• Title/Summary/Keyword: joint instability

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Arthroscopic Pull-out Wire Fixation Using Cannulated Screw of Tibial Eminence Fractures (도관 나사못을 이용한 경골 과간 융기 골절의 관절경적 견인 봉합술)

  • Kim, Jong-Min;Kim, Hyung-Gyu;Park, Byeong-Mun;Song, Kyeong-Seop;Jung, Sung-Hoon;Noh, Haeng-Kee;Yoon, Jong-Joo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.254-258
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    • 2009
  • Tibial eminence fracture is caused by distortion, excessive flexion and extension, varus and valgus injury of the knee joint in the form of avulsion fracture. A failure over the exact anatomical reduction of fragment can lead to instability and limitation of joint motion. Recently, a variety of arthroscopic assisted reduction and fixation technique have been used. In the tibial eminence fracture, we created an arthroscopic pull-out wire fixation technique using a cannulated screw that is easy and more convenient than in the conventional technique. So we report this technique with a review of current literatures.

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Immediate Effects of Flexi-bar Exercise With Knee Push-up Plus on Shoulder Joint Position Sense and Muscle Activity in Subjects With Scapular Winging

  • Kim, Seok-hyun;Cynn, Heon-seock;Baik, Seung-min
    • Physical Therapy Korea
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    • v.28 no.4
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    • pp.256-265
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    • 2021
  • Background: Individuals with scapular winging may have proprioceptive dysfunction which is important for motor control and causes shoulder instability. Reduced serratus anterior (SA) and lower trapezius (LT) muscle activity accompanied by over-active upper trapezius (UT), and pectoralis major (PM) may be contributing factors. Flexi-bar (FB) exercise may be used to increase joint position sense (JPS) and alter the target muscle activities. Objects: This study aimed to investigate the immediate effects of flexi-bar exercise prior to knee push-up plus (FPK) versus knee push-up plus (KPP) on JPS and muscle activity of SA, LT, UT, and PM in subjects with scapular winging. Methods: Eighteen subjects with scapular winging were recruited. JPS was investigated at baseline, after KPP and after FPK. Passive and active JPS errors were calculated by isokinetic equipment. Surface electromyography was used to record muscle activities during KPP and FPK. One-way repeated-measures analysis of variance and post hoc analyses were used to analyze the JPS error measured at baseline, after KPP and after FPK. Paired t-tests were used to compare muscle activities between KPP and FPK. Results: Passive JPS error was significantly decreased after KPP (p = 0.005) and after FPK (p = 0.003) compared to the baseline. Active JPS error was also significantly decreased after KPP (p = 0.016) and after FPK (p = 0.012) compared to the baseline. There was no significant difference in the passive and active JPS errors between KPP and FPK. SA activity during FPK was significantly increased (p = 0.024), and LT activity during FPK was significantly increased (p = 0.006). There were no significant differences in the UT and PM activity. Conclusion: FB might be recommended to immediately improve passive and active JPS and to selectively increase SA and LT muscle activities during KPP in individuals with scapular winging.

Surgical Resection of Neurogenic Heterotopic Ossification around Hip Joint in Stroke Patients: A Safety and Outcome Report

  • Jae-Young Beom;WengKong Low;Kyung-Soon Park;Taek-Rim Yoon;Chan Young Lee;Hyeongmin Song
    • Hip & pelvis
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    • v.35 no.4
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    • pp.268-276
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    • 2023
  • Purpose: Resection remains the most reliable treatment for established heterotopic ossification, despite questions regarding its effectiveness due to the potential for complications. This study evaluated the clinical outcomes and complications of neurogenic heterotopic ossification (NHO) resection in stroke patients' ankylosed hips. Materials and Methods: We retrospectively analyzed nine hip NHO resections performed on seven patients from 2010 to 2018. The pre- and postoperative range of motion of the operated hip were compared. Analysis of postoperative complications, including infection, recurrence, iatrogenic fracture, and neurovascular injury was performed. Results: The mean operative time was 132.78±21.08 minutes, with a mean hemoglobin drop of 3.06±0.82 g/dL within the first postoperative week. The mean duration of postoperative follow-up was 52.08±28.72 months for all patients. Postoperative range of motion showed improvement from preoperative. Flexion and external rotation (mean, 58.89±30.60° and 16.67±18.03°, respectively) showed the greatest gain of motion of the operated hip joint. Postoperative infections resolved in two cases through surgical debridement, and one case required conversion to total hip arthroplasty due to instability. There were no recurrences, iatrogenic fractures, or neurovascular injuries. Conclusion: Resection is a beneficial intervention for restoring the functional range of motion of the hip in order to improve the quality of life for patients with NHO and neurological disorders. We recommend performance of a minimal resection to achieve a targeted functional arc of motion in order to minimize the risk of postoperative complications.

Anterior Talofibular Ligament and Superior Extensor Ankle Retinaculum Thicknesses: Relationship with Balance

  • Malloy, Brooke;Furrow, David;Cook, Haily;Smoot, Elizabeth;Cash, Lindsey;Aron, Adrian;Jagger, Kristen;Harper, Brent
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.173-182
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    • 2019
  • Purpose: This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI). Materials and Methods: The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests. Results: There were no significant differences in the average ATFL thickness between stable and unstable ankles in those subjects with CAI (0.25±0.03 cm and 0.21±0.05 cm, respectively) or in the SEAR thickness (0.09±0.04 cm and 0.10±0.03 cm, respectively). There were also no significant differences in the right and left ATFL thicknesses (0.23±0.07 cm and 0.21±0.04 cm, respectively) or the SEAR thicknesses (0.09±0.01 cm and 0.09±0.01 cm, respectively) in those without CAI. There were no differences between limbs in composite scores on YBT in those with CAI (p=0.35) and those without CAI (p=0.33). There was a moderate correlation between the left SEAR thickness and the large forward/backward perturbations on the NeuroCom (Natus) motor control test (r=0.51, p=0.006 and r=0.54, p=0.003, respectively). Conclusion: There were no differences in the ATFL/SEAR thicknesses or balance measures between or within the groups, likely because CAI is multi-factorial and related to mechanisms other than tissue changes alone. More sensitive technology and a better definition of the measurement process may provide more definitive results.

In vivo 3D Kinematics of Axis of Rotation in Malunited Monteggia Fracture Dislocation

  • Kim, Eugene;Park, Se-Jin;Jeong, Haw-Jae;Ahn, Jin Whan;Shin, Hun-Kyu;Park, Jai Hyung;Lee, Mi Yeon;Tsuyoshi, Murase;Sumika, Ikemototo;Kazuomi, Sugamoto;Choi, Young-Min
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.25-30
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    • 2014
  • Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

A Case Study of Tunnel Keyblock Stability by the Block Failure Likelihood (블록파괴가능성을 이용한 터널키블록의 안정해석 사례연구)

  • 이인모;박준경;이석원
    • Proceedings of the Korean Geotechical Society Conference
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    • 1999.03a
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    • pp.315-322
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    • 1999
  • The probabilistic keyblock concept which was based upon block theory was applied to the example site by using the observed block moulds data. The more was the block failure likelihood (P(B)) which was defined by the product of the joint combination probability, the shape parameter and the instability parameter, the more were the frequencies of failures observed. If we can acquire these data during a tunnel construction stage, they will be used as a very useful data to construct another tunnel in the neighborhood. Furthermore, a sedimentary rock may have larger P(B) values than a crystalline rock, and for the given P(B) value, the percent block moulds are larger in the former than latter.

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Global torque optimization of redundant manipulator using dynamic programming

  • Shim, Ick-Chan;Yoon, Yong-San
    • 제어로봇시스템학회:학술대회논문집
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    • 1997.10a
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    • pp.811-814
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    • 1997
  • In this paper, the torque optimization of a kinematically redundant manipulator for minimizing the torque demands is discussed. The minimum torque solution based on a local optimization has been known to encounter the instability problem and then the global torque optimization was suggested as one of the alternatives. Herein, by adopting the infinity-norm rather than the 2-norm for the magnitude of torques, we are to propose a new cost function more advantageous to the avoidance of torque limits. By the way, a solution to the global torque optimization formulated with the new cost function can not be obtained by the previous methods due to their difficulties such as inability to treat discontinuous cost functions and various constraints on the joint variables. Thus, to overcome those deficiencies, we are developing a new approach using the dynamic programming. The effectiveness of the proposed method is shown through simulation examples for a 3-link planar redundant manipulator.

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Analysis of Discontinuity Distribution Property to Predict Rock Slope Failure (암반 사면의 파괴 예측을 위한 불연속면 분포 특성 분석)

  • 윤운상;김정환;배기훈
    • Proceedings of the Korean Geotechical Society Conference
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    • 1999.10a
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    • pp.147-152
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    • 1999
  • Distribution of fracture system is an important factor to analyse instability of jointed rock slope. In the most case of rock slopes, joint distribution properties are related to potential, shape, size and locality of slope failure. The purpose of this paper is to present an application of fracture characterization related to rock slope failure. Fracture data used in this study are collected by scanline survey. Two aspects of fracture characterization for rock slope are handled in this study First, In order to determine the potential and shape of slope failure, trace length of joints is considered as the weighting factor about collected orientation data. Second, Relationship between trace length and spacing is analysed to estimate failure location and size. The distribution of fracture system is directly influenced on wedge failure. It is effective to analyse the orientation of fractures by using weighting factors associated with the trace length of fractures rather than to analyse only that of fractures. It gives a conclusion that the wedge failure occurred along the peak of fracture density(or intensity) cycles.

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Dynamic Control of Redundant Manipulators based on the Minors of Jacobian Matrix (쟈코비안 행렬의 마이너(Minor)에 기초한 여유자유도 로봇의 동력학적 제어)

  • Chung, W.J.;Chung, W.K.;Youm, Y.
    • Proceedings of the KIEE Conference
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    • 1991.07a
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    • pp.767-770
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    • 1991
  • For the control of redundant manipulators, conventional dynamic control methods of local torque optimization showed the instability which resulted in physically unrealizable torque requirements. In this paper, a new dynamic control method which is based on the concept of aspects is proposed. The proposed method starts with the basic understanding of the minors in the Jacobian matrix. It was shown by computer simulations that the proposed method demonstrates a drastic reduction of torque loadings at the joints in the tracking motion of a long trajectory, and thus guarantees the stability of joint torque.

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Successful Treatment of Occipital Radiating Headache Using Pulsed Radiofrequency Therapy

  • Lee, Sun Yeul;Jang, Dae Il;Noh, Chan;Ko, Young Kwon
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.89-92
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    • 2015
  • Rheumatoid arthritis (RA) is a chronic inflammatory disease involving multiple joints. The cervical spine is often affected, and cases involving atlantoaxial joint can lead to instability. Anterior atlantoaxial subluxation in RA patients can lead to posterior neck pain or occipital headache because of compression of the C2 ganglion or nerve. Here, we report the successful treatment of a RA patient with occipital radiating headache using pulsed radiofrequency therapy at the C2 dorsal root ganglion.