• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.60-67
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• 2006

Purpose: The purpose of this study was to compare the method of using coraco-clavicular (C-C) sling with modified Phemister operation by postoperative clinical results, radiologic analysis and complications. Materials and Methods: 33 patients of acromioclavicular joint dislocation were included in this study. Thirteen patients were treated with simple C-C sling method and twenty patients were treated with modified Phemister operation. The assesment of clinical and radiological evaluation were performed and the final results were examined by using the Weitzman's classification. Results: In the final result of C-C sling method group, forward elevation $161^{\circ}$, external rotation $70^{\circ}$, internal rotation T8 level, Visual Analogue Scale (VAS) 83.3 points were checked. In modified Phemister operation group, forward elevation $155^{\circ}$, external rotation $67^{\circ}$, internal rotation T6 level, VAS 83.8 points were checked. In coracoclavicular distance of C-C sling method group, pre-operation 12.82 mm and last follow up 8.37 mm were checked. In modified Phemister operation group, pre-operation 12.8 mm and last follow up 7.7 mm were checked. In functional evaluation by the Weitzman criteria, C-C sling group had excellent 8, good 1, fair 1 and modified Phemister group had excellent 13, good 4, fair 3. Conclusion: C-C sling method would be the better than the Modified Phemister operation because of short operation time and smaller skin incision.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.202-208
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• 2021

Background: We aimed to assess the effect of plate hook bending in treatment of acromioclavicular (AC) dislocation by analyzing clinical and radiological results according to the angle of the plate hook (APH). Methods: This was a retrospective, observational, case-control study including 76 patients with acute AC joint dislocation that were divided into two groups according to treatment with bent or unbent plate hook. The visual analog scale (VAS), the American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion (ROM) were evaluated as clinical outcomes. Comparative coracoclavicular distance (CCD) was measured to evaluate radiological outcomes. Results: While the VAS and ASES of the bending group at 4 months after surgery were significantly higher (p=0.021 and p=0.019), the VAS and ASES of the bending group at other periods and ROM of the bending group showed no significant difference. The initial CCD decreased from 183.2%±25.4% to 114.3%±18.9% at the final follow-up in the bending group and decreased from 188.2%±34.4% to 119.1%±16.7% in the non-bending group, with no statistical difference (p=0.613). The changes between the initial and post-metal removal CCD were 60.2%±11.2% and 57.3%±10.4%, respectively, with no statistical difference (p=0.241). The non-bending group showed greater subacromial osteolysis (odds ratio, 3.87). Pearson's coefficients for the correlation between APH and VAS at 4 months after surgery and for that between APH and ASES at 4 months after surgery were 0.74 and -0.63 (p=0.027 and p=0.032), respectively. Conclusions: The APH was associated with improved postoperative pain and clinical outcomes before implant removal and with reduced complications; therefore, plate hook bending is more useful clinically during plate implantation.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.59-67
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• 2017

Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

• Journal of TMJ Balancing Medicine
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• v.4 no.1
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• pp.21-26
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• 2014

Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in recurrent or habitual type temporomandibular joint (TMJ) dislocation. One Recurrent or habitual type TMJ dislocation case was managed with the Yinyang Balancing Appliance on TMJ, combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. The patient showed positive changes even after the initial treatment and this effect maintained over the follow-up period. Although it is not clear the effect is sustaining or temporary in its nature, a positive effect was observed and further clinical and biological research on FCST is expected.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.161-165
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• 2024

Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.

• Journal of Yeungnam Medical Science
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• v.15 no.2
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• pp.263-274
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• 1998

One of the main purposes in the treatment of developmental dislocation of the hip is to achieve and maintain concentric, congruent, and stable reduction. The arthrogram performs an important role in the diagnosis and treatment of developmental dislocation of the hip. The arthrogram provides much information about the soft tissue status of the hip joint. Limbus and ligamentum teres is exactly evaluated so that we can plan the reduction and treatment before operation. Eighteen preoperative hip arthrograms of 17 children treated for developmental dislocation of the hip from 1992 to 1998 were reviewed. The limbus, ligamentum teres and transverse acetabular ligament were compared with the pathoanatomy seen at the time of open reduction. Arthrography proved to be reliable in identifying the limbus and ligamentum teres. So we recommend that arthrography must be performed before closed or open reduction. Also, we recorded the radiographic parameters: acetabular index, acetabular floor thickness, center edge(CE) angle of Wiberg, and Y-coordinate. The center edge(CE) angle of Wiberg obtained from arthrography was measured more accurately than from simple roentgenograms because the ossification of the femoral head was frequently located eccentrically in the developmental dislocation of the hip.

• Journal of Biomedical Engineering Research
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• v.41 no.4
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• pp.165-171
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• 2020

In this study, it focuses on the development of radiographic devices for patellar imaging. On the previous X-ray examination of patella and patellofemoral joint, it analyzed the problems which could affect the results: unstable patients' pose, radiation exposure, and deterioration of image quality. The purpose of the research is to propose a future use of a developed device with an explanation of the process, function, and advantage of the device including the methods. The device is developed to focus on the diagnosis of the longitudinal and longitudinal fractures of the patella and patella/femoral joint, displacement such as dislocation, bone formation, stenosis of the patella/femorla joint, and cartilage wear. Due to the patient's anxious posture, it caused a shaking image, overlapping structures, and etcs, these factors challenge to diagnose accurately. In addition, the existing Settegast method and Hughston method, which are most frequently performed in the hospital field, are not suitable for the presence or absence of features or dislocation due to the heavy load on the patella of the patient. The developed device requires patients in a lying position and placing only their leg on the device, it increases the conveniences of the examination and decreases unnecessary radiation exposure of the patient except the patellar examination area. Moreover, one of the systems in the device fixes the detector, where the patients no longer need to hold the detector nor be in unstable posture, but describes the structure of the patella/femoral joint more clearly. Hoping the device will apply to more patients.

• Clinics in Shoulder and Elbow
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• v.25 no.3
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• pp.224-229
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• 2022

Background: Most acromioclavicular joint (ACJ) injuries are caused by direct trauma to the shoulders, and various methods and techniques are used to treat them; however, none of the options can be considered the gold standard. This study examines the horizontal stability of the ACJ after a complete dislocation was repaired using one of two Ethibond suture techniques, the loop technique and the two holes in the clavicle technique. Methods: In this single-blind, randomized clinical trial, 104 patients diagnosed with complete ACJ dislocation type V were treated using Ethibond sutures with either the loop technique or the two holes in the clavicle technique. Horizontal changes in the ACJ were radiographically assessed in the lateral axial view, and shoulder function was evaluated by the Constant (CS) and Taft (TS) scores at intervals of 3, 6, and 12 months after surgery. Results: The horizontal stability of the ACJ was better with the two-hole technique than the loop technique at all measurement times. CS and TS changes showed a significant upward trend over time with both techniques. The mean CS and TS at the final visit were 95.2 and 11.6 with the loop technique and 94.0 and 11.9 with the two-hole technique, respectively. The incidence of superficial infections caused by the subcutaneous pins was the same in the two groups. Conclusions: Due to the improved ACJ stability with the two-hole technique, it appears to be a more suitable option than the loop technique for AC joint reduction.

• Nuclear Engineering and Technology
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• v.55 no.11
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• pp.4066-4076
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• 2023

Pressure resistance welding is usually used to seal the connection between the cladding tube and the end plug made of zirconium alloy. The seal welded joint has a direct effect on the service performance of the fuel rod cladding structure. In this paper, the pressure resistance welded joints of zirconium alloy tube-plug structure were obtained by thermal-mechanical simulation experiments. The microstructure and microhardness of the joints were both analyzed. The effect of processing parameters on the microstructure was studied in detail. The results showed that there was no β-Zr phase observed in the joint, and no obvious element segregation. There were different types of Widmanstätten structure in the thermo-mechanically affected zone (TMAZ) and heat affected zone (HAZ) of the cladding tube and the end plug joint because of the low cooling rate. Some part of the grains in the joint grew up due to overheating. Its size was about 2.8 times that of the base metal grains. Due to the high dislocation density and texture evolution, the microhardnesses of TMAZ and HAZ were both significantly higher than that of the base metal, and the microhardness of the TMAZ was the highest. With the increasing of welding temperature, the proportion of recrystallization in TMAZ decreased, which was caused by the increasing of strain rate and dislocation annihilation.

• The Journal of Korean Physical Therapy
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• v.13 no.1
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• pp.197-204
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• 2001

Knee is a middle joint in lower extremity and has relationship with hip joint and ankle joint alignment. Therefore the knee joint alignment is very important in aspect of biomechanically. Knee joint alignment depend upon patellar stability. Instability of the patellofemoral articulation, in the form of patellar subluxation or dislocation may be associated with a number of factors. Normal range of patellofemoral angle is very different by the reporter and by the gender also.