• Title/Summary/Keyword: fracture repair

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Internal Fixation of Long Bone Fractures in 6 Calves (송아지에서 발생한 긴뼈골절의 내고정 치료 6례)

  • Park, Jin-Uk;Cho, Ki-Rae;Kim, Joong-Hyun;Choi, Seok-Hwa;Kim, Gon-Hyung
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.658-662
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    • 2007
  • The simple and easy treatment with cast or splint has been applied to stabilize long bone fractures in farm animals. Applying cast or splint is relatively easier than surgical fixation and may temporarily stabilize fracture site. However, the internal fixation provides strong stabilization and early recovery of limb function. In this report, we describe six cases of limb fractures in calves repaired by internal fixation. Fracture sites are various and affected ages are between 1 day and several months old. In some cases, patients were treated with cast or splint before admitting to Veterinary Medical Center. In these patients, regardless of initial treatment fractures were not immobilized. Consequently we decided to treat these patients with open reduction and internal fixation. The fracture repair with implants(bone plate, screw, cerclage wire, and intramedullary pin) were effective and satisfactory in calves which had been failed by application of cast. Although the cost of orthopedic treatment in farm animal is one of the most important considerations from the practical point of view, internal fixation has many benefits in newborn and young calves. And simplicity of postoperative management is also practically significant benefit expected from infernal fixation In conclusion, we suggest that internal fixation will produce better result than external coaptation in calve.

Femoral Bony Avulsion Fracture of the Posterior Cruciate Ligament in a Seventy one Year Old Man - A Case Report - (71세 남자에서 발생한 후방십자인대 대퇴골 부착부 견열 골절 - 1례 보고 -)

  • Lee, Yeong-Hyeon;Ahn, Gil-Yeong;Nam, Il-Hyun;Moon, Gi-Hyuk;Kim, Ki-Choul;Lee, Chae-Kyung;Lee, Sang-Chung
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.128-130
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    • 2010
  • Femoral avulsion fracture of posterior cruciate ligament (PCL) is rare, especially in adult. We experienced a case of femoral bony avulsion fracture of PCL. The patient was seventy one year old man with limitation of motion in the knee joint due to previous trauma and he was injured by fall down from 2 m height. We took CT scan and MRI study. We treated with arthroscopic repair technique using transfemoral two wire sutures. Second look arthroscopy was done for removal of the wires at postoperative one year.

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Management of gunshot wounds near the elbow: experiences at a high-volume level I trauma center

  • Umar Ghilzai;Abdullah Ghali;Aaron Singh;Thomas Wesley Mitchell;Scott A. Mitchell
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.3-10
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    • 2024
  • Background: Gunshot-related fractures near the elbow are challenging, and available data to guide the practitioner are lacking. This report analyzes injury patterns and treatment strategies in a case series from a high-volume urban trauma center. Methods: All periarticular gunshot fractures near the elbow treated at a level 1 trauma center from 2014 to 2018 were retrospectively reviewed. Fracture location, patient demographics, concomitant injuries, treatment modalities, and complications were analyzed. Results: Twenty-four patients were identified. All patients received prophylactic antibiotics upon admission and underwent urgent surgical debridement. Open reduction and internal fixation (ORIF) was performed with initial debridement in 22 of 24 patients. Seven patients sustained distal humerus fractures, 10 patients sustained isolated proximal ulna or proximal radius fractures, and seven had combined fracture patterns. Eleven patients presented with nerve palsy, and two had transected nerves. Two patients had vascular injury requiring repair. One patient required a temporary elbow-spanning external fixator and underwent staged debridement followed by ORIF. One patient with a grade IIIC fracture developed a deep infection that precluded ORIF. One patient required revision ORIF due to fracture displacement. Conclusions: This investigation reports on management of ballistic fractures near the elbow at a busy urban level I trauma center. Our management centered on rapid debridement, early definitive fixation, and intravenous antibiotic administration. We report on associated neurovascular injury, bone loss, and other challenges in this patient population. Level of evidence: IV.

Advantage of Middle Meatal Antrostomy in Transnasal Endoscopic Reconstruction of Medial Orbital Blow-out Fracture (안와내벽외향골절의 비내시경적정복술에 있어 중비도상악동절개술의 장점)

  • Kim, Soon Heum;Lee, Soo Hyang;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Kim, Bo Hyung
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.735-740
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    • 2007
  • Purpose: Blowout fracture is an outward fracture of the orbital wall. That usually occurs at inferior or medial wall of the orbit. The main pathophysiology is high intraocular pressure derived from impact of trauma. Among the four orbital wall, the medial wall is thinnest and most vulnerable to trauma. Many kinds of methods were introduced for correction of medial orbital wall fracture. Recently, transnasal endoscopic reconstruction methods were widely used. Endoscopic methods had many advantages. However, we experienced some cases of postoperative maxillary sinusitis. This study was planned to find out the effectiveness of middle meatal antrostomy after endoscopic reconstruction of medial orbital wall fracture. Methods: This study was retrospective analysis of 28 patients who underwent transnasal endoscopic repair of medial orbital wall fracture. The 18 male and 10 female patients were ranged from 17 to 57 years of age(mean, 30.9 years). Among 28 patients, randomly selected 17 patients underwent middle meatal antrostomy as additional procedure by the same surgeon. After at least 12 months of follow-up period, we examined the nasal symptom, endoscopic and CT findings. Results: One patient complained of nasal obstruction in middle meatal antrostomy group and four patients complained nasal symptoms in non middle meatal antrostomy group. On the endoscopic findings, three patients of non middle meatal antrostomy group had continuous nasal discharge. But middle meatal antrostomy group had no abnormal endoscopic findings. The abnormal CT finding(abnormal mucosal hypertrophy) were detected in four patient of non middle meatal antrostomy group. There were no abnormal CT findings in middle meatal antrostomy group. The data were statistically significant at comparative study. Conclusion: Authors think that the middle meatal antrostomy has some advantages as a additional procedure of endoscopic reconstruction of medial orbital wall fracture. Especially, it is good at preventing postoperative maxillary sinusitis. But, more larger group and strict application of disease entity are need for correct evaluation of middle meatal antrostomy effect.

Surgical Treatment for Type 11 Distal Clavicle Fracture using Mersilene tape and K-wire (Mersilene tape와 K-강선을 이용한 제 II형 원위부 쇄골 골절의 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha;Hong, Chang-Wha;Lee, Bum-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.123-128
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    • 2006
  • Purpose: Surgical reconstruction is usually indicated for type II distal clavicle fracture due to high rate of nonunion and delayed union. We report the clinical outcome of a surgical technique for type II distal clavicle fracture using Mersilen tape and K-wire. Materials and Methods: From 1999 through 2003, this technique has been used on 11 patients with type II distal clavicle fracture. The procedure consist of fracture reduction with a Mersilene tape, repair of torn coracoclavicular ligament, and K-wire fixation of the fracture fragment. All patients with at least 12 months of complete postoperative follow-up were included for functional and radiographic evaluation. We used simple X-ray and UCLA scoring system and constant scoring system for evaluation at last follow up in OPD. Results: Solid union of the fracture could be achieved at 11 weeks after operation in all patients. All patients could return to the same level of preinjury activity. Good and excellent results were obtained in all patients according to UCLA system. Conclusion: This technique was simple procedure and allowed for stable fixation with early mobilization and early return to work and sports.

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Clinical and Radiographic Outcome of Shoulder Function after Unreamed Antegrade Intramedullary Nailing for Humerus Fracture: Ultrasonographic Evaluation for Rotator Cuff Integrity (비확공성 전향적 상완골 금속정 고정술후 견관절 기능에 대한 임상적 및 방사선학적 평가: 초음파를 이용한 회전근 개 추시관찰)

  • Baek, Seung-Hoon;Choi, Chang-Hyuk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.1
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    • pp.1-9
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    • 2013
  • Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.

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Fracture Mechanics Analysis of Cracked Plate Repaired by Patch (I) (보강재로 보수된 균열평판의 파괴역학적 해석(I))

  • Jeong, Gi-Hyeon;Yang, Won-Ho;Jo, Myeong-Rae
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.24 no.8 s.179
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    • pp.2000-2006
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    • 2000
  • The enhancement of service life of damaged or cracked structures is currently major issue to the researchers and engineers. In order to improve the life of cracked aging aircraft structures, the repair technique which uses adhesively bonded boron/epoxy composite patches is being widely considered as a cost-effective and reliable method. This paper is to study the performance of the bonded composite patch repair of a plate containing an inclined central through-crack. A 3-dimensional finite element method having three layers to the cracked plate, composite patch and adhesive layer, is used to compute the stress intensity factor. In this paper, the reduction of stress intensity factors near the crack-tip are determined to evaluate the effects of various non-dimensional design parameter including composite patch thickness, and material properties of the composite patch and thickness of the adhesive layer, materials of patch etc., and the crack length, Finally, The problem of how to optimize the patch geometric configurations has been discussed.

Acute Osteomyelitis of the Humeral Head after Arthroscopic Rotator Cuff Repair (관절경적 회전근 개 봉합술 이후 발생한 상완골두의 급성 골수염)

  • Shin, Sang-Jin;Jeong, Byoung-Jin;Kook, Seung Hwan;Shin, Sung-Joon
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.141-147
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    • 2013
  • A 57-year-old man who simultaneously underwent an operation for repair of rotator cuff and a revision operation for nonunion of a Pilon fracture presented with osteomyelitis of the humeral head on the $19^{th}$ day after surgery due to MRSA (Methicillin-resistant Staphylococcus aureus) infection. Infection was controlled after administration of appropriate intravenous antibiotic therapy and performance of several surgical procedures. However, devastating defects at the humeral head and the rotator cuff remained. No case of short term MRSA induced osteomyelitis has been reported.

Effect of adhesive application method on repair bond strength of composite

  • Hee Kyeong Oh;Dong Hoon Shin
    • Restorative Dentistry and Endodontics
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    • v.46 no.3
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    • pp.32.1-32.10
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    • 2021
  • Objectives: This study aimed to evaluate the effect of the application method of universal adhesives on the shear bond strength (SBS) of repaired composites, applied with different thicknesses. Materials and Methods: The 84 specimens (Filtek Z350 XT) were prepared, stored in distilled water for a week and thermocycled (5,000 cycles, 5℃ to 55℃). They were roughened using 400-grit sandpapers and etched with phosphoric acid. Then, specimens were equally divided into 2 groups; Single Bond Universal (SU) and Prime&Bond Universal (PB). Each group was subdivided into 3 subgroups according to application methods (n = 14); UC: 1 coat + uncuring, 1C: 1 coat + curing, 3C: 3 coats + curing. After storage of the repaired composite for 24 hours, specimens were subjected to the SBS test and the data were statistically analyzed by 2-way analysis of variance and independent t-tests. Specimens were examined with a stereomicroscope to analyze fracture mode and a scanning electron microscope to observe the interface. Results: Adhesive material was a significant factor (p = 0.001). Bond strengths with SU were higher than PB. The highest strength was obtained from the 1C group with SU. Bonding in multiple layers increased adhesive thicknesses, but there was no significant difference in SBS values (p = 0.255). Failure mode was predominantly cohesive in old composites. Conclusions: The application of an adequate bonding system plays an important role in repairing composite resin. SU showed higher SBS than PB and the additional layers increased the adhesive thickness without affecting SBS.

Fabrication of surveyed crown and repairing the artificial teeth for existing removable partial denture using digital technology: a case report (디지털 방식을 이용한 기존 국소의치 맞춤 보철 제작과 심미적인 인공치 수리 증례)

  • Ina Kim;Eunji Oh;Sang-Won Park;Hyun-Pil Lim;Kwi-dug Yun;Chan Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.2
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    • pp.82-90
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    • 2024
  • It often happens that a removable partial denture needs to be repaired due to tissue changes in the remaining alveolar ridge, fracture of the denture, or fracture of the abutment tooth. There are several advantages to retrofitting a customized surveyed crown under the existing RPD. Retrofitting a crown to the RPD decreases the economic burden to the patient and avoids the need for several appointments to fabricate a new RPD. It is difficult for artificial teeth used to repair dentures due to fractured natural teeth to have a shape similar to that of natural teeth, and to repair aesthetic artificial teeth, it is necessary to manufacture customized artificial teeth similar to the shape of each patient's teeth. Recently, CAD/CAM technology has been used to fabricate customized prosthetics on existing RPD to achieve high retention and fitness accuracy, and by manufacturing customized artificial teeth, more aesthetic and harmonious artificial tooth repair is possible. This is a case in which a denture was repaired using a digital method to fabricate a customized prosthesis on an existing partial denture and customized artificial teeth that mirrored the adjacent dentition, saving time and cost, simplifying the process, and achieving aesthetically and functionally satisfactory results.