• 제목/요약/키워드: Lower extremity joint

검색결과 302건 처리시간 0.028초

사지에 발생한 신경초종의 미세수술적 치료 (Microscopic Excision of Neurilemmoma of the Extremities)

  • 이광석;우경조;김종원
    • 대한골관절종양학회지
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    • 제2권1호
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    • pp.88-93
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    • 1996
  • Neurilemmomas are the most common benign tumor of the peripheral nerve trunks, and arises from the cells in the sheath of Schwann. Neurilemmomas are well encapsulated and may be separated easily from surrounding tissue and lie completely within a larger nerve trunk, with bundles of neurofibrils spread out over the surface of the tumor. A careful dissection and retraction of the nerve bundles will allow the tumor to be enucleated from the parent nerve without any significant interference with the function of the nerve. Resection of the involved nerve is seldom necessary and should be avoided if at all possible. Our aim in microscopic excision of neurilemmoma of extremities is to reduce any disturbance of the intact neurofibrils of the parent nerve. Thirteen cases of neurilimmomas were treated by microscopic excision at the Department of Orthopaedic Surgery, Korea University Hospital between January 1990 and March 1995. The results was as follows ; 1. The average age at surgical intervention was 40.1 years. Cases in fourth and fifth decades predominated. 2. In their anatomical distribution, 8 cases were in the upper extremity and 5 cases in the lower extremity. 11 cases were on the flexor surface. 3. On the operative field, all the tumors were well encapsulated, however 1 case of 13 was adherent to the periosteum of fibula. 4. In all cases, the tumor were enucleated from the parent nerve without any injury to nerve under high-power magnification, preserving individual fascicles, and sensory and motor function.

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횡문근육종의 치료 (Treatment of Rhabdomyosarcoma)

  • 이종석;전대근;김석준;이수용;박현수
    • 대한골관절종양학회지
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    • 제1권2호
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    • pp.200-204
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    • 1995
  • Twenty three rhabdomyosarcoma patients who were registered in Korea Cancer Center Hospital from Mar. 1985 to Apr. 1994 were analysed in the aspect of treatment and survival. Thirteen cases were male and 10 female. Average age was 29.5 years(range 1 to 66). Locations of the tumor were as follows: 13 in lower extremity, 6 in upper extremity and 4 in trunk. According to the UICC classification, stage II b was 1 case, stage III a 4, stage III b 10, stage IV a 3 and stage IV b 5. In histological categories, embryonal rhabdomyosarcoma was 7 cases, alveolar 7, pleomorphic 7 and undetermined 2. Average follow up period was 35.3 months(1 tk 7.5 years). Ten cases were continuous disease free, 3 no evidence of disease, 3 alive with disease and 7 died of disease at final follow up. Kaplan-Meier's actuarial 5-year survival rate was 60.3% and 5-year continuous disease free survival rate was 31.4%, Surgical margin was an important factor in local tumor control. Although there was no definite statistical significance, our results suggest chemotherapy and radiation therapy have meaningful roles in reducing local recurrence and improving survival.

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BACKLIFT와 LEGLIFT의 들기 유형에 따른 역학적 변인 비교분석 (Comparative Analysis of Biomechanic Variables between Backlift and Leglift Type)

  • 김의환;김태완;김성섭;정재욱
    • 한국운동역학회지
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    • 제17권4호
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    • pp.209-219
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    • 2007
  • The purpose of this study was to analyze biomechanical mechanism (posture, moment of back joint, EMG) when athletes (Judo, Ssirum) and lay people lifted a load according to two different lift methods; backlift and leglift. The number of subjects was 12; 8 athletes (4 for Judo, 4 for Ssirum) and 4 lay people. We recorded a lift motion in backlift and leglift using 7 real time infrared cameras (vicon) and analyzed EMG pattern of major muscles for a lift (lattisimus dorsi, erector spinae, biceps femoris). In a backlift Judo players showed a biggest range of back flexion and extension motion and lay people flexed more than other groups at phase 2 in which an interaction between groups and events was statistically significant (p=.024). In a leglift Ssirum players more flexed their back in a barbell lift and there was a statistical significance (p=.021) between groups and events. For moment of back joints, 1) in a backlift a larger loading on back joints in all three groups at phase 2 when lifting down a barbell, 2) in a leglift a larger loading on back joints when lifting down a barbell in two athlete groups but a larger loading when lifting up a barbell in lay people group, and all groups did not show any statistical significance. For EMG, right lattisimus dorsi muscle in a backlift was statistical significant (p=.006) in an interaction between groups and phase but left lattisimus dorsi muscle was insignicant, and there was not any significance in a leglift. Generally atheletes (Judo and Ssirum) used more their muscles of lower extremity in lifting up and down and lay people did more their ones of upper extremity.

노인의 하지 정렬 상태와 보행 시 슬관절 내전 모멘트 특성 (Relationship between lower limb alignment and knee adduction moment during ambulation in the healthy elderly)

  • 조유미;홍정화;문무성
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2003년도 추계학술대회 논문요약집
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    • pp.24-24
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    • 2003
  • For the elderly, achieving a close-to-normal ambulation is important for activities of daily life. Recent researches of SE(Silver Engineering) restoring physical ability would help the elderly by developing the advanced gait assisting devices and orthoses. For the applications using the advanced technologies, the gait characteristics of the elderly must be understood. However, a few studies were performed to investigate the physiological or pathological gaits. The purpose of this study is to provide the gait analysis data and also to investigate relationships between alignment of the lower limb, foot progression angle and knee joint moments in the healthy elderly. By participating a total of 20 healthy elderly persons in this study, the following facts were found: 1) Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04m, Step length was 0.56m; 2) The maximum knee flexion angle through swing phase showed left 46.82$^{\circ}$, right 40.19$^{\circ}$ and the maximum knee extension angle showed left -1.32$^{\circ}$, right 2.01$^{\circ}$. Knee varus showed left 26.90$^{\circ}$, right 30.93$^{\circ}$; 3) The maximum knee flexion moment showed left 0.363 Nm/kg, right 0.464 Nm/kg, The maximum knee extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximum knee adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg. The maximum internal rotational moment showed left 0.13 Nm/kg, right 0.140 Nm/kg; 4) The subjects who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase; and 5) The subjects who had large foot progression angle had statistically lower in knee adduction moment in late stance phase.

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하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가 (Evaluation of Prosthetic Reconstruction in Lower Extremity)

  • 이상훈;오주한;유광현;서성욱;구기형;김한수;임수택
    • 대한골관절종양학회지
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    • 제8권1호
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    • pp.1-11
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    • 2002
  • 목적 : 하지의 골 종양에서 종양 대치물을 이용한 사지 구제술의 기능적 및 방사선학적 결과를 평가하였다. 대상 및 방법 : 종양 대치물을 이용한 사지 구제술을 시행받고 기능적 평가의 설문이 가능하였으며, 방사선학적인 평가를 계속적으로 할 수 있었던 88명을 대상으로 하였고, 평균 추시기간은 76(22~174)개월이었다. 연령(20세 이하 군과 20세 이상 군), 시멘트 사용 여부, 골절제율, 항암치료 여부, 국소 재발 및 원격 전이 여부에 따라 대치물의 생존율, MSTS 기능적 평가와 ISOLS 방사선학적 평가를 시행하였다. 결과 : 종양 대치물의 5년 누적 생존율은 근위 대퇴골에서 100%, 원위 대퇴골에서 83.3%, 근위 경골에서 81.9%이었다. 기능적 점수는 각각 73.3%, 72%, 68.7%이었다. 원위 대퇴골에서 비 항암치료 군의 종양 대치물 생존율이 높았고, 기능적으로는 원위 대퇴골에서 국소 재발이 없는 군과 비 원격 전이 군이, 근위 경골에서 비원격전이 군이 우수하였으며, 방사선학적으로는 원위 대퇴골에서 20세 이상인 군과 시멘트 사용 군에서 골 재형성이 우수하였다. 수술 후 감염과 해리는 종양 대치물 실패의 주요 원인이었다. 결론 : 하지에서 발생한 골 종양의 치료에서 종양 대치물을 사용한 골 종양의 치료는 만족할 만한 방법으로 생각된다. 골 절제율, 항암치료 여부, 국소 재발 및 원격 전이 등이 종양 대치물의 결과에 영향을 미치는 것으로 생각되고, 보다 많은 예를 분석하여 예후 인자를 파악하고 장기적인 추적 조사가 필요할 것으로 생각된다.

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정상인의 오름 경사로 보행 시 경사각에 따른 하지 관절의 삼차원적 동작 분석 (The 3-D Motion Analysis of Kinematic Variety on Lower Extremity during Ramp Ascent at Different Inclinations)

  • 한진태;이종대;배성수
    • The Journal of Korean Physical Therapy
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    • 제17권4호
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    • pp.633-650
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    • 2005
  • The aim of this study was to investigate the kinematics of young adults during ascent ramp climbing at different inclinations. Twenty-three subjects ascended a four step at four different inclinations(level, $8^{\circ},\;16^{\circ},\;24^{\circ}$). The 3-D kinematics was analysed by a camera-based falcon system. Groups difference was tested with one -way ANOVA and SNK test. The different kinematic patterns of ramp ascent were analysed and compared to level walking patterns. The kinematics of ramp walking could be clearly distinguished from the kinematics of level walking. In sagittal plane, Ankle joint was more dorsiflexed at initial contact and Max. dorsiflex. during stance phase with $16^{\circ},\;24^{\circ}$ inclination and more plantarflexed at toe off and Max. plantarflex. during swing phase with $24^{\circ}$(p<.001). Knee joint was more flexed at initial contact with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Hip joint was more flexed at initial contact and Max. flex. during swing phase with $16^{\circ},\;24^{\circ}$ inclination and at toe off with $24^{\circ}$(p<.001) and was more extended at Max. ext. during stance phase with $24^{\circ}$(p<.05). In frontal plane, ankle joint was more everted at Max. eversion. during stance phase with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Knee joint was more increased at Max. varus. during stance phase with $16^{\circ},\;24^{\circ}$ inclination(p<.001). Hip joint was not differentiated with different inclinations. In horizontal plane, all joints were not differentiated with different inclinations. Conclusionally, In ascent ramp walking, the different gait pattern generally occurred at over $16^{\circ}$ on the ascending ramp in sagittal and frontal plane. These results suggest that there is a certain inclination angle or angular range where subjects do switch between a level walking and a ascent ramp walking gait pattern. This shows their motor control strategy between level and ascent ramp walking. Further studies are necessary to confirm and detect the ascent ramp gait patterns.

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보행 장애인을 위한 로봇형 보행훈련 시스템의 개발 (Development of the Robotic Gait Trainer for Persons with Gait Disorder)

  • 황성재;손종상;김정윤;손량희;김영호
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2008년도 심포지엄 논문집 정보 및 제어부문
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    • pp.73-74
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    • 2008
  • In this study, we developed a robotic gait trainer which induces the active gait training based on predefined continuous proper lower extremity joint movements. AC servo motors and linear actuators were used to control hip and knee joints of patients and the weight support system was used to support the patient's weight during the gait training. We also implemented a Gill program to set the gait training pattern with several training parameters and to confirm states of patients and the system through the visual feedback. The effectiveness of the gait training system will be determined by the long-term clinical experiments in the future. We expect that the developed robotic gait training system could be applied very practically to recover gait abilities for persons with gait disorder.

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허약한 노인을 위한 고유수용성 신경근 촉진법과 타이치의 적용에 관한 고찰 (Review of the approach in the PNF and Tai Chi on frail elders)

  • 조정선;배성수;박래준
    • PNF and Movement
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    • 제5권1호
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    • pp.29-35
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    • 2007
  • Purpose : The purpose of this study was investigated to find the approach in the PNF and TC for frail elder Method : This is a literature study with books, articles, seminal note and books for PNF and TC international course. Result : Neural mechanisms contribute significantly to the gains that occur in the range of motion about a joint with stretching exercises. The participation in a stretch-training program decreases tonic reflex activity and increases flexibility and decreases in force production and muscle activation. Also the stretching-induced decreases may be due to a central nervous system inhibitory mechanism. PNF stretch techniques can increase ROM in older adults. These results may differ from those of studies performed with younger populations because of age-related physiologic changes. TC exercise improves balance control and muscle strength and were associated with reorganized lower extremity neuromuscular patterns. Conclusions : The stretch training program of the PNF and TC contribute to increase the balance and coordination for frail elder. Therefore, The frail elder prevent falling. Further study, The PNF and TC be introduced as the new therapeutic intervention for frail elder.

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수근부에 발생한 유골 골종: 증례 보고 (Osteoid Osteoma in Wrist: A Case Report)

  • 이채칠;김상우;정승현
    • 대한골관절종양학회지
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    • 제20권2호
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    • pp.94-98
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    • 2014
  • 유골 골종은 골격계의 모든 부위에서 발생 가능하지만 하지에서 절반 이상이 보고 되고 있고 수근부에서 발생이 드문 것으로 알려져 있다. 임상적으로는 통증이 거의 유일한 증상이며 주로 밤에 악화 되고, asprin이나 다른 NSAIDs에 의해 빠르게 호전 되는 특징이 있다. 저자들은 전형적인 임상양상을 나타냈던 수근부의 유골골종, 증례 2예를 방사선 검사로 진단 후 수술적 치료로 좋은 결과를 얻어 문헌고찰과 함께 보고하는 바이다.

Intraosseous Calcaneal Lipoma with Subtalar Perforation through Cystic Degeneration: A Case Report

  • Kumar, Abhishek;Stephanie, Stephanie;Choi, Jun Young;Chang, Sunhee;Suh, Jin Soo
    • 대한족부족관절학회지
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    • 제19권1호
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    • pp.27-31
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    • 2015
  • Intraosseous lipoma is a benign tumor that originates from proliferating mature lipocytes. It often occurs in the metaphysis of long bones of the lower extremity, and also in the calcaneus, humerus, mandible, sacrum, and rib bones. Frequently, it involutes spontaneously through a process of infarction, calcification, and cyst formation. It can either present as pain, or be asymptomatic and only discovered through an incidental radiological finding. In our case, the patient presented with heel pain. Intraoperatively, it was found that the intraosseous cavity was filled with fat along with an adjacent but separate area of cystic degeneration. There was also a cortical perforation at the cystic lesion which was communicating with the subtalar joint. This cortical breach is most likely the cause of diffuse lateral heel pain experienced by our patient, and such a pathological fracture due to intraosseous lipoma has never been reported.