• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.75-80
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• 2018

Objective : Among the various sacropelvic fixation methods, S2 alar-iliac (S2AI) screw fixation has several advantages compared to conventional iliac wing screw. However, the placement of S2AI screw still remains a challenge. The purpose of this study was to describe a novel technique of free hand S2AI screw insertion using a K-wire and cannulated screw, and to evaluate the accuracy of the technique. Methods : S2AI screw was inserted by free hand technique in sixteen consecutive patients without any fluoroscopic guidance. The gearshift was advanced to make a pilot hole passing through the sacroiliac joint and directing the anterior inferior iliac spine. A K-wire was placed through the pilot hole. After introducing a cannulated tapper along with the K-wire, a cannulated S2AI screw was installed over the K-wire. Results : Thirty-three S2AI screws were placed in sixteen consecutive patients. Thirty-two screws were cannulated screws, and one screw was a conventional non-cannulated screw. Thirty out of 32 (93.8%) cannulated screws were accurately positioned, whereas two cannulated screws and one non-cannulated screw violated lateral cortex of the ilium. Conclusion : The technique using K-wire and cannulated screw can provide accurate placement of free hand S2AI screw.

• Archives of Plastic Surgery
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• 제50권3호
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• pp.248-253
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• 2023

Metal fixation systems for cranial bone flaps cut by a drill are convenient devices for cranioplasty, but cause several complications. We use modified craniotomy using a fine diamond-coated threadwire saw (diamond T-saw) to reduce the bone defect, and osteoplasty calcium phosphate cement without metal fixation. We report our outcomes and tips of this method. A total of 78 consecutive patients underwent elective frontotemporal craniotomy for clipping of unruptured intracranial aneurysms between 2015 and 2019. The follow-up periods ranged from 13 to 66 months. The bone fixation state was evaluated by bone computed tomography (CT) and three-dimensional CT (3D-CT). The diamond T-saw could minimize the bone defect. Only one wound infection occurred within 1 week postoperatively, and no late infection. No pain, palpable/cosmetically noticeable displacement of the bone flap, fluid accumulations, or other complications were observed. The condition of bone fixation and the cosmetic efficacy were thoroughly satisfactory for all patients, and bone CT and 3D-CT demonstrated that good bone fusion. No complication typical of metal fixation occurred. Our method is technically easy and safety, and achieved good mid-term bone flap fixation in the mid-term course, so has potential for bone fixation without the use of metal plates.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.171-179
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• 1995

The conservative treatment of the condylar fracture has been used for a long time because of its simplicity, good prognosis and less complication. Traditionally the conservative treatment has been carried out by maxillomandibular fixation using arch bar and wire. But a simplified technique of maxillomandibular fixation introduced here is a procedure that 4 bone screws are placed above the apecies of the maxillary and mandibular canines and then ipsilaterally placed maxillary and mandibular bone screws are linked by a loop of wire each other. This procedure has several advantages compared with the traditional maxillomandibular fixation method. 1) it provides simplicity for the operators. 2) it sustains maxillomandibular fixation more rigidly compared with arch bar technique. 3) it keeps stable maxillomandibular fixation in the region of the anterior teeth so that anterior open bite tendency can be remarkably minimized. 4) it does not injure the periodontal tissue because the teeth are not engaged and causes less discomfort to the patient. 5) it decreases the possibility of operator's AIDS infection through inadvertent skin puncture. 6) it is highly recommended for the patients whose teeth are available for maxillomandibular fixation. The two male patients were diagnosed as bilateral condylar and symphyseal fracture of the mandible. They restored stable occlusion and functional mandibular movement only by a simplified technique of maxillomandibular fixation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권2호
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• pp.122-124
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• 2022

Various techniques are well documented to obtain anatomic reduction, such as reduction forceps, manual reduction, or a combination of these methods. However, these techniques have inherent drawbacks. We propose a new intra-operative technique for anatomic reduction using screw-wire traction for open reduction and internal fixation of mandibular fractures.

• 대한정형외과스포츠의학회지
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• 제5권1호
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• pp.58-62
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• 2006

목적: 쇄골 원위부 골절의 치료에 있어 재건 금속판과 강선 고정술을 이용한 치료 결과를 알아보고자 하였다. 대상 및 방법: 2001 년 3월부터 2003년 7월까지 본원에서 쇄골 외측단의 골절에 대하여 재건금속판과 강선고정술을 이용하여 수술한 환자 중 1년 이상 추시관찰이 가능하였던 9예를 대상으로 하였다. 수술 방법은 재건 금속판을 쇄골 상단에 지지대로 사용하였고, 분쇄가 있는 골절 부분을 나사를 대신하여 $2{\sim}3$개의 강선 고정으로 고정하였으며 고정이 약한 경우 견봉쇄골 관절을 포함하였다. 수술 후 기능회 복의 정도는 Rowe의 견관절 평가 방법을 이용하였다. 결과: 추시 관찰상 평균 9주에 골유합의 소견을 얻었다. 기능적 평가로 Rowe의 견관절 평가방법상 우수가 7예, 양호가 2이었다. 견관절의 운동 제한이나 견봉 쇄골 관절의 관절염 소견은 보이지 않았고, 합병증으로는 금속판에 의한 피부자극이 1예 있었다. 결론: 쇄골 원위부 골절에서 재건 금속판과 강선 고정술을 이용한 부분적인 고정법은 분쇄가 심하고, 원위골절편이 작은 경우 특히 유용하였다. 이 방법은 간단하고, 관절 운동 향상, 조기 기능 회복과 합병증이 적다는 측면에서 유용할 것으로 사료된다.

• 대한족부족관절학회지
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• 제15권3호
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• pp.149-152
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• 2011

Purpose: The Akin osteotomy which is a closing wedge osteotomy of the proximal phalanx widely used for the correction of hallux valgus has several methods of fixation. we tried to report the effects of the fixation using an absorbable suture material during the Akin osteotomy for the hallux valgus. Materials and Methods: This study was based on 448 cases of 346 patients who were able for follow-up more than 12 months among the patients who had an Akin osteotomy together with the surgery of hallux valgus between March of 2006 and May of 2010. Absorbable suture material had been used in all cases. Radiologically displacement and union of osteotomy site were observed after the surgery, and clinically postoperative complication such as skin irritation, pain and satisfaction were investigated. Results: Radiologically all cases had showed complete union and no case had the loss of an correction due to loss of fixation. Also, any case had no skin irritation due to a knot. Three cases had a medial cortical breakage due to a strong knot, and the initial one case among them had additionally fixed the osteotomy site for four weeks using K-wire, and the remaining two cases had fixed a suture on an articular surface without any fixation of an additional wire. If a medial cortical bone was lost by carrying out an ostectomy due to proximal protrusion of proximal phalanx, three cases could show union through the fixation of suture on an articular surface. Conclusion: This study considers that the fixation of the osteotomy site using an absorbable suture material in an Akin osteotomy was effective method and the advantage of this procedure was unnecessity of the material removal and no skin irritation.

• 한국임상수의학회지
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• 제15권1호
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• pp.222-227
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• 1998

This survey was based on the data of one hundred four dogs with 108 case,T of fracture admitted to the veterinary teaching hospital, College of Veterinary Medicine, Kyungpook National University and 24 private small animal hospitals from January, 1995 to Decemberi 1996. The results were analyzed as following criteria; the distribution of fractures causes of fractured age and sexual distributions month of the most frequencel total body weights presence of communicating external wound, extent of damaged direction of fracture line, location of fracture liner fracture managements fixations methods, fixations methods according to location of fracture. The results of survey were as follow: 1. Main distribution of fracture; radius . ulna (23.1%).2. Causes of fracture; road toraffic accident (39.4 T,). 3. Age; over 24 months (27.9%). 4. Sex; male (53.89)), female (46.2%). 5. Month of the most frequence; July (14.4%) 6. Total body weight: 2-5 kg (45.27)). 7. Presence of communicating external wound; closed fracture (94.2%). 8. Extent of damage; complete fracture (92.6%). 9. Direction of fracture line: comminuted fracture (27.8 To). 10. Location of fracture line; diaphysis (62.0%). 11. Fracture management; open reduction (58.3% ). 12. Fixation methods; not treat (22.2%). 13. Fixation methods according to location of fracture; radius ulna-Kirschner wire fixation (45.5%), femur. shaft-intramedullary pinning (71.4%), pelvis-bone plate (53.3%), metacarpus-not treat, Kirschner wire fixation (each 30.8%).

• Journal of Chest Surgery
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• 제8권1호
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• pp.37-44
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• 1975

Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

• 대한족부족관절학회지
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• 제19권4호
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• pp.197-200
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• 2015

The Akin osteotomy is a complimentary procedure in hallux valgus surgery. Surgical techniques may vary depending on the operators or fixation devices. Suture fixation, for which a removal procedure is not necessary, can often be recommended. However, there is a risk of failure due to the thin cortex of the phalanx. We describe a new technique using Ethibond suture fixation in Akin osteotomy, which can lower the risk of phalangeal cortical failure and articular cartilage irritation. First, the Akin osteotomy was performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. Then bone holes were drilled from dorsum to plantar parallel to osteotomy with the Kirschner wire. The final procedure involved passing the Ethibond sutures connected to a straight needle through the holes and tying it. This fixation method offers an effective and easy technique for performance of Akin osteotomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.270-276
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• 2001

The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.