the right and central residual ridge area and the right canine of the telescopic type increased and comparing to those of the Alters clasp type. 2. As the magnitude and angulation of applied force were increased, the mesial direction of displacement on the right residual ridge area and the right tooth of the telescopic type increased and the distal direction of displacement on left residual ridge area and the left canine increased comparing to those of Akers clasp type. 3. As the vertical force was applied, the distal direction of the displacement of the right tooth were greater and that of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. 4. As the 30 degree force was applied, the mesial direction of the displacement of the right tooth were greater and the distal direction of the displacement of the left canine was smaller and the upward displacement of the right canine was greater in telescopic partial denture than those of Akers clasp type. In the horizontal force the results were same in right area tooth but the distal direction of displacement was greater in left canine. 5. In both removable partial dentures, as the magnitude and degree of force were increased, the stress and displacement were increased. The compressive force was dominative than the ten sile force. 6. In both removable partial dentures, the magnitude of stress was greater on mucosal tissue area than that of the alveolar bone area on distal extension residual ridge area but the result was reversed on anterior residual ridge area. The displacement was always greater on mucosal tissue area than that of alveolar bone area.

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Influence of the length and location of implants on distal extension removable partial dentures: finite element analysis (후방연장 가철성 국소의치에서 임플란트의 길이와 위치가 응력분산에 미치는 영향)

  • Kim, Jin-Hee;Cho, Jin-Hyun;Lee, Cheong-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.3
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    • pp.186-194
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    • 2015
  • Purpose: To evaluate the effects of implant location and length on stress distribution and displacement in osseointegrated-implants that were associated with mandibular distal extension removable partial dentures (DERPD). Materials and Methods: A sagittally cut model with the #33, #34 teeth and a removable partial denture of the left mandible was used. Seven models were designed with NX 9.0. Models A, B, C had implants with lengths of 11, 6, 4 mm, respectively, under the denture base of the #37 artificial tooth. Models D, E, F had implants with lengths of 11, 6, 4 mm, respectively, under the denture base of the #36 artificial tooth. Model G did not have any implants. Axial force (250 N) was loaded on #36 central fossa. The finite element analysis was performed with MSC Nastran. Von Mises stress maps were plotted to visualize the results. Results: The models of #37 implant placement showed much lower stress concentration on the surrounding bone of the implant compared with #36. The #36 implant position tended to reduce displacement more than #37. Conclusion: When an IARPD is designed, the distal positioning of implant placement has more advantages in the edentulous bone of DERPD on the prognosis of short implants and the stress distribution of edentulous alveolar bone. Using implants with longer lengths are important for stress distribution. However, Additional studies are necessary of the effects of length on implant survival.

Hemiarthroplasty for Distal Humerus Fracture: A Systematic Review and Meta-analysis for Functional Outcome

  • Kwak, Jae-Man;Kholinne, Erica;Sun, Yucheng;Lee, Gwan Bum;Koh, Kyoung Hwan;Chun, Jae-Myeung;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.120-126
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    • 2018
  • Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included 'distal humerus fracture' and 'hemiarthroplasty'. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion ($107.6^{\circ}$ flexion-extension, $157.5^{\circ}$ for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.

Long-Term Changes in the Distal Aorta after Aortic Arch Replacement in Acute DeBakey Type I Aortic Dissection

  • Cho, Kwangjo;Jeong, Jeahwa;Park, Jongyoon;Yun, Sungsil;Woo, Jongsu
    • Journal of Chest Surgery
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    • v.49 no.4
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    • pp.264-272
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    • 2016
  • Background: We analyzed the long-term results of ascending aortic replacement and arch aortic replacement in acute DeBakey type I aortic dissections to measure the differences in the distal aortic changes with extension of the aortic replacement. Methods: We reviewed 142 cases of acute DeBakey type I aortic dissections (1996-2015). Seventy percent of the cases were ascending aortic replacements, and 3 0% of the cases underwent total arch aortic replacement, which includes the aorta from the root to the beginning of the descending aorta with the 3 arch branches. Fourteen percent (20 cases) resulted in surgical mortality and 86% of cases that survived had a mean follow-up period of $6.6{\pm}4.6years$. Among these cases, 64% of the patients were followed up with computed tomography (CT) angiograms with the duration of the final CT check period of $4.9{\pm}2.9years$. Results: There were 15 cases of reoperation in 13 patients. Of these 15 cases, 13 cases were in the ascending aortic replacement group and 2 cases were in the total arch aortic replacement group. Late mortality occurred in 13 cases; 10 cases were in the ascending aortic replacement group and 3 cases were in the total arch aortic replacement group. Eight patients died of a distal aortic problem in the ascending aortic replacement group, and 1 patient died of distal aortic rupture in the total arch aortic replacement group. The follow-up CT angiogram showed that 69.8% of the ascending aortic replacement group and 35.7% of the total arch aortic replacement group developed distal aortic dilatation (p=0.0022). Conclusion: The total arch aortic replacement procedure developed fewer distal remnant aortic problems from dilatation than the ascending aortic replacement procedure in acute type I aortic dissections.

A Study of Morphology of Maxillary Sinus by using the Orthopantomograms (Orthopantomogram을 이용한 상악동의 형태에 관한 연구)

  • Kim Hyung Shick
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.13 no.1
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    • pp.107-115
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    • 1983
  • This study was performed in order to analyse the morphology of maxillary sinus on orthopantomogram. The author anlaysed the anterior-posterior width of mesial wall, the extension of anterior margin in maxillary sinus and the interrelation between the root apex of maxillary 1st molar and sinus floor. The films consisted of 514 orthopantomograms divided into three groups ranging the 3rd decade, 4th and 5th decade and 6th decade. The obtained results were as follows: 1. The mean dimensions of the anterior - posterior width of mesial wall were 43.81±4.55㎜ for male and 43.80±4.49㎜for female in the right of maxillary sinus, 43.75±74㎜ for male and 43.37±3.92㎜ for female. 2. With age, the dimensional change of the anterior - posterior width of mesial wall in maxillary sinus was not observed. 3. The extension order of anterior margin of the maxillary sinus was distal to canine side, 1st premolar mesial side, canine mesial side, and 1st premolar distal side. 4. In the distance between the root apex of upper 1st molar and the maxillary sinus floor, the degree of closeness was more increased in the older-aged group than in the younger-aged group.

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THE EFFECTS OF TOOTH MOBILITY AND DESIGN OF DIRECT RETAINER ON THE STRESS OF SUPPORTING TISSUES IN UNILATERAL DISTAL EXTENSION REMOVABLE PARTIAL DENTURE (편측후방연장 국소의치에서 지대치 동요도와 직접유지장치의 설계가 지지조직의 응력에 미치는 영향)

  • Jong, Young-Wan;Jin, Tai-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.38 no.1
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    • pp.59-72
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    • 2000
  • This study was performed to investigate the effects of tooth mobility and design of the direct retainer on the stress of supporting tissues in distal extension removable partial denture. Tooth mobility was simulated and four different types of direct retainer such as Alters clasp, I-bar clasp, wrought wire clasp, and Dalbo attachment were designed and stress on the support-ing tissues were measured and analyzed with straingauge method. The following conclusions were drawn from this study. 1. The stress revealed at the lingual side of alveolar bone of the abutment tooth in edentulous area was the largest. 2. The stress at the lingual side of alveolar bone of the abutment tooth in edentulous area was increased according to the increase of tooth mobility in I-bar clasp and Dalbo attachment. 3. The stress at the residual ridge crest was the great in Dalbo attachment on mobility 0, in I-bar clasp on mobility 1, and in wrought wire clasp on mobility 2. 4. There was little changes of stress according to the increase of tooth mobility at buccal and lingual side of the residual ridge crest and around the abutment teeth in dentulous area.

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STRESS ANALYSIS OF ABUTMENT FOR DISTAL EXTENSION REMOVABLE PARTIAL DENTURE BY CLASP DESIGN AND IMPRESSION METHOD (편측후방연장 국소의치에서 인상채득 방법과 클라스프 설계에 따른 지대치의 응력분석에 관한 연구)

  • Ahn Hee-Young;Kim Kwang-Jun;Cho Hye-Won;Jin Tai-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.5
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    • pp.547-555
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    • 2001
  • This study was performed tn investigate the effects of impression method and design of the retainer on the stress of abutment tooth in distal extension RPD. Three different types of direct retainer such as Akers clasp, RPI clasp, and wrought wire clasp were designed. Stress on the abutment tooth was measured and analyzed with strain gauge method. Impressions were anatomic impression technique and functional impression technique. The following conclusions were drawn from this study. 1. The stress at the abutment tooth on all RPD was decreased in functional impression except RPI clasp retained RPD. 2 The stress at the abutment tooth on RPI clasp retained RPD was the most smallest in anatomic Impression. 3. While load is increase the stress at the abutment tooth was increased, but the change of stress at the buccal side of abutment tooth was not too much in functional impression.

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