• Title/Summary/Keyword: Lateral instability

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Double Hill-Sachs Lesion in a Recurrent Anterior Shoulder Dislocation Patient -A Case Report - (견관절 전방 재발성 탈구 환자에서 발생한 이중 Hill-Sachs 병변 - 증례 보고 -)

  • Kim, Yong-Min;Park, Kyoung-Jin;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Hong, Kyung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.121-124
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    • 2011
  • Hill-Sachs lesion is the most common lesion in shoulder dislocation patient and it represented by postero-lateral bony defect of humerus. The lesion could be found in patients who dislocate shoulder joint first time, and it is reported that Hill-Sachs lesion proportionally increases as dislocation does. The location and presence of Hill-Sachs lesion play significant roles in shoulder instability. Authors experienced a double Hill-Sachs lesion in a recurrent anterior shoulder dislocation patient, and thereby report the case with a review of the literature.

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The effect of hip abductor fatigue on static balance and gait parameters

  • Hwang, Wonjeong;Jang, Jun Ha;Huh, Minjin;Kim, Yeon Ju;Kim, Sang Won;Hong, In Ui;Lee, Mi Young
    • Physical Therapy Rehabilitation Science
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    • v.5 no.1
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    • pp.34-39
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    • 2016
  • Objective: Hip abductors play a role in providing stability and movement to the lower limbs. The purpose of this study was to examine the effects of hip abductor fatigue on static balance and gait in the general population. Design: One group pre-test post-test design. Methods: Thirteen university students in their twenties volunteered for the study and had underwent a functional assessment. To induce fatigue, the subjects were instructed to raise their dominant lower extremity up against a load of 50% of 1 repetition maximum while producing hip abduction in a side-lying position. Subjects were instructed to maintain an abduction speed of 30 repetitions per minute to induce fatigue. Muscle fatigue was considered to be established when subjects were unable to perform hip abduction three consecutive times along with the metronome. A post-test of balance and gait was performed immediately in order to prevent fatigue recovery. The center of pressure (COP) distance area was measured using the Zebris FDM-S Multifunction Force measuring plate. Gait performance was analyzed using the GAITRite. Results: The COP distance was increased after fatigue was induced. There was a significant increase in the standard deviation of the medio-lateral and antero-posteror distance (p<0.05). Although there was no significant difference in gait parameters, there was a significant decrease in single support time after fatigue was induced (p<0.05). Conclusions: There was an increase in static balance instability and a significant decrease in single support time during gait due to hip abductor muscle fatigue.

Modified Bilhaut-Cloquet Method for Correction of Bifid Thumb (Bilhaut-Cloquet 변법을 이용한 이열엄지의 교정)

  • Sohn, Hyung Bin;Son, Daegu;Kim, Hyun Ji;Kim, Jun Hyung;Han, Ki Hwan
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.485-490
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    • 2006
  • Purpose: As the traditional treatment of the Wassel's type I or II of bifid thumb, Bilhaut-Cloquet, has always been the standard method despite several disadvantages such as tearing of the finger nail, injuries of the growth plate, joint instability, and long visible scarring. To overcome these drawbacks, we applied a modified Bilhaut-Cloquet Method. Methods: The subjects used for the this study were 10 of 20 patients evaluated. The patients underwent modified methods under every type of Wassel's classification. We designed a central wedge Zig-Zag incision and removed the nail and bony tissues in the remaining digit, but not soft tissue if possible, and transferred the ligaments, tendons, and soft tissue to the remaining thumb from the extra digit. We evaluated the patients' lack of extension, the total ROM of the MP and IP joints, the ROM of IP joints, and the lateral deviations of the reconstructed thumb. Results: The results were encouraging, with all patients showing a good functional and aesthetic outcome. Conclusion: The modified method proved a very effective procedure in the treatment of bifid thumb in all types, especially types I or II.

Failure of Cross-Pin Femoral Fixation after Anterior Cruciate Ligament Reconstruction - A Case Report - (전방십자인대 재건술후 대퇴골 경골핀 고정의 실패 - 증례보고 -)

  • Lee Kee-Byoung;Kwon Duck-Joo;Ji Yong-Nam
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.92-95
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    • 2003
  • A 34-year-old man with ACL total rupture due to slip down injury, had received ACL reconstruction using autogenous hamstrings tendon with cross-pin femoral fixation. Postoperative course was as usual. But postoperative 3 months later, he complained posterolateral knee pain, recurrent effusion and mild instability. He was managed repeatitive aspiration and nonsteroid antiinflammatory drugs but was failed to relieve symptoms & signs. In CT scans, perforation of posteromedial femoral cortex of lateral femoral condyle was found. In second look arthroscopy, two pieces of broken femoral cross pin were found in between tibiofemoral Joint which was badly injured cartilage. We considered malposition of pins was the main cause of failure. We propose that femoral tunnel must be made more acute angle and femoral cross-pin guide must be positioned more external rotation 10-20 degree than transepicondylar axis made confirm the cross-pin tunnel position in order to avoid posterior cortex perforation and early failure.

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The Impact of Abdominal Drawing-in Maneuver and Tensor Fasciae Latae-iliotibial Band Self-stretching on Lumbopelvic Kinematics in Individuals With Lumbar Extension Rotation Syndrome

  • One-bin Lim;Oh-yun Kwon;Heon-seock Cynn;Chung-hwi Yi
    • Physical Therapy Korea
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    • v.31 no.1
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    • pp.79-88
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    • 2024
  • Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

Widening of Bony Tunnel after ACL Reconstruction Using Hamstring Tendon with Ligament Anchor(LA) Screw (슬괵건 및 LA나사를 이용한 관절경적 전방 십자 인대 재건술 후 골터널의 확장)

  • Song Eun Kyoo;Yoon Taek Rim;Jung Jong Wook;Jeong Kwang Cheul
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.69-73
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    • 2001
  • Purpose : To evaluate the clinical results and widening of bony tunnel after anterior cruciate ligament(ACL) reconstruction using hamstring tendon with Ligament Anchor(LA) screw, which is newly designed fur fixation of graft into femur. Materials and Methods : Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon were included in this study. The graft was fixed with LA screw at femoral tunnel and with bioabsorbable interference screw at tibial tunnel. The average period of follow-up was 28 months. The clinical results such as physical examination and Lysholm knee score and radiological results. widening of bony tunnel and instrumented anterior laxity test with $Telos^{\circledR}$(Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results . The Lysholm knee score was 60.0 in average preoperatively and improved to 94.0 in average at follow up. On the Lachman test, there were mild(+) instability in 16 cases, moderate(++) in 24, severe(+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 20 lb was 12.9mm in average preoperatively, and was decreased to 3.1mm in average follow-up. The femoral tunnel was widened from 10.6mm postoperatively to 12.7mm$(21.1\%)$ at follow up on antero-posterior plane and from 10.7mm to 12.4mm$(16.5\%)$ on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm$(20.7\%)$ on antero-posterior plane and from 9.9mm to 11.7mm$(18.9\%)$ in lateral plane. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixatives in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel.

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Analysis of revision anterior cruciate ligament reconstruction (전방 십자인대 재재건술의 분석)

  • Park, Chan-Hee;Song, Eun-Kyoo;Seon, Jong-Keun;Yim, Ji-Heoun;Kang, Kyung-Do;Lee, Tae-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.47-53
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    • 2011
  • Purpose: As the number of the anterior cruciate ligament (ACL) reconstruction has increased, the incidence of revision of ACL reconstruction due to reconstruction failure has been also increased. Therefore, authors analyzed the reason of the failure of ACL reconstruction and the clinical result of the ACL revision. Materials and methods: From February 1998 to July 2010, we selected 36 cases which was followed at least 12months after the ACL reconstruction failure. Duration from reconstruction to revision, the average duration was 60 months (5~334) and on first reconstruction, we used allograft on 23 cases (63.9%) and autograft on 13 cases (36.1%). For the main symptom of ACL reconstruction failure, instability was the most common symptom, and 35 cases (97.5%) were undergone only one reconstruction and 1case (2.5%) was undergone two reconstruction. Clinical results were evaluated by Lysholm knee joint score, pivot shift test, and Telos device. Results: Average follow-up duration of the patients was 21 months (12~40), and the reason for the ACL reconstruction failure, trauma was most common by 19 cases (52.8%), malposition of the femoral tunnel was 13 cases (36.1%), malposition of the tibia tunnel was 1case (2.8%), and failure of osteointegration was 3 cases (8.4%). On performing the ACL revision, we used allograft on 34 cases (94%) and autograft on 2 cases (6%), and 21 cases accompanied injury of the meniscus (medial meniscus 14 cases, lateral meniscus 7 cases). Lysholm knee joint score was improved from 66.5 points, preoperatively to 92 points on last follow-up (p<0.01). In most cases, patients were satisfied (92%) with the operation results. Tegner activity score was also improved from 2.0 points preoperatively to 6.2 points on the last follow-up. On Lachman and pivot sift test, 33 cases and 30 cases were improved to grade I respectively, and on stability test using Telos device, the bilateral difference was improved from mean 15.5 mm preoperatively to 4.5 mm on the last follow-up. Conclusion: After 1 year follow-up, Revision of ACL had a little anterior instability but it showed satisfactory result on clinical result and patient's subjective satisfaction.

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Statistical Study of the Ferguson's Angle, Lumbar Gravity Line and Lumbar Lordotic Angle in HIVD Patients. (요추간판탈출증 환자의 요천각, 요추중력중심선 및 요추전만각의 통계적 관찰)

  • Koh, Dong-Hyun;Hong, Soon-Sung;Lee, Jin-Ho;Jung, Sung-Yub;Shin, Joon-Shik
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.17-32
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    • 2007
  • Objectives : The lumbosacral joint is unstable area from an anatomical viewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint. The purpose of this study is to assess the difference of the Ferguson's angles, Lumbar gravity lines, Lumbar lordotic angles among Herniated of Intervertebral Disc(HIVD) patients. Methods : We analyzed the lateral view of lumbar spine checked at erect position on 88 patients who had been diagnosed as HIVD by Magnetic Resonance Imaging(MRI). We investigated the Ferguson's angle, Lumbar gravity line, Lumbar lordotic angle on X-ray film. Results and Conclusions : In the acute lumbago group the Ferguson's angle had a tendency to decrease, while in the chronic group it had a tendency to increase. In the acute lumbago group the Lumbar gravity line fell in front of the normal range(sacrum), while in the chronic group it fell behind the normal range(sacrum). In the acute lumbago group the Lumbar lordotic angle usually decreased, while in the chronic group it increased. The Ferguson's angle and the Lumbar gravity line, the Ferguson's angle and the Lumbar lordotic angle, the Lumbar gravity line and Lumbar lordotic angle each had a positive realtionship. The Ferguson's angle, the Lumbar gravity line and the Lumbar lordotic angle was less influenced by the level of HIVD and was more influenced by how long the patient had the pain. The correlationship between each factor was less in the chronic lumbago group than the acute group. In the chronic lumbago group the instability of the lumbosacral joint increased, while in the acute group the compression of the weight on the sacrum increased.

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Effects of Intramedullary K-wire Insertion on Femoral Lengthening in Canine with Monolateral External Fixator (단측성 외고정 기구를 이용한 개의 대퇴골 신연에 있어서 골수강내 K-강선 삽입의 효과)

  • Hwang, Jae-Min;Kim, Young-Ki;Chin, Hee-Tec;Seok, Seong-Hoon;Lee, Hee-Chun;Koh, Phil-Ok;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.291-299
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    • 2006
  • During long bone lengthening, there are many disadvantages including axial deviation, malalignment and re-fracture which are commonly encountered inspite of its proven abilities. To study the effects of intramedullary K-wire application on the lengthening of long bone, ten skeletally mature mongrel dogs were separated into two groups(Group I, II). Right femurs of group I(5 dogs) were fixed with only monolateral external fixator after subperiosteal osteotomy. Right femurs of group II(5 dogs) were fixed with mono lateral external fixator and intramedullary K-wire after subperiosteal osteotomy. Lengthening was started at 7 days after the surgery with the rate of 0.5 mm per day for 5 weeks and the dogs were sacrificed after 15 weeks postoperatively to examine histologic differences and evaluate bone mineral density. Radiographic examination at an interval of two weeks was done to evaluate the type of callus formed and to analyze complications including instability of external skeletal fixation and axial deviation. Bone mineral density at the lengthened area and contralateral nonlengthened area were measured using quantitative computerized tomography. Histological examination of regenerated bone was performed using Masson's trichrome stain method. The radiographs demonstrated poor callus formation, higher incidence of axial deviation and screw loosening in the group I compared to the group II. The bone mineral density at the lengthened area in the group II was higher than that of the group I(P<0.05). Histological examination showed that the new bone trabeculae in the group II were greater than that of the group I. In conclusion, the combination of monolateral external fixator and intramedullary K-wire can prevent pin loosening, axial deviation and reduce healing period in dogs.

The Influence of Electromyographic Activation on Gluteus Medius and Tensor Fascia Lata by Functional Leg Length Discrepancy in Women's University Students During Lunge (여대생의 기능적 다리길이 차이가 런지 자세에서 중간볼기근, 넙다리근막긴장근의 근활성도에 미치는 영향)

  • Kim, Hae-Ree;Song, Ye-Jin;Moon, Sung-Gi;Jang, Hyun-Jeong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.2
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    • pp.39-46
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    • 2013
  • Background: The purpose of this study was to realize the relations between gluteus medius, tensor fascia lata of pelvic muscles and functional leg length in women's university students. This study is examined the change of electromyographic activation on gluteus medius and tensor fascia lata according to the leg length discrepancy. Methods: All of the female of freshman and sophomore in 'D'college were gathered and separated fourteen of healthy women in two groups by functional leg length discrepancy. and The subjects divided into two groups that the difference with less than 2cm or more would have structural defects by tapeline. The electromyographic activation on the gluteus medius and tensor fascia lata muscles were recorded by surface electrodes at maximal voluntary isometric contraction (MVIC) during lunge posture. The collected datas were analyzed using Independent t-test with SPSS win19.0. Results: In intergroup comparison of electromyographic activation levels for gluteus medius and tensor fascia lata in short or long leg, the influence of electromyographic activation on tensor fascia lata is shown to be more statically higher than gluteus medius according to functional leg length discrepancy in coeds. Even though both muscles are shown to be statistically higher in comparison of electoromyographic activation levels for tensor fascia lata and gluteus medius between short leg and long leg in Group I, Differences of electoromyographic activation levels for tensor fascia lata is shown to be statistically higher than gluteus medius. Conclusion: Through this study, we realized that tensor fascia lata than the long leg, and also, tensor fascia lata is significantly effective for functional leg length discrepancy than gluteus medius. It leads to pelvic lateral instability. This means that cause tensor fascia lata to have a leg length discrepancy.

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