• Title/Summary/Keyword: Fracture & dislocation

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The Shoulder Pain due to Metastatic Breast Cancer -A Case Report-

  • Kim, Sae-Young;Jung, Min-Woo;Kim, Jin-Mo
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.119-122
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    • 2011
  • A rotator cuff tear causes shoulder pain and limits movement of the shoulder joint. A chronic degenerative change or impingement is the reason for a rotator cuff tear. Diagnosis is made based on medical history and, physical and radiological examinations. Other causes of shoulder pain include calcific tendinitis, degenerative arthropathy, joint dislocation, fracture, and primary or metastatic neoplasm. However, metastatic cancer in the shoulder joint is difficult to diagnosis. We experienced a case in which a 46-year-old female patient complained of left shoulder pain and limited joint mobility, and these symptoms were due to metastatic breast cancer in the shoulder.

Descending Necrotizing Mediastinitis Combined with Cervical Spine Injury (경추 손상과 동반된 하행성 괴사성 종격동염)

  • 금동윤;양보성
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.76-79
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    • 2001
  • A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

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Effects of microstructure on impact transition temperature of low carbon HSLA steels (저탄소 HSLA강의 천이 온도 미치는 미세 조직의 영향)

  • Kang, J.S.;Lee, C.W.;Park, C.G.
    • Proceedings of the Korean Society for Technology of Plasticity Conference
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    • 2008.05a
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    • pp.431-434
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    • 2008
  • Effects of microstructure on the toughness of low carbon HSLA steels were investigated. Nickel decreased the ferrite-austenite transformation temperature, resulted in increase of the fraction of bainitic ferrite. However, it was decreased with increasing deformation amount at austenite region. Since fine austenite grains formed by dynamic recrystallization under large strain transformed to acicular ferrite or granular bainite rather than bainitic ferrite. The effective grain size, thus, was decreased by deformation and it resulted in lower ductile-brittle transition temperature (DBTT). The bainitic ferrite was thought to inhibit the fracture crack initiation and to delay the crack propagation by its high dislocation density and hard interlath $2^{nd}$ phase constituents, respectively. Thus, DBTT was also decreased by Ni addition in low carbon HSLA steels.

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Hemiarthroplasty for the Comminuted Fracture of the Proximal Humerus (상완골 근위부 분쇄 골절에서의 상완골 두 치환술)

  • Seo Joong-Bae;Won Choong-Hee;Kim Yong-Min;Choi Eui-Seong;Lee Ho-Seung;Hong Yoon-Chul
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.61-67
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    • 2000
  • Purpose: Most proximal humeral fractures are minimally displaced and can be treated satisfactorily with a conservative method. But in many comminuted fractures, hemiarthroplasty is usually done as a primary treatment. The authors evaluated how much functional improvement was achieved after hemiarthroplasty and which factors influence on the final functional results. Materials and Methods: Eleven hemiarthroplasties were performed for three- and four-part fractures(including fracture-dislocation) between April 1992 and June 1999. There were eight women and three men, and the mean age was 65 years. According to Neer classification, six was three-part fracture and five was four-part fracture. Six patients were injured on their right shoulder and five on the left shoulder. Among the five four-part fractures, three had axillary nerve injury and among the six three-part fractures, only one patient had axillary nerve injury. The average follow-up period was 2.4 years(1 year-7 years) after operation. The functional results were evaluated with the UCLA scoring system(Modification for hemiarthroplasty). In addition to the overall results, we compared the results according to the classification of the fracture, the cause of injury, and whether the axillary nerve was injured. Results: At the last follow-up, average total UCLA score was 18.2. The mean score for pain was 7.0, mean muscle power and motion score was 5.5 and 5.7 respectively. The pain relief was more satisfactory than any other functional results. The average score for three-part fractures was 22, and the average for four-part fractures was 13.6. The average score for the patients fractured by vehicle accidents was 15.3, and 19.3 for the patients fractured by slip-down injury. In patients without axillary nerve injury, the average score was 20, and with axillary nerve injury, the score was 15. Conclusion: Shoulder hemiarthroplasty, for the treatment of proximal humeral fractures, cannot restore the shoulder function to normal, but can achieve the functional result to some degree, especially for the activity of daily living. And as for pain, we think that it is relatively effective measure. And we think that the severer the comminution, the more the chance of axillary nerve injury, and the poorer the functional results. In conclusion, the severity of initial injury seems to be the major prognostic factor.

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TRAUMATIC ROOT FRACTURE IN YOUNG PERMANENT TEETH : A CASE REPORT (미완성된 근첨을 가진 영구치 치근 파절의 치유에 관한 증례)

  • Kang, Sun-Hee;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.4
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    • pp.576-580
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    • 2003
  • A 7-year-old male was refered to Department of Pediatric Dentistry, Wonkwang Dental Hospital for treatment of a traumatic injury to the teeth of the maxillary anterior region of the mouth. His right central incisor presented subluxation and root fracture, the left central incisor had suffered intrusive luxation and root fracture. The initial treatment involved reposition and fixation of the teeth with 0.5mm stainless steel wire and composite resin. The patient was submitted for clinical and radiographic fallow-up. After 4 years, radiographically the right central incisor seemed to be healed by hard tissue union and showed to be indistinct fracture line, intact lamina dura. The left central incisor radiographically was healed by interposition of bone and connective tissue and showed to be distinct horizontal fracture line separating the fragments, and pulp canal obliteration. In clinical examination, the teeth showed a normal response to elective pulp test, percussion and mobility test. Pulp survival after injuries appears to be dependent upon the type of luxation injury, age of patient, stage of root development and degree of dislocation. In this case, the two teeth with incomplete root formation were suffered different type of injury by trauma and has showed different healing aspect.

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Analysis of Surgical Treatment and Factor Related to Closed Reduction Failure for Patients with Traumatically Locked Facets of the Subaxial Cervical Spine (축추 이하 경추손상 환자에서 외상성 탈구에 의한 도수 정복의 실패 요인의 분석과 수술적 치료에 대한 분석)

  • Paeng, Sung Hwa
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.7-16
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    • 2012
  • Purpose: Cervical dislocations with locked facets account for more than 50% of all cervical injuries. Thus, investigating a suitable management of cervical locked facets is important. This study examined factors of close reduction failure in traumatically locked facets of the subaxial cervical spine patients to determine suitable surgical management. Methods: We retrospectively analyzed of the case histories of 28 patients with unilateral/bilateral cervical locked facets from Nov. 2004 to Dec. 2010. Based on MRI evaluation of disc status at the injury level, we found unilateral dislocations in 9 cases, and bilateral dislocations in 19 cases, The patients were investigated for neurologic recovery, closed reduction rate, factors of the close reduction barrier, fusion rate and period, spinal alignment, and complications. Results: The closed reduction failed in 23(82%) patients. Disc herniation was an obstacle to closed reduction (p=0.015) and was more frequent in cases involving a unilateral dislocation (p=0.041). The pedicle or facet fracture was another factor, although some patients showed aggravation of neurologic symptoms, most patients had improved by the last follow up. The kyphotic angle were statistically significant (p=0.043). Sixs patient underwent anterior decompression/fusion, and 15 patients underwent circumferential fusion, and 7 patients underwent posterior fusion. All patients were fused at 3 months after surgery. The complications were 1 case of CSF leakage and 1 case of esphageal fistula, 1 case of infection. Conclusion: We recommend closed reduction be performed as soon as possible after injury to maximize the potential for neurological recovery. Patients fot whom closed reduction of the cervical locked facets have a higher incidence of anatomic obstacles to reduction, including facet fractures and disc herniation. Immediate direct open anterior reduction or circumferential fixation/fusion of locked cervical facets is recommended as a treatment of choice for traumatic locked cervical facet patients after closed reduction failure.

Nonconstrained Total Elbow Arthroplasty with or without Radial Head Resection (요골 두 절제 유무에 따른 비구속형 전 주관절 성형술)

  • Kim, Jung-Man;Chung, Yang-Kook;Kim, Yang-Soo;Huang, Seung-Hyun
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.37-41
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    • 2002
  • Purpose : To evaluate the effect of radial head resection on longevity in nonconstrained total elbow arthroplasty, Materials and Methods : The results of 20 cases of radial head replaced Pritchard ERS and 18 cases of radial head excised Kudo elbow was followed for 6 to 16 years, 10.6 years in average. The rate of loosening, osteolysis, radial head subluxation, joint dislocation and valgus deformity were compared between the two groups. Results'There was no exaggerated cubitus valgus in Pritchard ERS group. However there developed one case of delayed subluxation of radial head occurred in 6 years postoperatively, one case of loosening, and one case of sponta- neous fracture of humeral shaft due to osteolysis. In Kudo elbow group,5 cases (27.8%) showed exaggerated valgus deformity with instability. There were one case of loosening and one case of delayed dislocation occurred in a year postoperatively. Conclusion : The most clear feature of Kudo elbow was exaggerated cubitus valgus. However, the ostolysis was developed in both groups and there was no difference in rate of the other complications between the two groups.

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

  • Altintas, Burak;Yildiz, Fatih;Uzer, Gokcer;Kapicioglu, Mehmet;Bilsel, Kerem
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.59-67
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    • 2017
  • Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

A Case Report of Korean Medicine Rehabilitation Treatment after Sauve-Kapandji Procedure (Sauve-Kapandji 수술 후 한방재활치료에 대한 증례보고)

  • Cho, Eun-Byul;Geum, Ji-Hye;Baek, Dong-Gi;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.1
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    • pp.49-59
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    • 2019
  • Objectives : The purpose of this study was to report the clinical progress of a patient exposed to a Sauve-Kapandji procedure after being diagnosed with dislocation of distal radioulnar joint and was treated using Korean medicine rehabilitation treatment. Methods : During the admission period, the patient was treated with acupuncture, cupping, herbal medicine, and Chuna therapy. The clinical progress was assessed by using range of motion(ROM), manual muscle test(MMT), numeric rating scale(NRS), and pain disability index(PDI). Results : After receiving the above treatments, the active ROM and motor grade of the elbow, wrist, and finger joints were improved; the NRS and PDI were decreased. Conclusions : Although this is a single case report, Korean medicine rehabilitation treatment, including Chuna manual therapy, might be an effective intervention for a patient after being exposed to a Sauve-Kapandji procedure.

A Study of Radiographic Methods to X-ray Study of Patients with Spinal Scoliosis and Vertebrae Bone Fracture of Lumbar Spine (척주측만증과 허리뼈 골절 수술 환자의 엑스선 촬영법 연구)

  • Ahn, Byung-Ju;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.425-431
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    • 2019
  • The Study In order to obtain images of overlap of the two iron cores in the spinal cord simple x-ray scan after surgery of patients with ulcer lateral sclerosis and a fractured backbone, the researcher conducted a subjective evaluation on five radiographers of the university hospital's imaging department for more than 10 years. The results of the experiment showed that the lateral shot of lateral scoliosis of the spinal cord was taken with the middle face of the IR plane, and then the X-ray tube angle was taken vertically with the vertical spinal column fan-tom position, resulting in two overlapping images and high scores in the subjective evaluation. In addition, lateral shots of the lumbar dislocation fractured lumbar vertebrae were taken with the forehead aligned with the center of the IR plane and then with the X-ray angle perpendicular to the fourth waistline and the angle of the spinal cord perpendicular to the fourth waistline, the image of the two iron cores could be obtained from the radiographer.