• 제목/요약/키워드: screw fixation

검색결과 431건 처리시간 0.028초

진구성 전방 십자 인대 견열 골절의 수술적 치료 (The Surgical Treatment of Chronic Avulsion Fracture of the Anterior Cruciate Ligament)

  • 송은규;설종윤;최진
    • 대한관절경학회지
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    • 제6권1호
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    • pp.31-36
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    • 2002
  • 목적 : 진구성 전방 십자 인대 견열 골절의 치료후 임상적, 방사선학적 결과를 평가하고자 하였다. 대상 및 방법 : 손상후 3개월 이상 지난 진구성 전방 십자 인대 견열 골절로 진단 받고 본원에서 치료받은 환자중 2년 이상 추시 관찰이 가능하였던 11예를 대상으로 하였으며 평균 연령은 26세(9-66)이었고 평균 추시 기간은 53개월(24-131)이었다. 수술은 전 예에서 관절경하에 병변의 확인 및 동반 손상의 치료후 관혈적 정복을 통한 내고정이나 골편 제거술을 시행하였다. 고정 방법은 8예에서 견인 봉합술을 2예에서 나사못 고정을 시행하였다. 결과 : Lysholm knee score는 술전 평균 64.3점에서 술후 96.2점으로 호전되었으며, 술전 Lachman 검사상 7예에서 경도의 양성, 4예에서 중등도의 양성 소견을 보였으며 술후 Lachman 검사상 9예는 음성이었으며, 2예에서 경도의 양성소견을 보였다. Meyers와 Mckeever의 평가 기준에 의하면 9예$(81.8\%)$에서 우수, 2예$(18.2\%)$에서 양호의 결과를 보였다. $Telos^{\circledR}$기기를 이용한 건측과의 전방이완도 차이의 평가에서 술전 평균 7.8(10-4)mm의 차이를 보였으며 술후 최종 추시상 평균 2.1(6-0)mm의 차이를 보였다. 결론 : 진구성 전방 십자 인대 견열 골절에 대한 치료에 있어 관절경 검사를 통해 동반 손상의 평가와 관절 절개술을 통해 해부학적 정 복과 고정 또는 골편 제거를 병행함으로서 만족할만한 결과를 얻을 수 있을 것으로 생각된다.

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상완골 소두 골절의 치료결과 (Treatment Results of Capitellum Fractures)

  • 박진수;정영기;유정한;노규철;정국진;정성욱
    • 대한정형외과스포츠의학회지
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    • 제4권2호
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    • pp.116-121
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    • 2005
  • 목적: 상완골 소두 골절은 매우 희귀한 골절의 형태인데 관절면의 침범으로 인해 적극적인 수술적 치료가 요한다. 이러한 상완골 소두 골절의 관혈적 정복 후 내고정 후의 결과를 보고하는 바이다. 대상 및 방법: 1998년부터 2004년 까지 상완골 소두 골절로 수술 시행받은 4명의 환자를 대상으로 하였다. Morrey의 분류법 상 제 1형이 3례, 제 3형이 1례였다. 전 례에서 주관절의 외측 도달법을 사용하였으며, 관혈적 정복후 유관 나사못 고정을 실시하였다. 수술후 주관절의 부목등의 고정은 4일에서 28일 까지 소요되었다. 최종 추시 판정 시 Mayor의 주관절 기능 평가 방법을 이용하여 주관절 운동 범위, 주관절의 안정성, 동통 유무 등을 평가하였다. 결과: 평균 추시기간은 12개월에서 36개월이었으며 평균 15개월(12개월-36개월) 이었다. 3례의 경우 견고한 골고정을 얻었으며 우수한 관절 운동범위를 얻을 수 있었다. 그러나 만성 소두골 골절 및 부정유합으로 내원하였던 1 례의 경우 추시 관찰동안 재활에 순응하지 않아서 40도-100도의 운동범위만을 보여주었다. 전 례에서 무혈성 괴사나 주관절 관절염의 소견은 보이지 않았다. 결론: 상완골 소두 골절은 희귀하지만 적극적으로 관혈적 정복 및 내고정시 우수한 결과를 보여 줄 수 있었다.

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Long-term Stability after Reduction of Mandible Fracture by Keyhole Plate: Evaluation at the Time of Plate Removal

  • Cheon, Kyeong-Jun;Cho, Seoung-Won;Jang, Won-Seok;Kim, Ju-Won;Yang, Byoung-Eun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.6.1-6.6
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    • 2020
  • Background: Various types of miniplates have been developed and used for the reduction of facial bone fractures. We introduced Yang's Keyhole (YK) plate, and reported on its short-term stability. The purpose of this study was to evaluate the long-term stability of the YK plate, as a follow-up study, by examining the patients who had used the YK plate among the patients with the reduction of mandible fractures and who visited for plate removal. Methods: We reviewed the medical records of 16 patients who underwent mandibular fracture fixation using a YK plate (group I) and 17 patients who underwent mandibular fracture fixation using a conventional plate (group II). Assessment was then made on malunion, occlusal stability, discomfort during the application, and clinical symptoms. Results: From January 2015 to December 2017, a total of 36 patients underwent mandibular fracture surgery using a YK plate. A total of 16 patients received plate removal. Among them, 15 were male and 1 female. The average age was 26 years. The applied surgical sites were the 12 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of YK plate was an average of 335 days. During the same period, 45 people underwent surgery on the conventional plate. A total of 17 patients received plate removal. Among them, 15 were male and 2 females. The average age was 36 years. The applied surgical sites were the 8 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of the conventional plate was an average of 349 days. No malocclusion occurred at the time of removal, and occlusion was stable. No patient complained of joint disease or discomfort. Conclusion: The YK plate system, in which the screw was first inserted and the plate was applied, for clinical convenience did not cause any particular problem and no significant difference from the conventional plate.

인장대 강선 고정술을 이용한 제5 중족골 기저부 골절의 수술적 치료 (Treatment of Fifth Metatarsal Base Fracture Using Tension Band Wiring)

  • 안종국;정형진;배서영;박지용
    • 대한족부족관절학회지
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    • 제15권1호
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    • pp.18-21
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    • 2011
  • Purpose: To evaluate the clinical and radiological results of internal fixation with tension band wiring for the fracture at the base of fifth metatarsal bone. Materials and Methods: From January 2008 to December 2009, 15 cases with displaced fracture at the base of fifth metatarsal were analyzed and average follow up period was 13.8 months. Lawrence classification was used to classify fracture type. We evaluated clinical results by American Orthopedic Foot Ankle Society (AOFAS) midfoot score and radiological results by union time. Complications was also checked. Results: According to classification, zone I fracture were 11 cases and zone II fracture were 4 cases. Bony union was achieved in all cases after 7 weeks. In the final follow-up, average AOFAS score was 94. There were no complications except hardware irritation. Conclusion: Satisfactory results were obtained after tension band wiring for the fifth Metatarsal base fracture in zone I fracture or comminuted zone II fracture for which it is not easy to be fixed with screw.

Danis-Weber B형 족근 관절 골절에 있어 유경 나사를 이용한 비골 외 과 골절의 치료 (Treatment of Lateral Malleolar Fractures with Cannulated Screws in Danis-Weber type B Ankle Fractures)

  • 박용욱;정영기;유정한;박홍준;유선오;강기만
    • 대한족부족관절학회지
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    • 제5권2호
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    • pp.129-135
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    • 2001
  • Purpose: To evaluate the radiographic results of the treatment for Danis-Weber type B lateral malleolar fracture with 2 cannulated screws. Materials and Methods: Thirty-four cases of Danis-Weber type B lateral malleolar fracture were available. Follow-up averaged 8 months (6-25 months). The medial clear space for lateral displacement of talus, talo-crural angle for lateral malleolar shortening, and malunion evidence of lateral malleolar fracture were observed. Results: Medial clear space was from 2mm to 4mm in 34 cases. Talo-crural angle was from $73^{\circ}$ to $82.5^{\circ}$ in 33 cases. One case was complicated with malunion of lateral malleolus. But, we found the same condition in the immediate post- operative radiographic film. Conclusion: We believe that the 2 cannulated screws fixation for Danis-Weber type B lateral malleolar simple fractures is an excellent treatment method.

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외상성 척수공동증의 치료를 위한 지주막하강 재건술 - 증례보고 - (Subarachnoid Space Reconstruction for Treatment of Posttraumatic Syringomyelia - A Case Report -)

  • 정대진;김성민;김훈;심영보;박용기;최선길
    • Journal of Korean Neurosurgical Society
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    • 제29권2호
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    • pp.255-260
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    • 2000
  • The authors report a posttraumatic syringomyelia in a 30-year-old man who has complained pain, weakness of upper arm and dissociation sensory loss since 2 months before. He was underwent by decompressive laminectomy from T12 to L1, reduction of encroached bony fragments, transpedicular screw fixation from T12 to L2 and posterolateral bony fusion due to burst fracture of L1 at other hospital 3 years ago. Preoperative spinal MRI was highly suggestive of wide-spread, multiseptated syringomyelia from C3 to thoracolumbar junction. We performed wide decompressive laminectomy from T10 to L2 and subarachnoid space reconstrucion composed of microdissection of meningeal fibrosis widely, iatrogenic meningocele formation with lefting the dura mater opened for treatment of spinal-spinal pressure dissociation. Clinical manifestations and radiological findings of the patient were improved after the operation. This technique was thought to be superior to shunting procedures in cases of wide-spread, multiseptated post-traumatic syringomyelia.

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이두근 장두 건 고정술시 강한 고정이 필요한가? (Is the Strong Fixation Necessary in Performing Biceps Tenodesis?)

  • 송현석;최우혁
    • Clinics in Shoulder and Elbow
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    • 제15권2호
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    • pp.148-153
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    • 2012
  • 다양한 이두근 건고정술이 시행되고 있어서, 문헌들의 결과를 단순 비교하기 어렵게 만든다. 이두근 장두의 건고정술은 첫째로, 시술을 관혈적 절개를 통하여 시행하는가 또는 관절경을 이용한 방법으로 시행하는가로 구분해 볼 수 있다. 두 번째로는, 이두건 자체를 고정하는 주변 조직에 따라서 연부 조직 건고정술과 골 고정술로 나눌 수 있다. 세 번째로는, 고정하는 위치에 따라 근위부와 원위부로 구분할 수 있다. 네 번째로는, 건 고정술에 기구(간섭 나사, 봉합 나사, 비매듭 봉합 나사 등)를 사용하는 가에 따라서 구분해 볼 수 있다. 적절한 고정력이 어느 정도인지 밝혀지기까지는 단정적인 결론은 보류되어야 한다.

Collapsed L4 Vertebral Body Caused by Brucellosis

  • Ekici, Mehmet Ali;Ozbek, Zuhtu;Kazanci, Burak;Guclu, Bulent
    • Journal of Korean Neurosurgical Society
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    • 제55권1호
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    • pp.48-50
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    • 2014
  • Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.

Transforaminal Lumbar Interbody Fusion Using Wedged Cages for Isthmic Spondylolisthesis : A Short-Term Radiological Analysis

  • Lee, Dong-Yeob;Lee, Sang-Ho;Lee, Han-Soon
    • Journal of Korean Neurosurgical Society
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    • 제40권5호
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    • pp.346-350
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    • 2006
  • Objective : The ability to induce segmental lordosis has been reported to be marginal with transforaminal lumbar interbody fusion[TLIF]. Therefore, we analyzed the short-term radiological outcomes of TLIF using $8^{\circ}$ wedged cages for isthmic spondylolisthesis. Methods : Twenty-seven patients with isthmic spondylolisthesis who underwent single level TLIF with pedicle screw fixation[PSF] using $8^{\circ}$ wedged cages were retrospectively evaluated. Changes in disc height, degree of anterolisthesis, segmental lumbar lordosis, whole lumbar lordosis and L1 axis S1 distance were evaluated using standing lateral radiographs before surgery, at 6 weeks follow-up and at the final follow-up. Results : The mean age of the patients was 49.9 years [range, 38 to 64 years]. The affected levels were L4-5 in 17 cases and L5-S1 in 10. There were 18 cases of Grade I isthmic spondylolisthesis and 9 cases of Grade II. At a mean follow-up duration of 9.9 months [range, 6 to 18 months], the disc height [p< 0.001] was significantly increased, and the degree of anterolisthesis was significantly reduced [p< 0.001]. Regarding the sagittal balance, the segmental lumbar lordosis was significantly increased [p=0.01], but other parameters were not significantly changed after surgery. Conclusion : TLIF with PSF using $8^{\circ}$ wedged cages significantly increased the segmental lumbar lordosis.

Anterior and Posterior Stabilization by One Stage Posterolateral Approach in the Unstable Fracture of Thoracolumbar and Lumbar Spine

  • Lee, Young-Min;Cho, Yang-Woon;Kim, Joon-Soo;Kim, Kyu-Hong;Lee, In-Chang;Bae, Sang-Do
    • Journal of Korean Neurosurgical Society
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    • 제40권1호
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    • pp.22-27
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    • 2006
  • Objective : The purpose of this study is to investigate the clinical results of anterior and posterior stabilization by one stage posterolateral approach for the unstable fracture of thoracolumbar and lumbar spine. Methods : By posterolateral approach with curved skin incision, unilateral facet and pedicle were removed. Through this route, corpectomy was performed, and then this space was replaced with mesh cage filled up with autologous bone graft. Both side pedicle screw fixation was followed to upper and lower levels. Results : Six of seven patients of this study showed neurological improvement. The other one patient showed no neurological change. One patient had postoperative infection, another patient had postoperative kyphosis. The other patient had epidural hematoma on operation site after surgery. And all patinets on this study made to have spinal stability except one patient happened postoperative kyphosis. Conclusion : In the unstable fracture of thoracolumbar and lumbar spine, one stage anterior and posterior stabilization and fusion by posterolateral approach seems to be an effective procedure, if we have more care and supplementation.