• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.359-365
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• 2020

Developmental dysplasia of the hip broadly includes inadequate development of the hip joint involving the acetabulum or proximal femur, or both. Although ultrasonographic studies in neonates have greatly lowered the frequency of neglected or operatively treated cases, its sensitivity is less than desired. Hip dysplasia without subluxation is commonly diagnosed incidentally and strongly related to degenerative arthritis in females after the 4th decade. Hip dysplasia with subluxation shows symptoms through various periods, depending on its severity, especially for women with onset during pregnancy. A complete physical examination and early treatment for neonates are extremely important for obtaining satisfactory outcomes. To avoid underdiagnosis and to serve appropriate treatment on time, the authors recommend examining any suspicious hips in infants under two years of age. The study will discuss the diagnosis and primary treatment of developmental dysplasia of the hip.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.143-148
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• 2002

Purpose: We examined patients to evaluate the clinical results of traumatic metacarpophalangeal(M-P) dislocations of the thumb, uncommon and irreducible. Materials and Methods: In 11 traumatic M-P dislocations of the thumb, the types of dislocations were 10 dorsal and 1 volar dislocations resulted from the impacted and hyperextended forces on thumb. Authors evaluated the possibility of closed reduction, the anatomical structures interfering with closed reduction, and the surgical approaches. Results: Eight cases were treated with open reduction through volar approach and two cases were treated with closed reduction. Joint fusion was done with a plate in a chronic case. Initial closed reduction was attempted in all cases, but succeeded in only 2 cases because the interposed ruptured volar plate, the flexor pollicis brevis tendon and ulnar sesamoid bone at the volar side of the M-Pjoint were the obstacles to reduce. The metacarpal head was caught in button-hole slit between theflexor pollicis brevis and the ruptured volar joint capsule in all cases. Conclusion: Similar with the M-P joint dislocations of other fingers, the dorsal complex M-P dislocations of the thumb due to hyper extension are unusual and can't easily be reduced by closed manipulation. It is necessary to pay attention to the ruptured volar plate, capsule, the subluxated portion ofthe sesamoid and flexor pollicis brevis as interfering structures.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.28-32
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• 2011

Snapping triceps syndrome is a rare disease in which medial head of triceps dislocates over the medial epicondyle during elbow flexion. It is difficult to diagnose the snapping triceps syndrome, because that this syndrome is frequently misdiagnosed as other elbow disease such as ulnarnerve dislocation. The dynamic ultrasonographic imaging allows continual visualization of the ulnar nerve and triceps muscle throughout active elbow flexion and extension. We report two patients of snapping triceps syndrome who were diagnosed with the use of dynamic ultrasonography and treated with ulnar nerve anterior transposition and repositioning or resectioning of medial head of triceps.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.51-60
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• 2021

Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

• 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.

• The korean journal of orthodontics
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• v.32 no.4 s.93
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• pp.257-264
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• 2002

If dental ankylosis occurs in maxillary incisors of a growing child, the ankylosed tooth can not move vertically with the subsequent disturbance in vertical growth of the alveolar process. Because ankylosed tooth does not respond orthodontic force, extraction was recommended in the past. But the loss of tooth and accompaning alveolar bone loss incur compromised esthetic situation. And it is very hard to replace by prosthetics. So intentional surgical luxation and orthodontic movement was attempted, but usually this approach is followed by recurrence of the ankylosis. Nowadays the unitooth subapical osteotomy and rapid movement of block bone was reported. Two cases we presented, one is treated by intentional luxation and the other is by unitooth subapical osteotomy following application of light continuous force soon.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.239-247
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• 2018

Purpose: We investigated occurrence of reduction loss after extension block (EB) Kirschner wire fixation or additional interfragmentary fixation (AIF) and clinical results including extension lag of the distal interphalangeal joint for treating bony mallet finger. Methods: Forty-six patients were included with a mean follow-up of 28 months (range, 12-54 months). Twenty-seven patients were treated with EB K-wire fixation (Group A) while 19 patients were treated with AIF (Group B). We checked radiologic factors, such as amount of articular involvement, volar subluxation, mallet fragment angle, reduction loss, range of motion including extension lag, and functional outcomes using Crawford's criteria. Results: Reduction loss occurred in eight patients (17%). Differences in mean extension lag, age, preoperative volar subluxation and mallet fragment angle between patients with reduction loss and those with reduction maintaining were significant. However, there were no significant differences in gender, hand dominance, amount of articular involvement, AIF, or further flexion between reduction loss and reduction maintaining. As for patterns of displacement, there was a significant relationship between gap or step-off and extension lag. Using Crawford's evaluation criteria, functional outcomes were excellent in 31, good in 10, fair in 3, and poor in 2 patients. Conclusion: Reduction loss should be careful in older age, smaller mallet fragment angle and preoperative volar subluxation.

• 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.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.134-141
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• 2021

Purpose: Patellar dislocations have a range of causes. This study examined the results of treatment aimed at balancing soft tissues around the patella. Materials and Methods: Thirty-two patellar dislocations in 28 patients (21 females and seven males) were examined. The mean patient age at the time of surgery was 11.5 years, and the mean follow-up period was 4.6 years. Dislocations were 19 chronic, six habitual, six congenital, and one acute. Soft tissue balancing surgery included lateral capsular release, medial capsular plication, and inferolateral transfer of the vastus medialis obliquus. Medial transfer of the patellar tendon, partial strip of the rectus femoris and patella tendon, and distal femoral osteotomy were also performed selectively. The preoperative Q angle, femoral anteversion angle, tibial external rotation angle, tibial tubercle-trochlear groove distance (TT-TG distance), mechanical femoral-tibial angle, and femoral trochlear dysplasia according to Dejour were measured, and the pre- and postoperative Lysholm-Tegner scores were used to analyze the clinical results. Results: The mean preoperative Q angle, TT-TG distance, femoral anteversion angle, tibial external rotation angle, mechanical femoraltibia angle, and Lysholm-Tegner score were 9.3°, 15.5 mm, 25.6°, 30.4°, 3.0°, and 75.8, respectively. Eleven patients had systemic ligament laxity with a Beighton score of five or more. Twenty-two patients had femoral trochlear dysplasia: four type A (3 patients), 16 type B (15 patients), one type C (1 patient), and four type D (3 patients). Of the 32 cases, 28 were corrected successfully by the first operation. Of four cases of postoperative subluxation, three were corrected by the second operation, and one of them was corrected after a third operation. The last patient is currently being followed-up. The mean Lysholm-Tegner score improved to 85.6 after the operation. Conclusion: Correcting all the causes of patella dislocation simultaneously is difficult. Nevertheless, satisfactory outcomes were obtained with soft tissue balancing surgery around the patella and a corrective osteotomy for an abnormal mechanical axis of the femur-tibia and torsion.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.45-48
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• 2013

A 12-year-old male poodle weighing 2.0 kg presented for evaluation of right thoracic limb lameness. The owner reported that the dog showed recurrent bilateral shoulder joint luxation after a car accident for a year. Recently, the left shoulder joint appeared well maintained, but right shoulder joint luxation was exacerbated. On physical examination, the dog showed non-weight bearing lameness on the right thoracic limb. Craniocaudal radiographic views revealed medial displacement of the right humerus. Mediolateral radiographic views revealed overlap of the glenoid cavity and humeral head. Muscle atrophy of the right thoracic limb, reduced biceps brachii muscle tendon tone, a tear of the medial glenohumeral ligament, and a rupture of the subscapularis tendon were identified intraoperatively. Transposition of the biceps muscle tendon was performed. However, at 7 days, there was evidence of right shoulder reluxation on radiographs. The second surgery was performed with two $2mm{\times}6mm$ cortical bone anchors and a $4mm{\times}6mm$ cancellous bone anchor placed in the cortical bone of the distal scapula and the cancellous bone of the proximal humerus respectively. Two scapular bone anchors were then connected with a humeral bone anchor using heavy nylon suture to minimize shoulder abduction range of motion. On radiographs right after surgery and 6 weeks after surgery, the affected limb revealed no evidence of medial shoulder luxation. At 6 months, no evidence of lameness was noted on the right thoracic limb.