• Title/Summary/Keyword: partial tear

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Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft (봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과)

  • Ko, Sang-Hun;Park, Ki-Bong;Park, Gil-Young;Kwon, Sun-Hwan;Kim, Myung-Seo;Park, Sun-Jae
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.135-142
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    • 2020
  • Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.

Arthroscopic Decompression of Subacromial Impingement Syndrome (관절경적 감압술에 의한 견봉하 충돌증후군의 치료)

  • Kim Seong Jae;Kim Beom Su;Choe Nam Hong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1995.05a
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    • pp.13-13
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    • 1995
  • The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.

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Esophageal Injury Following Anterior Cervical Plate Fixation

  • Park, Jae-Sung;Kim, Young-Baeg;Hong, Hyun-Jong;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.141-145
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    • 2005
  • We report five patients of esophageal injuries confirmed by clinical signs and radiological evidences. They include a partial tear and a perforation which were not noticed during the operation, a perforation which was primarily repaired during the operation, and two perforations which occurred during the reoperations for the removal of mal-positioned screws or plate. The partial tear was not repaired. The perforation which occurred during the operation was primarily sutured and didn't receive further treatment. Two perforations which occurred during the reoperations were treated by irrigation, debridement with surgical drainage, and systemic antiobiotics. One who was diagnosed later after the operation showed the poorest outcome and required longest hospital days among our series. Early detection and appropriate treatment of esophageal injury following anterior spinal surgery can only improve the prognosis by preventing secondary complications.

Stress Radiographs under Anesthesia for Painful Chronic Lateral Ankle Instability (동통을 동반한 족관절의 만성 외측 불안정성에 있어서 마취하 스트레스 방사선 검사)

  • Choi, Jun Young;Ahn, Hee Chan;Shin, Myung Jin;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.12-16
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    • 2017
  • Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

Pharmacopuncture and Autohemo-Seperated Regeneration Pharmacopuncture for Acute Traumatic Subdeltoid Bursitis with Patial Tear of Subscapularis Tendon After Bongchuna Treatment - A Case Report - (봉추나요법 후 유발된 견갑하건 부분파열을 동반한 급성 외상성 삼각 근하 점액낭염의 약침과 자가혈 분리 재생약침 시술 1례)

  • Oh, Won-Kyo
    • Journal of Pharmacopuncture
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    • v.14 no.2
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    • pp.61-74
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    • 2011
  • This is a case report about effect of syeom pharmacopuncture, bee venom and autohemo-seperated regeneration pharmacopuncture(ASRP) for acute traumatic subdeltoid bursitis with partial tear of subscapularis tendon, which was diagnosed by symptoms and MRI(Magnetic resonance imaging) and caused by bongchuna treatment. We evaluated the patient using Visual Analogue Scale(VAS) every two or four days and range of movement(ROM), physical examination of shoulder about one per ten days and observed improvement with reexamination by ultrasonography and MRI as well. Pharmacopuncture rapidly reduced pain and improved range of motion and function of shoulder in patients with acute sub-deltoid bursitis even though it was severe symptom. Our result suggest that autohemo-seperated regeneration pharmacopuncture might be effective in regenerating the tear of soft tissue such as subscapularis tendon.

Partial Tear of Upper Portion of Subscapularis (견갑하근 상 1/3 파열)

  • Kim Dong-Hui;Kim Kug-Jin;Moon Young-Lae
    • Clinics in Shoulder and Elbow
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    • v.8 no.1
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    • pp.9-13
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    • 2005
  • An isolated tear of the subscapularis is uncommon, and there are a few literatures regarding the treatment of this problem. But, the incidence has increased with development of the arthroscopic techniques. An all-arthroscopic rotator cuff repair is a challenging procedure that can be effectively performed for treatment of subscapularis tendon tears. Often, tears of the subscapularis tendon do not involve entire tendon, and retraction of the torn edge is within to 2 cm of its attachment site. Occasionally, the entire tendon is torn and retracted medially to the glenoid. This article outlines the examination, preoperative planning and details the steps necessary to perform this procedure on upper third of subscapularis tears.

Treatment of cemental tear associated with periapical lesion using regenerative surgery; A case report (재생술식을 이용한 치근단 병소를 동반한 백악질 열리의 치료)

  • Kang, Hyo-Jin;Jung, Gyu-Un;Pang, Eun-Kyoung
    • The Journal of the Korean dental association
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    • v.54 no.5
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    • pp.365-373
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    • 2016
  • Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

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A Case Report on the Meniscal Tear due to Repetitive Foot-Switch Stepping (반복적으로 풋스위치를 밟는 작업에 의한 반월상 연골 손상 증례)

  • Yu, Sun-Hee;Lim, Hyun-Sul;Kim, Doo-Hie;Chae, Dong-Ju;Kang, Suk
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.805-814
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    • 1997
  • Injuries to the menisci occur in a variety of ways, most commonly with a twist, pivot, squat, or valgus stress to the knee. Tear patterns are classified to longitudinal, horizontal, or transverse features according to the mechanism of injury. Work-related meniscal tear usually occurs with a repetitive usage of the foot, hence it can be classified as a cumulative traumatic disorder. We found a 47 year-old female worker who had been taking charge of repetitive foot-switch stepping for 8 years. She suffered from pain in the right knee since 5 months ago. Tenderness along the medial joint line of the right knee was observed and pain was aggravated with full flexion of the right knee. On magnetic resonance imaging, high signal intensity was observed at the posterior horn of the medial meniscus of the right knee. Degenerative longitudinal and transverse complex tear in the medial meniscus was observed on arthroscopy. Arthroscopic partial meniscectomy was performed. We surveyed the work process and the health status of co-workers. It turned out that the work process was compatible to injure the meniscus and nine out of fourteen co-worker(64.3%) complained pain of the knee. No other factors related to her meniscal tear could be found except for the situation at her work. Therefore, we conclude that meniscal tear is related to the repetitive stepping of foot switch.

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