• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.124-131
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• 2011

Ankle arthrodesis has been considered to be the standard operative treatment for end-stage ankle arthritis, nevertheless currently increasing arthroplasty. Indication for arthrodesis is painful ankle from global arthrosis regardless of the etiology. But it is hard to be carried out in the several circumstance such as infection states, poor vascularity, severe diabetes, prematurity, etc. So thorough evaluation should be done before the surgery, including adjacent joints status. The ideal position for fusion is neutral in flexion, functional valgus, and slightly external rotation. Methods of arthrodesis would be largely divided into two categories as in situ fixation and realignment procedure. The lateral and anterior longitudinal approaches are two common procedures, and fixation modalities are also variable. The long-term results of arthrodesis have been reported. Even the close follow-up have shown subsequent degeneration of adjacent joints, benefits such as reliable pain loss, easy correctability for deformity, and improved functional status with considerable durability can be expected in the most patients.

• Hip & pelvis
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• v.34 no.3
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• pp.172-176
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• 2022

A 58-year-old-male patient presented with worsening pain and restricted movements of his right hip after undergoing multiple procedures for treatment of an inter-trochanteric fracture. Secondary arthrosis and an incorporated intramedullary fibular cortical bone graft which caused severe narrowing of the medullary canal were observed by imaging. Total hip arthroplasty (THA) using knee arthroscopic tools was performed for preparation of the severely narrowed femoral canal. A satisfactory clinical outcome was achieved and stable components were observed on radiographs at the 11-year follow-up. The technique described here may be considered when attempting to perform a conversion THA for preparation of a severely narrowed femoral canal using a fibular strut in order to minimize morbidity and prevent structural destabilization.

• Korean Journal of Oriental Medicine
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• v.1 no.1
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• pp.289-319
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• 1995

The clinical studies were performed on 301 cases who took Yongkakkyo-tang from June 1993 to December 1994 The results were as follows: 1. About 80%(239 cases) patients who took Yongkakkyo-tang were improved. 2. The ratio of male to female patients was 106:133. In the age distribution, it was found that under 20's were 8%(24/301), 30's and 40's were 33%(98/301), and over 50's was 39%(117/301). 3. In the regional distribution, it was found that Cervical region was 22 cases, thoracic region was 12 cases, cervical & lumbar region complex was 50 cases, upper limbs region was 6 cases, lower limbs region was 12 cases, and lumbar region was 153 cases(64%). 4. Among improved cases, the cases treated only with Yongkakkyo-tang were 16(5%), the cases treated with Yongkakkyo-tang, and treated with Chiropractic were 19(6%), the cases treated with Yongkakkyo-tang and Yanggun-tang chiropratic were 133(44%). 5. Among improved cases, the number of Chiropractic treatment, less then 15 teimes were 69 cases, 15 to 30 times were 91cases. Basedon these results, it was shown that Yongkakkyo-tang could be used for the treatment of degenerative disease of vertebra, and the treatment with Yongkakkyo-tang, Yanggun-tang and Chiropratic is more effective.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.134-138
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• 2000

Arthrodesis of the ankle joint is inevitable in the cases of severe arthrosis or defective bony structures around ankle joint. There have been many kinds of arthrodesis methods were introduced. In cases with failed athrodesis with previous arthrodesis surgery and neuropathic joints have difficulty to achieve fusion of joint with conventional methods. Authors underwent four cases of ankle fusion with vascularized fibular graft from 1997 in the cases of three failed fusions and one diabetic neuropatic joint. Two of four performed free vascularized fibular transplantation from contralateral side leg with microvascular anastomosis, two of four performed with pedicled fibular transposition to the ankle joint in same side leg. Three of four cases achieved arthrodesis average 9.2 months after surgery, one case was failed due to vascular thrombosis of the anastomosed site in diabetic neuropathic condition. The result of this technique revealed 75%(three of four) success rate and longer bone union time required. However, in these cases had no recommendable options with conventional bone graft and additional ankle joint fusions procedure because of poor bone quality and defect of distal tibia and talus portions. Free vascualrized fibular transfer to the failed athrodesis of ankle joint is one of the effective alternative methods in failed ankle fusion cases, especially the quality of the bone around previous fusion site is poor.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.268-271
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• 2013

Occipital neuralgia is a rare pain syndrome characterized by periodic lancinating pain involving the occipital nerve complex. We present a unique case of entrapment of the greater occipital nerve (GON) within the semispinalis capitis, which was thought to be the cause of occipital neuralgia. A 66-year-old woman with refractory left occipital neuralgia revealed an abnormally low-loop of the left posterior inferior cerebellar artery on the magnetic resonance imaging, suggesting possible vascular compression of the upper cervical roots. During exploration, however, the GON was found to be entrapped at the perforation site of the semispinalis capitis. There was no other compression of the GON or of C1 and C2 dorsal roots in their intracranial course. Postoperatively, the patient experienced almost complete relief of typical neuralgic pain. Although occipital neuralgia has been reported to occur by stretching of the GON by inferior oblique muscle or C1-C2 arthrosis, peripheral compression in the transmuscular course of the GON in the semispinalis capitis as a cause of refractory occipital neuralgia has not been reported and this should be considered when assessing surgical options for refractory occipital neuralgia.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.3
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• pp.203-213
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• 2006

Purpose : This study was carried out to evaluate correlation between Bone Mineral Density(BMD) and degenerative lumbar disease in postmenopausal low back pain patients. Methods : 69 postmenopausal patients with low back pain were examined. Magnetic resonance imaging was performed to evaluate degenerative lumbar disease and bone mineral density of lumbar spine was measured by Dual energy X-ray absorptiometry. Data were analyzed by Pearson's Linear Correlation Coefficient. Results : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had negative correlation with the grade of intervertebral disc herniation and positive correlation with weight. Other lumbar diseases including Spinal stenosis, Spondylolisthesis and Facet joint arthrosis didn't have significant correlation with BMD. Conclusion : In postmenopausal patients with low back pain, BMD(T-score, Z-score) had inverse relationship with the grade of intervertebral disc herniation.

• Journal of Oral Medicine and Pain
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• v.39 no.3
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• pp.100-106
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• 2014

Purpose: This study was performed to investigate the relationship between temporomandibular disorders (TMDs) and the asymmetry of the mandibular height. Methods: We compared 100 randomly selected TMD patients diagnosed by the research diagnostic criteria for TMD (RDC/TMD) Axis I with 100 non-TMD control subjects matched with the TMD patients in age and gender. The mandibular heights were measured on an orthopantomogram and the asymmetry index (AI) was calculated as previously described. Results: The absolute AI value of 4.37% turned out to be the least cut-off value defining asymmetry, which showed a significant difference in asymmetry incidence (p<0.01) between the TMD and control groups. The risk of TMD increased in the asymmetry group by 4.57 (odds ratio). The incidence of asymmetry was not related to age and gender in both of the TMD and control groups. When dividing the TMD group according to the RDC/TMD Axis I diagnosis, neither the incidence of muscle disorder nor disk displacement was related to the incidence of asymmetry. However, a higher incidence of asymmetry was observed in the subjects classified into the arthrosis/arthritis groups (p<0.01). Conclusions: Although it does not imply a direct cause-and-effect relationship, asymmetry resulting in more than 4.37% difference between mandibular heights may increase the risk of TMD and correlates positively to the incidence of arthritic change in the temporomandibular joint of TMD patients.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.144-150
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• 2002

Mandibular condylar fracture is common in mandibular fractures. Unlike other facial, skeletal fractures, most of mandibular condylar neck or head fractures are treated with closed reduction and subsequent functional therapy is essential for preventing complications including ankylosis, arthrosis and growth disturbance. From January, 2000 to September, 2002, we have treated 15 cases of mandibular condylar fractures with closed reduction by using functional appliance with bite block. Among these cases, we report a case of 14-year-old female with mandibular condylar neck fracture, resulted in good clinical and radiographic progress.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.23-27
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• 2001

It has been known that the ankle arthrodesis is a common surgical procedure for treating the ankle arthrosis and deformity that do not respond to the non-operative treatment. To date, various surgical techniques for the ankle arthrodesis have been reported. Clinical and biomechanical trials have shown that the rigid internal fixation leads the increased rate of the union. The ankle arthrodesis may be complicated with the nonunion, delayed union, malunion, and infection. In cases of the Charcot joint of the ankle in diabetic patients, however, arthrodesis could reduce the disadvantage of the nonoperative treatment, such as the loss of the reduction, progressive collapse, multiple ulcerations and infection. The object of this case report is to report our experience of a successful ankle arthrodesis using an anterior T plate in treating the unstable ankle of a diabetic patient, associated with the ankle fracture and the neuropathy. The surgical approach of this technique is simple so that it would allow less soft tissue injury, and this procedure would be regarded as one alternative to provide the rigid internal fixation in the ankle arthrodesis.

• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.72-78
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• 2000

Purpose: To validate the major bony causes and postoperative results of the first metatarsal head plantar pain. Materials and Methods: We experienced one case of the fracture and non-union of the medial sesamoid treated by autogenous calcaneal bone graft, one case of the fracture and non-union and two cases of the hypoplasia of the medial sesamoid treated by excision of medial sesamoid, one case of the arthrosis between the first metatarsal head and the medial sesamoid treated by plantar 1/2 partial excision of the medial sesamoid, and two cases of the metatarsus primus nexus treated by basal metatarsal closing wedge osteotomy between October 1995 and September 1999. The mean follow-up period was 28 months. We evaluated the results by using of the clinical rating systems for the hallux and the radiographic findings. Results: An excellent results were achieved in all cases except one which was preoperatively diagnosed as metatarsus primus nexus. But, clinically this one case also satisfied with the postoperative result. Radiologically, We did not find the malunion or nonunion of the medial sesamoid treated by bone graft and of the metatarsus primus flex us treated by basal metatarsal closing wedge osteotomy. And also we did not find the postoperative fracture of the medial sesamoid treated by plantar 1/2 partial excision. There were no postoperative complications in all cases. Conclusion: We think that the good results may be achieved from the patients with the plantar pain of the first metatarsal head by the exact diagnosis and aggressive treatments.