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강선의 인장력과 추가 Half pin이 혼성외고정장치 시스템의 안정성에 미치는 영향
김윤혁(Y. H. Kim),이현근(H. K. Lee),박원만(W. M. Park),오종건(J. K. Oh) 한국정밀공학회 2004 한국정밀공학회 학술발표대회 논문집 Vol.2004 No.10월
It is clinically well known that pre-tension of wires increases the fracture stability in ring or hybrid external fixation. In some cases, additional half pin should be necessary to increase the stability when soft tissue impalement occurs during fixation. In this paper, the fracture stability of a hybrid external fixator system with different pre-tension effects and additional half-pins was analysed using FEM to investigate the effects of these pre-tension and half pin on the system stability quantitatively. 3-D finite element models of five different fixator frames were developed using by beam elements. In axial compression analysis, the fracture stiffness was increased maximally 62% as the pre-tension increased. In torsion analysis, in the other hand, there is little variations in the fracture stiffness. Additional half pin increased the system stiffness about 200 %. From the results, proper pre-tension and additional half pin would provide good methods to increase the fracture stability of the hybrid external fixator and provide more surgical options to minimize soft tissue damage at the fracture site.
박동,서승우,이순혁,오종건,김경수,김철준 대한골절학회 1996 대한골절학회지 Vol.9 No.3
This review was undertaken to analyze the rate of bone union according to accuracy of reduction, methods of fixation, timimg of wound closure and to determine if immediate wound closure increases the infection rate. The materials used in this study included 49 cases of open digital fractures of hand which had been treated at Ansan Hospital, Korea University, College of Medicine from January, 1988 to May, 1995. Of the 38 patients, male were 34(89.5%) and female were 4 (10.5%). The average age at operation was 31.9(ranging from 18 to 56 years). On terms of sites of injury within digits, proximal phalanx injured in 18 cases, mid-phalanx l 6 cases, distal phalanx 20 cases. As a fixatives. K-wire was used in 36 cases(73.5%), mini-plate 8 cases(16.3%), splint immobilization in 5 cases(10.2%). Average time to bone union for K-wire fixation was l2.8weeks, miniplate was 13.6weeks, splint immobilization l3.2weeks. On terms of accuracy of reduction, width of gap between fragments were measured, cases with width of gap less than 2ae were 28cases(57.6%), cases more than 2mm were 21cases(42.4%). Bone union periods according to the accuracy of reduction are as follows: cases with width of gap less than 2ae was 11.4weeks, more than 2mm-15.7weeks, apposition more than 2/3-12.6weeks, less than 2/3- 16 weeks. Degree of soft tissue injuries was classified based on modified Gustillo-Anderson's classification. One case belonged to type I injury. 15 cases to type II an 33 cases to type III. Bone union periods for type I,II was 12.9weeks in average, and 13.8weeks for type III.