• Title/Summary/Keyword: fascia

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Ultrasonographic Appearances of the Plantar Fasciitis (족저 근막염의 초음파 영상학적 형태)

  • Hong, Seung-Hwan;Chu, In-Tak;Chung, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.145-148
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    • 2007
  • Purpose: This retrospective study was designed to evaluate the appearances of plantar fasciitis by ultrasonography. Materials and Methods: 48 cases of unilateral plantar fasciitis were enrolled in this study. Plain radiograph and realtime sonography of both feet were perfomred and the results were compared between the affected feet and controlateral symptomless feet. Calcaneal spur were observed on plain radiograph and thickness of plantar fascia, hypoechogenecity, blurring of border of plantar fascia, perifascial effusion, wavy plantar fascia were observed on sonography. Results: Women (35 cases) and left feet (30 cases) were more frequent than men and right feet. Thickness of plantar fascia in affected site was thicker than normal site (p<0.01). Hypoechogenecity was observed only in 39 cases (81%) affected site, blurring of border of plantar fascia in affected site was 30 cases (62%) and 7 cases (15%) in normal site, perifascial effusion was observed only in 38 cases (79%) affected site, wavy plantar fascia in affected site was 43 cases (90%) and 2 cases (4%) in normal site. Calcaneal spur in affected site was 36 cases (75%) and 33 cases (69%) in normal site. Conclusion: Sonography is a useful diagnostic procedure for the plantar fasciitis especially in the unilateral plantar fasciitis.

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Temple and Postauricular Dissection in Face and Neck Lift Surgery

  • Lee, Joo Heon;Oh, Tae Suk;Park, Sung Wan;Kim, Jae Hoon;Tansatit, Tanvaa
    • Archives of Plastic Surgery
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    • v.44 no.4
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    • pp.261-265
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    • 2017
  • Periauricular paresthesia may afflict patients for a significant amount of time after facelift surgery. When performing face and neck lift surgery, temple and posterior auricular flap dissection is undertaken directly over the auriculotemporal, great auricular, and lesser occipital nerve territory, leading to potential damage to the nerve. The auriculotemporal nerve remains under the thin outer superficial fascia just below the subfollicular level in the prehelical area. To prevent damage to the auriculotemporal nerve and to protect the temporal hair follicle, the dissection plane should be kept just above the thin fascia covering the auriculotemporal nerve. Around the McKinney point, the adipose tissue covering the deep fascia is apt to be elevated from the deep fascia due to its denser fascial relationship with the skin, which leaves the great auricular nerve open to exposure. In order to prevent damage to the posterior branches of the great auricular nerve, the skin flap at the posterior auricular sulcus should be elevated above the auricularis posterior muscle. Fixating the superficial muscular aponeurotic system flap deeper and higher to the tympano-parotid fascia is recommended in order to avoid compromising the lobular branch of the great auricular nerve. The lesser occipital nerve (C2, C3) travels superficially at a proximal and variable level that makes it vulnerable to compromise in the mastoid dissection. Leaving the adipose tissue at the level of the deep fascia puts the branches of the great auricular nerve and lesser occipital nerve at less risk, and has been confirmed not to compromise either tissue perfusion or hair follicles.

The Treatment for The Intractable Epidural Abscess Using Tensor Fascia Lata Graft and Anterolateral Thigh Free Flap (대퇴근막 이식과 전외측 대퇴 유리 피판을 이용한 난치성 경막 외 농양의 치료)

  • Park, Byung-Chan;Ryu, Min-Hee;Kim, Tae-Gon;Lee, Jun-Ho
    • Archives of Reconstructive Microsurgery
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    • v.18 no.1
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    • pp.23-26
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    • 2009
  • Purpose: Artificial dura maters are commonly used in cranioplasty, but sometimes they can result in serious postoperative infection. Once complications such as epidural abscess or chronic draining ulcer arise, they are very difficult to treat. In this case, reclosure of dura defect using artificial dura mater may give rise to recurrence of infection. We experienced a case of intractable epidural abscess caused by use of artificial dura. To avoid repeated infection, we decided to use autologous tissue for the coverage of dura and soft tissue defect. Therefore, autologous tensor fascia lata graft and anterolateral thigh free flap were harvested at the same donor site incision to cover composite defect on the scalp and dura mater. Methods: A 13 year old male patient, who underwent the decompression cranioplasty and duroplasty, suffered from the intractable infection lesion. Twice, the epidural abscess was removed, both times the infection recurred. And eventually dura mater was exposed through the infected open wound. Nine months after dura exposed, infected aritificial dura mater was removed and extensive debridement was performed. Through a surgical incision on donor thigh, first, tensor fascia lata graft was harvested in process of the anterolateral thigh flap elevation. After the fascia lata graft was fixed over the dural defect, the anterolateral thigh flap was used to fill the dead space as well as the scalp defect. Results: Postoperatively, no recurrent infection and cerebrospinal fluid leakage are observed for a year. After the surgery, on the first and second day, venous congestion of the flap was observed, this problem was solved by thrombectomy and vein reanastomosis. And partial necrosis of flap occurred, but completely healed as conservative treatment for two weeks. Conclusion: Using the autologous tensor fascia lata graft and anterolateral thigh flap, we could obtain satisfactory results as treatment for the intractable infection lesion after duroplasty. Autologous tensor fascia lata in conjunction with anterolateral thigh flap is useful method for covering composite defect of scalp and dura mater.

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Evidence-based use of cold for plantar fasciitis

  • Laymon, Michael S.;Petrofsky, Jerrold S.;Alshammari, Faris;Fisher, Stacy
    • Physical Therapy Rehabilitation Science
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    • v.2 no.2
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    • pp.75-80
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    • 2013
  • Objective: The purpose of this study was to examine the effect of cold applied the night before or in the morning on pain and symptoms of plantar fasciitis. Design: Experimental study. Methods: Thirty subjects with plantar fasciitis were recruited for this study. Subjects with plantar fasciitis either had no intervention, cold applied (20 minutes) at night before bed, or 20 minutes in the morning upon wakening. Plantar fascia tenderness and pain were evaluated. There were ten subjects in each group. Measures included visual analog scale, plantar facial thickness via high resolution ultrasound, algometer measure, and range of motion of the ankle and foot. There were 3 groups of 10 subjects, control (no intervention), cold the night before bed, and cold in the morning before rising. Results: The greatest relief of symptoms was cold used at bedtime the night before the measurements. Cold used in the morning was not as effective as cold used in the evening before bed. Cold use reduced the thickness of the plantar fascia and irritation. There was a 13% reduction in plantar fascia thickness with cold the night before (p<0.05), a 44% reduction in pain and an 86 % increase in the force that could be applied to the bottom of the foot without pain (p<0.05). Conclusions: Cold applied for 20 minutes prior bedtime is effective for reduced symptomology caused by plantar fascia inflammation.

USING OF THE TEMPORALIS MUSCLE AND FASCIA FLAP FOR MAXILLA RECONSTURCTION (상악 결손부 수복을 위한 측두피판의 이용)

  • Kim, Young-Jo;Lee, Dong-Keun;Kim, Kui-Hee;Yoon, Sung-Phil;Chung, Chang-Joo;Jin, Kook-Bum
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.1-11
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    • 1994
  • The functional deformity following removal of the maxilla is considerable, especially following maxilla cancer excision. Rehabilitation of oral and maxillofacial region used to be very difficult with prosthesis or traditional flaps. Temporal muscle and fascia flaps have been described for immediate reconstruction following hemi-maxillectomy, but not total maxillectomy. The muscle and superficial fascia of the temporal area differ in their physical characteristics, vascular supply and clinical applications. Both can be employed independently or simultaneously as regional flaps in the reconstruction of a variety of complex craniofacial defects. Four case is presented in which 3 case maxilla cancer, one case non-union after maxilla fracture, and all case showed successful use of this flap. Only one patient developed partial necrosis of the flap ; significant necrosis did not occur in any other patient. This present paper reviews the anatomy, surgical technique and utilisation of temporal muscle and fascia flaps.

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Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report (실패한 제 1중족 족지관절 유합술 후 대퇴근막 장근 개재 관절 성형술을 이용한 치료: 증례 보고)

  • Sim, Jaewoo;Hyun, Yoonsuk;Park, Junsik;Kang, Saehyun;Kwon, Hwanjin;Kim, Gablae
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.39-42
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    • 2017
  • Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.

A Case Report on a Patient of Bilateral Avascular Necrosis of Femur Head, Treated with Korean Medicine and Hip Joint Fascia Chuna Therapy (한방 치료 및 고관절 경근 추나로 호전된 양측성 대퇴골두 무혈성 괴사 환자의 치험 1례)

  • Park, Jae-Hong;Oh, Eun-Young;Park, Su-A;Shin, Yoo-Bin;Kim, Young-Jun
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.9 no.1
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    • pp.115-124
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    • 2014
  • Objectives : The aim of this study is to report the improved case of bilateral avascular necrosis(AVN) of femur head treated with Korean medicine and Fascia Chuna Therapy Methods : The patient diagnosed with bilateral AVN is hospitalized at department of korean rehabilitation medicine, Samse hospital of korean medicine. The subject is treated by herbal medicine, acupuncture, SBV and hip joint gyoung-geon chuna. This study was measured by visual analogue scale(VAS) score, walking time without pain per 6 minutes and harris hip score(HHS). Results : The patient showed decreased VAS score, HHS and improved walking time without pain per 6 minutes after treated with korean medicine and hip joint Fascia Chuna Therapy. Conclusions : The patient showed reduced pain and positive effect on activities of daily living.

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Influence of Hip Abduction Velocity and Position on the Onset Times of Gluteus Medius and Tensor Fascia Latae Relative to Quadratus Lumborum in Healthy Subject: A Pilot Study

  • Kim, Jung-Bin;Yun, Chang-Kyo;Hwang-Bo, Gak
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.3
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    • pp.105-110
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    • 2016
  • PURPOSE: The aim of this study was to investigate the influence of hip abduction velocity and position change on the relative onset times of the gluteus medius, the tensor fascia latae, and the quadratus lumborum in healthy subjects. METHODS: For this study, 15 healthy young adults were recruited. The subjects were asked to move their hip joints up to 35 degrees of abduction at a speed of $70^{\circ}/sec$ and $17.5^{\circ}/sec$ in the supine and side-lying positions. Electromyography data was collected for the gluteus medius, tensor fascia latae, and quadratus lumborum to determine the onset times. RESULTS: There were significant differences between the fast speed ($70^{\circ}/sec$) and the slow speed ($17.5^{\circ}/sec$) in hip abduction in a supine position and in a side-lying position, relatively. The onset time of the gluteus medius was faster than that of the tensor fascia latae and the quadratus lumborum in the side-lying position at the speed of $70^{\circ}/sec$ and $17.5^{\circ}/sec$. CONCLUSION: The findings of this study indicated that hip abduction in a side-lying position is an effective method to recruit the gluteus medius earlier than the tensor fascia latae and the quadratus lumborum. Thus, the exercise position is considered necessory in the purpose of rehabilitation for gluteus medius muscle strengthening program.

The Effect of Fascia Relaxation and Mobilization of the Hyoid on the Range of Motion, Pain, and Deviation of the Hyoid in Neck Pain

  • Lee, Byung-jin;Yoon, Tae-lim
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.70-77
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    • 2020
  • Background: Neck pain can be caused by any structure in the neck, such as intervertebral discs, ligaments, muscles, facet joints, dura mater, and nerve roots. The hyoid bone is a structure that is also related to head and neck posture, neck movement and pain, but there are no studies on hyoid deviation, neck pain, and range of motion (ROM). Objects: The purpose of this study was to investigate the effect of fascia relaxation and mobilization of the hyoid bone on the ROM, pain, and lateral deviation of the hyoid bone. Methods: Twenty-five patients with neck pain identified by the lateral motion test (10 males [35.13 ± 7.67 years, 172.69 ± 3.90 cm, 78.77 ± 6.96 kg] and 15 females [35.13 ± 10.05 years, 161.11 ± 4.09 cm, 52.59 ± 2.98 kg]) was chosen randomly. Baseline values for pain, neck ROM, and lateral deviation in the hyoid bone were recorded using a visual analogue scale (VAS), goniometer, and tape measure. Then, each patient was treated with hyoid fascia relaxation and mobilization, and all results were recorded after intervention. Comparison of the results before and after intervention was analyzed using paird t-test (p < 0.05). Results: Right rotation, extension, VAS, and rotational asymmetry statistically significant differences (p < 0.05). Right rotation and extension increased ROM, rotational asymmetry ratio and VAS decreased. However, there was no significant difference in flexion, left rotation, center point (p > 0.05). Conclusion: Fascia relaxation and hyoid mobilization could improve the ROM of cervical extension, asymmetry of the cervical rotation and neck pain.

Extraction of Transverse Abdominis Muscle form Ultrasonographic Images (초음파 영상에서 복횡근 근육 추출)

  • Kim, Kwang-Baek
    • Journal of the Korean Institute of Intelligent Systems
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    • v.22 no.3
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    • pp.341-346
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    • 2012
  • In rehabilitation where ultrasonographic diagnosis is not popular, it could be subjective by medical expert's experience. Thus, it is necessary to develop an objective automative procedure in ultrasonic image analysis. A disadvantage of existing automative analytic procedure in musculoskeletal system is to designate an incorrect muscle area when the figure of fascia is vague. In this study, we propose a new procedure to extract more accurate muscle area in abdomen ultrasonic image for that purpose. After removing unnecessary noise from input image, we apply End-in Search algorithm to enhance the contrast between fascia and muscle area. Then after extracting initial muscle area by Up-Down search, we trace the fascia area with a mask based on morphological and directional information. By this tracing of mask movements, we can emphasize the fascia area to extract more accurate muscle area in result. This new procedure is proven to be more effective than existing methods in experiment using convex ultrasound images that are used in real world rehabilitation diagnosis.