PURPOSE: To analyze the clinical and radiological results of the different fixation methods according to the type and displacement of unstable pelvic ring injuries. MATERIALS AND METHODS: Twenty-three patients with unstable pelvic ring injuries from January 2005 to December 2009 were classified according to the AO/OTA classification system. When patients had been diagnosed with unstable pelvic ring injuries with partial instability, they were treated by anterior fixation with a plate and posterior percutaneous iliosacral screw fixation. When patients had been diagnosed with unstable pelvic ring injuries with complete instability, they were treated by open reduction and anterior to posterior fixation with a plate through the ilioinguinal approach. The radiological results were evaluated using Matta and Saucedo's method, and the clinical results were evaluated using Rommens and Hessmann's method. RESULTS: The outcomes from the radiological evaluation were that the displacement of the posterior pelvic ring were improved by about 6.65 mm in unstable pelvic ring injuries with partial instability. The displacement of the posterior pelvic ring were improved by about 7.8 mm in unstable pelvic ring injuries with complete instability. The clinical results were excellent in 13 cases and good in 6 cases on latest follow-up. CONCLUSION: Good results can be achieved by selecting the treatment method according to the type of unstable pelvic ring injurie and displacement.
Displacement (Psychology) ; Humans

PURPOSE: Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. MATERIALS AND METHODS: We evaluated factors that have an effect on bone union and bone function after union. We evaluated age, fracture site, comminution, displacement, shortening and other factors. Among 523 clavicular midshaft fractures that presented between January 2004 and Jun 2009 at our Department of Orthopaedic Surgery, we identified 270 who had conservative treatment and 173 patients who had surgical treatment. RESULTS: The period required for bone union increased with the degree of displacement. For the group below 12 years of age, and the group without comminution, it took half the time to achieve bone union compared with the other groups. Displacement mostly occurred within 2 weeks after conservative treatment. CONCLUSION: In patients with a comminuted clavicular midshaft fracture, we might, because of expected delays in bone union, delay the start of rehabilitation until patients are more than 13 years old. Because the degree of displacement may be increased within 2 weeks during conservative treatment, we can think about surgical treatments.
Clavicle ; Displacement (Psychology) ; Humans

The incidence rate of calcaneal fracture consists about 2% of all fractures, and, of the fracture, calcaneal tubercle avulsion fracture is known to be rare. To treat non-displaced calcaneal tubercle avulsion fracture, conservative treatment such as cast fixation is applied. However, most cases accompany displacement of the avulsion fragment, and, usually, surgery is necessary to treat the displaced fracture. Although surgical fixation simply by cancellous screw or tension wire is widely used, fixation failure is potential complication in this method. Thus, this study wants to introduce a prospective and useful method that further strengthens the calcaneal fixation by using both cannulated screw and tension band wiring.
Displacement (Psychology) ; Incidence

Isolated acromial fracture is not common and it frequently accompanies fractures to the coracoid process and glenoid bone and also injuries to the acromioclavicular joint. Furthermore, most of these combined acromial fractures have minimal displacement, which needs no additional treatment other than protection for a certain period of time. We have experienced a case of isolated fracture of the posterolateral angle of the acromion, which we reduced and fixated using K-wire and cannulated screws. We report on the technical aspects and clinical results of this reduction and fixation, along with a review of the literature.
Acromioclavicular Joint ; Acromion ; Displacement (Psychology)

OBJECTIVE: To evaluate the validity of Sharp-Purser test in the assessment of anterior atlantoaxial subluxation in rheumatoid arthritis patients. METHOD: We assessed the validity of the Sharp-Purser test in 38 rheumatoid arthritis patients who were subjected to stabilization surgery. All patients were evaluated using manual laxity test and re-evaluated radiologically. RESULTS: In 31 out of 38 patients (81.6%) Sharp-Purser test was positive in spite of anterior displacement of C1 over C2 on radiograms, while the tests were negative in 7. Among those 7 patients with negative test, 4 (10.5%) were acute cases and 3 (7.9%) were chronic cases with high grade hypomobile slip. Among the 31 patients with positive Sharp-Purser test, ADI (atlantodental interval) was 4 mm in 4 patients, 5 mm in 9, and greater than 5 mm in 18 patients. Among the 7 patients with negative Sharp-Purser test, ADI was 4 mm in 4 patients and greater than 5 mm in 3 patients. CONCLUSION: Our results show that the Sharp-Purser test is a useful clinical examination to diagnose atlantoaxial instability.
Arthritis, Rheumatoid ; Displacement (Psychology) ; Humans

PURPOSE: The purpose of this study was to classify posterior malleolar fractures according to the position of fragments and to analyze radiologic features of each type. MATERIALS AND METHODS: We analyzed forty-six patients of ankle fractures involving a posterior malleolus who were treated between January 2004 and December 2007. The posterior malleolar fractures were categorized into three types (posterolateral, posteromedial, shell) based on the major fracture line. In each type, we analyzed amount of displacement, involvement of articular surface, existence of subluxation and osteochondral impacted fragments. RESULTS: The forty-six patients were categorized into three types: Posterolateral (PL) type (33 cases, 72%), Posteromedial (PM) type (8 cases, 17%), shell type (5 cases, 11%). Of the 8 cases with PM type, 7 cases showed displacement more than Grade II, 4 cases showed subluxation of ankle joint, and 3 cases showed osteochondral impacted fragment. Average involvement of articular surface of PM type is 35% (15~65%). CONCLUSION: Posterior malleolar fractures with medial extension tended to have adverse effect on ankle stability and Preoperative CT scan is essential for evaluation of fracture type and determination of appropriate surgical approach.
Animals ; Ankle ; Ankle Joint ; Displacement (Psychology) ; Humans

The purpose of this study was to develop the respiratory training system using individual characteristic guiding waveform to reduce the impact of respiratory motion that causes artifact in radiotherapy. In order to evaluate the improvement of respiratory regularity, 5 volunteers were included and their respiratory signals were acquired using the in-house developed belt-type sensor. Respiratory training system needs 10 free breathing cycles of each volunteer to make individual characteristic guiding waveform based on Fourier series and it guides patient's next breathing. For each volunteer, free breathing and guided breathing which uses individual characteristic guiding waveform were performed to acquire the respiratory cycles for 3 min. The root mean square error (RMSE) was computed to analyze improvement of respiratory regularity in period and displacement. It was found that respiratory regularity was improved by using respiratory training system. RMSE of guided breathing decreased up to 40% in displacement and 76% in period compared with free breathing. In conclusion, since the guiding waveform was easy to follow for the volunteers, the respiratory regularity was significantly improved by using in-house developed respiratory training system. So it would be helpful to improve accuracy and efficiency during 4D-RT, 4D-CT.
Artifacts ; Displacement (Psychology) ; Fourier Analysis ; Respiration

PURPOSE: To evaluate the radiological and clinical outcomes of intrapelvic anterior plate fixations for Day Classification Type II crescent fracture-dislocations of sacroiliac joints. MATERIALS AND METHODS: Ten patients who had undertaken the surgical treatment for the sacroiliac joint from 2006 to 2012 were enrolled in this study. All cases fell into Type II by Day Classification for sacroiliac joint injuries. For surgical treatments, the plate fixation through the intra-pelvic anterior approach was first performed for all cases and anterior ring fixation was performed in 4 cases with more severely displaced anterior pelvic ring injuries. Then, radiological and clinical evaluation was implemented. RESULTS: The bone union was observed from all patients whom performed the surgical fixation. In the radiological results, 9 cases with the anatomic and nearly-anatomic reductions were observed. Out of the 10 cases which performed the rotational displacement analysis, there were 3 excellent cases, 6 good cases and 1 fair case. The 10 cases that performed the deformity index and vertical displacement analysis, less variations were observed in the anterior ring fixations after intra-pelvic anterior plate fixation group. According to the clinical results, 4 excellent cases, 3 good cases, and 3 moderate cases were observed. CONCLUSION: In the Type II crescent fracture-dislocation of sacroiliac joint, the intrapelvic anterior plate fixation achieved satisfactory anatomical reductions, radiological stabilities and clinical results.
Congenital Abnormalities ; Displacement (Psychology) ; Humans ; Sacroiliac Joint

OBJECTIVE: To evaluate the factors that affect torque control during anterior retraction when utilizing the C-retractor with a palatal miniplate as an exclusive source of anchorage without posterior appliances. METHODS: The C-retractor was modeled using a 3-dimensional beam element (0.9-mm-diameter stainless-steel wire) attached to mesh bonding pads. Various vertical heights and 2 attachment positions for the lingual anterior retraction hooks (LARHs) were evaluated. A force of 200 g was applied from each side hook of the miniplate to the splinted segment of 6 or 8 anterior teeth. RESULTS: During anterior retraction, an increase in the LARH vertical height increased the amount of lingual root torque and intrusion of the incisors. In particular, with increasing vertical height, the tooth displacement pattern changed from controlled tipping to bodily displacement and then to lingual root displacement. The effects were enhanced when the LARH was located between the central and lateral incisors, as compared to when the LARH was located between the lateral incisors and canines. CONCLUSIONS: Three-dimensional lingual anterior retraction of the 6 or 8 anterior teeth can be accomplished using the palatal miniplate as the only anchorage source. Using LARHs at different heights or positions affects the quality of torque and intrusion.
Displacement (Psychology) ; Incisor ; Splints ; Tooth ; Torque

OBJECTIVE: The purpose of this study is to evaluate the accuracy and safety of pedicle screws in the treatment of thoracic spine disease. METHODS: Thirty-eight patients who had undergone thoracic pedicle screw fixation between January 2003 and December 2007 were retrospectively studied. Postoperative computed tomography scans were obtained using 3-mm axial cuts to evaluate the pedicle screw placement. The screws were further evaluated by the location and degree of the perforation. RESULTS: Of the 214 thoracic pedicle screws placed, 174 (81.3%) were fully contained within the pedicle or anterior cortices of the vertebral body. Of the remaining 40 (18.7%) screws, 25 (62.5%) were lateral perforations, 12 (30.0%) were medial perforations, and 3 (7.5%) were anterior perforations of the vertebral body. The screws inserted at T1-T4 (28.5%) and T5-T8 (34.8%) revealed a higher perforation rate than the screws inserted at T9-12 (11.4%). No neurologic or vascular complications were encountered, but one screw 6 mm above a medial perforation required reinsertion. CONCLUSION: Although clinical outcomes were not affected by mild displacement of thoracic pedicle screws, accurate measurements and considerable experience were required in the placement of screws, especially screws placed in the upper and midthoracic spine.
Displacement (Psychology) ; Humans ; Retrospective Studies ; Spine