• 제목/요약/키워드: Lateral instability

검색결과 266건 처리시간 0.023초

슬개대퇴관절 불안정성에서의 관절경적 All-inside 관절막 중첩술 및 외측 지대 유리술 (수술 술기) (All-inside Arthroscopic Capsular Imbrication and Lateral Release in Patellofemoral Instability (Operative technique))

  • 김재화;조덕연;윤형구;김정열
    • 대한관절경학회지
    • /
    • 제10권1호
    • /
    • pp.118-122
    • /
    • 2006
  • 목적: 슬개대퇴관절 불안정성에 대한 치료 방법 중 하나인 관절경적 all inside 관절막 중첩술 및 외측 지대 유리술을 소개하고자 한다. 방법: 슬관절의 관절경적 기본 검사 후, 관절경을 전내측 도달법을 개설하여 위치한 후, 외측 지대의 근위부에서 원위부까지 유리술을 시행하기 위하여 상외측 도달법을 개설하여 관절경 scissor를 위치한다. 슬개골의 가장자리부터 5 mm에서 1 cm정도에서 외측 지대 유리술을 시행한다. 외측 지대 유리술 후, 관절경을 전외측 도달법을 개설하여 위치한 후, 상외측 도달법을 개설하여 5 mm 배관을 삽입하고, 조작용 상내측 삽입구를 개설한다. 경피적으로 만곡 침을 상내측 삽입구를 통해 통과시킨 후 봉합사를 상외측 삽입구를 통해 회수하는, all inside 수기로 시행된다. 결론: 근위부 재정렬을 위한 여러 가지 관절경적 방법이 제시되었지만, 대부분이 내측 절개를 이용한 관절경 보조수기 방법들이었다. 관절경적 all inside 관절막 중첩술 및 외측 지대 유리술은 기존의 관절경 보조 수기 방법들에 비해 내측 절개를 피함으로써 내측 광사근에 손상을 주지 않는 점에서 장점을 가진다. 이 수기는 최소 침습적이면서 직접 관찰하면서 내측 슬개대퇴 인대의 긴장의 정도를 조절하기가 쉬운 수술 수기로 사료된다.

  • PDF

정상 한국 성인에서 발목관절 외측 안정성의 방사선학적 계측 (Radiographic Measurement of Ankle Lateral Stability in Normal Korean Adults)

  • 손현철;김용민;김동수;최의성;박경진;조병기;박지강;홍경호
    • 대한족부족관절학회지
    • /
    • 제14권1호
    • /
    • pp.41-46
    • /
    • 2010
  • Purpose: Anterior drawer and varus stress test are commonly used for radiologic evaluation of chronic lateral ankle instability. However, there are controversies regarding the method of measurement and the normal value. This study was performed to investigate radiologic normal values in normal Korean adults and to analyze differences by age and gender. Materials and Methods: Sixty Korean adults were recruited and divided in three groups (20 in their twenties, 20 in their thirties, 20 in their forties). There were 10 males and 10 females in each group. The selection criteria were no history of ankle injury and no evidence of instability on physical examination. Radiologic measurement of varus talar tilt and anterior talar translation were performed through anterior and varus stress radiographs using Telos device (150N force). The measurement was repeated twice by three researchers, and intraobserver reproducibility and interobserver reliability were analyzed. The average talar tilt and anterior talar translation were obtained. Results: Talar tilt and anterior talar translation on ankle stress radiographs had good intraobserver reproducibility and interobserver reliability. Talar tilt was average $3.7^{\circ}$ and $5.1^{\circ}$ in male and female of twenties of age, $3.9^{\circ}$ and $4.8^{\circ}$ in their thirties, $3.4^{\circ}$ and $4.5^{\circ}$ in their forties. Anterior talar translation was average 3.5 mm and 4.2 mm in their twenties, 4.1 mm and 3.8 mm in their thirties, 3.6 mm and 4.1 mm in their forties. There was no significant difference in talar tilt and anterior talar translation by age. However, there was significant difference in talar tilt by gender. Conclusion: Normal range of talar tilt angle in Korean adults was below $8.3^{\circ}$, and normal range of anterior talar translation was below 7.6 mm. It seems to be able to serve as a good reference for radiologic evaluation and for treatment of chronic lateral ankle instability.

후방불안정성을 동반한 요추 추간판 탈출증에서 Graf 고정술후 발생한 합병증 분석 (The Complications of the Graf Stabilization for Lumbar Disc Herniation with Posterior Instability)

  • 박주태;신영식;양정호;민강우
    • Journal of Yeungnam Medical Science
    • /
    • 제15권1호
    • /
    • pp.164-172
    • /
    • 1998
  • 본 포항성모병원 정형외과에서는 1991년 5월부터 1995년 12월까지 척추불안정성과 관련된 요추부질환 중 연성고정술을 시행한 145례 중 문제점이 발생된 22례를 분석하여 다음과 같은 결론을 얻었다. 1. 총 145례 중 22례(15.1%)에서 연성고정술로 유발되는 문제점을 발견하였다. 2. 문제점으로 주위분절의 불안정성 증가 10례, 추간판 간격의 감소 8례, 척추경 나사못의 해리 3례, Graf band의 파열이 1례였다. 3. 추간판 간격의 감소 8례 중 초기 질환의 원 인으로 추간판이 파열된 경우가 6례로 의의있는 소견을 보였다. 이상과 같은 문제점이 관찰되었으나 주위분절의 불안정성 증가 및 척추경 나사못의 해리는 견고한 고정술에 비해 그 빈도가 낮은 것으로 보이며, 추간판 간격의 감소의 경우 역시 단순 수핵 제거술후 발생된 추간판 간격의 감소 보다 빈도가 적었으나, 보다 장기간의 추시 및 계속적인 관찰과 연구가 필요할 것으로 사료된다.

  • PDF

Topology optimization of bracing systems using a truss-like material model

  • Zhou, Kemin
    • Structural Engineering and Mechanics
    • /
    • 제58권2호
    • /
    • pp.231-242
    • /
    • 2016
  • To minimize the compliance of frame, a method to optimize the topology of bracing system in a frame is presented. The frame is first filled uniformly with a truss-like continuum, in which there are an infinite number of members. The frame and truss-like continuum are analysed by the finite element method altogether. By optimizing the distribution of members in the truss-like continuum over the whole design domain, the optimal bracing pattern is determined. As a result, the frame's lateral stiffness is enforced. Structural compliance and displacement are decreased greatly with a smaller increase in material volume. Since optimal bracing systems are described by the distribution field of members, rather than by elements, fewer elements are needed to establish the detailed structure. Furthermore, no numerical instability exists. Therefore it has high calculation effectiveness.

명치각의 비대칭 성과 몸통 측 이동 거리 사이의 상관 관계 (Correlation between the asymmetry of the infrasternal angle and trunk side shift distance)

  • 정성훈;최슬아;하성민
    • 한국컴퓨터정보학회:학술대회논문집
    • /
    • 한국컴퓨터정보학회 2021년도 제64차 하계학술대회논문집 29권2호
    • /
    • pp.691-694
    • /
    • 2021
  • The malalignment of the trunk causes abnormal stress in a specific area and lead to trunk instability. The purpose of this study was to investigate the correlation between the angle between the infrasternal angle and the trunk side shift distance. The participants in this study 22 subjects were participated. The infrasternal angle and trunk side shift distance were measured using a camera and analyzed using the Image J program. The correlation between the asymmetry of the infrasternal angle and trunk side shift distance was moderate (r=-0.413; p=0.028). According to the asymmetry of the infrasternal angle, it was confirmed that trunk lateral shift appeared in a specific direction. Based on result, it suggests that infrasternal angle and trunk side shift should be considered in the intervention plan of patients with asymmetry of the infrasternal angle.

  • PDF

Three-column reconstruction through the posterior approach alone for the treatment of a severe lumbar burst fracture in Korea: a case report

  • Woo Seok Kim;Tae Seok Jeong;Woo Kyung Kim
    • Journal of Trauma and Injury
    • /
    • 제36권3호
    • /
    • pp.290-294
    • /
    • 2023
  • Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.

Fractures and Dislocations of the Cervicothoracic Junction

  • Kim, Jin-Wook;Jeong, Ju-Ho
    • Journal of Korean Neurosurgical Society
    • /
    • 제42권3호
    • /
    • pp.211-215
    • /
    • 2007
  • Cervicothoracic junction instability should be stabilized with the circumferential fusion. In addition, cervicothoracic junctional area should be examined carefully in acute traumatic injury not only to confirm hidden lesions but also to make the proper surgical plans. Here, three patients who underwent cervicothoracic arthrodesis at our institution are presented with a review of literature.

요측측부인대 및 외측척골측부인대의 동시재건술을 이용한 주관절 후외측회전 불안정성의 수술적치료: 새로운 수술 기법 - 증례 3예 보고 - (Dual reconstruction of both the radial collateral ligament and lateral ulnar collateral ligament at the annular ligament in posterolateral rotatory instability of the elbow: a new technique - A report of 3 cases-)

  • 류인혁;김형진;정재익;서보건;김경철
    • 대한견주관절학회:학술대회논문집
    • /
    • 대한견주관절학회 2009년도 제17차 학술대회
    • /
    • pp.189-190
    • /
    • 2009
  • PDF

다양한 불안정면에서의 스쿼트 운동이 체간 및 하지 근육 활성도에 미치는 영향 (The Effect on Muscle Activation in Trunk and Low-limbs during Squat Exercise on Various Instability Surface)

  • 최남영;장희승;신윤아
    • 한국체육학회지인문사회과학편
    • /
    • 제54권1호
    • /
    • pp.505-514
    • /
    • 2015
  • 이 연구는 다양한 불안정면에서의 스쿼트 운동이 체간과 하지근육의 활성도에 미치는 영향을 비교하는데 목적이 있다. 10명의 피험자가 안정면, 불안정면인 스타빌리티 블루와 블랙, 보수에서 75% 1RM의 강도에서 스쿼트 동작을 실시하였다. 체간근육으로는 복직근, 외복사근, 내복사근 및 다열근에 근전도를 부착하였고, 하지근육으로는 대둔근, 중둔근, 대퇴이두근, 대퇴직 근, 외측광근, 내측광근, 내측비복근, 외측비복근, 가지미근, 전경근에 근전도를 부착하여 스쿼트 동작의 상승과 하간구상의 근활성도를 측정하였다. 안정면과 불안정면에서의 근활성도를 비교하기 위하여 일원변량분석을 실시하였으며, 사후검증으로 sheffe를 이용하였다. 하강구간에서 근활성도는 보수에서의 스쿼트 동작 시 내측광근, 다열근, 대둔근과 중둔근의 활성도가 안정면과 다른 불안정면에서의 스쿼트 동작 시보다 높게 나타났다. 상승구간에서 근활성도는 보수에서의 스쿼트 동작 시 대둔근의 활성도가 안정면과 다른 불안정면에서의 스쿼트 동작 시보다 높게 나타났다. 이러한 결과는 보수에서의 스쿼트 동작이 체간근육과 둔근의 활성도를 증가시키는데 효과적이라고 제시할 수 있다. 그러나 하지근육의 활성도는 불안정성에 따른 차이가 없는 것으로 사료된다.

Visible Perforating Lateral Osteotomy: Internal Perforating Technique with Wide Periosteal Dissection

  • Rho, Bong Il;Lee, In Ho;Park, Eun Soo
    • Archives of Plastic Surgery
    • /
    • 제43권1호
    • /
    • pp.88-92
    • /
    • 2016
  • There are two general categories of lateral osteotomy techniques-the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.