• Hip & pelvis
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• v.35 no.3
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• pp.175-182
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• 2023

Purpose: This study aims to compare patients in whom fixation failure occurred via cut-out (CO) or cut-through (CT) in order to determine patient factors and radiographic parameters that may be predictive of each mechanism. Materials and Methods: This retrospective cohort study includes 18 patients with intertrochanteric (IT) hip fractures (AO/OTA classification 31A1.3) who underwent treatment using a single lag screw design intramedullary nail in whom fixation failure occurred within one year. All patients were reviewed for demographics and radiographic parameters including tip-to-apex distance (TAD), posteromedial calcar continuity, neck-shaft angle, lateral wall thickness, and others. Patients were grouped into cohorts based on the mechanism of failure, either lag screw CO or CT, and a comparison was performed. Results: No differences in demographics, injury details, fracture classifications, or radiographic parameters were observed between CO/CT cohorts. Of note, a similar rate of post-reduction TAD>25 mm (P=0.936) was observed between groups. A higher rate of DEXA (dual energy X-ray absorptiometry) confirmed osteoporosis (25.0% vs. 60.0%) was observed in the CT group, but without significance. Conclusion: The mechanism of CT failure during intramedullary nail fixation of an IT fracture did not show an association with clinical data including patient demographics, reduction accuracy, or radiographic parameters. As reported in previous biomechanical studies, the main predictive factor for patients in whom early failure might occur via the CT effect mechanism may be related to bone quality; however, conduct of larger studies will be required in order to determine whether there is a difference in bone quality.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.105-115
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• 2016

Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.57-64
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• 2022

Background: There are various conservative treatment options for lateral epicondylitis (LE). The aim is to evaluate pain, daily functioning, and complications after ultrasound-standardized autologous blood injections in patients with LE. Methods: For this prospective cohort study, consecutive patients (>18 years) diagnosed with LE were included. Autologous blood was injected using a medical device containing an injection disposable with 12 small needles (Instant Tennis Elbow Cure [ITEC]) device. Patient-Rated Tennis Elbow Evaluation (PRTEE), subjective elbow score (SES), palpation and provocation pain, satisfaction, and complications of treatment were measured at baseline and two months after treatment. Paired t-tests and Fisher's exact tests were used for calculating the difference between pre- and post-treatment outcomes. Results: Fifty-five elbows were analyzed. Mean time between pre- and post-treatment was 11.1 weeks (standard deviation [SD], 8.9 weeks). The mean PRTEE score decreased from 68.2 (SD, 15.7) before surgery to 53.2 (SD, 25.9; p<0.001) after. The mean SES improved from 36.9 (SD, 20.8) to 51.7 (SD, 27.4; p<0.001). Despite this improvement, only 44.7% of patients showed relevant clinical improvement in PRTEE, and 37.3% showed significant clinical improvement based on SES. Four patients reported a complication and the injection disposable failed three times. Conclusions: Ultrasound-standardized autologous blood injection using the ITEC device is not an effective tool in reducing symptoms related to LE. This study showed that only half of all patients experienced a positive effect. In this heterogeneous cohort of patients, we showed no added value of ultrasound standardization.

• Journal of Korean Foot and Ankle Society
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• v.22 no.2
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• pp.49-54
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• 2018

Ankle sprains are among the most common injuries sustained during athletic activities and daily life. Acute ankle sprain is usually managed conservatively with functional rehabilitation but the failure of conservative treatment leads to the development of chronic ankle instability. The development of repetitive ankle sprains and persistent symptoms after injury has been termed chronic ankle instability. Acute ankle sprains and chronic ankle instability require a careful evaluation to detect other comorbidities, such as subtalar instability, osteochondral defect, peroneal tendinopathy, tarsal coalition, os trigonum, flexor hallucis longus tendinitis, calcaneus anterior process fracture, and neural injuries. For the successful treatment of acute ankle sprains and chronic ankle instability, the treatment of comorbidity lesions should be performed first.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.181-191
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• 1998

The age of specialization is upon physical therapy, as evidenced by the many special interest group. One of the special interest is manual therapy, which is the study of neurology, biomechanic, behavior science and pathology as well as the application of evaluative and treatment techniques of the neuromusculoskeletal system. Trend of manual therapy cover the whole medical in Europe. but America has two categories which is the neurologic manual therapy and the orthopedic manual therapy. The neurologic manual therapy was integrated with theory of PNF, Bobath technique, Vojta which is neurophysiologic approach concept. It is called motor control. A key aspect of the motor control requires a through knowledge of neurobiologic, biomechanic, and behavioral science. The orthopedic manual therapy runs to the evaluation and treatment of joints and their surrounding structures increase or decrease mobility and Fain control. In this article has to define and clarify the basic concepts of orthopedic manual therapy by comparing the general concepts, evaluation schemes, and treatment procedures of John McM Mennell, James Cyriax, Geoffrey Maitland, Freddy Kaltenborn and Ola Grimsby.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.4 no.1
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• pp.35-43
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• 1998

This study was introduce to Manual Mobilization of the Extremity Joints of Freddy M. Kaltenborn(1989). Much of Orthopedic Manipulative Therapy is devoted to the evaluation and treatment of joint and related soft tissue disorders and one of the primary treatment methods is mobilization. When examination reveals joint dysfunction, especially decreased range of motion, joint mobilization techniques are often utilized. Kaltenborn's joint mobilization techniques are performed as passive examination or treatment movements by the therapist. There are three basic joint play movements: (1) traction, (2) compression, and (3) translatoric gliding. The purpose of joint mobilization is to restore normal, painless joint function. Mechanically, the goal is to restore joint play and thus normalize roll-gliding which occurs during active movements.

• 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.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.179-182
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• 2011

Naviculocuneiform coalition is one of uncommon tarsal coalitions and especially symptomatic cases which need operative treatment are rare. Authors report 2 cases of pediatric naviculocuneiform patients who showed symptomatic condition as mainly pain. Plain radiographs, computed tomography or magnetic resolution imaging study showed bony bridge in naviculo-medial cuneiform joint. After over six months conservative treatment, excision of coalition and interposition $Tisseel^{(R)}$ was performed for motion preservation and relief of pain.

• Journal of Korean Foot and Ankle Society
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• v.25 no.1
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• pp.38-45
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• 2021

Subtalar joint instability (STI) is one of the causes of persistent hindfoot pain even after treatment for ankle instability. Diagnosis of STI is often neglected because it is a poorly understood concept. However, understanding of the anatomy and injury mechanism of the subtalar joint is a prerequisite of appropriate treatment. Patients with STI usually complain of several symptoms, such as recurrent sprains or a giving way sensation and rolling over. Recently, various diagnostic tools and treatment methods have been investigated. This study was undertaken with the aim of helping clinicians by providing a comprehensive understanding of STI.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.161-164
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• 2020

A peroneal dislocation is a rare disease that is often misdiagnosed as a simple sprain and can be treated inadequately in the acute phase. For this reason, it is important to have an appropriate diagnosis in the early stages because it can progress to chronic and recurrent conditions. Surgical treatment is considered mainly when progressing to chronic recurrent dislocation. Recently, patients with an acute peroneal dislocation tend to prefer surgical treatment, so accurate initial diagnosis and management are very important. This paper reports a case of chronic recurrent peroneal tendon dislocation in both ankle joints, which was treated by a superior peroneal retinaculum reconstruction and a groove deepening procedure.