• 대한족부족관절학회지
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• 제25권1호
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• pp.1-5
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• 2021

Physical examination and surgical findings and symptoms are often inconsistent with magnetic resonance imaging (MRI) findings when diagnosing chronic ankle lateral ligament instability, and confirmed surgical findings are used as the gold standard in most clinical studies. Anterior drawer testing is considered unreliable because normal findings are highly variable, and its accuracy ranges from 50% to 100%. Furthermore, radiographic stress imaging, such as in anterior drawer stress view, is performed under manual stress or using a stress device, and its findings also vary widely and confuse when interpreting stress views. The average accuracy of MRI findings is around 85% (range, 66%~91.7%), and thus, cannot be used as a primary indicator for surgery. For patients with suspected lateral ankle ligament instability, based on symptoms and physical examination findings, MRI may be useful for identifying lesions in ankle joints and for differentiating them from other conditions.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2003년도 연수강좌
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• pp.51-56
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• 2003

The trained examiner can gain considerable information from visual inspections of the elbow joint, Because much of the joint is subcutaneous, any appreciable alteration in the skeletal anatomy often is detectable. Gross soft tissue swelling or muscle atrophy is also early observed. Inspection and palpation of the medial and lateral epicondyles and the tip of the otecranon from an equilateral triangle with the elbow is flexed. Normally, the arc of flexion extension, although variable, ranges from about O to 140 degrees plus or minus 10 degrees. The posterolateral rotatory instability(PLRI) of the elbow is most common pattern of elbow instability. The lateral collateral ligament complex also includes a narrow but stout band of ligamentous tissue blending with the distal and proterior fibers of the capsule to insert distally on the crista supinatoris of the ulna. This is the lateral ulnar collateral ligament(LUCL). A clinical elbow pivot shift test confirms the PLRI. There are also two active apprehension signs.

• Nuclear Engineering and Technology
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• 제55권5호
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• pp.1665-1670
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• 2023

It is shown that in the IBR-2M reactor by the end of the reactor cycle, changes in dynamics are observed associated with a strong weakening of the fast power feedback (PF), as a result of which the reactor becomes oscillatorily unstable. After each week of zero-power operation the negative changes in reactor dynamics disappear and the stability of the reactor is restored. Thus, the reactor undergoes cyclic changes in the oscillatory instability. The correlation between of a fast PF and a slow PF is experimentally observed, which makes it possible to almost completely eliminate the cyclic component of instability by changing the control mode of rods of the control system.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.254-261
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• 2018

목적: 무지 중수 수지 관절의 척측 측부 인대의 만성 파열에서의 직접 봉합술은 양호한 결과가 보고되고 있으나 요측 측부 인대에서의 결과는 논란이 있다. 본 연구의 목적은 무지 중수 관절의 척측과 요측 측부 인대의 만성 파열에서 인대 재부착술의 결과를 비교하는 것이다. 방법: 무지 중수 수지 관절의 6주 이상된 측부 인대 파열에서 봉합 앵커를 이용해서 재부착술을 시행한 요측 6예 및 척측 8예의 평균 22개월 추적한 방사선적 및 임상 결과를 후향적으로 검토하고, 통계적으로 비교하였다. 결과: 수술 후 평균 척측 변위 각은 요측 측부 인대에서 $13.3^{\circ}$, 척측 측부 인대에서 $2.0^{\circ}$였다(p=0.020). 수술 후 인대 불안정성은 요측 인대 6예 중 4예에서 관찰되었으나, 척측 인대에서는 관찰되지 않았다. 수술 후 경과 관찰에서 관절의 아탈구는 요측 인대 2예에서만 관찰되었다. 결론: 무지 중수 수지 관절의 요측 측부 인대의 지연 봉합은 덜 양호한 결과를 나타내며, 반 이상에서는 수술 후 인대의 불안정성이 관찰된다.

• Archives of Reconstructive Microsurgery
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• 제12권2호
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• pp.93-98
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• 2003

Purpose : The purpose of this study is to investigate an occurrence of valgus deformity of ankle joint after vascularized fibular graft in children. Materials and Methods : Four children under 15 years who were surgically treated with vascularized fibular graft were studied. The age of the patients was from 4 years to 13 years, the follow-up period was from 24 months to 108 months. The causes of vascularized fibular graft were open fracture (1 case), congenital psuedarthrosis (2 cases), hypoplastic ulna (1 case). The tibiofibular synostosis was done in 3 cases and not in 1 case. We measured the tibiotalar angle and bimalleolar angle at immediately postoperative and final radiography, and checked ankle motion, pain, and instability of ankle joint. Results : The A-P mortise angle was not different between initial and final radiography in all cases. The intermalleolar angle increased in all cases at the final radiography. There were no pain, instability and limitation of ankle motion. Conclusion: We consider the tibiofibular synostosis can prevent from ankle valgus deformity after vascularized fibular graft in children.

• 대한족부족관절학회지
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• 제15권4호
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• pp.187-194
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• 2011

Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.

• 국제물리치료학회지
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• 제10권2호
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• pp.1791-1796
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• 2019

Background: Vibration exercise after ankle surgery improves proprioception and ankle muscle strength through vibration stimulation. Objective: To examine the effects of vibration exercise on the ankle stability. Design: Randomized controlled clinical trial (single blind) Methods: Twenty soccer players were randomly divided into experimental group and control group. The Vibration exercise program was conducted 12 weeks and 3 times a week. Ankle joint proprioceptive sensory test and Isokinetic muscle strength test were performed using Biodex system pro III to measure plantar flexion / dorsiflexion and eversion / inversion motion. Results: The result of isokinetic test of ankle joint is showed significant improvement in all measurement items, such as leg flexion, lateral flexion, external and internal muscle forces, compared to previous ones by performing vibration movements for 12 weeks. However, in the comparison group, plantar flexor ($30^{\circ}$), eversion muscle ($120^{\circ}$), inversion ($30^{\circ}$) of limb muscle strength were significantly improved compared with the previous phase; was no significant difference in dorsi-flexion. There was no significant difference between groups in all the items. Conclusions: In this study, we analyzed the effects of rehabilitation exercise on soccer players who had reconstructed with an ankle joint ligament injury through vibration exercise device. As a result, we could propose an effective exercise method to improve the ability, and confirmed the applicability as an appropriate exercise program to prevent ankle injuries and help quick return.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.366-369
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• 2013

Lumbar microdiscectomy (MD) is the gold standard for treatment of lumbar disc herniation. Generally, the surgeon attempts to protect the facet joint in hopes of avoiding postoperative pain/instability and secondary degenerative arthropathy. We believe that preserving the facet joint is especially important in young patients, owing to their life expectancy and activity. However, preserving the facet joint is not easy during lumbar MD. We propose several technical tips (superolateral extension of conventional laminotomy, oblique drilling for laminotomy, and additional foraminotomy) for facet joint preservation during lumbar MD.

• 대한족부족관절학회지
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• 제6권2호
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• pp.261-264
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• 2002

Purpose: To investigate the clinical features of fistulas of the ankle joints. Materials and Methods: Seven fistulas in seven patients were reviewed during Apr. 2000 to Mar. 2002, retrospectively. There are five men and two wemen. Average age was 47.7 years (range, 42-65 years). Average follow-up period was 1.4 years. There were six cystic lesions after ankle sprain and one patient with persistent discharge after excision of bursa over lateral malleolus. Results: Duration from injury to presentation was average 9.8 years. The site of preoperative swelling was mostly over the lateral malleolus in five patients. In one patient, the area of swelling was extended to the anterolateral ankle joint and in another patient there was extensive swelling from Achilles tendon to the anterolateral ankle joint. Concomitant symptoms were instability in three patients, pain and instability in three patients. Methods of surgery were simple repair in one, modified Brostrom in three, augmentation with periosteal flap in addition to modified Brostrom in two and Chrisman-Snook in addition to augmentation with periosteal flap and modified Brostrom in one. There were no recurrence of instability as well as fistula. Conclusion: We think that the fistula of the ankle joint should be included in the differential diagnosis of the cystic lesion over the lateral malleolus and the result of surgical treatment would be satisfactory in most cases.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.62-70
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• 2020

Background: Recent studies have reported high rates of recurrence of shoulder instability in patients with glenoid bone defects greater than 20% after capsulolabral reconstruction. The purpose of the present study was to evaluate the failure rate of arthroscopic capsulolabral reconstruction for the treatment of anterior instability in the presence of glenoid bone deficits >20%. Methods: Retrospective analyses were conducted among cases with anterior shoulder instability and glenoid bone defects of >20% that were treated by arthroscopic capsulolabral reconstruction with a minimum 2-year follow-up (30 cases). We included the following variables: age, bone defect size, instability severity index score (ISIS), on-/off-track assessment, incidence recurrent instability, and return to sports. Results: The mean glenoid bone defect size was 25.8%±4.2% (range, 20.4%-37.2%), and 18 cases (60%) had defects of >25%. Bony Bankart lesions were identified in 11 cases (36.7%). Eleven cases (36.7%) had ISIS scores >6 points and 21 cases (70%) had off-track lesions. No cases of recurrent instability were identified over a mean follow-up of 39.9 months (range, 24-86 months), but a sense of subluxation was reported by three patients. Return to sports at the preinjury level was possible in 24 cases (80%), and the average satisfaction rating was 92%. Conclusions: Arthroscopic soft tissue reconstruction was successful for treating anterior shoulder instability among patients with glenoid bone defects >20%, even enabling return to sports. Future studies should focus on determining the range of bone defect sizes that can be successfully managed by soft tissue repair.