• 제목/요약/키워드: ankle injuries

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Ender Nail을 이용한 경골간부 골절의 치료 (Treatment of the Tibia Shaft Fractures with Ender Nails)

  • 김인기;이동철;서재성;안면환;김세동;안종철
    • Journal of Yeungnam Medical Science
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    • 제9권1호
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    • pp.130-136
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    • 1992
  • 본 영남대학교 의과대학 부속병원 정형외과에서는 1986년 12월에서 1991년 11월까지 경부 간부 골절 31례에 대하여 Ender nail을 시행하여 다음과 같은 결과를 얻었다. 1. 환자의 평균연령은 37.3세였고, 남자에게서 3배가 많았으며, 교통사고가 가장 많은 원인이었다(67%). 2. 폐쇄성 골절이 20례, 개방성 골절이 11례였으며, 분쇄골절과 분절골절이 18례(57.7%)였고, 중간부 골절이 16례로 가장 많았다. 3. 동반손상이 19례에서 있었고, 수상후 수술까지의 기간은 평균 7.6일이었다. 4. 평균 골유합 기간은 18.9주였으며, 2례에서 지연유합을 보였다. 5. 합병증으로 하지 단축이 2례, 각형성 변형이 3례, 관절 운동 제한 2례, 감염이 연부조직에 1례 있었다. 이상 경골 간부골절 치료에 사용한 Ender nail은 시술의 간편성, 적절한 고정성과 운동성, 비교적 폭넓은 적용 범위등으로 좋은 치료 결과를 기대할 수 있는 방법으로 사료된다.

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프로 축구팀의 시즌 전 체력검사 (Pre-seasonal Physical Examination of Professional Soccer Team)

  • 이경태;최병옥
    • 대한정형외과스포츠의학회지
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    • 제5권2호
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    • pp.129-134
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    • 2006
  • 목적: 국내 프로 축구팀에서 시즌 전 체력검사를 시행하여 포지션에 따른 자료를 분석하고 표준화하고자 했다. 대상 및 방법: 34명으로 구성된 한 개의 축구팀을 대상으로 시행하였으며 평균 나이 24.9세였다. 설문지를 통한과거 병력 조사, 이학적 검사를 통한 근 골격계 검사, 등속성 근력기기를 이용한 근력 검사, 생리적 검사, 기능적 검사를 시행하고 포지션에 따른 차이를 분석하였다. 결과: 과거력 상 슬관절 손상이 23예 중 11 예(47%)로 가장 빈번했고, 이학적 검사 결과 총 40예 중 족관절 손상이 14예 (46%)로 슬관절 손상 11예 (24%)보다 많은 손상이 있었다. 위치 별로 공격수는 장무지 굴곡 건염, 미드필드는 만성 족관절 불안정성 수비수는 아킬레스 건염이 많았고 근력 검사상 우세 $60^{\circ}$ 신전/굴곡 체중당 최대 염력비 평균이 55.1%였다. 생리학적 검사상 미드필드 체 지방율이 17.8% (표준편차 2.9)로 높게 측정되었고 기능적 검사 결과 배근력 125.5N (표준편차 28.3), 서전트 점프 59.6cm, 반응시간 208 5초, 유연성 19.2 m/s, 사이드 스텝 39.9 cm였다. 결론: 시즌 전 체력검사를 통하여 선수들의 체력을 평가하고 이를 기초로 하여 재 손상에 대한 예방적 수단을 강구 할 수 있다.

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Comparison of Biomechanical Characteristics for the Skill Level in Cycle Pedaling

  • Lee, Geun-Hyuk;Kim, Jai-Jeong;Kang, Sung-Sun;Hong, Ah-Reum;So, Jae-Moo
    • 한국운동역학회지
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    • 제26권1호
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    • pp.11-20
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    • 2016
  • Objective: This study aimed to compare biomechanical data between elite and beginner cyclists during cycle pedaling by performing a comparative analysis and to provide quantitative data for both pedaling performance enhancement and injury prevention. Methods: The subjects of this study included 5 elite cyclists (age: $18{\pm}0years$, body mass: $64.8{\pm}9.52kg$, height: $173.0{\pm}4.80cm$) and 5 amateur cyclists (age: $20{\pm}0years$, mass: $66.6{\pm}2.36kg$, height: $175.6{\pm}1.95cm$). The subjects pedaled on a stationary bicycle mounted on rollers of the same gear (front: 50 T and rear: 17 T = 2.94) and cadence of 90. The saddle height was adjusted to fit the body of each subject, and all the subjects wore shoes with cleats. In order to obtain kinematic data, 4 cameras (GR-HD1KR, JVC, Japan) were installed and set at 60 frames/sec. An electromyography (EMG) system (Telemyo 2400T, Noraxon, USA) was used to measure muscle activation. Eight sets of data from both the left and right lower extremities were obtained from 4 muscles (vastus medialis oblique [VMO], vastus lateralis oblique [VLO], and semitendinosus [Semitend], and lateral gastrocnemius [Gastro]) bilaterally by using a sampling frequency of 1,500 Hz. Five sets of events ($0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, and $360^{\circ}$) and 4 phases (P1, P2, P3, and P4) were set up for the data analysis. Imaging data were analyzed for kinematic factors by using the Kwon3D XP computer software (Visol, Korea). MyoResearch XP Master Edition (Noraxon) was used for filtering and processing EMG signals. Results: The angular velocity at $360^{\circ}$ from the feet was higher in the amateur cyclists, but accelerations at $90^{\circ}$ and $180^{\circ}$ were higher in the elite cyclists. The amateur cyclists had greater joint angles at $270^{\circ}$ from the ankle and wider knee joint distance at $0^{\circ}$, $180^{\circ}$, and $360^{\circ}$ than the elite cyclists. The EMG measurements showed significant differences between P2 and P4 from both the right VLO and Semitend. Conclusion: This study showed that lower body movements appeared to be different according to the level of cycle pedaling experience. This finding may be used to improve pedaling performance and prevent injuries among cyclists.

비복근을 이용한 교차하지 근육 피판술 (The Cross-Leg Gastrocnemius Muscle Flap for Leg Reconstruction of the Difficult and Unfavorable Conditions)

  • 김지예;양은정;황은아;김석원
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.583-590
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    • 2009
  • Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.

오르막보행 시 타이거스텝 하지 움직임에 미치는 영향 (Effect of Tiger Step on Lower Extremities during Uphill Walking)

  • Kang, Jihyuk;Yoon, Sukhoon
    • 한국운동역학회지
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    • 제32권1호
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    • pp.17-23
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    • 2022
  • Objective: The aim of this study was to investigate the effect Tiger-step walking on the movement of the lower extremities during walking. Method: Twenty healthy male adults who had no experience of musculoskeletal injuries on lower extremities in the last six months (age: 26.85 ± 3.28 yrs, height: 174.6 ± 3.72 cm, weight: 73.65 ± 7.48 kg) participated in this study. In this study, 7-segments whole-body model (pelvis, both side of thigh, shank and foot) was used and 29 reflective markers and cluster were attached to the body to identify the segments during the gait. A 3-dimensional motion analysis with 8 infrared cameras and 7 channeled EMG was performed to find the effect of tigerstep on uphill walking. To verify the tigerstep effect, a one-way ANOVA with a repeated measure was used and the statistical significance level was set at α=.05. Results: Firstly, Both Tiger-steps showed a significant increase in stance time and stride length compared with normal walking (p<.05), while both Tiger-steps shown significantly reduced cadence compared to normal walking (p<.05). Secondly, both Tiger-steps revealed significantly increased in hip and ankle joint range of motion compared with normal walking at all planes (p<.05). On the other hand, both Tiger-steps showed significantly increased knee joint range of motion compared with normal walking at the frontal and transverse planes (p<.05). Lastly, Gluteus maximus, biceps femoris, medial gastrocnemius, tibialis anterior of both tiger-step revealed significantly increased muscle activation compared with normal walking in gait cycle and stance phase (p<.05). On the other hand, in swing phase, the muscle activity of the vastus medialis, biceps femoris, tibialis anterior of both tiger-step significantly increased compared with those of normal walking (p <.05). Conclusion: As a result of this study, Tiger step revealed increased in 3d range of motion of lower extremity joints as well as the muscle activities associated with range of motion. These findings were evaluated as an increase in stride length, which is essential for efficient walking. Therefore, the finding of this study prove the effectiveness of the tiger step when walking uphill, and it is thought that it will help develop a more efficient tiger step in the future, which has not been scientifically proven.

대퇴신경 손상 환아의 보행분석 : 사례연구 (Gait Analysis of a Pediatric-Patient with Femoral Nerve Injury : A Case Study)

  • 황선홍;박선우;손종상;박정미;권성주;최익선;김영호
    • 대한의용생체공학회:의공학회지
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    • 제32권2호
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    • pp.165-176
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    • 2011
  • The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.