• Title/Summary/Keyword: 관절성형

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석회화 건염

  • Kim, Yang-Su
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2006.11a
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    • pp.76-84
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    • 2006
  • 석회화 건염은 회전근 개중 극상근 건에 석회가 침착되는 질환으로서 진행 양상에 따라 Formative, Resting, Resorptive phases로 나눈다. 치료는 물리 치료, Puncture, 국소 steroid 주사, 체외 충격파 등 보존적 치료에 반응을 잘 하며, 특히 resorptive phases때의 극심한 통증은 석회 침착 부위에 puncture나 needling lavege를 실시하면 즉각적인 동통 감소 효과와 함께 석회 침착의 자연 소실을 기대할 수 있다. 이러한 보존적 치료에 효과가 없을 경우 수술적 처치를 고려할 수 있는데 최근에는 대부분 관절경을 이용한 석회 제거술을 시행한다. 수술전 견관절 충돌 징후가 있거나 수술 소견상 이를 의심할 만한 소견이 있을 경우 견봉하 성형술을 함께 실시하기도 한다.

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Outcomes and Complications of Total Elbow Arthroplasty (주관절 치환술의 임상 결과와 합병증)

  • Park, Min-Jong
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.146-152
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    • 2011
  • Purpose: To describe the recent clinical results and complications of total elbow arthroplasty based on the literature review. Materials and Methods: The indications of total elbow arthroplasty include rheumatoid or inflammatory arthritis, posttraumatic arthritis, anklylosed elbow, tumor resection which cannot recover elbow function by other reconstructive procedures, and comminuted distal humerus fracture in elderly patients. Complications are aspetic loosening, infection, prosthesis fracture, periprosthetic fracture, ulnar neuropathy, ectopic ossification, triceps insufficiency, dislocation, and bushing wear. Results and Conclusion: Mean 10 year survival rate following total elbow arthroplasty has been reported 85% on the basis of revision. The prognosis in patients with an inflammatory arthritis is reported to be best, and loosening rate in patients with a posttraumatic arthritis tends to be high. Complication rate is known to be higher than that of other joint arthroplasty. In particular, deep infection occurs in 3~5% of the patients. Total elbow arthroplasty provide satisfactory results when it is performed properly in selected patients who have an elbow joint with irreversible dysfunction and low level activities.

Segmental Resection and Rotationplasty of Malignant and Aggressive Bone Tumors Around Knee (슬관절 주위 악성 및 침윤성 골종양의 분절 절제술 후 회전 성형술)

  • Hahn, Soo-Bong;Park, Hong-Jun;Kim, Hyoung-Sik;Kim, Sung-Hun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.51-58
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    • 2001
  • Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

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THE POSTOPERATIVE CONDYLAR POSITION RELATED TO TEMPOROMANDIBULAR DISCOMFORT IN SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상 분할술에 있어 술후 하악과두의 위치와 측두 하악관절장애)

  • You, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.130-134
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    • 1997
  • The sagittal split ramus osteotomy(SSRO) of the mandible has used one of the most popula methods for the correction of various dentofacial deformities, especially mandibular prognathism. In SSRO, there are produced bony gap following mandible setback because of mandibular flaring. For this reason, the condylar axis may be changed due to bony approximation both segment in three dimension more mesio-laterally. According to change of condylar position, the condition of TMJ structure are changed and change of TMJ symptoms are suggested theoretically, and the correction of malocclusion by SSRO may improve the TMJ symptoms by improvement of feeding difficulties. The pupose of this study was to determine relationship between expected alterations in condylar position and suggested TMJ symptoms produced by change of condylar position. TMJ symptoms of 15patients who had operated SSRO are checked at about postoperative 6 month ranging $5{\sim}11$ month. Anterior-posterior position of condyle which was comparison preoperative with postoperative position, was classified 5 groups. The author tried to identify relationship between positional change of condyle and TMJ discomfort.

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PERFORATION OF THE TEMPOROMANDIBULAR JOINT MENISCUS: DIAGNOSED BY MAGNETIC RESONANCE IMAGING (MAGNETIC RESONANCE IMAGING을 이용한 악관절 원판 천공 진단)

  • Kim, Houng-Gon;Dolan, Eward;Vogler, James B.;Nokes, Steven R.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.11-18
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    • 1989
  • Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders, however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using intrarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging(MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective review of fifteen patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging pre-operatively demonstrated a sixty-five percent correlation between the radiographic diagnosis and the surgical findings.

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Operative Treatment of the Displaced Midshaft Clavicle Fracture Using Precontoured Locking Compression Plate (Precontoured Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료)

  • Kim, Jeong Woo;Kang, Hong Je;No, Sung Hyun
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.117-122
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    • 2012
  • Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5 (range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.

Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report (실패한 제 1중족 족지관절 유합술 후 대퇴근막 장근 개재 관절 성형술을 이용한 치료: 증례 보고)

  • Sim, Jaewoo;Hyun, Yoonsuk;Park, Junsik;Kang, Saehyun;Kwon, Hwanjin;Kim, Gablae
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.39-42
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    • 2017
  • Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.

Analgesic Effect of Intraarticular Morphine or Ketorolac Injection after Arthroscopic ACL Reconstruction (관절경을 이용한 전 십자 인대 성형술 후 관절강내로 투여한 Morphine과 Ketorolac의 진통효과)

  • Lyu, Suk Joo;Kwon, Soon Haeng
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.119-123
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    • 1998
  • In order to obtain a good result in Arthroscopic ACL Reconstruction by immediate postoperative physical therapy, sufficient analgesia was needed. This study analyzes the analgesic effect of the intra-articular injection with ketorolac, Morphine together with bupivacaine in 80 male patients who had Arthroscopic ACL Reconstruction. On completion of the surgery under spinal anesthesia, the knee was injected with 30ml of 0.25% bupivacaine. Each of the study group received ketorolac and/or morphine, either through parenteral or intra-articular. Total amount of the drug used by Patient Controlled Analgesia(PCA) and Visual Analgesia Scale(VAS) for pain were measured and analyzed. The group which received intra-articular ketorolac or Morphine had a better analgesic effect than other group which received none. The group which received both did not do better in analgesic effect. Intra-articular infusion with either ketorolac or Morphine improved postoperative analgesia in Arthroscopic ACL Reconstruction surgery. However, combined injection did not offer more advantage.

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Arthroscopic Meniscal Repair in a Young Patient with a Chronic Radial Tear of the Incomplete Discoid Lateral Meniscus (젊은 환자의 외측 불완전 원판형 연골판의 만성 방사상 파열의 관절경적 봉합술)

  • Song, Ji Hun;Lim, Young Jin;Park, Jin Yeong;Huh, Soon Ho
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.185-189
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    • 2012
  • The objective of this case report was to evaluate meniscal suturing for a young patient with a chronic radial tear of the incomplete discoid lateral meniscus. The patient underwent saucerization in conjunction with repair of the displaced radial tear of the discoid meniscus. Six-months after surgery, arthroscopic examination showed the repaired meniscus to be healed well with good continuity. Repair of radial tears, even chronic tears, should be considered for young patients with torn discoid lateral menisci.

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Separation of tip from the bipolar radiofrequency system in the arthroscopic surgery - Case Report - (Bipolar radiofrequency system 사용 중 발생한 Tip의 분리 - 증례 보고 -)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Park, Ji-Kang;Bae, Seung-Whan
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.66-68
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    • 2008
  • Recently, devices using radiofrequency energy have been developed for arthroscopic soft tissue ablation, cauterization and shrinkage. After ACL reconstruction operation, articular metallic foreign body was found in the post-operative radiographs. It was proven to be the tip of bipolar radiofrequency system after foreign body removal. After that we experienced 2 more cases during the acromioplasty procedure. We requires attention to prevent the separation of the tip from the body in the arthroscopic surgery using bipolar radiofrequency system.

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