• 제목/요약/키워드: Joint subluxation

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골종양 절제후 방사선 조사한 자가골을 이용한 재건술 (Reconstruction with Extracorporeally Radiated Autogenous Bone Graft After Wide Resection of Bone Tumors)

  • 이종석;전대근;김석준;이수용;양현석
    • 대한골관절종양학회지
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    • 제3권1호
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    • pp.32-38
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    • 1997
  • PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.

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무지의 대능형중수간 관절의 아탈구에 대한 인대 재건술 (Ligament Reconstruction for Subluxation of the Trapeziometacarpal Joint of the Thumb)

  • 박진수;정영기;유정한;나경수
    • 대한정형외과스포츠의학회지
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    • 제3권2호
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    • pp.134-140
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    • 2004
  • 목적: 불안정성 무지수근중수관절의 손상을 가진 환자에서 전방사상 인대의 재건술을 권장하고 있다. 전방사상 인대손상을 요측수근굴근건을 이용해 치료받은 2명의 환자들의 기능적 결과를 후향적 연구하고자 하였다. 대상 및 방법: 전방사상인대 파열로 대능형중수관절의 불안정성을 지닌 2명의 환자가 요측수근굴건이식을 통해 재건술을 시행받았고 이환자들을 2년간 추시 분석하였다. 결과: 2년후의 추시 결과는 이들 모두 상당한 통증과 증상의 완화를 보였다. 건측에 비해 악력은 90$\%$로 회복되었다. 환자들은 주관적인 호전을 보였으며 "만약 이처럼 다친다면 다시 이러한 수술을 받을 것이다."라고 말했다. 결론: 이러한 손상에 대한 향상된 지식 을 통해 조기 진단과 정확한 진단이 가능해 환자가 적절히 처치될 수 있을 것이다.

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뇌졸중 환자의 견관절 통증과 운동 기능 및 삶의 만족도와의 관계 (The Shoulder Pain after Stroke and the relationship with Motor Function, and Quality of Life)

  • 이동진;안승헌
    • 대한물리의학회지
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    • 제6권3호
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    • pp.257-266
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    • 2011
  • Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

악성 섬유성 조직구종에서 광배근피판을 이용한 견관절 재건술 (Reconstruction of the Shoulder using Rotational Latissimus Dorsi Flap in the Malignant Fibrous Histiocytoma)

  • 한정수;정덕환;이영호;임양진
    • Archives of Reconstructive Microsurgery
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    • 제10권2호
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    • pp.111-117
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    • 2001
  • Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

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Risk Factors for Recurrence of Anterior Shoulder Instability after Arthroscopic Surgery with Suture Anchors

  • Choi, Chang-Hyuk;Kim, Seok-Jun;Chae, Seung-Bum;Lee, Jae-Keun;Kim, Dong-Young
    • Clinics in Shoulder and Elbow
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    • 제19권2호
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    • pp.78-83
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    • 2016
  • Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

Outcomes of arthroscopic capsulolabral reconstruction for anterior instability with greater than 20% glenoid bone defects: are Latarjet procedures absolutely indicated for these patients?

  • Kim, Sae Hoon;Jung, Whanik;Rhee, Sung-Min;Kim, Ji Un;Oh, Joo Han
    • 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.

심각한 외측 회전을 동반한 전완 기형의 외과적 교정 치료 2 증례 (Surgical Correction of an Antebrachial Deformity with Severe External Rotation in Two Dogs)

  • 윤헌영;노미영;정순욱
    • 한국임상수의학회지
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    • 제28권3호
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    • pp.328-331
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    • 2011
  • 간헐적 전지 파행을 보이는 두 마리 개가 내원하였다. 신체 검사에서 약 $90^{\circ}$ 외측 회전을 동반한 전완 기형을 두 마리 모두에서 확인 하였다. 일반 방사선 사진에서 척골 원위부 아탈구, 요골 앞쪽 휨 현상, 짧아진 요골 척골, 및 앞발의 외측 회전을 확인하였다. 외측 회전을 동반한 전완 기형의 교정을 위해 척골 원위부 골절제와 요골 원위부 쐐기형 절골술 및 요골 원위부 내측 회전을 실시 하였다. 관절 부조화를 예방하기 위해 척골 근위부 절골술을 첫 번째 개에서 실시 하였다. 수술 후 정기 검진은 수의사의 신체 검사를 통해 실시 되었으며 두 마리 모두에서 수술과 관련한 합병 증상 및 파행이 없음을 확인하였다.

관절원판의 손상과 관련된 하악과두 골절의 관혈적 정복술의 치험례 (OPEN REDUCTION OF MANDIBULAR CONDYLE FRACTURES WITH AND WITHOUT DISCAL INJURY : A CASE REPORT)

  • 송선철;강석기;강정훈;김진;김경욱;임창준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제13권3호
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    • pp.300-304
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    • 1991
  • This is case report of open reduction of condylar fractures with or without discal injury. Many articles described open reduction and internal fixation of condylar fractures emphasize the method of bony reduction and fixation without mention of the position of the disc. So we like to present our cases of open reduction of condylar fractures in conjunction with reconstruction of the disc and associated structures. The pupose of this presentation is to emphasize several well - established principles of trauma management and management of temporomandibular joint injuries, such as 1) in situations of traumatic injury, anatomic restoration is the goal of treatment and, 2) anatomic alignment of the TMJ disc over the condyle is preferable to disc subluxation because the latter may lead to chronic pain, limitation of opening and degenerative arthritis. Although our case is small with short term follow up, we believe that open reduction and internal fixation of condylar fractures in conjunction with disc repair is a biologically sound approach to those fractures indicated for open surgery. Long term follow up will allow better judge the validity of this treatment approach to us.

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A research about the processing for producing remedy sheets that radiate far infrared rays and magnetic force

  • Kim, eun-won
    • 산업경영시스템학회지
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    • 제24권68호
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    • pp.9-20
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    • 2001
  • A study on processing for producing cure seat radiated by Original Infrared Rays and Magnatic force. We are well aware that Original Infrared Rays and Magnatic force influence on our human body benificially. In the technical background of this research product, we treated that the product has some operations of ceramic hardwood charcoal, far infrared rays and magnetic, so it can serve large part curative values made of far infrared rays and magnetic force of ceramics. Also, in the special quality of the product deal with ceramic, hard charcoal, ferrite, gelatin what is needed in prodution. And among them, ferrite, ceramic and hard charcoal are introduced by the manufacturing process of the moleculeization. In concluding, this study described the manufacturing process on the basis of the worksheets and arranged theuseful effect which effect on human body. There are so many symptoms in the pain of muscle. It's very various. for example, it is the cause of the liver, the spleen and a kidney function's weakening. the cause of the backbone subluxation, the cause of the shoulderjoint and scapula, the cause of the sacrum andiliacjoint, the cause of hip joint and the cause of a sprain. In this thesis, we mainly deal with the method which the muscle and nervous system disease by fatigue and a sprain cure seat radiated by Original Infrared Rays and Magnatic force. then, Original Infrared Rays and Magnatic force pack up frapezius muscle, gluteus minimum muscle, gluteus medius muscle, gluteus maximus muscle, pririformis muscle around the spine. through this course the moral pressure by the nervous system disease can be treat.

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그리셀증후군 환자에서 I-gel 성문상기도유지기를 사용한 기도관리 -증례보고- (Airway Management Using the I-gel Supraglottic Airway Device in Patients with Grisel's Syndrome -Case Report-)

  • 이철형;두아람;우철종;손지선;이상귀;김연동
    • 한국융합학회논문지
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    • 제12권10호
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    • pp.305-310
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    • 2021
  • 그리셀 증후군은 환축관절의 비외상성 탈구로 인하여 전신마취 시 경추손상이 발생할 가능성이 있어 신중한 마취관리를 요한다. 이에 우리는 과거에 그리셀 증후군을 받은 진단받은 환자의 전신마취 하 전립선 레이저절제술 시 I-gel을 이용한 기도관리를 성공적으로 진행하였고, 환자는 신경학적 합병증 없이 잘 회복된 사례를 보고하고자 한다. 그리셀 증후군 환자의 마취 관리 시 기도관리를 위하여 I-gel을 사용하는 것이 좋은 대안이 될 수 있을 것이다.