• Title/Summary/Keyword: impingement syndrome

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Subtalar Distraction Bone Block Arthrodesis (Five Cases) (거골하 신연 골편 관절 유합술)

  • Yoo, Chong-Il;Eun, Il-Soo;Jung, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.101-106
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    • 2004
  • Purpose: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. Materials and Methods: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. Results: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improvedto 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. Conclusion: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.

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Hindfoot Endoscopy for the Treatment of Posterior Ankle Impingement Syndrome: A Comparison of Two Methods (a Standard Method versus a Method Using a Protection Cannula) (후방 발목 충돌 증후군에서의 후족부 내시경 사용: 고식적 방법과 보호 도관을 이용한 방법의 비교)

  • Kim, Eung-Soo;Lee, Chang-Rak;Kim, Young-Jun;Roh, Sang-Myung;Park, Jae-Keun;Gwak, Heui-Chul;Jung, Sun-Gyu
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.26-31
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    • 2018
  • Purpose: The purpose of this study is to compare the clinical results between two different methods of hindfoot endoscopy to treat posterior ankle impingement syndrome. Materials and Methods: Between January 2008 and January 2014, 52 patients who underwent hindfoot endoscopy were retrospectively reviewed. Two methods of hindfoot endoscopy were used; Group A was treated according to van Dijk and colleagues' standard twoportal method, and group B was treated via the modified version of the above, using a protection cannula. For clinical comparison, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, time required to return to activity, and the presence of complications were used. Results: There was no statistically significant difference in the AOFAS scores at the final follow-up, and there was also no statistically significant difference in the times for the scores to return to the preoperative level. There were no permanent neurovascular injuries and wound problems in either group. Conclusion: Use of protection cannula may provide additional safety during hindfoot endoscopy. We could not prove whether protection cannula can provide superior safety for possible neurovascular injury. Considering the possible safety and risk of using additional instrument, the use of this method may be optional.

Relation of the Degree of the Subacromial Bursitis with Acromial Shape and Pain in the Subacromial Impingement Syndrome (견봉하 충돌증후군에서 견봉하 점액낭의 염증 정도와 견봉의 모양 및 통증과의 연관성)

  • Lee, Kwan-Hee;Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Woo-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.34-38
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    • 2009
  • Purpose: To evaluate the association of subacromial bursa inflammation with acromial shape and shoulder pain in subacromial impingement syndrome. Materials and Methods: 24 cases with subacromial impingement syndrome were reviewed. Eighteen patines were males and six females(mean age: 58.3 yrs). During arthroscopic operation, the specimens were taken from subacromial bursa with arthroscopic knife($1{\times}1$ cm size). The shape of acromion were classified according to Bigliani grading system. The shoulder pain of patients was graded with visual analog scale (VAS). The grade of inflammation was classified to the pathological three grade system (mild, moderate, severe) by pathohistological 8 factors. Results: Of total 24 cases, 9 cases were the pathological grade I and 15 cases were grade II. None was grade III. In the 9 cases of pathological grade I, 6 cases were the radiologic grade II of acromial shape and 3 cases were grade III. In the 15 cases of pathological grade II, 5 cases were the radiologic grade II and 10 cases were grade III. The VAS was 7 point at pathological grade I and 8 point at grade II. As the statistical analysis, the pathological grade of subacromial bursa was associated with acromial shape (p<0.05), but not associated with pain of patient (p>0.05). Conclusion: Our study suggests that pathological grade of subacromial bursa inflammation was associated with acromial shape. But pathological grade of subacromial bursa inflammation was not associated with shoulder pain of patients.

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Impingement Syndrome & Rotator Cuff Tear: Etiology (견관절 충돌 증후군 및 회전근 개 파열의 병인)

  • Cho, Nam Su;Lee, Sang Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.72-78
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    • 2012
  • The rotator cuff is situated in a potential tight subacromial space and undergoes senescent structural changes commonly observed in other joints of the body. When the cuff fails, spontaneous healing of the torn tendon is not expected to occur, and multiple factors may be responsible. Its fibers are under tension and typically retract on tearing. The subacromial bursal inflammation and alterations in normal glenohumeral kinematics have been considered in the development of symptoms. Controversy continues to exist concerning the pathogenesis of rotator cuff disease. The heterogeneity of the disorder, as well as the notion that rotator cuff disease may not actually represent a continuum of the same process, but rather, is a compilation of independent disorders, may partly explain the differing viewpoints on its origin. Two contrasting pathogenetic mechanisms have been extensively described and include vascular, or intrinsic, causes and impingement, or extrinsic, factors. Other etiologies have also been reported that include trauma, congenital or developmental factors, and instability. For successful treatment of the rotator cuff diseases, it is essential to understand the structure and function of rotator cuff and to clarify the pathogenesis and natural history of its disorder.

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The Effect of Wheelchair Propulsion on Carpal Tunnel Syndrome of Wrist Joint

  • Kong, Jin-Yong;Kwon, Hyuk-Cheol;Chang, Ki-Yeon;Jeong, Dong-Hoon
    • Physical Therapy Korea
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    • v.11 no.4
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    • pp.7-17
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    • 2004
  • Individuals who propel wheelchairs have a high prevalence of upper extremity injuries (i.e., carpal tunnel syndrome, elbow/shoulder tendonitis, impingement syndrome). Musculoskeletal injuries can result from overuse or incorrect use of manual wheelchairs, and can hinder rehabilitation efforts. To better understand the mechanisms of upper extremity injuries, this study investigates the motion of the wrist during wheelchair propulsion. This study also examines changes in the variables that occur with fatiguing wheelchair propulsion to determine how the time parameters of wheelchair propulsion and the state of fatigue influence the risk of injury. A two dimensional (2-D) analysis of wrist movement during the wheelchair stroke was performed. Twenty subjects propelled a wheelchair handrim on a motor-driven treadmill at two different velocities (50, 70 m/min). The results of this study were as follows; The difference in time parameters of wheelchair propulsion (cadence, cycle time, push time, recovery time, and PSP ratio) at two different velocities was statistically significant. The wrist kinematic characteristics had statistically significant differences at two different velocities, but wrist radial deviation and elbow flexion/extension had no statistically significant differences. There were statistically significant differences in relation to fatigue in the time parameter of wheelchair propulsion (70 m/min) between initial 1 minute and final 1 minute. The wrist kinematic characteristics between the initial 1 minute and final 1 minute in relation to fatigue had statistically significant differences but the wrist flexion-extension (50 m/min) had no statistically significant differences. According to the results, the risk of musculoskeletal injuries is increased by fatigue from wheelchair propulsion. To prevent musculoskeletal injuries, wheelchair users should train in a muscle endurance program and consider wearing a splinting/grove. Moreover, wheelchair users need education on propulsion posture, suitable joint position, and proper recovery patterns of propulsion.

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Effects of Soft Tissue Massage of the Posterior Deltoid Muscle on Shoulder Horizontal Adduction

  • Park, Kyue-Nam;Kwon, Oh-Yun;Kim, Si-Hyun;Choi, Houng-Sik
    • Physical Therapy Korea
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    • v.17 no.4
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    • pp.35-40
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    • 2010
  • Stiffness of the posterior deltoid is as a causative factor in the limited range of glenohumeral horizontal adduction and various other shoulder pathologies including shoulder impingement syndrome, frozen shoulder, and humerus anterior glide syndrome. The purpose of this study was to compare the effects of two techniques (soft tissue massage and cross-body stretch) on increasing the range of horizontal adduction. Thirty-two subjects with a $10^{\circ}$ or greater difference between the right and left sides in horizontal adduction were selected. Sixteen subjects from each group were allocated randomly. Interventions were applied on six occasions for 2 weeks, and the range of horizontal adduction was measured using an inclinometer at pre-and post-intervention. A $2{\times}2$ analysis of variance (intervention${\times}$time) was used to compare the effects of the two techniques. In the soft tissue massage group, the angle of horizontal adduction significantly increased compared with the cross-body stretch group. These findings indicate that the soft tissue massage of the posterior deltoid muscle is a more effective method to increase the flexibility of the glenohumeral horizontal adduction.

Surgical Options for Failed Rotator Cuff Repair, except Arthroplasty: Review of Current Methods

  • Kim, Jangwoo;Ryu, Yunki;Kim, Sae Hoon
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.48-58
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    • 2020
  • Although the prevalence of rotator cuff tears is dependent on the size, 11% to 94% of patients experience retear or healing failure after rotator cuff repair. Treatment of patients with failed rotator cuff repair ranges widely, from conservative treatment to arthroplasty. This review article attempts to summarize the most recent and relevant surgical options for failed rotator cuff repair patients, and the outcomes of each treatment, except arthroplasty.

Orthopaedic Rehabilitation in Chronic Shoulder Pain (만성 견관절통에 대한 정형외과적 재활치료)

  • Tae, Suk-Kee;Lee, Kee-Hyun
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.99-107
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    • 2003
  • Disorders of the shoulder in which conservative management is indicated as a primary treatment include idiopathic frozen shoulder, atraumatic instability. acute calcific tendinitis , subacromial impingement syndrome, partial thickness or small full thickness tear of the rotator cuff, and chronic rotator cuff tear in elderly population. Aside from medication and various physical modalities used for relief of pain, the mainstay of orthopaedic rehabilitation consists of stretching of the tendons and capsulologamentous complex, and strengtnening of rotator cuff muscles as well as surrounding muscles. However, orthopaedic rehabilitation in chronically painful conditions of the shoulder differs in detail according to the specific diseases or injuries, And it is important to make the rehabilitation program that can be undertaken by the patients rather than adhering to a fixed schedule. Also the program should be changed as the condition of the patient improves or deteriorates. Nevertheless there are basic rules of stretching and strengthening , which should always be observed in applying orthopaedic rehabilitation treatment.

Short-term Effects of Kaltenborn-Evjenth Functional Glide on Pain, ROM, and Function in Patients with Breast Cancer

  • Hyunah Lee;Dongkwon Seo
    • Physical Therapy Rehabilitation Science
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    • v.13 no.3
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    • pp.354-367
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    • 2024
  • Objective: The purpose of this study was to investigate the effect of Kaltenborn-Evjenth concept functional glide (KEFG) on shoulder pain, range of motion (ROM), upper extremity dysfunction in breast cancer patients. Design: Cross-sectional study. Methods: In this study, 42 subjects were randomly assigned and distributed to 21 subjects in the KEFG group and 21 subjects in the Mulligan technique (MWM) group. Results: After the application of joint mobilization, pain decreased significantly in both groups, and there was no significant difference between the two groups. The ROM of the joint was significantly increased in both groups, and there was no significant difference between the two groups. The SPADI pain was significantly decreased in both groups, and the disability and total components were significant only in the KEFG group, and there was no significant difference between the two groups. Conclusions: KEFG and MWM were found to be effective in improving shoulder pain, ROM and upper extremity dysfunction in breast cancer patients. KEFG is thought to be an intervention that can yield positive outcomes among breast cancer patients with upper extremity dysfunction.