• Title/Summary/Keyword: Lateral ligament

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Surgical Procedures for Chronic Lateral Ankle Instability (만성 외측 발목 불안정증의 수술적 치료)

  • Young, Ki Won;Lee, Hong Seop;Hwang, Ji Sun
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.17-24
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    • 2021
  • Surgical treatments for chronic lateral ankle instability include anatomic repair, anatomic reconstruction using an auto or allograft, non-anatomic reconstruction, and arthroscopic repair. Open anatomic repair using the native ligament with or without reinforcement of the inferior extensor retinaculum is commonly performed in patients with sufficient ligament quality. Non-anatomical reconstruction using the adjacent peroneus brevis tendon is typically used only in patients with poor-quality ligament remnants or when previous repair failed. Anatomical reconstruction can be considered in patients in whom anatomical repair is expected to fail and when performed using auto or allografts can provide good to excellent short-term results, although the long-term outcomes of these methods remain unclear. Arthroscopic repair can provide good to excellent short-term clinical outcomes, but evidence supporting this technique is limited. The advantages and disadvantages of various surgical methods should be compared, and appropriate treatment should be implemented based on patient characteristics.

Risk Factors for Failure after Lateral Ankle Ligament Repair (족관절 외측 인대 봉합 후 실패의 위험 인자)

  • Park, Jun Sung;Kim, Bom Soo
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.2
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    • pp.62-66
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    • 2016
  • A modified $Brostr{\ddot{o}}m$ procedure has been widely accepted as a treatment of choice for patients with chronic lateral ankle instability. The procedure is highly reliable and provides successful outcomes in approximately 90% of cases. Severe degree of instability, absence or poor quality of the ligamentous remnant, obesity, and generalized joint hypermobility have been regarded as poor prognostic factors related to the modified $Brostr{\ddot{o}}m$ procedure. However, these perceptions are based on a low level of evidence studies or expert opinions. Therefore, the aim of this article was to search for evidences regarding the poor prognostic factors of the modified $Brostr{\ddot{o}}m$ procedure.

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

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.6
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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.

CORA Based Leveling Osteotomy with Tibial Tuberosity Transposition for Cranial Cruciate Ligament Rupture with Concurrent Medial Patellar Luxation in Two Small Breed Dogs

  • Shin, Seo-Hyun;Kang, Jin-Su;Lee, Dong-bin;Lee, Hae-Beom;Kim, Nam-Soo;Heo, Su-Young
    • Journal of Veterinary Clinics
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    • v.36 no.5
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    • pp.285-288
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    • 2019
  • A 5-year-old 6 kg male mongrel (case 1) and a 7-year-old 4.3 kg male yorkshire terrier (case 2) were presented to Chonbuk animal medical center (CAMC). Both animals had non-weight bearing hind limb lameness. Case 1 had complete rupture of cranial cruciate ligament with grade 3 medial patellar luxation. Case 2 had complete cranial cruciate ligament rupture with grade 4 medial patellar luxation. During surgery, in both cases, trochlear block recession was performed followed by CORA based leveling osteotomy (CBLO) and tibial tuberosity transposition (TTT). General soft tissue reconstructions for medial patellar luxation including medial releasing and lateral imbrication were also performed. Postoperatively, both animals demonstrated excellent recovery and regained normal weight bearing of the affected hind limb without any recognizable complication. CBLO followed by TTT can be a curative surgical option without complications in cases of cranial cruciate ligament rupture with high-grade medial patellar luxation in small breed dogs.

Anatomy and Physical Examinations of the Knee (슬관절의 해부학과 신체 검진법)

  • Yoo, Jae Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.50-57
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    • 2008
  • The anatomy which is the systemic understanding of a structure and the physical examinations which is the functional assessment of its role comprise the fundamental capability for a clinician providing medial care to the knee. This article provides the basic anatomy of the bones, meniscus, anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, muscles, medial and lateral 3 layer concept, anterior and posterior aspect of the knee, bursae around the knee, and the physical examinations of the meniscus, medial and lateral collateral ligament, anterior and posterior cruciate ligament with posterolateral corner. The conceptual and systemic understanding of the anatomy and the physical examinations of the knee would be a compass or lighthouse for the physician providing medical care to the knee.

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Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica

  • Kim, Jeong-Eun;Lee, Sang-Gon;Kim, Eun-Ju;Min, Byung-Woo;Ban, Jong-Suk;Lee, Ji-Hyang
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.115-118
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    • 2011
  • Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.

A modified trans-anconeus approach to facilitate fixation of a posterior radial head fracture: a cadaveric feasibility study

  • Ahmed Mohamed Desouky;Ahmed Naeem Atiyya;Mohamed Elbishbishi;Marwa Mohamed El Sawy
    • Anatomy and Cell Biology
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    • v.56 no.1
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    • pp.39-45
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    • 2023
  • Fixation of radial head fracture with minimally invasive posterior approach remains a significant challenge. The aim of this study was to determine the feasibility of trans-anconeus posterior elbow approach and to observe lateral ulnar collateral ligament (LUCL) in extended elbows. This cadaveric study was performed in twenty upper limbs of fresh fixed adult male cadavers. An oblique incision was made in the middle segment of anconeus until the lateral ligament complex and the joint capsule had been revealed. A deep dissection was explored to observe the anatomical relationship of the LUCL to the anconeus. Measurements of the LUCL were recorded while the elbow was fully extended. The mean distance between the edge of the radial head and the proximal insertion of the LUCL was 13.3 mm (11.5-16.2 mm); the mean distance between the edge of the radial head and the distal insertion of the LUCL was 20.9 mm (19.2-23.4 mm); the distance between the edge of the radial head and the distal edge of the annular ligament was 11.2 mm (8.22-11.7 mm). By estimate correlation of the previous measurements, the direct and accessible way to expose the posterolateral articular capsule of the elbow joint was through a window in medial 2/3 of the middle segment of anconeus muscle. These trans-anconeus approach is useful. It provides good visualization, facilitates applying the implants, and lessens the risk of radial nerve injury. Awareness of the anatomy is mandatory to avoid injury of LUCL.

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

  • Yoo, Yon-Sik;Lee, Sang-Soo;Jeung, Eun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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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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Stress Radiographs under Anesthesia for Painful Chronic Lateral Ankle Instability (동통을 동반한 족관절의 만성 외측 불안정성에 있어서 마취하 스트레스 방사선 검사)

  • Choi, Jun Young;Ahn, Hee Chan;Shin, Myung Jin;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.12-16
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    • 2017
  • Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.