• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.140-145
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• 2011

Purpose: Installing a radial head prosthesis has developed into a reliable procedure to replace the native radial head for treating unreconstructible radial head fracture when this is associated with an unstable elbow or forearm. A variety of implants have been developed and these are now commercially available. This article reviews the literature related to the indications, the available implants and the surgical techniques of radial head replacement arthroplasty. Materials and Methods: The main indication for a metallic radial head prosthesis is a comminuted fracture that is not amenable to reconstruction, and particularly if it is associated with complex elbow injuries. Excision of the radial head should be avoided in the presence of combined injured ligaments or interosseous membrane injury. Three different implants are available in Korea, including the bipolar, press fit monopolar and loose fit monopolar radial head prostheses. A primary technical goal of radial head arthroplasty is the insertion of an implant that closely replicates the native radial head. The major pitfall when using a metallic radial head prosthesis is the insertion of a longer implant, which results in overstuffing of the radiocapitellar joint. Results and Conclusion: Satisfactory clinical results can be anticipated when a radial head prosthesis is used for the correct indications and when a systemic approach is undertaken to ensure proper sizing. For the future studies, we need data regarding the long term outcomes and comparison of the various types of prostheses.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.293-298
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• 2010

Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.50-59
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• 2006

Purpose: The nonoperative outcome of elbow dislocations with associated radial head and coronoid fractures are often unsatisfactory because of chronic instability and stiffness from proloned immobilization, Therefore we managed these injuries with well programed surgical appproaches. Method: Ten patients with this injury were evaluated retrospectively from May 1998 to June 2004 after a minimum of 12 months. These injuries include elbow dislocation and associated fractures of both the radial head and the coronoid process. All ten patients were treated by one clinic operatively with similar scheduled surgical methods which started on the lateral side and terminated on the medial side of the elbow. Radial head and neck fractures were classified Mason types, as two and three types respectively with six and four cases and six cases were fixated. Coronoid process were fixated with screws anteroposterior directly or anchor suture in all cases, each type was classified one, two and three. where were three type one, four type two, and three type three were according to Regan and Morrey classification. Results: The outcome was three resulting in excellent, four good, two normaland and the remaining case was one poor according to the Mayo Elbow Performance score. At a terminal follow up, the range of motion of the elbow averaged flection contracture, $6^{\circ}(0{\sim}20^{\circ})$ and further flection, $129^{\circ}(115{\sim}140^{\circ})$. Two patients had complications requiring additional care. One, displaced coronoid process which was repaired with capsule and the other patient experienced, palsy of ulnar nerve and contracted elbow joint. Conclusions: Usage of early operation as the minimum injury of medial ligaments complex and the rigid fixation of fractures to prompt motion with our scheduled management for elbow dislocations with associated radial head and coracoid fractures provided excellent results.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.100-106
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• 2013

Purpose: The purpose of this study is to evaluate the relationship between trochlear medial facet osteophyte (TMFO) and elbow flexion in the elbow joints without trauma history. Materials and Methods: Twenty five patients, who underwent computed tomography without elbow trauma history, were reviewed. Patients were checked for osteophyte or loose bodies in the coronoid and olecranon sides. The height and length of TMFO were measured. Results: The average elbow flexion contracture was $18.6^{\circ}$, and further flexion was $112.1^{\circ}$. The TMFO height and length was 2.2 mm and 4.7 mm, respectively. The average elbow further flexion was $105.1^{\circ}$ in the coronoid block group (n=14) and $119.1^{\circ}$ (p=0.011) in the coronoid free group (n=11). The relationship between further elbow flexion and TMFO was significant with a partial correlation coefficient of 0.687(p<0.000) in the TMFO length. Conclusion: Elbow joints with longer TMFO length decrease further flexion.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.170-177
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• 2013

Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.169-178
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• 2010

Objective. This study was conducted to observe the effect on appendage muscle strength according to increase in occlusal vertical dimension. Materials and methods. Ten males with a mean age of 21 were selected. The tested occlusal splints were made at the position of increased occlusal vertical dimension of 2mm,3.5mm and 5mm from the intercuspal position. Before and after wearing occlusal splints, the appendage muscle strength were tested by Cybex II dynamometer (Lumex Inc., Ronkonkoma, NY, USA). Results. Statistical analysis using the paired t-test revealed significant differences for flexion and extension of the hip, pronation of the forearm, internal rotation of the shoulder, external and internal rotation of the knee, and dorsiflexion and plantarflexion of the ankle (p<0.05). Conclusions. As the result of this study, we conclude that when occlusal vertical dimension was increased, most of mean muscular strength values were increased. Especially at the position of 3.5mm increased vertical dimension displayed the highest mean muscular strength value than other positions.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.142-149
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• 2009

Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.513-519
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• 2021

Metallic suture anchors are very useful and common fixation devices that are inserted into the target bone to sustain the tendon of a patient with musculus supraspinatus tendon ruptures. On the other hand, the presence of a metallic material prosthesis, such as a metal suture anchor, causes severe MR imaging artifacts, including field distortion, signal loss, and failure of fat suppression. The difference in magnetic susceptibility between metal and other organic materials causes magnetic field distortion surrounding the prosthesis. The resulting magnetic field inhomogeneity makes the images with a lower signal-to-noise ratio and distortion. For a patient with a suture anchor implanted, MR imaging is the golden standard for determining the postoperative prognosis, and a fat-saturation sequence is one of the imaging methods most affected by metal-induced artifacts. In this study, three fat-saturation sequences were compared. Artifact quantification and contrast comparison between the supraspinatus tendon and the surrounding muscle were presented. The images obtained using the STIR pulse sequence showed fewer susceptibility artifacts and better visibility in the supraspinatus tendon and the tissue area. Therefore, the STIR sequence is the most appropriate fat-saturation imaging method for patients with a metallic prosthesis.

• Journal of the Korean Geotechnical Society
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• v.24 no.11
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• pp.111-120
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• 2008

The characteristic of induced anisotropy is investigated in this study for the Pohang mudstone involving the cut plane discontinuity. The uniaxial and triaxial compression tests are performed for anisotropic rocks with artificial joint to look into anisotropic strength characteristics. Both the uniaxial compressive strength and triaxial compressive strength show the lowest value at the angle of cut plane, ${\beta}=30^{\circ}$ and the shoulder type of anisotropy is obtained. Anisotropy ratio (Rc) in uniaxial compression measures 9.0, whereas Rc=1.29-1.98 in triaxial compression is appeared. A series of analyses are made with the test results to derive the suitable parameter values when it is applied to the Ramamurthy (1985) failure criterion. The result of uniaxial compression test is analyzed by introducing the n-index into Ramamurthy failure criterion. The result shows that, n=l is suitable for ${\beta}=0^{\circ}{\sim}30^{\circ}$ and n=3 is suitable for ${\beta}=30^{\circ}{\sim}90^{\circ}$. To analyze the result of triaxial compression test by Ramamurthy failure criterion, anisotropy ratio in uniaxial compression test is added to Ramamurthy's equation and material constants are estimated by modified Ramamurthy's equation. When these values are applied back to Ramamurthy failure criterion, the predicted values are well fitted to the test results. And strength anisotropy for failure criteria of Jaeger (1960), McLamore & Gray (1967) and Hoek & Brown (1980) are also investigated.

• Journal of Acupuncture Research
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• v.27 no.6
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• pp.115-122
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• 2010

Objectives : The purpose of this study was to propose the utilization plan of Ryodoraku in the U-health care systems. Methods : Computerized literature searches were performed for Ryodoraku related articles using the following databases: KISS, RISS, DBPIA, NDSL from 1990 to Oct 2010. Search terms were '양도락' or 'Ryodoraku' or 'U-health'. Due to Ryodoraku coming from Japan, additional literature review(articles published by 2008) on Japanese journal of Ryodoraku medicine was done for compensation. Results : 1. Introduction of U-health : As rapid progress of population aging and strong interest in health, the demand for the traditional Korean medical service is increasing. Until now healthcare service has provided post treatment by face-to-face manner. But according to related researches, proactive treatment is resulted to be more effective for preventing diseases. Particularly, the existing healthcare services have limitations in preventing and managing chronic geriatric degenrative diseases such as metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis, etc., because the cause of the above is complex and even related to life habit. As the advent of ubiquitous technology, patients with the chronic geriatric degenrative diseases can improve life habit such as poor eating habits and physical inactivity without the constraints of time and space through u-healthcare service. Therefor, lots of researches for u-healthcare service focus on providing the personalized healthcare service for preventing and managing that. To cope with this situations, The concept of u-healthcare service should be adopted in the traditional korean medicine and diagnostic devices suitable for it should be also devised and developed based on traditonal korean medine. 2. Review of existing Ryodoraku related articles for applying to U-health : articles investigating feasibility applying Ryodoraku to meridian diagnosis and raising problems of it, articles providing recent research trends of Ryodoraku, Ryodoraku related articles considering usefulness for U-health, and articles confirming the repeatability and reproducity of Ryodoraku were included. Based on the review of the above Ryodoraku related articles, several application of Ryodoraku in the U-health care system. Conclusions : To make preparations for the increasing need of traditional Korean medicine due to rising morbidity rate of chronic geriatric degenerative diseases, it is necessary to appropriately apply Ryodoraku to the U-health care system. The application of Ryodoraku is as follows. 1. To use Ryodoraku additionally to the established diagnostic device of metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis. 2. To apply Ryodoraku to the symptoms or diseases having a tendency to be diagnosed by correlation between the affected meridian and the lesion such as headache, nuchal pain, shoulder pain, low back pain, sciatica, HNP, etc. 3. To secure the repeatability and reproducity of Ryodoraku. 4. To devise and develop Ryodoraku appliance in order to overcome the known drawbacks and to improve error of measurement.