• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.208-216
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• 2017

Background: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. Methods: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. Results: The ${\alpha}$ angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of ${\gamma}$ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). Conclusions: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.9-14
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• 2006

Purpose: The proximal tibial sarcoma patients, especially in their growing ages have problems of reconstruction. This study is to devise a methodology which can circumvent this limitations. Materials and Methods: Four cases of proximal tibial osteosarcoma underwent hemiarthroplasty. The mean age was 13 years (11~15) with a mean follow-up of 64 months (47~89). The procedure consists of ultrahigh molecular weight polyethylene (UHMWPE) liner as an substitute for the joint surface and this piece was fixed to the remaining tibial bone stock with Ender nail and bone cement. Results: Final functional score was 23.5 (78.3% of control) by MSTS criteria. All the cases showed stable joint without pain. Hemiarthroplasty related complications were absent. By saving the femoral physis, expected leg length discrepancy could be minimized by this procedure. Conclusions: Hemiarthroplasty of proximal tibia can be an option in pediatric sarcoma patients.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.91-96
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• 2015

Purpose: The purpose of this study is to evaluate the sequential changes of clinical and radiographic results after proximal chevron osteotomy in patients with moderate to severe hallux valgus. Materials and Methods: Between January 2008 and December 2009, 93 patients (117 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. The mean age of patients was 51 years (range, 19 to 71) and the mean duration of follow-up was 27.5 months (range, 24 to 35). Clinical results were evaluated using visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score preoperatively, at 3, 6, and 12 months after surgery, and at the last follow-up. Radiographic parameters including hallux valgus angle, intermetatarsal angle, and sesamoid position were evaluated preoperatively, immediately postoperatively, at 6 weeks, at 3, 6, and 12 months after surgery, and at the last follow-up. Results: VAS and AOFAS score showed significant improvement until 12 months after surgery. Hallux valgus angle and sesamoid position stabilized at 12 months after surgery and intermetatarsal angle stabilized at 6 months after surgery. Conclusion: Clinical and radiographic results were stabilized beyond 12 months after proximal chevron osteotomy in patients with moderate to severe hallux valgus.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.792-796
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• 2006

Purpose: After exposure of fracture site, the proximal segment must be reduced to their preinjury position for open reduction of fractured mandibular condyle. We examined the use of inter-maxillary fixation screws or titanium screws tied with stainless steel wire to assist in positioning of proximal segment. Since it enables to make a relatively small preauricular incision by not disturbing the operative field like Moule pin, we can reduce the danger of injury to the facial nerve. Methods: A preauricular approach was used for exposure, reduction, and rigid fixation in 4 cases of mandibular condylar fractures. Inter-maxillary fixation screws or titanium screws tied with stainless steel wire were used to assist in aligning proximal segment. The joints were submitted to functional exercises and postoperative radiologic and clinical follow-ups were performed. Results: No facial nerve lesions were found in all 4 cases. Radiologic follow-up showed correct reduction and fixation in all 4 cases. Clinical follow-up showed an initial limitation, but normal morbility of the condyle was achieved within 4 months after the operation, with a maximum mouth opening of $34.1{\pm}5.2mm$ after 12 months. There found no occlusal disturbances, no trismus, no lateral deviations of the mandible. Conclusion: By using Inter-maxillary fixation screws tied with stainless steel wire, it was shown that reducing the proximal segment to their preinjury position is easy to perform and it enables us to make a minimal dissection below preauricular skin incision to avoid facial nerve injury.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.216-222
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• 2016

Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.

• Journal of Biomedical Engineering Research
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• v.24 no.3
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• pp.233-239
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• 2003

Falling related injuries are categorized as the most serious and common medical problems experienced by the elderly, hip joint fracture, one of the most serious consequences of falling in the elderly, occurs in only about 1% of falling. Nevertheless, hip fracture accounts for a considerable part of the disability, death, and medical costs associated with falling. In this study, we considered the impact angle and displacement rate in falling as another factor affecting femoral strength. Using a fresh-frozen human femur, we developed system to simulate the falling condition and then conducted the experiments changing the impact angle (0$^{\circ}$, 15$^{\circ}$, 30$^{\circ}$) of proximal femur. Also, in order to analyze the relative risk due to falling to normal situation in proximal femur, we did the static test simulating the two-legged stance condition. The results showed that the change in impact angle affected the strain distribution in proximal femur, and that a large deformation in femoral neck than in other sites. Furthermore despite low impact velocity, a large deformation in proximal femur occurred in the impact test and different strain distribution was observed compare to the static case.

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.74-78
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• 2006

Objective : We examined the incidence of fenestration in the proximal segment of the anterior cerebral artery[ACA] and reviewed its clinical significance. Methods : Cerebral angiography was performed in 843 patients and magnetic resonance angiography[MRA] in 1,787; all patients had, or were suspected to have, cerebrovascular disease. We subsequently reviewed the angiography and MRA data. Results : Fourteen patients [six men and eight women, $35{\sim}81$ years of age, median age = 67 years] had proximal ACA fenestrations. Three of the 843 patients [0.36%] undergoing cerebral angiography had fenestrations of proximal ACA as did eleven of the 1,787 MRA patients [0.62%]. Seven fenestrations were located on the right side and seven fenestrations were located on the left side. The fenestrated ACA in one patient was associated with a saccular aneurysm at its proximal end. None of the 120 patients who underwent both conventional cerebral angiography and cranial MRA showed fenestration of proximal ACA. Conclusion : Although fenestration of ACA has little clinical significance, knowledge and recognition of this condition is important in the interpretation of cerebral images, especially during neurosurgical procedures.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.356-363
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• 2016

Objective: The additional arch length required for leveling (AALL) the curve of Spee (COS) can be estimated by subtracting the two-dimensional (2D) arch circumference, which is the projection of the three-dimensional (3D) arch circumference onto the occlusal plane, from the 3D arch circumference, which represents the arch length after leveling the COS. The purpose of this study was to determine whether the cusp tips or proximal maximum convexities are more appropriate reference points for estimating the AALL. Methods: Sixteen model setups of the mandibular arch with COS depths ranging from 0 mm to 4.7 mm were constructed using digital simulation. Arch circumferences in 2D and 3D were measured from the cusp tips and proximal maximum convexities and used to calculate the AALL. The values obtained using the two reference points were compared with the paired t -test. Results: Although the 3D arch circumference should be constant regardless of the COS depth, it decreased by 3.8 mm in cusp tip measurements and by 0.4 mm in proximal maximum convexity measurements as the COS deepened to 4.7 mm. AALL values calculated using the cusp tips as reference points were significantly smaller than those calculated using the proximal maximum convexities (p = 0.002). Conclusions: The AALL is underestimated when the cusp tips are used as measurement reference points; the AALL can be measured more accurately using the proximal maximum convexities.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.140-144
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• 2008

Purpose: The purpose of this study is to compare the treatment outcomes of distal chevron osteotomy with those of proximal metatarsal closing wedge osteotomy in patients with moderate severity hallux valgus. Materials and Methods: Forty-two patients (51 feet) who were underwent either distal chevron osteotomy (Group I, 22 patients, 27 feet) or proximal metatarsal closing wedge osteotomy (Group II, 20 patients, 24 feet) for the correction of moderate hallux valgus deformity were evaluated retrospectively. We assessed the radiographic results with several parameters including hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). And clinical results with modified AOFAS score at last follow-up. Results: There were no significant differences in IMA, HVA and DMAA between two groups preoperatively. We can achieve the good results with both procedures, but mean HVA and IMA of group II was significantly lower than those of group I. There was some loss of correction in group I at the last follow-up. There was no significant difference in clinical results according to modified AOFAS scoring between two groups at the last follow-up. Conclusion: The proximal metatarsal closing wedge osteotomy for the hallux valgus with moderate severity is better treatment option to achieve better radiographic correction and to prevent loss of correction or recurrence than distal chevron osteotomy.

• Development and Reproduction
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• v.23 no.4
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• pp.313-322
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• 2019

The epididymal fat pad is a male gonadal adipocyte tissue and is histochemically separated into distal and proximal parts. The development of epididymal fat during postnatal period has not been examined in detail. A previous research showed that expression of adipocyte-associated molecules in the distal epididymal fat of mouse is generally increased as postnatally aged. In the present study, expressional patterns of same adipocyte-associated molecules in the mouse proximal epididymal fat at 2, 5, 8, and 12 months of age were studied by quantitative real-time PCR analysis and were compared with those in the distal epididymal fat. The expressional levels of peroxisome proliferator-activated receptor gamma (Pparg), lipoprotein lipase (Lpl), and fatty acid synthase (Fasn) at 5 months of age were significantly lower than those at 2 months of age, while transcript level of leptin (Lep) at 5 months was higher than that at 2 months of age. The transcript levels of all molecules at 8 months of age were significantly increased, compared with those at 2 and 5 months of age. At 12 months of age, expression of delta like non-canonical Notch ligand 1 (Dlk1) was further significantly increased, while there was no change on the transcript level of Pparg and significant decreases of Fabp4, Retn, Lpl, Lep, Fasn, and adiponectin (Adipoq) transcript levels. The current findings show that expressional patterns of molecules associated with adipocyte in the proximal epididymal fat is somewhat different with those of the distal epididymal fat, suggesting the existence of regional variance in the epididymal fat.