• 제목/요약/키워드: Lateral instability

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만성 발목 불안정증의 치료에서 관절경 수술 (Arthroscopic Procedure in the Treatment of Chronic Lateral Ankle Instability)

  • 이호진;정비오
    • 대한족부족관절학회지
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    • 제25권1호
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    • pp.25-31
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    • 2021
  • The open Broström procedure is considered the surgery of choice for treating chronic lateral ankle instability. The role of arthroscopy has gained popularity in the surgical treatment of chronic lateral ankle instability, partly for the ability to manage the intra-articular pathology combined with ankle instability. Arthroscopic techniques can be divided broadly into the arthroscopic-assisted Broström technique and arthroscopic all-inside ligament repair. The clinical results of these arthroscopic techniques are similar to open procedures. The arthroscopic technique may be an excellent alternative to the open Broström procedure in treating chronic lateral ankle instability when applying the appropriate indications.

만성 족관절 외측 불안정증 (Chronic Lateral Ankle Instability)

  • 정홍근;박재용;박종태
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.73-78
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    • 2012
  • Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Br$\ddot{o}$strom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.

만성 족관절 외측 불안정성에서 변형 Brostrom 술식과 동시에 시행한 관절경적 치료의 유용성 (Effectiveness of arthroscopic procedure combined with Brostrom one)

  • 유연식;이상수;정언호
    • 대한족부족관절학회지
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    • 제7권2호
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    • pp.201-207
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    • 2003
  • Purpose: We reviewed the value of treatment for chronic lateral instability of theankle with arthroscopic procedure combined with Brostrom one. Material and Method: From May 2000 to June 2002, 18 patient with chronic lateral instability of the ankle with Modified Brostrom procedure and arthroscopic one. Mean follow-up period was 18 months. Result: Chronic lateral instability of the ankle almost had intraarticular pathology, such as osteophye, osteochondral lesion, So we could resolve intraarticular pathology by arthroscopic procedure during Brostrom one for lateral collateral ligament reconstruction. Conclusion: Modified Brostrom procedure and arthroscopic one are an excellent treating method for chronic lateral instability of the ankle which has intraarticular pathology.

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만성 외측 발목 불안정과 발목 인대 손상의 진단 (Diagnosis of Lateral Ankle Ligament Injury in the Evaluation of Chronic Lateral Ankle Instability)

  • 전지영
    • 대한영상의학회지
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    • 제82권6호
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    • pp.1402-1412
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    • 2021
  • 만성 외측 발목 불안정(chronic lateral ankle instability; 이하 CLAI)은 급성 발목 염좌의 주요 합병증으로 일상생활과 스포츠 활동에 불편을 줄 수 있으며, 장기 후유증으로 발목 관절에 퇴행성 변화를 가져오기도 한다. CLAI의 정확한 원인은 여전히 논쟁 중이며 다인자적으로 알려져 있으나, 특히 만성적인 외측 발목 인대 손상 여부를 확인하는 것이 환자의 원발 병소를 결정하고 적절한 치료 계획을 수립하는 데 필수적이다. 본 종설에서는 CLAI에서 인대 손상을 진단하는데 이용되는 여러 검사들의 특징과 유용성에 대해 기술해 보았다.

만성 족관절 외측 불안정 (Chronic Lateral Ankle Instability)

  • 배서영
    • 대한족부족관절학회지
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    • 제24권1호
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    • pp.1-8
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    • 2020
  • Acute ankle sprain is the most common injury in the lower extremities, and approximately 10% to 40% of acute lateral ankle ligament injury causes chronic pain or instability. For chronic symptoms lasting after an acute sprain, the possibility of joint damage, such as bony structures, ligaments, cartilage, and nerves around the ankle joint, should be considered. Patients with chronic lateral ankle instability usually complain of repeated sprains or giving way sensations. There has been steady progress in the treatment options until recently, however new treatments are still being attempted. This paper describes the causes, diagnosis, and recent trends in the conservative and operative treatment of chronic lateral ankle instability.

족관절 만성 외측 불안정증에서 관절경하 변형 Brostr$\ddot{o}$m 술식의 수술적 결과 (Surgical Outcomes of Arthroscopic Modified Brostr$\ddot{o}$m Procedure in Chronic Lateral Ankle Instability)

  • 차민석;차승도;김응수
    • 대한족부족관절학회지
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    • 제17권4호
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    • pp.283-287
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    • 2013
  • Purpose: To evaluate the result of arthroscopic modified Brostrom procedure with suture anchor for chronic lateral ankle instability. Materials and Methods: Fifty-two patients with chronic lateral ankle instability were analyzed, who underwent arthroscopic modified Brostrom procedure between December 2010 and May 2012. Clinical evaluation was performed using AOFAS scroring and Sefton grading system. Results: The average AOFAS hind foot score increased from preoperative 61.9 to 88.8 at the last follow up. There were 35 excellent, 9 good, 4 fair, 4 poor results according to Sefton grading system. For one patient, lateral ankle instability recurred. Conclusion: Arthroscopic modified Brostrom procedure is considered to be an effective and satisfactory technique.

족관절 불안정성의 인대 봉합술: Broström 술식의 효과 및 술기 (Ligament Repair in Chronic Lateral Ankle Instability: Efficacy and Technique of Broström Procedures)

  • 정비오;황역구
    • 대한족부족관절학회지
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    • 제22권3호
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    • pp.83-90
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    • 2018
  • Chronic lateral ankle instability occurs in 10% to 20% of individuals after acute ankle sprain. The management of chronic lateral ankle instability is traditionally conservative treatment in the acute phase. On the other hand, surgical intervention is considered if conservative treatment fails and the symptoms are ongoing. This review focuses on the surgical approaches to treatment of chronic lateral ankle instability, including $Brostr{\ddot{o}}m$ surgical techniques, with a review of the traditional procedure and newer techniques.

시공 중 풍하중에 의한 PSC 교량 거더의 횡방향 거동 해석 (Analysis of Lateral Behavior of PSC Bridge Girders under Wind Load During Construction)

  • 이종한;김경환;조백순
    • 콘크리트학회논문집
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    • 제27권4호
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    • pp.377-385
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    • 2015
  • PSC I 거더의 장경간화는 단면의 세장비와 자중의 영향 등을 증가시켜 거더의 횡적 불안정에 대한 위험성을 높였다. 특히 최근에는 시공 중 거더의 전도 붕괴사고가 증가하고 있어 거더의 횡적 불안정성에 대한 평가 기술이 절실히 요구되고 있다. 따라서, 본 연구에서는 시공 중 전도 붕괴의 한 원인으로 판단되어지고 있는 풍하중에 대하여 PSC I 거더의 횡방향 거동 특성과 안정성을 평가하였다. 거더의 횡방향 불안정성은 주로 거더의 길이와 받침의 강성 변화에 의해 영향을 받는다. 해석결과에 의하면 거더의 경간장이 증가함에 따라 거더의 횡적 불안정성을 유발할 수 있는 임계 풍하중은 감소하고, 거더의 변형과 회전각, 받침의 회전각은 모두 증가하였다. 최종적으로 시공 시 PSC I 거더의 임계 풍하중과 임계 횡변위량을 계산할 수 있는 해석식을 제시함으로써, 시공 시 거더의 횡적 안정성을 유지하기 위한 정량적 관리 수치를 제공할 수 있으리라 판단된다.

만성 외측 발목 불안정 (Chronic Lateral Ankle Instability)

  • 김대욱;성기선
    • 대한족부족관절학회지
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    • 제22권2호
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    • pp.55-61
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    • 2018
  • Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified $Brostr{\ddot{o}}m$ operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

만성 족관절 외측 불안정성에 대한 $Brostr{\ddot{o}}m$ 변형 술식 (The Modified $Brostr{\ddot{o}}m$ Procedure for Chronic Lateral Ankle Instability)

  • 송하헌;심대무;이병창;김동철;조용우;양정환
    • 대한족부족관절학회지
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    • 제8권1호
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    • pp.81-85
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    • 2004
  • Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

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