• 제목/요약/키워드: Joint instability

검색결과 337건 처리시간 0.023초

유리 중족-족지관절 이식술을 이용한 주관절 전치환술 (Biologic Arthroplasty of Elbow with Free Metatarso-Phalangeal Joint Transplantation)

  • 정덕환
    • Archives of Reconstructive Microsurgery
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    • 제9권2호
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    • pp.154-157
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    • 2000
  • Author report a case of double metatarso-phalangeal joint transplantation to the elbow joint in the 31 years old female patient who have large bone defect associated with skin and soft tissue defect. The donor joints were second and third metatarso-phalangeal joint as double joint transfer fashion to enhance stability of graft. The graft based on dorsalis pedis vessel to anastomosed with radial artery of recipient site. The result is unsatisfactory because of long lasting lateral instability of reconstructed elbow joint in spite of 40 degree flexion motion and fair axial stability. We can conclude that joints from foot can not be an effective donor for biologic joint arthroplasty of elbow joint even though double metatarso-phalangeal joint were harvested.

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제 5중수 수지관절에 단독으로 발생한 요측 측부 인대 완전 파열의 치험례 (An Isolated Complete Rupture of Radial Collateral Ligament of the Fifth Metacarpophalangeal Joint: A Case Report)

  • 김철한;탁민성
    • Archives of Plastic Surgery
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    • 제33권6호
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    • pp.780-783
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    • 2006
  • Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

접촉성 운동 선수에서 견관절 다방향 불안정성에 대한 하방 관절막 이동술 (Inferior Capsular Shift for Multidirectional Shoulder Instability in Contact Sports Athletes)

  • 최종혁;윤경환
    • Clinics in Shoulder and Elbow
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    • 제3권1호
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    • pp.10-19
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    • 2000
  • The aims of this retrospective study were to evaluate the results of inferior capsular shift operation which were approached anteriorly or posteriorly according to a main instability direction in contact sports population who had multidirectional shoulder instability. Fifty-three shoulders in 47 athletes who engaged in contact sports underwent an anterior or posterior inferior capsular shift procedure for the correction of multidirectional instability of the shoulder joint. The surgical approach was selected according to the predominant direction of the instability. Follow up was average of 42 months(24∼73 months). After anterior inferior capsular shift, anterior dislocation was recurred in three shoulders, posterior dislocation in one, and inferior dislocation in two shoulders. After posterior inferior capsular shift, one dislocation occurred anteriorly, one inferiorly and one posteriorly. The excessive tightening of capsule or improper diagnosis could be causative factors for the development of dislocation in the opposite direction to the preoperative major instability. Of six patients who could not return to their sports, five had bilateral repairs. Successful repair based on the criteria of the American shoulder and elbow association was achieved in 92% of anterior repairs, and 81 % of posterior repairs.

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Effect of Ankle Taping Type and Jump Height on Balance during Jump Landing in Chronic Ankle Instability

  • Kim, Mikyoung;Kong, Byungsun;Yoo, Kyungtae
    • 국제물리치료학회지
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    • 제11권2호
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    • pp.2077-2089
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    • 2020
  • Background: Chronic ankle instability is a common injury that decreases balance and negatively affects functional movements, such as jumping and landing. Objectives: To analyze the effect of taping types and jump heights on balance with eyes open and closed during jump landings in chronic ankle instability. Design: Within-subject design. Methods: The study involved 22 patients with chronic ankle instability. They performed both double-leg and single-leg drop jump landings using three conditions (elastic taping, non-elastic taping, and barefoot) on three different jump platforms (30, 38, and 46 cm). Balance was measured using the Romberg's test with eyes open and closed. Results: Interaction effect was not statistically significant. Balance with eyes open and closed was significantly improved in both the elastic taping and non-elastic taping conditions compared to the barefoot condition. There was no significant difference according to the jump height. Conclusion: Individuals with chronic ankle instability demonstrated increased balance ability with eyes open and closed when jump landing. Elastic taping and non-elastic taping on the ankle joint can positively affect balance during landing in individuals with chronic ankle instability.

Reliability and Validity of the Side-lying Instability and Prone Instability Tests in Patients with Lumbar Segmental Instability

  • Kim, Bo-Eon;Lee, Kwan-Woo;Park, Dae-Sung
    • 대한물리의학회지
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    • 제16권1호
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    • pp.1-7
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    • 2021
  • PURPOSE: The purpose of this study is to conduct inter-rater and intra-rater reliability tests in patients with low back pain (LBP) using the prone instability test (PIT) and side-lying instability test (SIT). We have analyzed the Korean version Oswestry disability index (K-ODI) correlations and radiograph finding (RF) for validity. METHODS: Individuals (n = 51) (mean age of 40.27 ± 13.28) with LBP for at least over a week were recruited, together with two participating physical therapist examiners. The measurement consisted of PIT, PST, K-ODI, and RF. Sensitivity (Sn), specificity (Sp), positive predictive value, negative predictive value, prevalence index, agreement %, Cohen's kappa, and prevalence-adjusted bias-adjusted kappa (PABAK) were calculated. The PIT and SIT were compared with RF for validity analysis, while PIT, SIT, K-ODI, and RF were calculated for the correlation analysis. RESULTS: The intra-rater reliability test measured for the PIT (kappa = .79, PABAK = .88) and SIT (kappa = .73, PABAK = .84), and inter-rater reliability test measured for the SIT (kappa = .80, PABAK = .88) showed good agreements. The PIT (Sn = .65, Sp = .63) and SIT validities (Sn = .68, Sp = .70) were compared with RF, showing a significant correlation in PIT and RF (r = .69), SIT and RF (r = .73), and PIT and K-ODI (r = .53). CONCLUSION: The SIT is a more comfortable position test than the PIT in patients. Both PIT and SIT have acceptable reliability and validity.

The characteristic features of traumatic anterior shoulder instability due to an event of minor trauma

  • Mura, Nariyuki;Goto, Yasuo;Momonoi, Yoshiyuki;Takei, Isao;Tsuruta, Daisaku;Sasaki, Jyunya;Harada, Mikio;Ogino, Toshihiko
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2009년도 제17차 학술대회
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    • pp.21-21
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    • 2009
  • There are some patients who have traumatic anterior shoulder instability due to minor injuries like overhead activities. The purpose of this study was to clarify characteristic features of traumatic anterior shoulder instability due to minor injuries. According to the mechanism of injury in an initial dislocation, 83 shoulders that underwent the stabilizing surgery for traumatic anterior shoulder instability were divided into two groups. Traumatic group included patients who suffered from a fall or a direct injury. Minor injury group included patients who suffered from the other injury like overhead activity. General joint laxity, range of motion and laxity under anesthesia, and intraarticular findings were compared between two groups. The morphology of superior and middle glenohumeral ligaments, Bankart lesion, Hill-Sachs lesion, and partial articular surface tendon avulsion lesion were observed in arthroscopy. Minor injury group consisted of 19 shoulders with 8 males, 11 females and the mean age of 22.5 years. Traumatic group consisted of 64 shoulders with 52 males, 7 females and the mean age of 24.3 years. Female in minor injury group was significantly more than that in traumatic group. There was no difference in general joint laxity and intraarticular findings between two groups. Range of external rotation in injured side in minor injury group was significantly more than that in traumatic group. Inferior laxity in both sides in minor injury group was more than that in traumatic group. In conclusion, the traumatic anterior shoulder instability due to minor injuries might incline to occur the shoulder in female and with inferior laxity of shoulder.

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Comparison of the Immediate Effects of Kinesio Taping on the Dynamic Balance of Stable Ankle and Functional Ankle Instability among Young Adults in Their Twenties: a preliminary study

  • Kim, Ki-Jong;Kim, Ju-Hong
    • 대한통합의학회지
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    • 제10권1호
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    • pp.73-79
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    • 2022
  • Purpose : Kinesio taping applied to the ankle varies, and if the overall ankle is taped as much as possible, several effects, including balance, can be expected, but clinically the cost reduction for intervention is very important. Therefore, this study attempted to find out the optimal way to the effect and cost of kinesio taping on ankle dynamic balance. Methods : The subject of this study was 24 university students in their 20s (male: 13, female: 11), who received sufficient explanation of the purpose and method of the study. The Cumberland ankle instability tool (CAIT) questionnaire was used for the degree of ankle instability of the study subjects. If the subject's CAIT score was 28 points or more, it was classified as a stable ankle, and if the score was 24 points or less, it was classified as functional ankle instability (FAI). In this study, Biodex Balance System® measurement equipment was used to calculate the dynamic balance of study participants. The application of kinesio taping was performed by one physical therapist to attach in the same way, and a method of wrapping the ankle joint was applied in the eight-shaped bandage. Results : The results are as follows in before and after taping of the stable ankle and FAI group. There was no significant difference in the overall, anterior-posterior, and medial-lateral stability index. The comparison is as follows between groups for the differences (post-pre value) in before and after the application of kinesio taping. There were no significant differences between groups in all the overall, anterior-posterior, and medial-lateral stability index. Conclusion : In this study, no significant difference in kinesio taping was found in the dynamic balance of stable ankle and FAI (overall, anterior-posterior, and medial-lateral). It is necessary to continue to study ways to find the maximum effect while minimally attaching them to the application method of ankle kinesio taping.

테이핑이 기능적 발목 불안정성이 있는 선수들의 점프 착지 시 하지에 미치는 영향 (The Effect of Taping on Lower Extremity during lump Landing in Subjects with functional Ankle Instability)

  • 김경훈;조준행;이성철
    • 한국운동역학회지
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    • 제19권2호
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    • pp.265-272
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    • 2009
  • 발목 테이핑은 상해 예방을 위해 임상적으로 이용되어 질 수 있는 보조적 수단으로 여겨지고 있다. 그러나 그동안의 연구들을 살펴보면 발목 자체에 대한 부분만을 언급하였다. 본 연구의 목적은 발목 테이핑의 적용이 기능적 발목 불안정성을 가진 선수들에게서 점프 후 착지 시에 하지 관절에 미치는 영향을 알아보는데 있다. 점프의 거리는 각 대상자 키의 50%로 결정하였으며 높이는 각 대상자 키의 20%로 결정하였다. VICON을 이용하여 하지관절의 데이터를 수집하였고, 점프 착지 동안 시상면, 관상면, 수평면의 관절 움직임의 변화를 측정하였다. 테이핑은 통계적으로 시상면에서 착지순간 저측 굴곡과 최대 저측 굴곡을 제한하는 효과가 있었으며, 반면에 착지순간 무릎 굴곡과 최대 무릎 굴곡, 착지순간 엉덩 굴곡과 최대 엉덩 굴곡을 통계적으로 유의하게 증가시키는 효과가 있었으며, 관상면에서는 최대 발목 내번, 착지순간 무릎 외반과 최대 무릎 외반, 최대 엉덩 외전을 감소시키는 효과가 있었고, 수평면에서는 최대 발목 외전, 최대 엉덩 내회전의 감소를 보였다. 발목 테이핑은 발목 관절 운동범위의 제한과 함께 무릎 관절이나 엉덩 관절에 영향을 미치는 것으로 나타났다.

슬관절 연부조직의 물리치료에 관한 문헌적 고찰 (Physical therapy of soft tissue surround the knee joint)

  • 이준희;윤상집;정영준;최원호
    • 대한물리치료과학회지
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    • 제9권3호
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    • pp.161-170
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    • 2002
  • knee injuries are among the most common problems confronting patients, physical therapist and physicians. since the bony structure provides little stability, the soft tissues are required to withstand high forces, often resulting in tissue overload and injury immobilization of the knee in the presence of a hemarthrosis usually leads to proliferation of intraarticular connective tissue adhesions and pint fibrosis. the physical basis of treating scar tissue is early controlled motion. the management of the knee with increased instability is to strengthening the muscles to properly treat an soft tissue injuries, physical therapist should know about the anatomic structures and biomechanical function of the knee joint, in this review article, we discuss the physiologic properties of soft tissue, biomechanical observation in fibrous connective tissue, managing soft tissue contractures, principles in treating scar tissue and treatment of the knee with increased instability.

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Correction of the Proximal Intertarsal Instability in a Dog

  • Jung, Yunsoo;Lee, Ho-hyun;Yun, Sungho;Kwon, Young-sam
    • 한국임상수의학회지
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    • 제36권3호
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    • pp.166-168
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    • 2019
  • A 22-month-old female mongrel dog weighing 4.8 kg was referred with chief complaint of bite wounds and lameness. The patient showed non-weight bearing lameness on left hindlimb and lateral instability of intertarsal joint. On radiograph, proximal intertarsal luxation between calcaneus and fourth tarsal bone was diagnosed. To imitate the long collateral and calcaneoquartal ligament, bone tunnels were drilled in the distal calcaneus and proximal fifth metatarsal bone. The figure-eight suture was placed with 0.5 mm cerclage wire through the predrilled holes. At 2 weeks after surgery, the lameness of hindlimb was still present. However, the patient had weight bearing lameness for 4 weeks after operation and was able to walk and run without lameness at 5 weeks after surgery. This case report explains the successful correction of intertarsal luxation with a single figure of eight wire suture in case of luxation to the intertarsal joint.