• Title/Summary/Keyword: Joint Instability

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Traumatic Dynamic Hallux Varus (A Case Report) (외상성 역동적 무지 내반증(1예 보고))

  • Yim, Soo-Jae;Lee, Young-Koo;Kim, Jin-Su;Kim, Chan-Ho;Kang, Hee-Kyung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.193-196
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    • 2009
  • The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

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Simultaneous Paraspinal and Midline Approach for Upper Lumbar Disc Herniation : Technique to Prevent Lamina Fracture

  • Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.111-115
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    • 2005
  • Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

A Study on the Shape Modeling and Structural Stability of an Icosahedron-typed Modular Dome (정20면체 모듈러 돔의 형상모델링 및 구조안정성에 관한 연구)

  • Shon, Su-Deok;Woo, Hyo-Jun;Lee, Seung-Jae
    • Journal of Korean Association for Spatial Structures
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    • v.15 no.2
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    • pp.51-59
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    • 2015
  • In this study, a shape design and an analysis considering structural stability were investigated to develop an icosahedron-based hemispherical modular dome. To design this modular dome, a program that can perform icosahedron shape modeling, modularization of joint connection members, and the analysis of structural stability was developed. Furthermore, based on the adopted numerical model, the eigen buckling mode, unstable behavior characteristics according to load vector, and the critical buckling load of the modular dome under uniformly distributed load and concentrated load were analyzed, and the resistance capacities of the structure according to different load vectors were compared. The analysis results for the modular dome suggest that the developed program can perform joint modeling for shape design as well as modular member design, and adequately expressed the nonlinear behaviors of structured according to load conditions. The critical buckling load results also correctly reflected the characteristics of the load conditions. The uniformly distributed load was more advantageous to the structural stability than concentrated load.

The Studies on the Foot Stability and Kinesiology by Direction of Carry a Load during Gait (보행 시 부하의 위치에 따른 발의 안정성 및 운동학적 분석에 관한 연구)

  • Lee, Sang-Yeol;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.21 no.2
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    • pp.97-101
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    • 2009
  • Purpose: This study examined how the direction of carrying a load affects the foot stability and kinesiology while walking. Methods: The heel rotation, Hallux stiffness, foot balance, metatarsal load, toe out angle, subtalar joint flexibility were measured in 40 adults (men and women) who carried a load back and forth, walking on a 2-meter-long board. The measurement was carried out three times and the mean of the measurements was used to compare the difference between the front, back and the condition without a load. Results: While walking, heel rotation and hallux stiffness occurred most when a front load was applied compared to a back load or no load condition (p<0.05). A metatarsal load also appeared to be the highest with the frond load, but there was no significant difference in the balance of the whole foot. Both the toe out angle and subtalar joint flexibility appeared to increase significantly (p<0.05). Conclusion: Applying the front load causes subtalar joint instability and increases the plantar foot pressure imbalance during walking.

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Treatment of the wide open wound in the Ehlers-Danlos syndrome

  • Baik, Bong Soo;Lee, Wu Seop;Park, Ki Sung;Yang, Wan Suk;Ji, So Young
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.130-133
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    • 2019
  • Ehlers-Danlos syndrome (EDS) is an inherited disorder of collagen biosynthesis and structure, characterized by skin hyperextensibility, joint hypermobility, aberrant scars, and tissue friability. Besides the skin, skeleton (joint) and vessels, other organs such as the eyes and the intestine can be affected in this syndrome. Accordingly, interdisciplinary cooperation is necessary for a successful treatment. Three basic surgical problems are arising due to an EDS: decreased the strength of the tissue causes making the wound dehiscence, increased bleeding tendency due to the blood vessel fragility, and delayed wound healing period. Surgery patients with an EDS require an experienced surgeon in treating EDS patients; the treatment process requires careful tissue handling and a long postoperative care. A surgeon should also recognize whether the patient shows a resistance to local anesthetics and a high risk of hematoma formation. This report describes a patient with a wide open wound on the foot dorsum and delayed wound healing after the primary approximation of the wound margins.

International Construction Joint Ventures with Developing Countries: Singapore's Case for Risk Assessment and Allocation

  • Hwang, Bon-Gang;Zhao, Xianbo;Chin, Eileen Wei Yan
    • International conference on construction engineering and project management
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    • 2015.10a
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    • pp.435-439
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    • 2015
  • It is important for Singaporean companies to manage the multifaceted risks when forming international construction joint ventures (ICJVs) with developing countries. The objectives of this study are to assess the risks associated with Singaporean ICJVs with developing countries, and investigate the risk allocation preferences in these ICJVs. To fulfill these objectives, a literature review was carried out and a questionnaire survey was performed with 38 professionals. The survey results reported "political instability" as the most critical risk, and market level risks were less critical than country and project level risks. Additionally, the results showed agreement on the risk ranking between building and infrastructure ICJVs, despite significant differences in the criticalities of five risks. Furthermore, five risks were preferably allocated to host and foreign partners, respectively, while 13 risks could be shared among partners. As few studies have explored the risk allocation preferences in ICJVs, this study expands the literature. Also, the identification of the risks allows other companies to customize their own lists of critical risks, while the preferred risk allocation provides valuable information for companies from various countries that intend to form ICJVs with developing countries. Thus, this study contributes to the global body of knowledge relating to ICJVs.

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Anterior Open Bite with Temporomandibular Joint Osteoarthritis Treated with Skeletal Anchorage Device: A Case Report

  • Seo-Rin Jeong;So-Yoon Lee;Sung-Hoon Lim;Hye-Min Kim;Shin-Gu Kang;Hyun-Jeong Park
    • Journal of Oral Medicine and Pain
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    • v.48 no.3
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    • pp.123-130
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    • 2023
  • This case report describes the orthodontic treatment of a patient with severe anterior open bite and skeletal class II malocclusion with temporomandibular joint (TMJ) osteoarthritis (OA) of the left condyle. The 21-year-old male patient had open-bite malocclusion, mild crowding, and protrusion of the anterior teeth. Mild erosive changes were detected in the anterior part of the left mandibular condyle on cone-beam computed tomography; however, because no clinical symptoms were present, orthodontic treatment was performed. It is imperative to consider the potential implications of orthodontic treatment on the stability of the TMJ throughout the duration of treatment, as any instability can exacerbate TMJ OA. Hence, it is crucial to opt for the least invasive treatment modality available. In this regard, orthodontic treatment using a skeletal anchorage system as an alternative to conventional orthognathic surgery for patients with open bite holds great promise, as it not only ensures mandibular stability but also significantly ameliorates the open-bite condition.

Strategy for Insecticide Resistance Management Approach to IPM

  • Motoyama, Naoki;Dauterman, W.C.
    • Korean journal of applied entomology
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    • v.31 no.3
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    • pp.314-327
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    • 1992
  • Insecticide resistance is a serious is a serious threat to IPM, resulting in various adverse effects not to mention the loss of yield in agriculture. One approach to counter the problem is the disruption of resistance mechanisms. This can be achieved by (1) compounds which show a negative correlation with resistance at the site of action, (2) specific metabolic inhibitors which serve as synergists, or (3) a certain combination of two insecticides producing a joint action. This approach, however, requires certain precautions for the side effects may cause an increase in toxicity to mammals. Owing to the recent advances in theoretical studies on resistance management employing computer simulation and mathematical models, a few principles to reduce the risk of development of resistance have been clarified. They are helpful in designing operational strategies with regard to, for instance, insecticide doses to be applied, mode of application, and choice and nature of the insecticide(s) to be used. For restoration of insecticide susceptibility of a resistant population, reintroduction of susceptible individuals to the resistant population is feasible when certain conditions are met. Natural enemies which developed resistance to insecticides can be an important component of IPM as has been shown in the pest management in apple orchards. After all, the implementation of a successful resistance management program depends upon cooperation between different sigments of the agricutural community. Although resistance is a preadaptive phenomenon, in some cases spontaneous loss of resistance does occur without contamination by susceptible individuals. The instability of resistance in these insects implies the possible existence of a switch machanism controlling the expression of resistance gene(s). Elucidation of such a mechanism may eventually provide us with a new technical approach with which we can combat the problem of insecticide resistance.

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Comparison of ACL Reconstruction using Patellar tendon Autografts and Allografts (자가 슬개건과 동종 슬개건을 이용한 전십자인대의 재건의 비교)

  • Byun Ki-Yong;Rhee Kwang-Jin;Shin Hyun-Dae;Lee Won-Sok
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.116-122
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    • 1997
  • We have studied the results of reconstruction by freeze-dried patellar allografts or patellar autografts in ACL-deficient patients prospectively. From January 1995 to December 1995, we performed ACL reconstruction using an arthroscopic-assisted technique with patellar autografts in 21 patients and patellar allografts in 13 patients. Minimum followup time was 1 year(average 26 months). All patients were evaluated by using KT-2000 arthrometer and MRI as well as by physical examination. Final results were rated as satisfactory or unsatisfactory by using a modified Feagin knee scoring scale. Good or excellent were considered to have satisfactory results and fair or poor were considered to have unsatisfactory results. As measured by the KT-2000, 19 cases$(90.5\%)$ had a 5-mm or Jess side-to-side differential, a satisfactory results in autograft group, 2 cases of unsatisfactory results had joint instability. In allograft group, 10 cases$(76.9\%)$ had a 5-mm or less side-to-side differential, a satisfactory results, 3 cases of unsatisfactory results had joint instability including postoperative infection(1 case). In conclusion, the results of ACL reconstruction with autografts were better than those with allografts. The problem of allograft reconstruction were rehydration, aseptic control and improper mechanical tensioning. So, we thought that success of allograft reconstruction was depended on careful implant preparation including pretensioning technique.

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Transposition of Flexor Carpi Radialis and Superficial Digital Flexor Muscles for Reconstruction of Carpal Injury in a Dog (개에서 요골쪽앞발목굽힘근과 얕은앞발가락굽힘근을 이용한 앞발목 부위의 연부조직 결손 재건 증례)

  • So, Kyoung-Min;Kim, Joo-Ho;Lee, Hae-Beom;Heo, Su-Young;Ko, Jae-Jin;Lee, Cheol-Ho;Chon, Seung-Ki;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.276-279
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    • 2007
  • A 2-year-old male, 3 kg body weight Japanese Chin was injured in the automobile accident three months ago. The dog became antebrachiocarpal joint instability, and performed pancarpal arthrodesis using 3 K-wires in localanimal hospital. But, the result was failure. Therefore the dog was referred to Chonbuk Animal Medical Center, Chonbuk National University. In physical examination, right carpal joint instability, knuckling sign and pain were evident. In radiography, sclerosis was observed on the 4th carpal bone. Complete blood count (CBC), serum chemistry and urinalysis finding were within reference ranges. Pancarpal arthrodesis was re-performed using 7-hole plate. However, mild skin and muscle defects was appeared by skin tension of extremity. We expected that granulation would fill the defect, but inflammation was continued on the lesions for 3 days. So, operation which is filling it was done by using the muscle flap and tubed skin flap. The donor muscles were flexor carpi radialis and superficial digital flexor muscles. After 7 days, the muscle flap was survived, but tubed skin flap was necrosed. After 20 days, the skin defect was substituted with granulation tissues. The flexor carpi radialis muscle and superficial digital flexor muscle transposition can be a useful procedure for reconstructing soft tissue defects in the carpal and metacarpal areas.