• Title/Summary/Keyword: Microtrauma

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THE RELATIONSHIP BETWEEN TRAUMA AND TEMPOROMANDIBULAR JOINT DISORDER (외상과 턱관절 장애 연관성에 관한 연구)

  • Kim, Young-Kyun;Yun, Pil-Young;Ahn, Min-Seok;Kim, Jae-Seun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.375-380
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    • 2009
  • Objective : Trauma has been a controversial issue although it has been considered to be a major factor for the temporomandibular disorder(TMD). We evaluated the relationship between macrotrauma or microtrauma and TMD. Methods : This study was performed in patients with TMD undergoing treatment at SNUBH from October 2006 to January 2007. Sixty one male patients and 166 female patients(total 227) were included and the average age was 34 years(ranging from 14 to 85 years). We investigated the possible etiologic factors, diagnosis and treatment with the review of medical records and radiography. Chronic pain, depression, somatic score(including pain item), somatic score(excluding pain item) were evaluated on the basis of diagnostic index from the Research Diagnostic Criteria on TMD. Results : Eighteen patients(7.9%) out of 227 patients suffered from TMD as a result of macrotrauma. Ninety four(41.4%) patients had microtrauma and six patients(2.6%) had both macro- and microtrauma(etiologic factor). The main symptoms included pain. joint noise and mouth opening limitation while the other symptoms were headache and tinnitus. The patients had suffered from TMD for average 41 weeks (ranging from 1 to 480 weeks). 116 patients took splint as a major treatment. As a prognosis, 19 patients(8.4%) recovered completely. 26(11.0%) had improvement and 181(80%) had persistent symptoms. 1 patient(0.4%) underwent an arthroplasty. Diagnostic index from RDC chart showed that macrotrauma was the highest score(except depression score) among the other etiologic factors. Conclusion : This study showed that macro- and microtrauma can be considered to be the major etiologic factors of TMD, which also affect the chronic, depression and somatic discomfort.

Dynamic Contrast-Enhanced MR Imaging of Tietze's Syndrome: a Case Report

  • Kim, Dong Chan;Kim, Sang Yoon;Kim, Bong Man
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.1
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    • pp.55-60
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    • 2020
  • Tietze's syndrome is an inflammatory condition associated with painful swelling of the costochondral, costosternal, and sternoclavicular joints. Tietze's syndrome has been mostly attributed to microtrauma until now; however, this etiology is currently disputed. The diagnosis is based on clinical findings, although a few studies suggest the advantages of imaging. We report a case of Tietze's syndrome with a review of radiological findings, especially magnetic resonance imaging (MRI) with dynamic contrast enhancement.

Charcot Spine Treated Using a Single Staged Posterolateral Costotransversectomy Approach in a Patient with Traumatic Spinal Cord Injury

  • Kim, Tae-Woo;Seo, Eun-Min;Hwang, Jung-Taek;Kwak, Byung-Chan
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.532-536
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    • 2013
  • Charcot spine is a progressive and destructive process that affects the vertebral bodies, intervertebral discs, and posterior facets. It is the result from repetitive microtrauma in patients who have decreased joint protective mechanisms due to loss of deep pain and proprioceptive sensation, typically because of spinal cord injury. The objective of the study is to report an unusual case of Charcot spine, as a late complication of traumatic spinal cord injury, treated by a circumferential arthrodesis performed with a single staged posterolateral costotransversectomy approach.

Partial-Thickness Rotator Cuff Tears

  • Shin, Keun-Man
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.69-73
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    • 2011
  • Although the incidence of partial-thickness rotator cuff tears (PTRCTs) was reported to be from 13% to 32% in cadaveric studies, the actual incidence is not yet known. The causes of PTRCTs can be explained by either extrinsic or intrinsic theories. Studies suggest that intrinsic degeneration within the rotator cuff is the principal factor in the pathogenesis of rotator cuff tears. Extrinsic causes include subacromial impingement, acute traumatic events, and repetitive microtrauma. However, acromially initiated rotator cuff pathology does not occur and extrinsic impingement does not cause pathology on the articular side of the tendon. An arthroscopic classification system has been developed based on the location and depth of the tear. These include the articular, bursal, and intratendinous areas. Both ultrasound and magnetic resonance image are reported with a high accuracy of 87%. Conservative treatment, such as subacromial or intra-articular injections and suprascapular nerve block with or without block of the articular branches of the circumflex nerve, should be considered prior to operative treatment for PTRCTs.

Facial hematoma induced spontaneously or by minimal trauma in a facial plexiform neurofibroma: a case report and literature review

  • Sang Min Lee;Dae Ho Leem
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.152-156
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    • 2023
  • Plexiform neurofibroma is a rare benign tumor and a special subtype of neurofibromatosis 1. This report is a literature review with a case of patient with facial hemorrhage observed at the site of neurofibroma removal in the right lower face due to minor trauma. Through PubMed search, using terms ((facial hematoma) OR (facial bleeding)) AND (neurofibromatosis), 86 articles were identified, and five related articles (six patients) were finally selected. Of the six patients, two had previously undergone embolization. However, as a result, all patients received open surgery to remove hematomas. The hemostatic methods mentioned were vascular ligation (five patients), hypotensive anesthesia (two patients), and postoperative blood transfusion (four patients). In conclusion, spontaneous or minimally traumatic bleeding is possible in neurofibromatosis patients. In most cases, it can be resolved by vascular ligation under hypotensive anesthesia. Optionally, prior embolization and supplementary tissue adhesive may be used.

Long-Term Evaluation of Conservative Treatment for Craniomandibular Disorders (두개하악장애환자의 보존적 치료에 관한 장기평가)

  • June-Sang Park;Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • v.18 no.2
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    • pp.81-96
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    • 1993
  • In order to evaluate the prognosis of conservative treatment for Craniomandibular Disorders, 127 patients were subjected at the Dept. of Oral Medicine, Pusan National University Hospital from 1983 through 1991. All the changes of patients' symptoms and related factors were analyzed before treatment, after treatment and at follow-up examination by means of subjective and objective symptom indicies (Ai, AAI, SDS, Di, CDS, MCO). 1. All the indices were reduced and MCO became increased at follow-up examination (p<0.01). 2. As the duration after treatment became longer, all the indices became reduced and MCO became increased. 3. There were no significant differences in index scores according to sex and age. 4. Long-term patients showed higher index scores and lower MCO than short-term patients(p<0.01). 5. Chronic group showed higher index scores and lower MCO than acute group (p<0.05). 6. Macrotrauma group showed higher index scores and lower MCO than microtrauma group (p<0.05) 7. While muscle group showed the lowest MCO, muscle and joint group showed the highest index scores (p<0.01). 8. The long-term success rate of conservative treatment was more than 80% (p<0.01)

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The Weight Lifters' Shoulder (역도(力道)선수에서 견관절 질환)

  • Jeon, In-Ho;Kyung, Hee-Soo
    • Clinics in Shoulder and Elbow
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    • v.5 no.2
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    • pp.73-80
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    • 2002
  • Purpose: Weight lifting is a good training to control body weight, to correct body shape and to relieve stress. How-ever if the training is continued by inadequate training method and technique, the risks of the shoulder injuries are relatively high. Main Subject: The rotator cuff injury is the most common disorder to wright lifters and often results from the train- ing program of upright row, military press and pectoral deck. The chances of subacromial impingement in these postures are high because the shoulder rotates under the acromion at 90 abduction state. Shoulder instability in weight lifters can develop due to various causes. aepeated microtrauma and excessive abduction and external rotation may result in laxity of the anterior capsular structure, ligament and muscles. Behind the neck and bench press are high risk training postures. Other than those injuries, idiopathic osteolysis of distal clavicle, acromioclavicular separation, pectoralis major muscle rupture, and triceps muscle rupture nay develop. Conclusion: The best treatment option of the shoulder injury to weight lifters is to eliminate the possible risk elements for the weight lifters in training program and to provide proper and prompt treatment as soon as possible.

Study of spnial segmental stabilization for OMT in low back pain (요통 환자의 정형물리치료를 위한 척추분절 안정성에 관한 고찰)

  • Chang, Moon-Kyung
    • Journal of Korean Physical Therapy Science
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    • v.7 no.2
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    • pp.415-425
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    • 2000
  • It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.

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Clinical Features of the TMD Patients with Degenerative Joint Disease (퇴행성 악관절장애환자의 임상양태에 관한 연구)

  • Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • v.20 no.2
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    • pp.257-267
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    • 1995
  • An Epidemiologic study was carried out on 77 TMD patients with degenerative joint disease who had visited the Orofacial Pain Clinic in Pusan National University Hospital. Al subjects were interviewed and examined clinically and radiologically using a standardized examination form. As related to gender and duration, subjective and objective sysmptoms in DJD patients were studied. The obtained results were as follows : 1. There were much more patients in the twenties or thirties, women and histories such as chronic duration and microtrauma. 2. Most patients responded positively more often to the questions of jaw function, unilateral chewing in habits, poot appetite and depression in behavioral response and shoulder pain in worsening prognosis 3. While the most common reasons for treatment were pain, noise, and limitation of opening, the associated symptoms such as headache, neckache, earache, jaw dysfunction, neck dysfunction, acute bite change and dizziness, ringing or fullness in the ears as secondary CNS excitatory effects were complained. 4. Opening the mouth in 25 to 40mm, soft end feel and deflective incisal pathway were seen and more tenderness to lateral or dorsal capsule of joint than intra or extra oral muscles were complained. 5. While there appeared no click, crepitus and single click in acute group, in chronic group, crepitus, single click and no click appeared in order of sequence. 6. Tomogram or bone scan revealed more bony changes than panorama and transcranial view.

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Treatment approach for the movement dysfunction of the shoulder girdle (견갑대 운동 기능장애에 대한 치료 접근)

  • Jang, Jun-Hyeok;Lee, Hyun-Ok;Koo, Bong-Oh
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.412-430
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    • 2003
  • Functional stability is dependent on integrated local and global muscle function. Movement dysfunction can present as a local and global problem, though both frequently occur together. To good understand how movement induces pain syndrome, the optimal actions and interaction of the multiple anatomic and functional systems involved in motion must be considered. Minor alterations in the precision of movement cause microtrauma and, if allowed to continue, will cause macrotrauma and pain. These alteration of the movement result in the development of compensatory movement and movement impairment. Muscle that become tight tend to pull the body segment to which they are attached, creating postural deviation. The antagonistic muscles may become weak and allow postural deviations due to lack of balanced support. Both hypertonic and inhibited muscles will cause an alteration of the distribution of pressure over the joint(s) that they cross and, thus, may not only result from muscle dysfunction, but produce joint dysfunction as well. Alteration of the shoulder posture and movement dysfunction may sometimes result in compression of neurovascular structures in the shoulder and arm. There is a clear link between reduced proprioceptive input, altered motor unit recruitment and the neurovascular compression. This report start with understanding of the impaired alignment, movement patterns and neuromuscular compression of the shoulder girdle by movement impairment to approach method of the movement dysfunction.

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