• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.77-81
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• 2003

목적: 슬관절 주위 골격의 기초과학을 생체역학을 중심으로 설명하고 빈도가 높은 스포츠 손상들에 대해 기술하고자 한다. 해부 밀 운동학: 슬관절은 순수한 경첩 관절이 아니며 적합하지 않으므로 여섯 방향의 운동이 가능하다. 경골대퇴간 운동역학: 슬관절의 굴곡-신전 축은 시상면에 수직이 아닐 뿐 아니라, 관상면상 관절선과 평행하지 않으므로, 경골대퇴관절은 굴곡 시 내반과 내회전이 동반되고 신전 시에는 외반과 외회전이 동반된다. 슬개대퇴 관절: 슬개대퇴 관절 압박력은 슬관절의 굴곡 각도와 사두고근력에 비례한다 슬개골은 신전기전의 moment arm을 증가시켜 신전기전의 효율을 증대시키고 지렛대 역할을 한다. 슬개골 골절: 비전위성 골절이면서 하지 직거상 운동이 보존된 경우에 비수술적 치료의 적응증이 되며 수술적 치료 시 고정 방법의 선택은 골절 양상에 따라 결정되겠으나 어느 술식을 선택하여도 신전지대의 봉합은 필수적이며 중요하다 슬개골 불안정성: 선행 해부학적 이상을 조사해야 하며 급성 탈구에서도 골연골 골절편이 있거나 재발의 위험이 높은 운동선수에서 인대 봉합을 고려할 수 있다. 비수술적 치료 및 재활에도 불수하고 계속되는 재발성 아탈구나 탈구는 수술이 필요하다 학령기 스포츠 손상: Idiopathic Adolescent Anterior Knee Pain, Osgood-Schlatter Disease, Sinding-Larsen-Johansson Disease 등이 흔하다

• PNF and Movement
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• 제8권1호
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• pp.41-50
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• 2010

Pain originating from the sacroiliac joint(SIJ) has been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction(SID) has been difficult to achieve. Clinical presentation of SID appears that pain and poor performance is responsive to local analgesia of periarticular structures with poorly defined pathology, and poor performance with bony pathological changes present as a result of chronic instability. Previous research indicates that physical examination cannot diagnose SIJ pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. Tests based on mechanics as manual provocation for SIJ pain have formed the basis of tests used to diagnose SIJ dysfunction. In this review summary, the purpose of this study was to describe the sacroiliac tests with a model of examination, diagnosis, and management of SID. Further research is warranted to determine whether SIJ tests is reliable means of evaluating innominate impairments.

• International Journal of Railway
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• 제3권1호
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• pp.1-6
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• 2010

The steel plate-girder bridges with concrete gravity piers have possibilities of overturning by lateral inertial force which can be reproduced by sudden earthquake attack. This paper explores an overturning mechanism of existing concrete gravity pier onto the sandy soil in the event of lateral push-over load by in-situ experimental observation. The in-situ push-over experiment for pier with earth anchors between spread footing and rock beds exhibits a reasonable enhancement of ductility against overturning. In unanchored system, a flexural crack at cold joint of concrete pier is not developed because of the over-turning of the pier. This leads a global instability (rotation) of pier-footing system with relatively low stresses in pier itself. While a lateral load is persistently increased in anchored system, the successive flexural cracking failure at cold joint is observed even after the local shear failure of soil due to redistribution of stress equilibrium between soil and pier structure as long as a tensile action of anchor cable is active.

• 한국운동역학회지
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• 제31권3호
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• pp.205-213
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• 2021

Objective: The aim of this study was to analyze body stability Joint coordination pattern though as bending stiffness of shoes during stance phase of running. Method: 47 male subjects (Age: 26.33 ± 2.11 years, Height: 177.32 ± 4.31 cm, Weight: 65.8 ± 3.87 kg) participated in this study. All subjects tested wearing the same type of running shoes by classifying bending stiffness (A shoes: 3.2~4.1 N, B shoes: 9.25~10.53 N, C shoes: 20.22~21.59 N). They ran 10 m at 3.3 m/s (SD ±3%) speed, and the speed was monitored by installing a speedometer at 3 m intervals between force plate, and the measured data were analyzed five times. During running, ankle joint, MTP joint, coupling angle, inclination angle (anterior-posterior, medial-lateral) was collected and analyzed. Vector coding methods were used to calculate vector angle of 2 joint couples during running: MTP-Ankle joint frontal plane. All analyses were performed with SPSS 21.0 and for repeated measured ANOVA and Post-hoc was Bonferroni. Results: Results indicated that there was an interaction between three shoes and phases for MTP (Metatarsalphalangeal) joint angle (p = .045), the phases in the three shoes showed difference with heel strike~impact peak (p1) (p = .000), impact peak~active peak (p2) (p = .002), from active peak to half the distance to take-off until take-off (p4) (p = .032) except for active peak~from active peak to half the distance to take-off (p3) (p = .155). ML IA (medial-lateral inclination angle) for C shoes was increased than other shoes. The coupling angle of ankle angle and MTP joint showed that there was significantly difference of p2 (p = .005), p4 (p = .045), and the characteristics of C shoes were that single-joint pattern (ankle-phase, MTP-phase) was shown in each phase. Conclusion: In conclusion, by wearing high bending stiffness shoes, their body instability was increased during running.

• 대한족부족관절학회지
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• 제20권1호
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• pp.12-18
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• 2016

Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

• 대한족부족관절학회지
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• 제9권1호
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• pp.87-93
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• 2005

Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

• 대한족부족관절학회지
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• 제11권2호
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

• 대한족부족관절학회지
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• 제11권2호
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• pp.204-208
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• 2007

Purpose: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. Materials and Methods: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, $18{\sim}61$ years). Mean follow-up period was 32 months (range, $10{\sim}48$ months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. Results: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. Conclusion: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.

• Clinics in Shoulder and Elbow
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• 제19권2호
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• pp.78-83
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• 2016

Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

• 한국컴퓨터정보학회논문지
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• 제27권1호
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• pp.97-105
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• 2022

이 연구는 플로싱밴드 운동이 기능적 발목 불안정성 태권도 시범단 선수들의 관절가동범위와 수직점프에 어떠한 영향을 미치는지 분석하여 플로싱 밴드의 효과를 알아보는데 목적이 있다. D 대학교에 재학 중인 남성 태권도 시범단 선수 21명을 대상으로 기능적 발목 불안정성 그룹(FAIG, n=7명), 경미한 발목 불안정성 그룹(MAIG, n=7명), 발목 안정성 그룹(ASG, n=7명)으로 구분하였다. 모든 그룹은 일회성 플로싱밴드 운동 프로그램을 실시하였다. 그 결과 FAIG의 발등굽힘(Dorsi flexion, p<.01), 안쪽번짐(Inversion, p<.01), 가쪽번짐(Eversion, p<.05)에서 유의하게 관절가동범위가 증가하였으며, 수직점프(p<.01)에서도 유의한 증가를 보였다. FAI를 가진 태권도 시범단 선수들의 플로싱밴드 운동은 발목의 관절가동범위와 수직점프를 증가시킴으로 경기력 향상과 발목손상의 위험을 줄일 수 있는 하나의 중재방법이 될 수 있는 가능성을 확인하였다.