• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.98-105
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• 2021

Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss' kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.

• Journal of Digital Convergence
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• v.19 no.2
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• pp.481-488
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• 2021

This study aimed to identify and to compare the difference the changes of one-leg drop landing pattern depending on chronic ankle instability (CAI) among basketball club members. For 30 basketball club members who are currently participating in recreational basketball games in Busan Metropolitan City, 21 CAI groups and 9 CON groups were classified according to the CAI standards provided by the International Ankle Consortium. The one-leg drop landing pattern was measured with the alignment of the lower extremity and joint movement at the initial contact (IC), and the point of peak knee flexion. In addition, the one-leg drop landing pattern was tested with the muscular activity of tibialis anterior, peroneus longus, medial gastrocnemius and gluteus medius at the initial contact (IC), heel contact (HC), and the point of peak knee flexion. The results of this study showed that there was no significant difference in lower limb alignment and lower limb muscular activity among single leg drop landing. These results showed no significant differences in the one leg drop landing pattern and muscular activity depending on CAI. The further studies should classify the types of chronic ankle instability and consider the physical demands and movement characteristics depending on their playing position for providing useful information on prevention of CAI in basketball club members.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.223-227
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• 2013

Objective : Although there is no consensus on the ideal treatment of the craniocervical instability, biomechanical stabilization and bone fusion can be induced through occipito-cervical fusion (OCF). The authors conducted this study to evaluate efficacy of OCF, as well as to explore methods in reducing complications. Methods : A total of 16 cases with craniocervical instability underwent OCF since the year 2002. The mean age of the patients was 51.5 years with a mean follow-up period of 34.9 months. The subjects were compared using lateral X-ray taken before the operation, after the operation, and during last follow-up. The Nurick score was used to assess neurological function pre and postoperatively. Results : All patients showed improvements in myelopathic symptoms after the operation. The mean preoperative Nurick score was 3.1. At the end of follow-up after surgery, the mean Nurick score was 2.0. After surgery, most patients' posterior occipito-cervical angle entered the normal range as the pre operation angle decresed from 121 to 114 degree. There were three cases with complications, such as, vertebral artery injury, occipital screw failure and wound infection. In two cases with cerebral palsy, occipital screw failures occurred. But, reoperation was performed in one case. Conclusion : OCF is an effective method in treating craniocervical instability. However, the complication rate can be quite high when performing OCF in patients with cerebral palsy, rheumatoid arthritis. Much precaution should be taken when performing this procedure on high risk patients.

• Journal of Korean Neurosurgical Society
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• v.42 no.3
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• pp.179-183
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• 2007

Objective : Posterior arthrodesis in atlantoaxial instability has been performed using various posterior C1-2 wiring techniques. Recently, transarticular screw fixation (TASF) technique was introduced to achieve significant immediate stability of the C1-2 joint complex. The purpose of this study is to assess the clinical outcomes associated with posterior C1-2 TASF for the patient of atlantoaxial instability. Methods : We retrospectively reviewed data obtained from 17 patients who underwent C1-2 TASF and supplemented Posterior wiring technique (PWT) with graft between 1994 and 2005. There were 8 men and 9 women with a mean age of 43.5 years (range, 12-65 years). An average follow-up was 26 months (range, 15-108 months). Results : Successful fusions were achieved in 16 of 17 (94%). The pain was improved markedly (3 patients) or resolved completely (14 patients). There was no case of neurological deterioration, hypoglossal nerve injury, or vertebral artery injury. Progression of spinal deformity, screw pullout or breakage, and neurological or vascular complications did not occur. Conclusion : The C1-2 TASF with supplemental wiring provided a high fusion rate. Our result demonstrates that C1-2 TASF supplemented by PWT is a safe and effective procedure for atlantoaxial instability. Preoperative evaluation and planning is mandatory for optimal safety.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.123-129
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• 2010

Purpose: To evaluate the efficacy of the arthroscopic exploration combined with modified Brostrom operation (MBO) for the treatment of chronic lateral ankle instability (CAI). Materials and Methods: Sixty patients who diagnosed a CAI were performed MBO. We divided to 2 groups, whether simultaneously inspected by arthroscopy (group B) or not (group A). The both group's results were compared according to American Orthopedic Foot and Ankle Society Ankle-hindfoot score (AOFAS), functional ankle score and visual analog scale (VAS) at preoperative and final follow-up period. Results: There were no significant differences of AOFAS, functional ankle score and VAS between both groups at final follow-up. However, in group A, 2 cases associated with medial ankle instability and syndesmotic injuries were did not diagnosed preoperatively, showed poor prognosis. In group B, one case had a permanent peroneal nerve symptom. The match rate of intra-articular lesions between preoperative diagnosis and postoperative arthroscopic diagnosis was 30% in group B. Conclusion: Combination of arthroscopic exploration and MBO is effective strategy for intra-operatively discrimination of intra-articular associated lesions for CAI.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.1
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• pp.29-38
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• 2022

Background: Task-oriented training on an unstable support surface is an effective intervention for improving the ankle joint stability and muscle strength in patients with ankle instability. This study examined the effects of balance training on an unstable support surface in patients with ankle sprains with ankle instability. Methods: Forty-four patients with ankle sprains participated in this study. Screening tests were performed and assigned to an experimental group, who performed task-oriented training on an unstable support surface (n=22), and a control group, who performed task-oriented training on a support surface (n=22) using a randomization program. All interventions were applied 3 times per week for 4 weeks. The numeric rating scale (NRS), cumberland ankle instability tool (CAIT), balance ability, muscle activity, and muscle thickness were compared to evaluate the effects of the intervention. Results: Both groups showed significant differences in the NRS, CAIT, balance ability, and muscle activity between before and after the intervention (p<.05). In addition, there were significant differences in balance ability, muscle activity, and muscle thickness between the experimental and control groups (p<.05). Conclusion: Task-oriented training on an unstable support surface is an effective intervention for improving the balance ability, muscle activity, and muscle thickness during contraction.

• 대한관절경학회:학술대회논문집
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• 2008.04a
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• pp.23-28
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• 2008

1. 손상받은 조직을 보호하면서 동시에 주위 조직과의 유착을 방지하고 soft tissue의 pliability를 유지시켜 관절 운동 범위를 향상하기 위해 통증을 유발하지 않는 범위 내에서 부드러운 수동 관절 운동을 먼저 실시한다. 2. 모든 재활 프로그램은 환자의 개개인의 특성에 맞춰 운동 내용과 시기를 조정해야 한다. : Important to individualize rehab. program. 3. 능동적 관절운동 (active ROM)은 수술한 조직이 치유될 충분한 시간이 경과되었거나 환자가 통증없이 독립적인 견관절 운동이 가능할 때 실시한다. 4. Strengthening of the dynamic stabilizer(muscles around shoulder joint) 가 모든 shoulder instability 재활에 가장 기본적인 요소이다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.3
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• pp.276-282
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• 2016

This study examined the effects of 8-weeks hip muscle training on the hip joint abductor muscle isokinetic strength and foot pressure distribution in elite players with chronic ankle instability (N=19). A total of 19 subjects had chronic ankle instability from at least 2 ankle sprains, and were given 8-weeks hip muscle training exercise. The hip muscle strength of the elite players with chronic ankle instability increased significantly, but the foot pressure distribution and ratio of the foot pressure distribution of the elite players with chronic ankle instability did not reach statistical significance and the ratio of the foot pressure distribution showed a similar trend. These results suggest that the strength and foot pressure distribution of the affected-side might increase to that of the unaffected-side. The 8-weeks hip muscle training helped improve the chronic ankle instability of the elite players. Therefore, the hip muscle strength and foot pressure distribution are the primary factors of a rehabilitation program on ankle sprains.

• Journal of Ocean Engineering and Technology
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• v.3 no.2
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• pp.87-100
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• 1989

해양구조물의 원통형 조인트에 대한 파괴역학적 피로수명 산출방법이 개발되었다. 개발된 방법을 이용해서 2평면 K형 조인트에 대한 피로수명을 구체적인 파괴역학적 방법으로 산출 하였다. 이 분석을 위해 용접부위 표면균열의 응력확대 계수를 3차원 유한요소법에 의해 계산하였다. 계산된 결과에 의하면 용접부위 표면균열 첨단은 단순한 Mode I형태를 보이지 않고 Mode I, II, III이 복합된 형태임이 입증되었다. 계산된 응력확대 계수를 사용해서 16개의 용접부위균열 성장형태를 일반적인 피로균열 성장법칙을 적용해서 계산하였고, 균열성장의 안정분석을 통해 각 균열의 최종 파괴상태를 파괴해석도면(failure assessment diagram)법을 이용해서 계산하였다.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.95-98
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• 2009

Charcot arthropathy of the foot and ankle is characterized by a combination of sensory, motor and autonomic peripheral neuropathy leading to gross swelling, bony destruction and finally severe bony deformity with joint instability. We report a case of very unstable Charcot arthropathy in ankle joint managed with ankle arthrodesis using fibular strut bone grafting technique.