• Title/Summary/Keyword: Lateral muscle

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Arthroscopic Iliopsoas Tenotomy of Iliopsoas Impingement after Total Hip Arthroplasty (고관절 전치환술 후 발생한 장요건 충돌의 관절경하 장요건 절단술)

  • Huh, Soon Ho;Choi, Byeong Yeol;Han, Sang Roc;Chung, Woo Chull
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.125-133
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    • 2021
  • Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1-9 months) in patients of an average age of 60 years (range, 50-69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40-88) before surgery to an average of 35.0 (range, 15-76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2-6) before surgery to an average of 1.4 (range, 0-4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted. The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion: Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.

Evaluation for Biomechanical Effects of Metatarsal Pad and Insole on Gait (보행 중 중족골 패드와 인솔의 생체역학적 영향성 평가)

  • Choi, Jung-Kyu;Park, In-Sik;Lee, Hong-Jae;Won, Yong-Gwan;Kim, Jung-Ja
    • Korean Journal of Applied Biomechanics
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    • v.21 no.4
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    • pp.487-494
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    • 2011
  • The purpose of this study was to evaluate the effects of metatarsal pad (MP) compared with barefoot and MP with using different insoles on gait. 15 healthy females who had no history of injury in the lower extremity with an average age of 22.7 year(SD=1.35), height of 160 cm(SD=3.4), weight of 48.8 kg(SD=5.52) and average foot size of 232.5 mm(SD=6.8) participated in this study as the subjects. The subjects walked on a treadmill under four different experimental conditions: 1) walking with barefoot, 2) walking wearing MP 3) walking wearing a soft insole with MP(SIMP), 4) walking wearing a rigid insole with MP(HIMP). During walking, foot pressure data such as force, contacting area, peak pressure, and mean pressure was collected using Pedar-X System(Novel Gmbh, Germany) and EMG activity of lower limb muscles such as tibialis anterior(TA), lateral gastrocnemius(LG), rectus femoris(RF), and musculus biceps femoris(MBF) was gathered using Delsys EMG Work System(Delsys, USA). Collected data was then analyzed using paired t-test in order to investigate the effects of each of experimental conditions. As a result of the analysis, when MP and HIMP were equipped, overall contacting area was increased while the force, peak pressure and the mean pressure were decreased. Especially, when the SIMP was equipped, every data were significantly decreased. In case of EMG, wearing MP, SIMP and HIMP made three muscles(TA, LG, RF)'s activity decrease. A result of the analysis will be able to apply for manufacturing functional shoes, diabetes shoes, senior shoes and lower extremity orthosis. Significance of the study due to a metatarsal pad and the insole is to analyze the changes in muscle strength.

Airway analysis in unilateral cleft lip and palate patients (편측성 순$\cdot$구개열자의 기도 분석)

  • Son, Woo-Sung;Baek, Jae-Ho
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.591-598
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    • 2000
  • This study was designed to analysis the airway which affects to breathing, speech and facial growth pattern in unilateral cleft lip and palate patients. Upper airway and the position of hyoid bone pattern were analyzed on the lateral cephalometric radiographs of the 78 subjects of complete unilateral cleft lip and palate group and each group was divided two sub-groups by circumpubertal growth peak and gender. These data were statistically analyzed to examine the difference between pre-circumpubertal growth peak group and post-circumpubertal growth peak one, and between male and female group. The results of this study were as follows: 1. After circumpubertal growth peak stage, the position of hyoid bone was lower than before in both male and female group. 2. After circumpubertal growth peak stage, the measurement were increased in CV3ia-APH, PNS-ad which related to the volume of pharyngeal space. This was due to the decrease of adenoid and anteroiferior growth of mandible and affected to breathing and speech after circumpubertal growth peak. 3. During circumpubertal growth peak stage, all measurements increased more in male than female group, which due to the different amount of growth in different gender. 4. The position of hyoid bone was lower in male than female group in all age group. 5. After circumpubertal growth peak stage, CV3ia-APH increased more in male. This was due to the more growth in madible of male which resulted in the activation of digastric muscle.

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Sural nerve involvement accompanying peroneal nerve palsy (비골신경 마비에 따른 비복신경 손상의 정도)

  • Yoon, Won-Tae;Lee, Taek-Jun;Shin, Kyung-Jin;Kim, Byoung-Joon
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.31-34
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    • 2004
  • Backgrounds: The pathway of the sural nerve (SN) is variable, but usually divided into medial and lateral sural branches joining the posterior tibial nerve (PTN) and the peroneal nerve (PN). The sural nerve may be affected by PN palsy. The frequency or the severity of SN involvement in peroneal palsy is not known. The purpose of the study is to investigate the frequency and the severity of the SN involvement by the peroneal nerve palsy. Methods: Total 85 patients were included with peroneal palsy. Amplitudes of distal peroneal, sural, and superficial peroneal nerves (SPN) were compared between normal and paralyzed sides. The frequency and severity of SN involvement by peroneal palsy were investigated. Results: Mean age was $48.4{\pm}17.4$ years old at the time of the test. Peroneal palsy was right side in 32, left in 38, and bilateral in 15 patients. Mean amplitudes of affected distal PN, SPN, and SN were $1.51{\pm}1.64mV$, $3.50{\pm}4.86{\mu}V$, and $10.42{\pm}6.59{\mu}V$ in right side, and $1.19{\pm}1.57mV$, $4.38{\pm}5.67{\mu}V$, and $11.06{\pm}6.87{\mu}V$ in left side, respectively. Sensory nerve action potential (SNAP) amplitude of the SN in the affected side was average $73.7{\pm}33.1%$ of normal, which was significantly lower than that in the normal side(p<0.01). The decrease of the sural SNAP amplitude was more than 15% in 39 out of 70 patients with unilateral peroneal palsy. Peroneal compound muscle action potential (CMAP) amplitude was not correlated with the amplitude of the sural SNAP. By complete peroneal palsy, SN SNAP amplitude was decreased to 4% of SNAP and $57.7{\pm}31.8%$ of that in normal side. Conclusions: PN injury without PTN involvement may induce reduction of sural SNAP amplitude. Because of the anatomic variation of SN, the electrophysiological findings are variable. It should be considered to interpret the location of the PN lesion.

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Reconstruction of the Large Soft Tissue Defects around Knee Joint with Para-Scapular and Latissimus Dorsi Myocutaneous Free Flap based on Subscapular Vessels (슬관절 주변의 광범위한 연부조직 결손 시에 시행한 광배근-부견갑 피판을 동시에 사용한 유리 피판술의 효과)

  • Chung, Duke-Whan;Lee, Jae-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.11-18
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    • 2002
  • Large soft tissue defects around the knee joint are known to significantly diminish joint function. Severe soft tissue defects on the anterior aspect of the knee joint especially bring on significant joint motion limitation. Although simple split skin grafts can cover the skin defect, the progressing scar contracture of the grafted skin causes joint stiffness. One of the best solutions of large soft tissue defects around the knee joint is covering the defect with a good quality skin flap. Separated flaps with one vascular pedicle are good candidates for covering anterior and posterior aspects of the joint for example. Authors performed 12 cases of combined scapular and latissimus dorsi free flaps from 1984 to 2000. Among them, we experienced 5 cases of knee joint defect covering using the double free flap for coverage of the soft tissue defect with preservation of the knee joint function and satisfactory results. The system of flaps based on the subscapular artery and vein provides a variety of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flap, the serratus anterior and latissimus dorsi muscular flap, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available for multiple tissue defects or complex defects because it can be incorporated with skin, muscle and bone flaps. A main advantage is the independent vascular pedicles of each component, which allow freedom in orientation of each components. Consequently it can be freely applied to any form of three dimensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in five patients to reconstruct massive defects on the extremities with resultant improved joint function. There was no flap failure and minimal complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed. All of the five flaps survived and there was no scar contracture affecting the joint motion.

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The effects of strength training on the change of ground reaction force for the children with Down syndrome (근력 훈련이 다운증후군 아동의 지면반력의 변화에 미치는 영향)

  • Lim, Bee-Oh;Han, Dong-Ki
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.1-16
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    • 2002
  • The purposes of this study were to investigate the effects of strength training on the change of ground reaction force for the children with trisomy 21 Down syndrome. The subjects of this study were consisted of eight elementary school students with Down syndrome who participated in the strength training. The strength training was administered by six items such as squat, leg curl, leg extension, toe raise, sit-ups, and hyperextension. For strengthening muscle, each group also was treated by walking for 8 weeks, three times a week, 10-15RM, 3sets, which was based on the principle of progressive overload. For inquiring the effect of strength training, the ground reaction force variables were measured in two phases : before-training and 8 week-after training. The gait of each subject was acquisition using 2 AMTI force platforms set at 100 frequency. The results of this study were as follows: The pattern of vertical, antero-posterior and medio-lateral forces, trajectory of net COP and the timing ratio of reaching the each events were shown variously. So, it is not easy to explain these variables clearly. As the result of strength training, these variables were changed. However, the results of within subjects differ greatly, there was no difference statistically.

Development of Wireless Ambulatory System Measuring 3-D Motion as Podiatric Diagnosis (족부 진단용 3차원 움직임 측정을 위한 무선 이동형 시스템 개발)

  • Kim, Jin-Ho;Kim, Hwa-In;Kim, Dong-Wook;Won, Yong-Gwan;Kim, Jung-Ja
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.36 no.5B
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    • pp.502-510
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    • 2011
  • In this research, a wireless movable systems is introduced that is applicable for real-world clinical examination in order to resolve the inconvenience of wired motion analysis system which uses markers by measuring more accurately the angle of the 3D motion. The system is composed of bluetooth data transmission and 6 DOF inertial measurement system that is composed of 3-axis acceleration and 3-axis gyroscope. The samples were collected from 10 feet of 5 young children who were confirmed as patients having flat feet and achilles tendonitis by podiatric expert in pediatrics, and the validity of the system was evaluated by comparison with the opinion by the expert using the EMG data and the data measured by the developed system. ROM of ankle was measured by the difference between the maximum and the minimum peaks of 3-axis values (pitch, roll and yaw) measured at lateral malleolus bone, and based on this measured value, the eversion rate became relatively higher as flat feet state become worse, which is equivalent to the opinion from the podiatric experts. It was shown that there is a relation between the certain muscle activities and the abnormal motion of foot caused by disease.

The clinical observation of patient with Headache Treated by Trigger point acupuncture therapy (발통점(發通點)을 이용(利用)한 두통(頭痛) 치험례(治驗例) 보고(報告))

  • Lee Seung-Yeon;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.12 no.1
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    • pp.133-143
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    • 1998
  • Myofascial pain syndrome is one of the pain syndrome resulted from myofascia which covered muscles and clinically characteristic feature by sensitive trigger point in skeletal muscles and referred pain reactivated by stimulating each trigger point. The origin of headache are local lesion such as head, chest, abdominal organ, systemic lesion with fever or in toxic state. the other factors are consciousness, personality, anxiety, depression, which cause muscle strain in physiological environment. The Oriental Medical therapy for headache has herb medication and acupuncture. especially acupuncture therapy has not only classical systemic acupuncture(體鍼) but also neo-acupuncture(新鍼) such as commonly using auricular acupuncture(耳鍼) and manual acupuncture (手鍼), recently trigger point acupuncture is used. The author analyzed 27 cases of patient with headache treated by trigger point acupuncture therapy in Dong-yu Oriental Medical Hospital from March 1st 1997 to February 28th 1998. The following results were obtained. 1. The sex ratio of the female was 59.26%(16 cases) and male was 40.74%(11 cases), the ratio of high school student was 62.96%(17cases) as first. 2. The headache duration ratio of 2-3 years was 37.04%(10 cases) as first, 1-2 years was 25.93%(7 cases) as second. 3. The portion ratio of whole headache was 33.33%(9 cases) as first, lateral headache was 29.63%(8 cases) as second 4. The combined symptoms ratio of anorexia was 40.74%(11 cases) as first, fatigue was 33.33%(9 cases) as second, neck stiffness and dizziness was each 25.93%(7 cases) as third. 5. The therapeutic duration ratio of below 1 week was 29.63%(8 cases) as first, 2-3 weeks was 22.22%(6 cases) as second, 1-2 weeks and 3-4 weeks was each 18.52%(5 cases) as third. 6. The ratio of family history was 11 cases(40.74%). mother with headache was 6 cases, father was 3 cases, and brothers & sisters was 2 cases. 7. The herb medication ratio of Chungsanggyuntongtang(淸上?痛湯) was 37.04%(10 cases), Kamiondamtang(加味溫膽湯) was 22.22%(6 cases), Hyangsapyunguisan(香砂平胃散) was 18.25%(5 cases) etc. 8. The remedial effect ratio of good was 25.93%(7 cases), fair was 48.15%(13 cases), not improved was 7.41%(2 cases), side effect was 3.70%(1 cases), and unknown was 14.81%(4 cases).

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Reverse Total Shoulder Arthroplasty: Where we are? "Principles" (견관절 역행성 인공관절 치환술의 원칙)

  • Noh, Kyu-Cheol;Suh, Il-Woo
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.105-110
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    • 2011
  • Purpose: The purpose of this article is to identify and understand the complications of RTSA and to review the current methods of preventing and treating this malady. Materials and Methods: Previous constrained prostheses (ball-and-socket or reverse ball-and-socket designs) have failed because their center of rotation remained lateral to the scapula, which has limited of the motion of the prostheses and produced excessive torque on the glenoid component, and this leads to early loosening. The Grammont reverse prosthesis imposes a new biomechanical environment for the deltoid muscle to act, thus allowing it to compensate for the deficient rotator cuff muscles. Results: The clinical experience does live up to the lofty biomechanical concept and expectations: the reverse prosthesis restores active elevation above $90^{\circ}$ in patients with a cuff-deficient shoulder. However, external rotation often remains limited and particularly in patients with an absent or fat-infiltrated teres minor. Internal rotation is also rarely restored after a reverse prosthesis. Failure to restore sufficient tension in the deltoid may result in prosthetic instability. Conclusion: Finally, surgeons must be aware that the results are less predictable and the complication/revision rates are higher in revision surgery than that in the first surgery. A standardized monitoring tool that has clear definitions and assessment instructions is surely needed to document and then prevent complications after revision surgery.

Expression of Translationally Controlled Tumor Protein (TCTP) Gene of Dirofilaria immitis Guided by Transcriptomic Screening

  • Fu, Yan;Lan, Jingchao;Wu, Xuhang;Yang, Deying;Zhang, Zhihe;Nie, Huaming;Hou, Rong;Zhang, Runhui;Zheng, Wanpeng;Xie, Yue;Yan, Ning;Yang, Zhi;Wang, Chengdong;Luo, Li;Liu, Li;Gu, Xiaobin;Wang, Shuxian;Peng, Xuerong;Yang, Guangyou
    • Parasites, Hosts and Diseases
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    • v.52 no.1
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    • pp.21-26
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    • 2014
  • Dirofilaria immitis (heartworm) infections affect domestic dogs, cats, and various wild mammals with increasing incidence in temperate and tropical areas. More sensitive antibody detection methodologies are required to diagnose asymptomatic dirofilariasis with low worm burdens. Applying current transcriptomic technologies would be useful to discover potential diagnostic markers for D. immitis infection. A filarial homologue of the mammalian translationally controlled tumor protein (TCTP) was initially identified by screening the assembled transcriptome of D. immitis (DiTCTP). A BLAST analysis suggested that the DiTCTP gene shared the highest similarity with TCTP from Loa loa at protein level (97%). A histidine-tagged recombinant DiTCTP protein (rDiTCTP) of 40 kDa expressed in Escherichia coli BL21 (DE3) showed immunoreactivity with serum from a dog experimentally infected with heartworms. Localization studies illustrated the ubiquitous presence of rDiTCTP protein in the lateral hypodermal chords, dorsal hypodermal chord, muscle, intestine, and uterus in female adult worms. Further studies on D. immitis-derived TCTP are warranted to assess whether this filarial protein could be used for a diagnostic purpose.