• 제목/요약/키워드: Ligament

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무지 중수지 관절의 만성 파열된 척측, 요측 측부 인대 봉합술 후 결과 비교 (Comparison between Chronic Ulnar and Radial Collateral Ligament Repairs in the Metacarpophalangeal Joint of the Thumb)

  • 이상림;하지윤;김지영;전숙하
    • Archives of Hand and Microsurgery
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    • 제23권4호
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    • pp.254-261
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    • 2018
  • 목적: 무지 중수 수지 관절의 척측 측부 인대의 만성 파열에서의 직접 봉합술은 양호한 결과가 보고되고 있으나 요측 측부 인대에서의 결과는 논란이 있다. 본 연구의 목적은 무지 중수 관절의 척측과 요측 측부 인대의 만성 파열에서 인대 재부착술의 결과를 비교하는 것이다. 방법: 무지 중수 수지 관절의 6주 이상된 측부 인대 파열에서 봉합 앵커를 이용해서 재부착술을 시행한 요측 6예 및 척측 8예의 평균 22개월 추적한 방사선적 및 임상 결과를 후향적으로 검토하고, 통계적으로 비교하였다. 결과: 수술 후 평균 척측 변위 각은 요측 측부 인대에서 $13.3^{\circ}$, 척측 측부 인대에서 $2.0^{\circ}$였다(p=0.020). 수술 후 인대 불안정성은 요측 인대 6예 중 4예에서 관찰되었으나, 척측 인대에서는 관찰되지 않았다. 수술 후 경과 관찰에서 관절의 아탈구는 요측 인대 2예에서만 관찰되었다. 결론: 무지 중수 수지 관절의 요측 측부 인대의 지연 봉합은 덜 양호한 결과를 나타내며, 반 이상에서는 수술 후 인대의 불안정성이 관찰된다.

전방십자인대의 해부학 (Anatomy of the Anterior Cruciate Ligament (A Blueprint for Repair and Reconstruction))

  • 정영복;염재광
    • 대한관절경학회지
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    • 제1권1호
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    • pp.1-8
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    • 1997
  • The anterior cruciate ligament(ACL) is, perhaps, the most intriguing component of the knee joint. Initially referred to crucial ligament because of the cruciate or crossed arrangement or the anterior and posterior ligaments within the knee. the irony or the ACL being crucial to the well-being or the joint has only recently appreciated. The anterior cruciate ligament of human knee joint is a complex structure and its orientation, construct and biology arc directly related to the knee function as a constraint of knee joint motion. In addition to its functional role as a static stabilizer or the knee. the ACL has a unique neurovascular system. The vascular anatomy of the ACL plays a crucial role in the repair and reconstruction of the ligament, and the neuroreceptors found in its substance suggest a possible proprioceptive role for the ligament. The structural complexity of the ACL allows the ligament to function through the normal range of motion as a static stabilizer or the knee. hut it also makes the exact duplication of this structure very difficult. A comprehensive knowledge or the anatomy of the ACL can provide the orthopedic surgeon with a blueprint for the idealized repair and reconstruction of this most complex structure.

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다양한 NSAID가 인간 치주인대세포의 prostaglandin 합성 및 세포 형태에 미치는 효과에 대한 연구 (EFFECTS OF VARIOUS NSAIDS ON PROSTAGLANDIN SYNTHESIS AND CELLULAR CONFIGURATION OF HUMAN PERIODONTAL LIGAMENT CELLS)

  • 김혁수;심혜영;채창훈;장영일;박준우
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권5호
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    • pp.455-463
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    • 2007
  • The present study was designed to evaluate effects of the commonly used NSAIDs(acetaminophen, aspirin, and ibuprofen) on human periodontal ligament cells. Human periodontal ligament cells were grown from a cell line provided by Kyungpook National University. Effects of NSAIDs on the proliferation of human periodontal ligament cells were assessed using MTT assays. And then $PGE_2$ concentrations were determined by ELISA and the changes of cellular configuration were found by electron micrograph. The results were as follows; 1. The MTT assay demonstrated that the commonly used NSAIDs(acetaminophen, aspirin, and ibuprofen) had not significant cytotoxic effect on human periodontal ligament cells. 2. NSAIDs inhibited the $PGE_2$ synthesis of human periodontal ligament cells compared with the control group. These inhibitory effects had no significant differences with NSAID type and concentration. 3. Electron micrographs of human periodontal ligament cells treated with NSAIDs showed more narrow and irregular shape.

An Analysis of Stress Pattern in the Coracoclavicular Ligaments with Scapular Movements: A Cadaveric Study Using Finite Element Model

  • Kim, Yoon Sang;Kim, In-Sung;Yoo, Yon-Sik;Jang, Seong-Wook;Yang, Cheol-Jung
    • Clinics in Shoulder and Elbow
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    • 제18권3호
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    • pp.152-158
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    • 2015
  • Background: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. Methods: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6- mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. Results: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. Conclusions: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.

삼각인대 손상 의심 시 진단과 치료방법 (Diagnosis and Management of Suspected Deltoid Injury)

  • 양성훈;이준영
    • 대한족부족관절학회지
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    • 제26권1호
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    • pp.16-21
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    • 2022
  • 도수 또는 중력 외회전 부하 방사선 검사는 족관절 양과 유사 골절과 단독 외과 골절을 구별할 수 있는 기준이 된다. 부하 방사선 검사상 내측 관절 간격이 넓어지면 삼각인대 손상을 진단할 수 있고 비골 골절에 대한 수술적 처치가 권장된다. 비골 골절에 대하여 관혈적 정복술 후 Cotton test를 시행하여 경비원위인대가 벌어질 경우 이에 대한 고정을 시행한 후 삼각인대의 봉합술 시행 여부는 술자의 선호도 및 수술장 내 소견에 의하여 결정된다. 삼각인대 봉합술은 내과에 suture anchor를 삽입하고 심부와 천부 삼각인대에 대하여 중첩술 후 내과에 anchor를 통하여 고정함으로써 시행한다. 유일하게 무작위로 시행된 족관절 골절에서의 삼각인대 봉합술의 유용성 평가 연구에서는 삼각인대 봉합술의 유용성에 대하여 긍정적인 결론을 도출하지 못하였으나 연구 자체의 제한점이 많아 해석을 하는 데 있어 한계가 있었다. 추후 이에 대한 심도 있는 연구가 필요하리라 판단된다.

키토산이 배양중인 치주인대세포에 미치는 영향 (Effects of Chitosan on Human Periodontal Ligament Cells in Vitro)

  • 김옥수;정현주
    • Journal of Periodontal and Implant Science
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    • 제31권1호
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    • pp.163-180
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    • 2001
  • The aim of this study was to evaluate the effects of chitosan coating on the attachment, proliferation, functional and morphological change of periodontal ligament cells. Primary human periodontal ligament cells were cultured in dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. In experimental group, cells of 4th to 7th passage were inoculated in the multiwell plates coated with chitosan in concentration of 0.22, 0.2, and $2mg/m{\ell}$. Cell counting and MTT assay were done after 0.5, 1.5, 3, 6 and 24 hours of incubation to evaluate the cell attachment, and then after 2 and 7 days of culture to evaluate the cell proliferation. The alkaline phosphatase activity was measured after 4 and 7 days of culture and the ability to produce mineralized modules was evaluated after 21 days of culture. The results were as follows : 1. The morphology of periodontal ligament cells on the chitosan coating was round or spheric. Round cells were aggregated after 6 hours of culture. Aggregated cells on the chitosan coated surface showed nodule-like appearance after 24 hours of culture and not achieved confluency at 7 days. 2. During early period of culture, the attachment of periodontal ligament cells were inhibited by chitosan coating. Inhibition of cell attachment tended to increase with the concentration of chitosan. 3. At the chitosan concentration of 0.02 and $0.2mg/m{\ell}$, periodontal ligament cells were more rapidly proliferated at 7 days, compared to the control group. At the concentration of $2mg/m{\ell}$, the proliferation of periodontal ligament cells was inhibitied(p<0.01). 4. Alkaline phosphatase activity of periodontal ligament cells was increased in chitosan coated group, especially at the concentration of $0.02mg/m{\ell}$after 4 days of culture.5. Periodontal ligament cells produced mineralized nodules on chitosan coated wells without the addition of mineralized nodule forming materials (ascorbic acid, ${\beta}-glycerophosphat$, dexamethasone). With the addition of mineralized nodule forming materials, periodontal ligament cells produced more mineralized nodules at the concentration of $0.02mg/m{\ell}$, compared to the control. In summary, the attachment, proliferation, cell activity, and alkaline phosphatase activity of periodontal ligament cells depended on the concentration of coated chitosan. Chitosan stimulated mineralized nodule formation by periodontal ligament cells. At the appropriate concentration($0.02mg/m{\ell}$), chitosan could increase alkaline phosphatase activity and stimulate the formation of mineralized nodule by periodontal ligament cells. These results suggest that chitosan can be used as an adjunct for bone graft material, and the matrix of tissue engineering for periodontal regeneration, especially bone regeneration.

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손상(損傷) 인대(靭帶) 부위 아시혈(阿是穴)의 직접구(直接灸)를 이용한 부위별 염좌치험(捻挫治驗) 3례 (A Case Report about the Sprain Treated with Direct Moxibustion on Painful Point of Injured Ligament)

  • 조윤철;나경원;정원석
    • 한방재활의학과학회지
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    • 제15권1호
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    • pp.163-169
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    • 2005
  • Objective : Direct moxibustion applied on painful point of injured ligament, not acu-point, is effective method to treat acute pain and chronic weakness of injured ligaments. We recently experienced 3 case of sprain treated with direct moxibustion on painful point of ligaments. Methods : Patients who injured in lateral collated ligament, anterior talo-fibular ligament, and collateral ligament of finger were treated by direct moxibustion on tender points of injured ligaments. Results and conclusion : There was successful results that pain and ROM was improved. It seems that burns due to moxibustion facilitate repair of ligament and control inflammation.

족관절 회내 손상에서 발생한 삼각인대 파열을 동반한 내과 골절 (Medial malleolar fracture associated with deltoid ligament rupture following ankle pronation injury)

  • 박찬호;박재우;박철현;박상진
    • Journal of Yeungnam Medical Science
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    • 제34권1호
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    • pp.146-148
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    • 2017
  • Concurrent injury of medial malleolus and deltoid ligament is difficult to occur considering the injury mechanism. When the concurrent injury comes about, the deltoid ligament injury could be missed and it may lead to medial ankle instability. There are few reported cases of the concurrent injury and domestic case of concurrent failure of both structures over the medial side has been reported just once; however, the injury mechanism is different from this case. The authors report a case of medial malleolus fracture with deltoid ligament rupture following pronation injury with a review of necessity of repairing deltoid ligament for ankle stability.

후방 십자 인대의 해부학과 생역학 (Anatomy and Biomechanics of the Posterior Cruciate Ligament)

  • 김형수
    • 대한관절경학회지
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    • 제2권1호
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    • pp.4-14
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    • 1998
  • As with anterior cruciate ligament reconstruction, posterior cruciate ligament(PCL) reconstruction requires a good understanding of the anatomy and biomechanical properties of the PCL to place the graft correctly as well as to choose the appropriate structure and material for the graft. The anatomy and function of the PCL can be somewhat confusing and continuing to evolve so far. Recent studies have focused on the insertion site anatomy and the identification of the functional components of the ligament. The issue of the ligament isometry and the role of PCL in knee kinematics are still totally resolved. This article can be provided an update on current concepts of the anatomy and biomechanics of the PCL through literature reviews. A clear understanding of these knowledges enables the clinicians to diagnose injuries to the PCL accurately and to reconstruct these structures successfully.

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후방십자인대 견열 골절의 관절경적 정복술(증례 보고) (Arthroscopic Fixation for Avulsion Fracture of the Posterior Cruciate Ligament(Cases Report))

  • 김경택;손성근;양성욱
    • 대한관절경학회지
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    • 제2권2호
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    • pp.173-176
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    • 1998
  • Isolated posterior cruciate ligament injuries are rare and their management is controversial. But, there is general concept that a bony avulsion of posterior cruciate ligament should be repaired. The treatments for the bony avulsion of posterior cruciate ligament were conservative treatment, open reduction and internal fixation and arthroscopic fixation. We report 2 cases of posterior cruciate ligament avulsion fractures, which were arthroscopically reduced and stabilized with cannulated screws and Kirschner wires, and introduce the arthroscopic fixation technique.

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