• Title/Summary/Keyword: 내측부

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Treatment of Patella Recurrent Dislocation Through Percutaneous Lateral Release and Arthroscopic Medial Reefing (슬개골 재발성 탈구에 대한 외측부 유리술 및 내측 중첩술을 이용한 치료)

  • Hwang, Byoung-Yoon;Choi, Chong-Hyuk;Yang, Ick-Hwan;Park, Yoon-Ghil
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.85-90
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    • 2010
  • Purpose: To evaluate the results of percutaneous lateral release and arthroscopic medial plication for patients with recurrent patella dislocation. Materials and Methods: This study includes the thirty-one cases of patients who have had a surgical operation from March 2001 to March 2008. All the patients had recurrent patella dislocation after trauma history. The average age was 24.2 years old and the average follow up was 47.4 months (minimum 24 months). Results: The preoperative congruence angle, lateral patellofemoral angle, Lysholm score was $24.8^{\circ}$, $-6.2^{\circ}$, 75 points on average respectively. However, the postoperative congruence angle, lateral patellofemoral angle, Lysholm score was improved to normal range: $-2.8^{\circ}$, $10.2^{\circ}$, 95 points on average. Five cases showed the recurrent dislocation after operation. Among them, three cases showed femoral trochlear dysplasia. Conclusion: Percutaneous lateral release and arthroscopic medial plication showed satisfactory results for recurrent patella dislocation with low complication rate. However, in cases with femoral trochlear dysplasia, another surgical treatment may be considered.

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Arthroscopically Assisted Lateral Release and Medial Imbrication for Recurrent Patella Dislocation (재발성 슬개골 탈구에서 관절경적 외측 유리술 및 내측부 중첩술)

  • Kang, Sung-Shik;Yoo, Jae-Doo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.98-103
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    • 2010
  • Purpose: We reported the results of arthroscopically assisted lateral release and medial imbrication for the recurrent patella dislocation. Materials and Methods: Twenty patients (20 knees) underwent arthroscopically assisted surgery for the recurrent patella dislocation. There were 4 males and 16 female. The average age was 20.2 years. All patients had definite trauma history and average follow-up period was 19 months. The surgical results were evaluated according to the Lysholm knee score and the Kujala score. The congruence angle and lateral patellofemoral angle were measured on plain radiograph and the tibial tubercle-trochlear groove distance was calculated on computerized tomography. Results: The median value of preoperative congruence angle was $16.5^{\circ}$ (range, $0.0{\sim}+34^{\circ}$) and the average final follow-up was $-6.4^{\circ}$ (range, $-19{\sim}10^{\circ}$) with statistically significant improvement (p=0.025). The median value of preoperative Lysholm knee score was 70 (range, 63~81) and the final follow-up score had changed to 88 (range, 80~95) with statistically significant improvement (p=0.0341). The median value of preoperative Kujala score was 72 (range, 65~80) and the average final follow-up score showed 87 (range, 80~92) with statistically significant improvement (p=0.024). Recurrent dislocations after surgery occurred in 2 cases, one case which showed positive "thumb to forearm test" had been treated with medial patellofemoral ligament reconstruction. Conclusion: Arthroscopically assisted lateral release and medial imbrication for recurrent patella dislocation without bony malaligmenent showed the effective treatment, but would be inappropriate for the patients with the generalized joint laxity.

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Review of the Reasons in Cases Requiring Varus/Valgus Constrained Prosthesis in Primary Total Knee Arthroplasty (일차 슬관절 전치환술 시내·외반 구속형 치환물이 필요했던 사례들의 원인 분석)

  • Kong, Dong Yi;Park, Sang Hoon;Choi, Choong Hyeok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.253-260
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    • 2021
  • Purpose: The least constrained prosthesis is generally recommended in primary total knee arthroplasty (TKA). Nevertheless, a varus/valgus constrained (VVC) prosthesis should be implanted when a semi-constrained prosthesis is not good for adequate stability, especially in the coronal plane. In domestic situations, however, the VVC prosthesis could not always be prepared for every primary TKA case. Therefore, it is sometimes impractical to use a VVC prosthesis for unsual unstable situations. This study provides information for preparing VVC prostheses in the preoperative planning of primary TKA through an analysis of primary VVC TKA cases. Materials and Methods: This study reviewed 1,797 primary TKAs, performed between May 2003 and February 2016. The reasons for requiring VVC prosthesis and the preoperative conditions in 29 TKAs that underwent primary TKA with a VVC prosthesis were analyzed retrospectively. Results: In primary TKA, 29 cases (1.6%) in 27 patients (6 male and 21 female) used VVC prosthesis. Two patients underwent a VVC prosthesis on both knees. The mean age of the patients was 63.4 years old (34-79 years). The mean flexion contracture was 16.2° (-20°-90°), and the mean angle of great flexion was 111.7° (35°-145°). The situations requiring a VVC prosthesis were severe valgus deformity in 10 knees, knee stiffness requiring extensive soft tissue release in 10 knees, previously injured collateral ligaments in five knees, and distal femoral bone defect due to avascular necrosis in four knees. The mean tibiofemoral angle was 25.7° (21°-43°) in 10 cases with a valgus deformity. The mean flexion contracture was 37.5° (20°-90°), and the mean range of motion was 48.5° (10°-70°) in 10 cases with knee stiffness. Conclusion: The preparation of VVC prosthesis is recommended, even for primary TKA in cases of severe valgus deformity (tibiofemoral angle>20°), stiff knee (the range of motion: less than 70° with more than 20° flexion contracture), and the cases with a previous collateral ligament injury. This information will help in the preparation of adequate TKA prostheses for unusual unstable situations.

Pathophysiology of Stiff Elbow (주관절 강직의 병태 생리)

  • Song, Hyun-Seok;Yoon, Hyung-Moon
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.286-292
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    • 2010
  • Purpose: Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. Materials and Methods: Morrey et al. reported that the functional range of motion of the elbow joint is $30-130^{\circ}$ of flexion-extension and $50^{\circ}C$ of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge. Results and Conclusions: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.

A Pedunculated Cavernous Hemangioma located beneath the Inferomedial Scapular Area -A Case Report- (견갑골 내측부 하방에 발생한 자루를 동반한 해면 혈관종 -증례 보고-)

  • Park, Tae Soo;Kim, Sung Jae;Ryu, Jeong Ah
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.93-96
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    • 2011
  • We reported a patient with a large pedunculated cavernous hemangioma located beneath inferomedial border of the scapular bone and the trapezius muscle checked by ultrasonography before and after the operation. In ultrasonographic finding, the peduncle was difficult to be visualized preoperatively due to acoustic shadowing.

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Throwing injury of elbow

  • 최창혁
    • 대한정형외과스포츠의학회:학술대회논문집
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    • 2003.11a
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    • pp.158-166
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    • 2003
  • 반복적인 투구동작은 성장기의 주관절에 손상을 주기 쉬우며 투구 시 통증을 유발할 경우, 투구를 중지하고 관절의 능동적 휴식을 통해 유연성을 회복하고 점차 근력강화운동을 시행해야 한다. 유소년기 Little league elbow의 주된 병변인 상완골 내상과 골단염을 포함한 대부분의 손상은 보존적 요법으로 치료가 가능하며, 굴곡구축 등의 운동제한을 동반한 통증이나 관절 내 유리골편 등의 감입으로 인한 증상이 있을 경우 수술적 치료를 요하며, 성인의 경우 내측 측부인대의 만성 불안정성 둥에 대해서 인대 재건술 등의 수술적 치료가 고려된다. 투구 시 주관절의 손상은 대부분의 경우 과 사용으로 인한 것이며, 특히 성장기에 손상의 예방이 무엇보다 중요하다. 따라서 부모와 코치 그리고 경기 관계자 둥이 성장기 소년의 근력과 관절의 상태가 성인과 다름을 이해하고, 운동의 강도와 횟수를 적절히 조절하며 손상시 조기치료를 받을 수 있는 환경을 조성하는 것이 필요하다.

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스피츠버겐 페리도타이트에 대한 Lu-Hf 및 Re-Os 동위원소 시스템의 활용: 맨틀-지각간의 성인적 연계성에 대한 고찰

  • Choe, Seong-Hui;Shzuki, K.;Mukas, S.B.;Lee, Jong-Ik
    • 한국지구과학회:학술대회논문집
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    • 2010.04a
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    • pp.23-23
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    • 2010
  • 스발바드 서측에 위치하는 스피츠버겐 하부의 암석권맨틀의 분화시기를 규명하기 위하여, 두 개의 독립적인 방사성동위원소 시스템인 Lu-Hf과 Re-Os 시스템을 스피넬 페리도타이트(spinel peridotite)에 활용하였다. 전암에 대한 Re-Os 계통(Re-Os 에러크론, 알루미노크론, Re-결핍연대 등)은 연구지역의 페리도타이트가 대류하는 맨틀로부터 고기원생대/후기시생대에 분리되었음을 지시한다. 흥미롭게도 이런 연대는 페리도타이트내 단사휘석 결정들에 대하여 얻어진 Lu-Hf 에러크론 연대와 일치한다. 또한 시료 내에 지구화학적으로 기록된 현무암질 액의 결핍정도 역시 계통적으로 위의 연대를 지지한다. 위 연대는 스피츠버겐 서측부에 보고된 가장 오래된 지각의 연대와 일치한다. 따라서 연구지역의 암석권맨틀이 연약권으로부터 분리된 것은 접촉하고 있는 지각과 동시기적으로 이루어진 사건임을 알 수 있다. 연구지역은 팔레오세 이래로 복잡한 지구조적 응력장 변화(압축에서 신장환경으로의 변화)를 겪었다. 그럼에도 불구하고 지각과 커플링된 암석권맨틀이 현존한다는 것은 연구지역내 응력장변화가 대규모의 암석권 디라미네이션(delamination)을 유발하지는 않았다는 것을 의미한다. 그러므로 북극권의 화산활동을 설명하기 위하여 북극권 상부맨틀에 존재한다고 알려진 듀팔(DUPAL) 같은 부화된 물질의 성인으로 일부의 연구자들이 주장하여 온 디라미네이션된 암석권맨틀의 존재는 설득력이 없다고 판단된다.

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한국산 플라나리아 Phagocata vivida 인두에서 형성되는 점액과립

  • 장남섭
    • The Korean Journal of Zoology
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    • v.36 no.4
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    • pp.496-504
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    • 1993
  • 한국산 플라나리아 Phagocata vivida의 인두에서 다음과 같은 점액과립들을 관찰하였는데 그 결과는 다음과 같다. 인두외강의 인두측 상피조직과 내측부의 유조직에서 조직화학적 및 미세구조적 특징에 따라 5종류의 점액과립(G1형, G2형, G3형, G4형 및 G5형)이 관찰되었다. methylene blue-baslc fuchsin 이중염색을 시행한 결과 G1형, G3형 및 G4형 과립은 methylene blue에만 양성반응을 보인데 비해 G2형 및 G5형 과립은 두 염색액에 모두 양성반응을 보였다. G1형과 G3형 과립은 그 크기가 0.5mm정도이고. 전자밀도가 매우 높게 나타났으며 특히 G1형 과립에서는 흰 반점과 줄무의가 관찰되었다 G2형 과립은 그 크기가 0.750m정도이고, 전자밀도는 G3형 과립에 비해 약간 낮았다. G4형 과립은 그 크기가 0.3mm정도로 매우 작고, 전자밀도는 낮아서 밝게 보였다. G5형 과립은 그 크기가 0.4$\times$0.3mm정도이고. 전자밀도가 낮게 나타났으며 배상세포 형태를 하고 있었다.

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LCL Augmentation and Popliteal Tenodesis for Lateral and Posterolateral Instability Of The Knee (슬관절 외측 및 후외측 불안정성에 대한 외측 보강술 및 슬와근 건고정술)

  • Park, Jin-Uck;Lee, Ju-Hyup;Sohn, Sung-Won
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.98-102
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    • 2004
  • Purpose: The purpose of this study was to make a report on the clinical prognosis of post traumatic lateral and posterolateral instability of the knee after LCL augmentation and popliteal tenodesis. Materials and Methods: The assessment was made among 21 cases who underwent augmentation of lateral collateral ligament(LCL) and popliteal tenodesis with allograft or artificial ligament (synthetic polyester, ABC ligament, Surgicraft, U.K.) at this Medical Center during the period from July 1996 to July 2003 and whose follow-up period was longer than one year. The authors recorded and analysed the physical findings (external rotation recurvatum test & posterolateral drawer test), stress roentgenograms(preoperative and postoperative) and Lysholm score. Results: The lateral and posterolateral instability of the knee were improved in 20 cases postoperatively, acccording to the clinical test and stress roentgenograms . Average Lysholm score was 52.5 preoperatively and 86.7 postoperatively .Conclusion: Our study found the surgery of lateral and posterolateral instability of the knee with augmentation of LCL and popliteal tenodesis using allograft or artiflcial ligament is simple technique. Taking these results into consideration, it seems to be one of effective methods of treatment.

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Transcatheter Arterial Embolization for Hemoptysis (객혈환자에서 동맥 색전술의 효과)

  • Yoo, Byung-Su;Ryu, Jeong-Seon;Lee, Won-Yeon;Song, Kwang-Seon;Ahn, Kang-Hyun;Yong, Suk-Joong;Shin, Kye-Chul;Kim, Young-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.50-57
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    • 1995
  • Background: Transcather arterial embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function such as postpneumonectomy patients and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization and analysed the correlation of the clinical and angiographic characteristics and investigated the clinical course and outcome after arterial embolization in the patients with significant hemoptysis. Method: 58 patients with massive or recurrent hemoptysis underwent transcatheter arterial embolization for the treatment of hemoptysis from April 1992 to Sept. 1993. Results: Most common cause of hemoptysis was pulmonary tuberculosis(34 cases, 58.3%). Embolized vessels responsible for hemoptysis were 56 bronchial arteries and 32 nonbronchial systemic arteries. Initial most common angiographic findings were hypervascularity and shunt. Initial success rate of hemoptysis control revealed 81.1%. However, 15 of 58 patients(25.9%) showed recurrence of hemoptysis after transcatheter arterial embolization. The complications(18 cases, 31%) such as chest pain, fever, voiding difficulty, atelectasis, paralytic ileus and unwanted embolization were occured. Conclusion: Transcatheter arterial embolization is useful and relatively safe treatment modality for immediate bleeding control of patients with massive hemoptysis or inoperable cases. The further evaluation of the long term results according to the embolized material and underlying pulmonary disease will be required.

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