• Title/Summary/Keyword: screw fixation

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Treatment of hearing loss due to temporomandibular joint disorders: Case Report (턱관절 장애로 인한 청각장애의 치료: 증례보고)

  • Kang, Dong-Woo;Kim, Young-Kyun
    • The Journal of the Korean dental association
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    • v.57 no.4
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    • pp.204-212
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    • 2019
  • Introduction : Patients with temporomandibular disorder may have various ear-related symptoms. If an excessive load is applied to the ear area due to the skeletal shape of the mandibular condyle or malposition of the disc, an auditory problems may occur. Case report : The patient was referred to our clinic due to the suspicion of temporomandibular disorder from the local otorhinolaryngology clinic. A few days ago, his right ear could not be heard. MRI showed that the left TMJ disc was anterior displacement with reduction, the right TMJ disc was anteromedial displacement without reduction. Also Right mandibular condyle showed sclerotic bone change, subchondral cyst and was compressing the frontal wall of the ear on MRI view. Right TMJ arthroplasty was done under the diagnosis of right TMJ osteoarthritis and osteochondroma. Postoperative intermaxillary fixation was done with SAS screw and elastics for 2 weeks. One month after the operation, hearing and TMJ discomfort were recovered without any complications. Conclusions As seen in this case, hearing loss due to benign tumor-like lesions of the temporomandibular joint should be treated surgically to restore the TMJ function and hearing.

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Surgical Treatment of Talar Chondroblastoma via Partial Posterior Medial Malleolar Osteotomy: A Case Report (내과의 부분후방절골술을 통한 거골연골모세포종의 수술적 치료: 증례 보고)

  • Oh Jun Yu;Jin Soo Suh;Han Sung Kim;Jun Young Choi
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.2
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    • pp.75-78
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    • 2023
  • During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixation when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

Surgical Treatment of the Fracture of the Scapular Body (견갑골 체부 골절의 수술적 치료)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.150-157
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    • 2008
  • Purpose: We wanted to evaluate the results of surgical treatment for fracture of the scapular body. Materials and methods: The subjects of this study were seven patients with fracture of the scapular body and all these patients were managed surgically. We considered the operative indications as being 100% translation of the lateral border, or $25^{\circ}$ of angular deformity of the glenoid, or 1cm medialization or the variant of the double disruption of the superior scapular suspensory complex. There were five males and two females, and their ages ranged between 40 and 58 years (mean age: 49) with average follow up of 11 months (6~24 months). Two patients sustained multiple fractures of the ribs and spines. The surgical results were evaluated according to the subjective satisfaction, the UCLA score and the Korean shoulder score. Results: The mean UCLA score was 29 (17~33) and the mean Korean shoulder score was 86 (63~94). The self assessment for subjective satisfaction was 7.7 (4~9). There were two complications; one case of screw pull-out without the loss of the fracture fixation and the other case with screw penetration of the glenoid cavity. Conclusion: Surgical treatment may be effective for the management of severely displaced fracture of the scapular body in order to prevent the impairment of the shoulder function caused by the altered glenohumeral and scapulothoracic kinematics.

THE THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF STRESS DISTRIBUTION AND DISPLACEMENT IN MANDIBLE ACCORDING TO TREATMENT MODALITIES OF MANDIBULAR ANGLE FRACTURES (하악각 골절의 치료 방법에 따른 하악골의 응력 분포 및 변위에 관한 삼차원 유한요소법적 연구)

  • Ku, Je-Hoon;Kim, Il-Kyu;Chang, Jae-Won;Yang, Jung-Eun;Sasikala, Balaraman;Wang, Boon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.3
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    • pp.207-217
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    • 2010
  • The purpose of this study was to evaluate the effects of the stress distribution and displacement in mandible according to treatment modalities of mandibular angle fractures, using a three dimensional finite element analysis. A mechanical model of an edentulous mandible was generated from 3D scan. A 100-N axial load and four masticatory muscular supporting system were applied to this model. According to the number, location and materials of titanium and biodegradable polymer plates, the experimental groups were divided into five types. Type I had a single titanium plate in the superior border of mandibular angle, type II had two titanium plates in the superior tension border and in the inferior compression border of mandibular angle, type III had a single titanium plate in the ventral area of mandibular angle, type IV had a single biodegradable polymer plate in the superior border of mandibular angle, type V had a single biodegradable polymer plate in the ventral area of mandibular angle. The results obtained from this study were follows: 1. Stress was concentrated on the condylar neck of the fractured side except Type III. 2. The values of von-Mises stress of the screws were the highest in the just-posterior screw of the fracture line, and in the just-anterior screw of Type III. 3. The displacement of mandible in Type III was 0.04 mm, and in Type I, II, IV, and V were 0.10 mm. 4. The plates were the most stable in the ventral area of mandibular angle (Type III, V). In conclusion, the ventral area of mandibular angle is the most stable location in the fixation of mandibular angle fractures, and the just- posterior and/or the just-anterior screws of the fracture line must be longer than the other, and surgeons have to fix accurately these screws, and the biodegradable polymer plate also was suitable for the treatment of mandible angle fracture.

The Accuracy of Master Cast for Implant Prosthesis According to the Types of Impression Tray and Splinting Methods of Impression Copings (인상용 트레이의 종류와 인상용 코핑의 연결고정이 임플랜트 주모형의 정확성에 미치는 영향)

  • Lee, Jee-Hyuk;Choi, Yu-Sung;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.4
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    • pp.433-445
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    • 2010
  • The aim of this study was to evaluate the fixation effect by connecting impression copings and to compare the three types of impression trays which were used in open tray impression technique. Experimental groups used 3 types of impression trays which are custom tray, plastic metal combination tray and polycarbonate stock tray. These three groups were subdivided into splinted and non-splinted impression copings group. The total number of experimental groups was six. 10 specimens were made for each group. We used 1-screw test, observing the specimen on which only one side abutment of reference framework was fixated with 20 Ncm. The gap between implant analogue and abutment of the other side was observed by stereo microscope. It was measured at 6 points in each specimen. Measuring value was selected when same result was revealed 3 times. Recorded data were statistically analyzed. Whether impression copings were splinted or not, there was no significant difference among custom tray group, plastic metal combination tray group, and polycarbonate stock tray group. Significant statistical difference in vertical fit discrepancy was found between splinted and non-splinted impression copings group with custom tray, plastic metal combination tray and polycarbonate stock tray (p<0.05).

Elbow Arthrodesis with bone Autograft for the Management of Gunshot Fracture in a Dog (총상 골절 개에서 자가골 이식과 주관절 고정술)

  • Lee Jong Il;Alam Md. Rafiqul;Kim Nam soo
    • Journal of Veterinary Clinics
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    • v.22 no.1
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    • pp.60-64
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    • 2005
  • A 6year-old intact male hound cross dog, weighing 23 kg, was presented to the Teaching Animal Hospital, Chonbuk National University with the history of gunshot wound at the left elbow joint. Survey radiographs of the affected elbow revealed the presence of a metallic bullet caudal to the olecranon processes and comminuted fracture of the proximal radius and ulna. The first treatment strategy included removal of the bullet and fixation of the radius and ulna using separate bone plates, bone screw, K-wire and surgical wire, was failed. The second treatment strategy included olecranon osteotomy and rigid immobilization of the elbow joint with a bone plate applied to the caudal aspect of the humerus and ulna along with autogenous bone grafts collected from the 13th rib. The optimal angle of the joint following arthrodesis of this case appeared to be 130°. This resulted in improving the case but after 60 weeks the plate was bent and there was exudation from the wound. The third treatment strategy was the same with the second except for that the bone autografts were collected from the proximal metaphyses of the ipsilateral humerus. This resulted in a successful arthrodesis 6 weeks after the surgery. Elbow arthrodesis with bone autograft resulted in acceptable function, but abnormal gait remained in the dog due to mechanical interference with the movement of the joint.

A study of the cause of metal failure in treatment of femur shaft fracture - Fractographical and clinical analysis of metal failure- (대퇴골 간부 골절시 사용한 금속물의 금속부전(Metal failure)의 기전에 대한 연구)

  • Jeon, Chun-Bae;Seo, Jae-Sung;Ahn, Jong-Chul;Ahn, Myun-Whan;Ihn, Joo-Chyl
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.81-93
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    • 1990
  • The author fractographically analyized the cause of metal failure(the first time this procedure has been used for this metal failure)and also analyized it clinically. In this study, I selected eight cases which have been analyized fractographically. In all these cases, the analysis was done after treatment of metal failure of implants internally fixed to femur shaft fractures at the Department of Orthopedic Surgery, Yeung-Nam University Hospital during the six year period from May 1983 to September 1989. 1. Metal failure occured in five dynamic-compression plates, one Jewett nail, one screw in Rowe plate, and one interlocking nail. 2. The clinical cause of metal failure was deficiency of medial butress in five cases, incorrect position of implant in one case, and incorrect selection of implant in two cases. 3. The time interval between internal fixation and metal failure was four months in one case, between five months to twelve months in six cases, three years in one case. 4. The fractographically analytical cause of metal failure was ; first, impact failure, one case, second, fatigue failure, six cases, machining mark(stress liser), four cases type : low consistent cyclic fatigue failure irregular cyclic fatigue failure third, stress corrosion crack, one case. 5. 316L Stainless Steel has good resistance to corrosion. However, when its peculiar surface film is destroyed by fretting, it shows pitting corrosion. This is, perhaps, the main cause of metal failure. 6. It is possible that mechanical injury occured in implants during the manufacturing of implants or that making a screw hole is the main cause of metal failure.

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Physeal Remodeling after Internal Fixation of Slipped Capital Femoral Epiphysis (대퇴골두골단분리증 환자 중 금속내고정술을 시행받은 환자에서의 골단판의 재형성)

  • Kim, Se-Dong;Park, Byung-Won
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.28-35
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    • 2003
  • Purpose: To evaluate physeal remodeling after internal fixation of slipped capital femoral epiphysis, We performed a retrospective review of the medical records and radiographs of 14 children (17 cases) who had had slipped capital femoral epiphysis. Materials and Methods: We reviewed 14 patients who had slipped capital femoral epiphysis. They were divided two groups. Group I were in situ pinning with single screw and group II were corrective osteotomy with multiple pinning. We identified physeal remodeling camparing with their preoperative, postoperative and last follow-up radiographs with measuring physeal-shaft angle. Results: Early closure of the physis was observed in 6 cases among 14 patients (17 hips). Compared with their postoperative radiographs, the last follow up radiographic study revealed that physeal remodeling was observed in 4 patients (4 hips) at group I (mean, $7.8^{\circ}$), in 2 patients (3 hips) at group II (mean, $10.7^{\circ}$). Conclusion: In this study, physeal remodeling was observed in 4 patients (4 hips) in group I and 2 patients (3 hips) in group II. The incidence of physeal remodeling was related with degree of epiphyseal slippage, and age was not related with physeal remodeling potential.

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Arthroscopically assisted Operative Treatment of Tibial Plateau Fracture (관절경을 이용한 경골 고평부 골절에 대한 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.45-52
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    • 2006
  • Purpose: We evaluated the results of operative treatment of tibial plateau fractures using both arthroscopy and fluoroscopy. Materials and Methods: From May 1999 to February 2003, tibial plateau fractures were treated with arthroscopy. Tweenty seven patients are followed up over two years and the average follow-up period was fourty one months. We classified the fractures according to the Schatzker classification. We reduced the fracture over 2mm depression and displacement on articular surface in simple radiologic finding. Firstly, we treated the associated injuries and reduced the fractures using Steinmann pins. Then, we accomplished internal fixation or external fixation. Both the postoperative clinical and radiological results were evaluated by Rasmussen system. Results: In all tweenty seven cases, the fractures were healed completely in average fourty one months. According to Rasmussen classification, we obtained the excellent or good results in 23 cases. An average range of motion was between 2.5 degrees and 130 degrees. However, postoperative infection developed in one case and the other had loss of reduction. Conclusions: We consider that arthroscopically assisted operative treatment of tibial plateau fracture is a useful method. We can reduce joint surface correctly and treat associated injuries with arthroscopy. There are less complications.

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Surgical treatment of Mallet finger deformity with Hook plate (고리 금속판을 이용한 망치 손가락의 수술적 치료법)

  • Choi, Seok Min;Jung, Sung Gyun;Shin, Ho Seong;Park, Eun Soo;Kim, Yong Bae
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.318-321
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    • 2009
  • Purpose: The bony mallet finger injury is generally managed by conservative treatments, but operative treatments are needed especially when the fractures involve above 30% of articular surface or distal phalanx is accompanied by subluxation in the volar side. This is the reason they often result in chronic instability, articular subluxation and unsatisfactory cosmetic. In this report, We describe new method using the hook plate as an operative treatment of Mallet finger deformity. Methods: Among 13 patients with Mallet finger deformity who came from February 2006 to February 2008, six patient were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended through approximately $100^{\circ}$. Results: In all six cases which applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after surgery. At 2 weeks after operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. At 6 weeks after operation, the range of motion of DIP joint was average $64^{\circ}$. Conclusion: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations take 6 weeks, the operation using the hook plate begins an active motion at 2 weeks after operation. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method of the mallet finger deformity treatment.