• Title/Summary/Keyword: 관절경적 정복

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Treatment of Anterior Glenoid Rim Fracture with Comminuted Fragment Using Arthroscopic Reduction and AO Headless Compression Screw Fixation - A Case Report - (관절경하 AO 무두 압박 나사를 이용한 견갑골 전방 관절와 분쇄 골절의 치료 - 증례 보고 -)

  • Kim, Hyung-Sik;Koh, Il-Hyun;Kim, Sung-Guk;Chun, Yong-Min;Kim, Sung-Jae;Kang, Ho-Jung
    • 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.

Arthroscopic Treatment of Displaced Tibial Spine Fracture in Children (소아에서의 전위된 경골극 골절의 관절경적 치료)

  • Choi, Nam-Yong;Cheong, Hyung-Kook;Koh, Hae-Seok;Han, Suk-Ku;Nah, Ki-Ho;Song, Hyun-Seok;Kim, Bae-Gyun
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.148-153
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    • 2005
  • Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.

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Alternative Fixation Technique for Bony Bankart Lesion with Using Suture Anchor (봉합나사와 골터널을 이용한 골성 반카르트 병변의 고정)

  • Kim, Byung-Kook;Lee, Ho-Jae;Kim, Go-Tak;Dan, Jinmyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.574-578
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    • 2019
  • For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

Transpatellar Cannulated Screw Fixation of Displaced Tibial Intercondylar Eminence Fractures (전위성 경골 과간 융기부 골절의 슬개골 하단을 통한 삽관 나사못 고정술)

  • Nha Koung Wook;Jung Byung Hyun;Suh Jin Soo;Suk Seung Yeub;Park Gyu Won;Chae Dong Ju
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.25-30
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    • 2002
  • Purpose : To evaluate the clinical results of displaced tibial intercondylar eminence fractures which were treated with transpatellar cannulated screw fixation. Materials and Methods : Ten patients with displaced tibial intercondylar eminence fractures were treated between December 1998 and May 2001 and then followed up for more than one year. They were treated arthroscopic reduction and fixation of fracture site by cannulated screw through the hole of nonarticular surface of inferior patella. They were prospectively evaluated with regard to their clinical and radiologic results. Results : Radiologic unions occurred at an average of 9.2 weeks. Average anterior displacements were 1.8 mm in stress x-rays and 1.1 mm in KT-2000 arthrometer. Average loss of extension was $4.1^{\circ}$. Functional results were excellent in 7 cases and good in 3 cases. Conclusion : Arthroscopic transpatellar cannulated screw fixation is one of the useful methods for the treatment of displaced tibial intercondylar eminence fractures.

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Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures (상완골 간부 골절에서 교합성 골수강 내 금속정 고정 후 잔존한 골절편 전위에 대한 임상적, 방사선학적 추시)

  • Yum, Jae-Kwang;Lim, Dong-Ju;Jung, Eui-Yub;Sohn, Su-Een
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.107-114
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    • 2013
  • Purpose: This study is designed to evaluate the clinical and radiographical results for the displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures. Materials and Methods: We retrospectively reviewed the results of 8 cases of humeral shaft fractures that have displacements of over 10 mm and under 20 mm after interlocking intramedullary nailing between July 2004 and August 2011. The mean age was 54.1 years (range, 43 to 70 years) and there were 3 male and 5 female patients. Radiographically, the time to bony union, change of displacement and angulation of the fracture site, and degree of improvement of these two factors were measured. Clinically, the range of motion of shoulder and elbow joints, postoperative pain and complications were evaluated. Results: All cases showed complete bony union in last follow-up. The mean time to bony union was 16.1 weeks. At the last follow-up, almost all cases had normal range of motion of shoulder and elbow joints. But, one case had stiffness of shoulder joint. Therefore, arthroscopic capsular release and manipulation was performed. One case had transient shoulder pain and the other case had transient elbow pain. In the two cases, pull-out of proximal interlocking screw were noted, but they finally had bony union. Conclusion: Although considerable displacement of fracture fragments after interlocking intramedullary nailing in humeral shaft fractures was present, we had excellent radiographical and clinical outcomes. Therefore, an additional procedure, such as open reduction or another fixation for the fracture site, was not necessary.

Arthroscopic Repair of Anterior Root Injury in Lateral Meniscus Using Suture Anchor - Case Report and Technical Note - (Suture anchor를 이용한 외측 반월판 연골 전방 뿌리 파열의 관절경적 치료 -증례 및 술기 보고-)

  • Kim, Do-Young;Yoo, Yon-Sik;Lee, Sang-Soo;Jeong, Un-Seob;Seo, Eun-Min;Park, Seung-Jae
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.41-45
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    • 2011
  • As awareness of root tear of meniscus have been increased, it became necessary to have an intensive repair. Posterior horn tear, especially for a lot of repair methods and the results have been reported recently. The report of the anterior root tear has yet to be found. We recently encountered a patient with an iatrogenic meniscal subluxation caused by past experienced partial menisectomy for discoid meniscus. Thus, we repots the technique and clinical results of arthroscopic repair of subluxated lateral meniscus anterior root tear using suture anchor.

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Subtalar Arthroscopy : Indication and Results (거골하 관절경 : 적응증과 그 결과)

  • Ahn, Jae-Hoon;Lee, Kwang-Won;Kim, Ha-Yong;Lee, Seung-Hun;Choy, Won-Sik;Kim, Seung-Kwon
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.39-44
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    • 2007
  • Purpose: To evaluate the results of subtalar arthroscopy and to define the indications for the procedure. Materials and Methods: Fifty-four patients were followed up for more than 1 year after subtalar arthroscopy. The mean age was 40 years, and the mean follow-up period was 18 months. Preoperative diagnoses included sinus tarsi syndrome in 19 cases, degenerative arthritis in 13 cases, calcaneal fracture in 10 cases, arthrofibrosis in 5 cases, os trigonum syndrome in 3 cases, talar fracture in 3 cases, talocalcaneal coalition in 3 cases and calcaneal tumor in 1 case. Clinically AOFAS ankle-hindfoot scale and satisfaction of the patients were evaluated. Results: There were 23 synovectomies, 13 subtalar fusions, 11 diagnostic arthroscopies, 5 adhesiolyses, 4 loose body removals, 3 excisions of os trigonum and 1 arthroscopic reduction of fracture. Twenty-five ankle arthroscopies and 11 modified Brostrom's operations were performed for the accompaning 17 ankle impingment syndromes, 11 chronic ankle instabilities and 7 osteochondral lesions of talus. AOFAS ankle-hindfoot scale was increased from 33 points preoperatively to 77 points postoperatively in subtalar fusion group, and was increased from 69 points preoperatively to 89 points postoperatively in other-than-fusion group. Ninety one percent of patients were satisfied with the procedures. There were no serious complications related to the subtalar arthroscopy. Conclusion: Subtalar arthroscopy appears to be safe and highly accurate procedure for subtalar pathology, although it requires technical expertise.

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Arthroscopic Treatment of Greater Tuberosity fracture - Preliminary Report - (상완골 대결절 골절 손상에 대한 관절경적 치료 -예비 보고-)

  • Ji, Jong-Hoon;Kim, Young-Yul;Park, Sang-Eun;Ra, Ki-Hang;Do, Jeong-Hun;Kim, Weon-Yoo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.57-65
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    • 2007
  • Purpose: The purpose of this study was to evaluate the clinical result of arthroscopic treatments by using suture anchors or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture. Materials and Methods: From March 2004 to March 2006 we have used suture anchor or suture anchors combined with cannulated screw for 6 cases of the greater tuberosity fracture which include displaced fractures, comminuted fractures and minimally displaced fractures with comcomittent lesions such as rotator cuff tears, stiffness and labral lesion. In this retrospective study, we analyzed the clinical outcomes by using the range of motion, University of California at Los Angeles shoulder rating scale (UCLA) and the ASES shoulder index score (ASES) in the average 6 months follow up. Results: At the last follow up, average range of motion was improved to 154.3 degree, 145.8 degree, 32.6 degree and L1 vertebrae in each forward flexion, abduction, external rotation and internal rotation. Clinically the UCLA rating scales improved to 31.5 and the ASES shoulder index score (ASES) improved to 93.6 in the last follow up. Conclusion: Arthroscopic treatments by using suture anchor or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture is an alternative treatment of the greater tuberosity fracture of the proximal humerus fracture.

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