• 한국운동역학회지
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• 제28권4호
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• pp.219-225
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• 2018

Objective: Epidemiological research shows that 47 to 73% of athletes suffer from recurrent ankle sprains. Joint mobilization techniques (JMT) implemented in correcting may be beneficial in the management of ankle injuries. The purpose of this study is to examine the immediate JM on ankle complex as clinical measures in individuals with chronic ankle instability (CAI) through intervention. Method: Thirteen subjects with CAI (8 males and 5 females) participated in this study. Each subject tried total four alignments (Navicular drop test: NDT, Standing rearfoot angle: SRA, Tibia torsion: TT, and dorsiflexion range of motion: DFROM). The participants were performed the 10 meter shuttle run after JMT for post-task. Finally, it was tried to compare between pre-post tasks after shuttle run. Results: SRA and DFROM after intervention showed significant differences. SRA (p=.026), and DFROM (p=.034). Conclusion: We concluded that the JMT has resulted in improvement in SRA, DFROM. Increased DFROM and varus shapes of foot would be closed kinetic chain, indicating that reduce the risk factors of ankle sprain. Future study needs to be conducted in order to measure the effects of prolonged intervention of JMT.

• 대한족부족관절학회지
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• 제25권4호
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• pp.177-180
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• 2021

Pediatric ankle fractures can cause physeal injuries which can lead to the shortening of the fibula. This induces a lateral shift of the talus, valgus tilt, and instability of the ankle joint, which can result in an arthritic change in this joint. Patients with a shortening of the fibula may complain of constant pain and restricted movements in their daily lives and during sports activities. Ankle reconstruction with fibula lengthening Z-osteotomy can provide excellent results if arthritis is absent or minimal, especially in young and active patients. To the best of the authors' knowledge, this is the first report in South Korea regarding the treatment of fibula shortening following a growth arrest due to injury.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.302-305
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• 2023

The authors present a case of transient postoperative inferior subluxation of the shoulder after arthroscopic surgical stabilization for recurrent anterior dislocation. The patient was a 61-year-old woman with myasthenia gravis (MG). The first anterior shoulder dislocation occurred because of a fall to the ground. Despite a successful closed reduction, two more dislocations occurred in 3 weeks. Magnetic resonance imaging revealed an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, an engaging Hill-Sachs lesion, and large tears of the supraspinatus and infraspinatus tendons. The patient underwent arthroscopic rotator cuff repair and ALPSA repair with a remplissage procedure. Intraoperatively, no tendency for instability was found; however, a widened glenohumeral joint space and inferior subluxation of the humeral head without functional compromise was observed on the day after surgery and disappeared spontaneously on radiographs 2 weeks later. To the authors' knowledge, this is the first report documenting the occurrence of transient postoperative inferior subluxation of the shoulder in a patient with MG.

• Hip & pelvis
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• 제35권1호
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• pp.15-23
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• 2023

Purpose: Hip microinstability is defined as hip pain with a snapping and/or blocking sensation accompanied by fine anatomical anomalies. Arthroscopic capsular plication has been proposed as a treatment modality for patients without major anatomic anomalies and after failure of properly administered conservative treatment. The purpose of this study was to determine the efficacy of this procedure and to evaluate potential predictors of poor outcome. Materials and Methods: A review of 26 capsular plications in 25 patients was conducted. The mean postoperative follow-up period for the remaining patients was 29 months. Analysis of data included demographic, radiological, and interventional data. Calculation of pre- and postoperative WOMAC (Western Ontario and McMaster Universities Osteoarthritis) index was performed. Pre- and postoperative sports activities and satisfaction were also documented. A P<0.05 was considered significant. Results: No major complications were identified in this series. The mean pre- and postoperative WOMAC scores were 62.6 and 24.2, respectively. The WOMAC index showed statistically significant postoperative improvement (P=0.0009). The mean satisfaction rate was 7.7/10. Four patients with persistent pain underwent a periacetabular osteotomy. A lateral center edge angle ≤21° was detected in all hips at presentation. We were not able to demonstrate any difference in postoperative evolution with regard to the presence of hip dysplasia (P>0.05), probably because the sample size was too small. Conclusion: Capsular plication can result in significant clinical and functional improvement in carefully selected cases of hip microinstability.

• 대한치과보철학회지
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• 제39권3호
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• pp.297-305
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• 2001

Statement of problem. There have been previous studies about instability according to screw material by means of calculating preload in tightening screw or recording of the torque necessary to loosen screw after tightening screw. Purpose. The purpose of this study was to evaluate screw joint stability through the analysis of fitness at the mating thread surfaces between implant and screw after tightening screws made of different materials. Material and methods. In this study, screws were respectively used to secure a cemented abutment to a hexlock implant fixture; teflon coated titanium alloy screw and titanium alloy screw(Steri-Oss), gold-plated gold-palladium alloy screw and titanium alloy screw(Implant Innovation), gold screw and titanium screw(AVANA Dental Implant System). Each abutment screw was secured to the implant with recommended torque value using a digital torque controller. Each screw was again tightened after 10minutes. All samples were cross sectioned with sandpaper and polished. Then samples were evaluated with an scanning electron microscope analysis. Results. In titanium alloy screw, irregular contact and relatively large gap was present at mating thread surface. Also in teflon-coated titanium screw, incomplete seating and only partially contact was present at the mating thread surface. In gold-plated gold-palladium alloy screw, relatively close and tight contact without the presence of large gap was present by existing of gold coating at the mating thread surfaces. In gold alloy screw, relatively small gap between the mating components was seen. Conclusions. This result suggested that gold plated gold-palladium alloy screw and gold alloy screw achieved a greater degree of contact at the mating thread surfaces compared to titanium alloy screw and teflon-coated titanium alloy screw.

• 대한관절경학회지
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• 제13권3호
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• pp.254-258
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• 2009

경골 과간 융기부 골절은 슬관절의 뒤틀림, 과도한 굴곡 및 신전, 내반 및 외반 손상으로 인한 견열 골절의 형태로 발생을 하며 정확한 해부학적 정복이 이루어지지 않을 경우 슬관절의 불안정성과 관절 운동 제한을 초래할 수 있다. 최근 관절경을 이용한 정복과 다양한 고정 방법이 시행되고 있으며, 저자들은 이 중 견인 봉합술을 시행함에 있어서 도관 나사못을 이용한 터널을 만들어 기존에 시행되어지던 술기에 비해 보다 쉽고 편리하게 내고정을 얻을 수 있었으며, 이에 수술방법의 소개와 증례를 보고하고자 한다.

• 한국전문물리치료학회지
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• 제28권4호
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• pp.256-265
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• 2021

Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.

• Hip & pelvis
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• 제35권4호
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• pp.268-276
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• 2023

Purpose: Resection remains the most reliable treatment for established heterotopic ossification, despite questions regarding its effectiveness due to the potential for complications. This study evaluated the clinical outcomes and complications of neurogenic heterotopic ossification (NHO) resection in stroke patients' ankylosed hips. Materials and Methods: We retrospectively analyzed nine hip NHO resections performed on seven patients from 2010 to 2018. The pre- and postoperative range of motion of the operated hip were compared. Analysis of postoperative complications, including infection, recurrence, iatrogenic fracture, and neurovascular injury was performed. Results: The mean operative time was 132.78±21.08 minutes, with a mean hemoglobin drop of 3.06±0.82 g/dL within the first postoperative week. The mean duration of postoperative follow-up was 52.08±28.72 months for all patients. Postoperative range of motion showed improvement from preoperative. Flexion and external rotation (mean, 58.89±30.60° and 16.67±18.03°, respectively) showed the greatest gain of motion of the operated hip joint. Postoperative infections resolved in two cases through surgical debridement, and one case required conversion to total hip arthroplasty due to instability. There were no recurrences, iatrogenic fractures, or neurovascular injuries. Conclusion: Resection is a beneficial intervention for restoring the functional range of motion of the hip in order to improve the quality of life for patients with NHO and neurological disorders. We recommend performance of a minimal resection to achieve a targeted functional arc of motion in order to minimize the risk of postoperative complications.

• 대한족부족관절학회지
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• 제23권4호
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• pp.173-182
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• 2019

Purpose: This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI). Materials and Methods: The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests. Results: There were no significant differences in the average ATFL thickness between stable and unstable ankles in those subjects with CAI (0.25±0.03 cm and 0.21±0.05 cm, respectively) or in the SEAR thickness (0.09±0.04 cm and 0.10±0.03 cm, respectively). There were also no significant differences in the right and left ATFL thicknesses (0.23±0.07 cm and 0.21±0.04 cm, respectively) or the SEAR thicknesses (0.09±0.01 cm and 0.09±0.01 cm, respectively) in those without CAI. There were no differences between limbs in composite scores on YBT in those with CAI (p=0.35) and those without CAI (p=0.33). There was a moderate correlation between the left SEAR thickness and the large forward/backward perturbations on the NeuroCom (Natus) motor control test (r=0.51, p=0.006 and r=0.54, p=0.003, respectively). Conclusion: There were no differences in the ATFL/SEAR thicknesses or balance measures between or within the groups, likely because CAI is multi-factorial and related to mechanisms other than tissue changes alone. More sensitive technology and a better definition of the measurement process may provide more definitive results.

• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.25-30
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• 2014

Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.