• Title/Summary/Keyword: Recurrent instability

검색결과 76건 처리시간 0.033초

A Clinical Analysis of Surgical Treatment for Spontaneous Spinal Infection

  • Lee, Dong-Geun;Park, Kyung-Bum;Kang, Dong-Ho;Hwang, Soo-Hyun;Jung, Jin-Myung;Han, Jong-Woo
    • Journal of Korean Neurosurgical Society
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    • 제42권4호
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    • pp.317-325
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    • 2007
  • Objective : The purpose of the study was to determine the clinical effects of anterior radical debridement on a series of patients with spontaneous spinal infection. Methods : We retrospectively analyzed the clinical characteristics of 32 patients who underwent surgical treatment from January 2000 to December 2005 in our department. The average follow-up Period was 33.4 months (range, 6 to 87 months). Thirty-two patients presented with the following : 23 cases with pyogenic spondylitis, eight with tuberculous spondylitis and one with fungal spondylitis. The indications for surgery were intractable pain, failure of medical management, neurological impairment with or without an associated abscess, vertebral destruction causing spinal instability and/or segmental kyphosis. Results : The study included 15 (46.9%) males and 17 (53.1%) females ranging in age from 26 to 75 years (mean, 53.1 years). Diabetes mellitus (DM) and pulmonary Tbc were the most common predisposing factors for pyogenic spondylitis and tuberculous spondylitis. Staphylococcus aureus (13%) was the main organism isolated. The most prevalent location was the lumbar spine (75%). Changes in the pain score, Frankel's classification, and laboratory parameters demonstrated a significant clinical improvement in all patients. However, there were recurrent infections in two patients with tuberculous spondylitis and inappropriate debridement and intolerance of medication and noncompliance. Autologous rib, iliac bone and allograft(fibular) were performed in most patients. However, 10 patients were grafted using a titanium mesh cage after anterior radical debridement. There were no recurrent infections in the 10 cases using the mesh cage with radical debridement. Conclusion : The findings of this study indicate that surgery based on appropriate surgical indications is effective for the control of spinal infection and prevention of recurrence with anterior radical debridement, proper drug use and abscess drainage.

Clinical Outcome after Surgical Treatment of Recurrent Shoulder Dislocation with Small Bony Bankart

  • Kim, Jung-Han;Kim, Chang-Wan
    • Clinics in Shoulder and Elbow
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    • 제18권3호
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    • pp.144-151
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    • 2015
  • Background: The consensus is that a bony Bankart lesion shorter than 25% of the length of glenoid does not affect the clinical result; hence, such lesions were often neglected. However, small bony Bankart lesions are associated with various types of capsulolabral lesions. Methods: A total of 82 patients who had undergone arthroscopic capsulolabral lesion repair surgery for anterior shoulder dislocation were reviewed. The prevalence rates of early and late type of capsulolabral lesions were compared between a group of patients with and a group without small bony Bankart lesions. In addition, the types of accompanying capsulolabral lesion were analyzed according to the type of bony Bankart lesion. Finally, the clinical outcomes were evaluated (active range of motion, American Shoulder and Elbow Surgeons score and Rowe's score). Results: Among the 13 patients who had small bony Bankart lesions, the prevalence rate of early and late type of capsulolabral lesions was 38.5% and 61.5%, respectively. Among the 69 patients without bony Bankart lesion, the prevalence rates of early and late type of capsulolabral lesions were 74% and 26%, respectively. Significantly worse clinical outcome was observed for the group of patients with both small bony Bankart lesions and late type of capsulolabral lesion. Conclusions: More severe type of small bony Bankart lesion appears to be associated with late type of capsulolabral lesion. The significantly worse clinical outcome for patients with both small bony Bankart lesion and late type of capsulolabral lesion indicates that small bony Bankart lesions cannot always be neglected.

외측 거골 골연골 병변에 대한 자가 골연골 이식술 후의 중기 추시 임상결과 (Intermediate-Term Clinical Outcomes after Autologous Osteochondral Transplantation for Lateral Osteochondral Lesions of the Talus)

  • 김성후;조병기
    • 대한족부족관절학회지
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    • 제27권4호
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    • pp.137-143
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    • 2023
  • Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

관절경을 이용한 고 빈도 재발성 전방 견관절 탈구의 재건술 (Arthroscopic Reconstrucion in Megafrequency of Recurrent Anterior Shoulder Dislocations)

  • 고상훈;유총일;조성도;최창혁;전인호;우종근;곽창렬;윤동진;최승원
    • 대한관절경학회지
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    • 제9권2호
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    • pp.194-200
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    • 2005
  • 목적: 수면중 탈구가 동반된 고 빈도를 보이는 재발성 견관절 전방 불안정성의 제한된 증례에서 관절경 술식을 이용한 하 견갑 상완 인대 전대의 축화 성형술과 전하 관절 낭-관절 순 복합체의 상방 전위와 더불어 보조적으로 시행된 후 하방 봉합 축화술, 열선 수축술, 회전간 폐쇄술의 단기 추시 결과와 효용성을 알아보고자 하였다. 재료 및 방법: 1998년 3월부터 2004년 2월까지 수면중 탈구가 동반된 고민도 재발성 탈구를 보인 드문 증례에 대하여 18예의 증례를 분석하였다. 평균 나이는 29.4$(21{\sim}37)$세 였으며, 평균 추시 기간은 22.1$(12{\sim}45)$개월이었다. 술전과 술후 6개월, 1년, 마지막 추시에서 운동 범위와 Rowe점수를 측정하였다. 결과: 우수 6예, 우량 10예로 우량 이상이 88.9%(16예)였으며 보통이 1예, 불량이 1예였다. 결론: 수면중 탈구를 동반한 고 빈도 탈구를 보이는 재발성 전방 견관절 불안정성에서 관절경 하 재건술은 좋은 결과를 보여 관혈적 술식의 대체 방법이 될 수 있지만, 더 많은 증례에 대한 장기 추시가 필요할 것으로 사료된다.

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전방십자인대 재재건술 (Arthroscopic Revision ACL Reconstruction)

  • 안진환
    • 대한정형외과스포츠의학회지
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    • 제2권1호
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    • pp.20-27
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    • 2003
  • 전방십자인대재건술의빈도가증가함에따라실패율도증가되고있다. 전방십자인대재건술의실패원인중수술수기의잘못이가장흔한원인으로보고되고있다. 이에그실패의원인과재재건술의수기의문제점에대하여알아보고자한다.

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소아에서 발생한 전거비 인대 거골 부착부 견열 골절(1예 보고) (Avulsion Fracture of the Talar Attachment of the Anterior Talofibular Ligament in Pediatric Patient (A Case Report))

  • 조형래;황태혁;왕태현;김근영
    • 대한족부족관절학회지
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    • 제15권3호
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    • pp.175-178
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    • 2011
  • Inversion injury of the lateral ankle ligaments is very common. Few studies, however, have focused on avulsion fracture of the lateral ankle ligaments. A fracture producing a small fragment usually avulsed from lateral malleolus and may be easily misdiagnosed as a sprain because the fragment is superimposed on the lateral malleolus and goes undetected on early radiographs, especially in skeletally immature patients. We present a case of isolated avulsion fracture of the talar attachment of the anterior talofibular ligament in 13-year-old male patient. Diagnosis was confirmed by computed tomography and avulsed fragment was fixed to original talar footprint with suture anchors. A high level of suspicion must be maintained to obtain an accurate diagnosis of avulsion fracture in inversion ankle injury because of the high incidence in children and to prevent recurrent instability.

테이핑과 극초단파를 적용 후 가상현실 운동 프로그램이 기능적 발목 불안정성 균형에 미치는 효과 (Effects of Virtual Reality Exercise Program after Applying Taping and Microwave on Balance with Functional Ankle Instability)

  • 정찬주;김기종;양회송;유영대
    • 대한통합의학회지
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    • 제5권3호
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    • pp.63-70
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    • 2017
  • Purpose : The purpose of this study was to investigate the effects of the virtual reality exercise program on ankle balance with ankle taping or microwave. Methods : This study was performed on 18 subjects. Eighteen subjects were divided into two groups; conducted virtual reality exercises with taping (n=9), and performed virtual reality exercises after microwave application (n=9). Both groups performed the exercise three times a week for four weeks. The data was analyzed by the Wilcoxon signed-rank test for comparing before and after changes of factors in each group and performed the Mann-Whitney test for comparing groups. Result : Taping and microwave groups were increased dynamic balance after virtual reality exercises (p<.05). There was no significant difference in balance after applying taping and microwave for virtual reality exercises (p<.05). Conclusion : Reducing the frequency of recurrent ankle sprain in functional ankle subjects, it is recommended to perform virtual reality exercise after applying taping and microwave.

Immediate Effects of Joint Mobilization Techniques on Clinical Measures in Individuals with CAI

  • Kim, Byong Hun;Kim, Chang Young;Kang, Tae Kyu;Cho, Young Jae;Lee, Sae Yong
    • 한국운동역학회지
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    • 제28권4호
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    • pp.219-225
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    • 2018
  • Objective: Epidemiological research shows that 47 to 73% of athletes suffer from recurrent ankle sprains. Joint mobilization techniques (JMT) implemented in correcting may be beneficial in the management of ankle injuries. The purpose of this study is to examine the immediate JM on ankle complex as clinical measures in individuals with chronic ankle instability (CAI) through intervention. Method: Thirteen subjects with CAI (8 males and 5 females) participated in this study. Each subject tried total four alignments (Navicular drop test: NDT, Standing rearfoot angle: SRA, Tibia torsion: TT, and dorsiflexion range of motion: DFROM). The participants were performed the 10 meter shuttle run after JMT for post-task. Finally, it was tried to compare between pre-post tasks after shuttle run. Results: SRA and DFROM after intervention showed significant differences. SRA (p=.026), and DFROM (p=.034). Conclusion: We concluded that the JMT has resulted in improvement in SRA, DFROM. Increased DFROM and varus shapes of foot would be closed kinetic chain, indicating that reduce the risk factors of ankle sprain. Future study needs to be conducted in order to measure the effects of prolonged intervention of JMT.

The Immediate Effects of Elastic Taping on Center of Pressure and Foot Pressure Distribution

  • Jung-Hee Kim;Jong-Ho Kook;Sang-Mi Lee;Eun-Bin Ko;Song-Yi Han;Yeon-Jeong Kim;Byeong-Jun Min
    • PNF and Movement
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    • 제22권1호
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    • pp.23-30
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    • 2024
  • Purpose: Ankle instability is a common issue in both daily activities and sports, often leading to recurrent injuries. Elastic taping is a non-pharmacological intervention used to improve ankle stability. This study aimed to investigate the immediate effects of elastic taping on ankle stability, center of pressure (COP) movement, and foot pressure distribution. Methods: A single-group pre-posttest design was employed, with 30 participants included in the study. Plantar pressure and COP parameters were measured before and after the application of elastic taping. Taping was administered in three distinct patterns to enhance ankle stability. Results: Immediate effects of elastic taping were evident in COP parameters. Following taping application, there was a significant decrease in COP total displacement, COP area, and COP velocity. However, no significant changes were observed in plantar pressure parameters. Conclusion: The application of elastic taping in this study demonstrated immediate effects on ankle stability and COP parameters, indicating its potential as a viable intervention for improving balance. Further research with larger sample sizes and long-term follow-up is needed to elucidate the sustained effects of elastic taping on ankle stability.

견관절 전방 불안정성에서 Bankart 병변과 ALPSA 병변 (Bankart Lesion and ALPSA Lesion in Anterior Instability of the Shoulder)

  • 김영규;안승준;고영환
    • 대한관절경학회지
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    • 제9권2호
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    • pp.186-193
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    • 2005
  • 목적: ALPSA(anterior labroligamentous periosteal sleeve avulsion) 병변과 Bankart 병변을 관절경하에서 구별할 수 있는지를 알아보고자 하였으며 ALPSA 병변의 임상적 의의를 알아보고자 하였다. 대상 및 방법: 견관절의 전방 불안정성으로 관절경하에서 Bankart 복원술을 시행한 66예를 대상으로 하였다. 자기 공명 영상의 판독상 Bankart 병변은 56예(85%) ALPSA 병변은 10예(15%)였다. 각 병변의 관절경 소견을 분류하였으며 결과는 평균 22개월 추시하였다. 결과: Bankart 병변 보다 ALPSA 병변의 발생 시기가 보다 젊은 층에서 발생하였다 관절경하에서 ALPSA 병변은 여러 형태를 보였으며 특히 하내측으로 많은 전위를 보인 경우가 5예에서 관찰되었다. Bankart 병변도 심한 전위를 보인 경우가 21예였으며 견갑 경부로부터 뚜렷하게 외측 전위되지 않고 하내측으로 전위된 경우는 관절경하에서 ALPSA 병변과 구별하기 어려웠다. 재발은 ALPSA 군에서는 재탈구는 없었으나 불안감이 2예(20%)에서 있었고 하내측으로 많은 전위를 보인 예에서 나타났으며, Bankart 군에서는 재탈구 1예, 아탈구 1예, 불안감 2예로 총 4예(7.1%)에서 있었다. 결론: 하내측으로 심하게 전위된 Bankart 병변과 ALPSA 병변은 식별이 용이하지 않았으며 전위가 심한 ALPSA 병변에서 재발율이 높았다. 따라서 복원술시 ALPSA 병변을 철저하게 재분리하는데 보다 주의가 요할 것으로 사료된다.

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