• The korean journal of orthodontics
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• v.22 no.4 s.39
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• pp.837-853
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• 1992

The purpose of this study was to investigate the positional changes of the mandibular condyles after orthognathic surgery In patients with severe skeletal Class III malocclusion. This study was based on 21 patients who had received bilateral sagittal split osteotomy for mandibular setback. Among them 14 were fixated non - rigidly (W group), and 7 were fixated rigidly (R group). After submental vertex view analysis, each subject was given the T.M.J. Tomogram in both centric occlusion and centric relation immediate before, $4\~6$ weeks after and more than 6 months after surgery. The anteroposterior and vertical changes between each time interval were measured and analyzed statistically. Following results were obtained. 1. There was no significant difference between right and left condyles in their anteroposterior and vertical changes of the condylar position. 2. In anteroposterior changes of condylar position of the wire fixation group, the condyles were moved anteriorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, there was no significant difference in any observation periods of centric occlusion and centric relation. 3. In vertical changes of condylar position of the wire fixation group. the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery. In the rigid fixation group, the condyles were moved inferiorly 4-6 weeks after surgery, and then the pattern of reestablishment to their preoperative position was observed more than 6 months after surgery in centric occlusion only.

• Journal of Veterinary Clinics
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• v.25 no.5
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• pp.408-410
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• 2008

A four months old, 3.6 kg intact female Miniature Dachshund dog was referred for non-weight bearing lameness at right hind limb due to car accident. On physical examination, the patient was non-weight bearing on the right hind leg and had moderate swelling in the proximal to middle tibia region. There was palpable crepitus. Radiographs revealed a slightly displaced, spiral, oblique fracture involving the proximal diaphyseal region of the right tibia. Fibular fracture was also noted. Internal fixation was performed to repair the fracture. Due to bowed shape of fractured tibia, it was not possible to apply K-wire, containing appropriate diameter ($60{\sim}80%$ of bone marrow diameter) for intramedullary fixation. We fixed the bowed tibia fracture using a smaller diameter (30% of bone marrow diameter) K-wire with cross pins and cerclage wires. Four weeks after the operation, radiographs demonstrated healing of the tibia fracture as well as the fibular fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.4
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• pp.412-420
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• 1991

Seventeen rigid screw fixation and sixteen nonrigid wire fixation cases of mandibular sagittal slit ramus osteotomy were selected to compare postoperative dental and skeletal changes. A constructed horizontal plane was drawn seven degrees under sella-nasion plane and detailed cephalometirc assessment was applied to serial radiographic films taken before surgery($T_0$), immediately after surgery($T_1$), and at least six months after surgery($T_2$). Linear and angular positional changes were measured and analyzed statistically using paired t-test method and percent of positional changes(amount of post-op change/amount of intra-op change)${\times}100$. The results were as follows; 1. It was 29.4% in rigid fixation cases and 37.5% in nonrigid fixation cases comparing the postoperative positional change of more than 2mm at point B. So rigid fixation method was slightly more stable. 2. In nonrigid fixation cases, the positional change might be caused by incomplete bony union at the osteotomy site and soft tissue tension acting on this site. 3. In rigid fixation cases, the positional change might be caused by interaction between relapse tendency of protracted condyle-proximal segment and neighboring soft tissue tension.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.257-262
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• 2011

Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.

• Clinics in Shoulder and Elbow
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• v.17 no.2
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• pp.77-79
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• 2014

The migration of metallic devices such as Kirschner's wire (K-wire) from the shoulder is a well-recognized and significant complication of operation, the wire ending up in the lungs, the heart, the esophagus, the aorta or the subclavian artery. However, spinal migration is very rare. We report the case of a 72-year-old female patient with K-wire migration into the C7-T1 intervertebral foramen, 2 months after surgery for a lateral end fracture of left clavicle.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.201-206
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• 2005

Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.

• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.102-109
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• 2002

Purpose: To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods in adults Materials and Methods: Seven patients, aged 55 to 52 years (average,69 years), were reviewed after a mean follow-up of 37 months (range, 11-65 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). Six patients underwent closed reduction and one patient, open reduction after failure of closed reduction. Percutaneous fixation with cannulated screws was performed to the 4 patients, per- cuta)leous fixation with Kirschner wires in 3 patients. All except one patients have associated medical problems. The results were assessed based on the Mayo Elbow Performance Score. Results: All the patients with cannulated screw fixation had stable bony union with excellent ranges of motion (mean: 5-125 degrees). All the three patients who received percuatnaous smooth K-wire fixation had nonunion with poor results, one of them had changed into cannulated screw. and then had good result. Conclusion: Although simple supracondylar fracture is similar to the pediatric fracture in nature, it should be firmly fixed with the method such as threaded cannualted screw rather than the simple fixation with K-wires.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.94-98
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• 2011

Purpose: We present a case of anterior glenoid rim comminuted fracture that was treated with arthroscopic reduction and an AO headless compression screw (HCS) fixation. Materials and Methods: A 31-year old man complained of left shoulder pain after falling down on stairs. The anterior glenoid comminuted fragments were arthroscopically reduced. Fixation with an AO HCS was done after placement of 1.1 mm Kirschner wire as a guide pin through a standard cannulated anterosuperior portal. Results: Twelve months after the operation, union of the fracture was achieved and the range of motion was fully recovered. He did not complain of any discomfort during his activities of daily living. Conclusion: An AO HCS had various screw sizes and this was good for fixation of a small glenoid fracture and a long drill bit and screw driver were useful for fixation of deep seated glenoid fracture. A short guide wire could be replaced by a 1.1 mm K-wire. An AO HCS was useful for fixation of an anterior glenoid rim comminuted fracture.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.85-92
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• 1988

To avoid external facial scar which resulted from ordinary infraorbital and lateral eyebrow incision in surgical treatment of zygomatic tripod fractures, the author used intraoral incision and K-wire fixation method in 37 selected patients. This method contraindicated for the patient with multiple comminuted zygomatic fracture, patient combined with hard palatal fracture, and patient combined with herniated orbital floor fracture. The advantages of this method are simple, no external facial scar, and operate under direct visual field. The postoperative results were satisfactory. Balanced facial symmetry and good cosmetic results were obtained.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.91-94
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• 2009

Metatarsal head and neck fractures are injuries that often result from a direct blow of a heavy objects to the metatarsal head. The head is often impacted or displaced to the plantar aspect that if not treated may cause malunion which later induces painful plantar calluses. If the fracture fragment is large enough, closed reduction may be successfully performed, but when the fragment is small or closed reduction is unsuccessful, open reduction is needed. We present our reduction and fixation technique for the metatarsal head and neck fractures using antegrade intramedullary Kirschner wire (K-wire) without opening the fracture site or infringing the metatarsophalangeal (MTP) joint which allows immediate motion of the joint and partial weight bearing in a stiff soled shoe.