• Title/Summary/Keyword: triple-joint

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Surgical Treatments and Clinical Outcomes for Idiopathic Osteoarthritis of the Tarsometatarsal Joints (족근 중족 관절의 특발성 골관절염에 대한 수술적 치료 및 임상적 결과에 대한 분석)

  • Jung, Hong-Geun;Byun, Woo-Sup;Myerson, Mark S.;Schon, Lew C.
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.31-38
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    • 2004
  • Purpose: The purpose of the study was to identify the subtypes of idiopathic osteoarthritis of the tarsometatarsal joints based on accompanying hindfoot, midfoot, or foot deformities and their corresponding surgical options and also to evaluate the overall clinical results. Materials and Methods: The study included 59 patients (67 feet) with idiopathic tarsometatarsal joint osteoarthritis. Tarsometatarsal fusion was performed for tarsometatarsal joint and accompanied secondary change was divided into subtypes and various bony reconstruction was carried out. The patients were evaluated with the AOFAS midfoot score and FFI. The average patient age was 60.2 years with 40.6 months follow-up. Fifty-four feet (80.6%) had been treated with realignment fusion. Twenty-six feet had first and second tarsometatarsal joint fusion, and 20 feet had first tarsometatarsal fusion only. Six subtypes were identified based on associated foot deformities: 1) in-situ without deformities (18%), 2) pes planovalgus (45%), 3) rockerbottom (15%), 4) cavus foot (1%), 5) hallux valgus (12%), and 6) hallux valgus with pes planovalgus or rockerbottom (9%). Plantar-medial closing-wedge resection was used in 10 feet to correct rockerbottom. For pes planovalgus, a medial sliding calcaneal osteotomy was done. Lateral column lengthening with medial sliding calcaneal osteotomy was done for severe pes planovalgus, and triple arthrodesis was done for rigid pes planovalgus. Hallux valgus was corrected with the Lapidus procedure (85.7%). Results: AOFAS midfoot scores improved from preoperative 34.1 points to postoperative 83.9 points (p<0.05). The Foot Function Index postoperatively also showed significant improvement (p<0.05), with a high satisfaction rate (86.6%). There were 29 complications, most commonly sesamoid pain. Conclusion: Idiopathic tarsometatarsal OA feet can be classified into six categories. Pes planovalgus feet should be treated with medial sliding calcaneal osteotomy, lateral column lengthening, or triple arthrodesis in addition to tarsometatarsal joint realignment fusion. Rockerbottom and hallux valgus deformities should also be addressed.

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Triple Disruption of the Superior Shoulder Suspensory Complex - Case Report at 5-year-follow up - (상부 견갑 현수 복합체의 3중 붕괴 - 5년 추시 증례 보고 -)

  • Sung, Chang-Meen;Park, Hyung Bin
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.143-147
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    • 2012
  • A triple disruption of the SSSC, an extremely rare injury, has been reported by only a few authors. We present a patient who had sustained a triple disruption of the SSSC: coracoid and scapular spine fractures, and an acromioclavicular joint separation. Treatment consisted of an anatomical restoration of the SSSC, with maintenance of the acromiohumeral and coracohumeral distances; this was achieved by open reduction and internal fixation of the fractures and of the separation. Six months after surgery, the injured shoulder was asymptomatic, with full range of motion. Five years after surgery, at the final follow-up, the function of the SSSC had been restored to the patient's complete satisfaction.

The Results of Triple Osteotomy in Adult Hallux Valgus Patients with Highly Increased Distal Metatarsal Articular Angle (고도의 원위 중족골 관절면 각을 동반한 성인 무지 외반증 환자에서의 삼중 절골술의 결과)

  • Lee, Kyung-Tai;Cha, Seung-Do;Young, Ki-Won;Kim, Jae-Young;Joh, Joo-Won
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.28-34
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    • 2007
  • Purpose: To evaluate the clinical and radiographical results of triple osteotomy as a treatment for adult hallux valgus with highly increased distal metatarsal articular ankle (DMAA). Materials and Methods: From October 2003 to April 2005, we retrospectively reviewed 7 hallux valgus patients (3 cases: moderate, 4 cases: severe) treated with triple osteotomy and followed-up for more than 1 year after operation. The mean follow up was 15.1 months. The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA) and the length of 1 : 2 metatarsal bone were measured. Proximal chevron osteotomy and distal biplanar chevron osteotomy were done in 1st metatarsal bone. Akin osteotomy was added to the base of the proximal phalanx. The clinical result was assessed using the AOFAS Hallux score, tenderness on the medial eminence, ROM of 1st metatarsophalangeal joint, calluses and patient satisfaction. Results: The mean HVA and IMA was improved from $37.5^{\circ}$ and $13.4^{\circ}$ to $10.5^{\circ}$ and $6.2^{\circ}$ respectively. The mean DMAA was corrected from $34.2^{\circ}$ to $11.2^{\circ}$ and mean shortening of 1st metatarsal was 2.4 mm (0.9-5.8 mm). The mean AOFAS hallux score was improved from 66.4 to 92.5 and VAS score (pain on the medial eminence) from 4.3 points to 0.4 points. Metatarsalgia disappeared in all cases and there was no complications such as necrosis of the metatarsal head. Conclusion: Triple osteotomy for adult hallux valgus with a highly increased DMAA is effective and should be considered as a part of the treatment armamentarium.

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Treatment of Talonavicular Subluxation Accompanied by Calcaneal Malunion (A Case Report) (종골 부정 유합에 동반된 거주상 관절 아탈구의 치료 (1예 보고))

  • Cha, Seong-Mu;Chang, Bo Hoon;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.270-275
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    • 2012
  • There may be complications after comminuted or intraarticular calcaneal fracture regardless of the initial treatment. Transcalcaneal talonavicular dislocation is rarely reported severe form of calcaneal fracture. We experienced a neglected transcalcaneal talonavicular subluxation case, who had been treated for intraarticular calcaneal fracture conservatively. Subtalar distraction bone block fusion was done for calcaneal malunion with talonavicular subluxation. Inspite of successful subtalar fusion, pain was persisted because of talonavicular re-subluxation with arthritis and calcaneocuboid arthritis. So, second operation, the talonavicular and calcaneocuboid fusion, was done. After union achieved, the patient's foot pain was improved. Calcaneal malunion combined with talonavicular subluxation and unstable transverse tarsal joint, such as this case, initial triple arthrodesis could be considered.

Radiographic Characteristics and the Clinical Results of the Operative Treatment of M$\ddot{u}$ller-Weiss Disease (뮐러-와이스 병의 방사선학적 특징 및 수술적 치료의 결과)

  • Choi, Hong-Joon
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.100-105
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    • 2013
  • Purpose: To present radiographic characteristics and report the clinical results of the operative treatment of M$\ddot{u}$ller-Weiss disease. Materials and Methods: This is a retrospective study including 13 patients, 14 feet who had been operated for M$\ddot{u}$ller-Weiss disease between April 2006 and December 2011. Osteoarthritis of the peri-navicular joints were radiographically evaluated. Various range of peri-navicular fusion and joint-preserving surgeries according to patients' symptoms and radiographic findings were done. The clinical results were evaluated by American Orthopaedics Foot and Ankle Society (AOFAS) midfoot scale and visual analogue scale (VAS). Results: On radiographs, osteoarthritic changes were presented at talonavicular joint in 11 cases, calcaneocuboid joint in 7 cases, subtalar joint in 6 cases, naviculo-cuneiform joint in 1 case. The mean anteroposterior talocalcaneal angle was 16.6 degrees. On hindfoot alignment view, 6 cases were varus, 5 cases were neutral and 3 cases were valgus alignment. Fusion comprised 6 cases in triple fusion, 1 case in talonavicular-cuneiform fusion, 2 cases in talonavicualr fusion and 1 case in talonavicular & calcaneocuboid fusion. Joint-preserving surgeries were bony fragment excision of the lateral part of navicular & medial displacement calcaneal osteotomy in 1 case, bony spur excision of talonavicular joint in 1 case and medial displacement calcaneal osteotomy in 2 cases. The postoperative AOFAS and VAS score were improved significantly (p=0.000, p=0.000). Conclusion: In cases of M$\ddot{u}$ller-Weiss disease without osteoarthritic changes at peri-navicular joints, fragment excision of navicular, bony spur excision with or without medial displacement calcaneal osteotomy were effective operative treatments.

Position Control of the Two Links Inverted Pendulum with a Time Varying Load on the Top (상부 시변 부하를 갖는 2축 도립진자의 위치 제어)

  • 이건영
    • The Transactions of the Korean Institute of Electrical Engineers A
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    • v.48 no.9
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    • pp.1147-1153
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    • 1999
  • The attitude control of a double inverted pendulum with a periodical disturbance at link top is dealt in this paper. The proposed system is consisted of the double inverted pendulum and a disturbing link; a triple inverted pendulum with two motors. The lower link is hinged on the plate to free for rotation in the vertical plane. The upper link is connected to the lower link through a DC motor. The DC motor is used to control the posture of the pendulum by adjusting the position of the upper link. The periodical disturbance can be generated by the additional like attached at the end of link 2 through another DC motor, which is the modeling of a posture for a biped supporting with one leg. The motor for the joint simulates the knee joint(or hip joint) and the disturbance for the legs moving in air. The algorithm for controlling the proposed inverted pendulum which is regarded as a virtual double inverted pendulum with a periodic disturbance, is consisted of a state feedback control and a fuzzy logic controller connected in parallel. The fuzzy controller keeps the center of gravity of the biped within the specified range through the nonlinear feedback compensator. The state feedback control takes over the role to maintain a desired posture regardless the disturbance at the link top. Simulations with a mathematical model and experiments are conducted to show the validity of the proposed controller.

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Effect of the Heat Input on the Tensile Properties in Arc Brazing of Ferritic Stainless Steel using Cu-Si Insert Alloy (Cu-Si계 삽입금속을 사용한 페라이트계 스테인리스강의 아크 브레이징에서 인장성질에 미치는 입열량의 영향)

  • Kim, Myung-Bok;Kim, Sang-Ju;Lee, Bong-Keun;Yuan, Xin Jian;Yoon, Byoung-Hyun;Woo, In-Su;Kang, Chung-Yun
    • Korean Journal of Metals and Materials
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    • v.48 no.4
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    • pp.289-296
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    • 2010
  • The effects of heat input and different microstructureswere investigated on the tensile-shear properties of an arc-brazed joint of theferritic stainless steel 429EM using a Cu-Si insert alloy. The brazing speed was fixed at 800 mm/min whilethe brazing current varied from 80 to 120A. For abrazing current lower than 100A, fracturing occurred at the joint root in the direction perpendicular to the tensile load. As the brazing current increased to 120A, fracturing occurred at the base metal or the joint root. The joint and the base metal had very similar yield and tensile load values. However, the amount of elongation was decreased considerably compared to when the base metal was used. The fracturing began at the triple point of the root part and was classified into three types. The difference in the tensile-shear properties was closely related to the three fracture types.

Anatomic coracoclavicular ligament reconstruction with triple flip-buttons leads to good functional outcomes and low reduction loss: a case series

  • Raul Aguila;Gonzalo Gana;J Tomas Munoz;Diego Garcia de la Pastora;Andres Oyarzun;Gabriel Mansilla;Sebastian Coda;J Tomas Rojas
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.140-147
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    • 2023
  • Background: The management of acromioclavicular (AC) joint dislocation remains controversial. Recently, anatomic coracoclavicular (CC) fixation with a double clavicular tunnel and three flip-buttons has shown promising results. This study aimed to evaluate functional and radiological outcomes in patients with high-grade AC joint dislocation treated with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Methods: A retrospective, unicentric study was performed. The study included patients with high-grade AC joint dislocation who underwent surgery with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Demographic data were obtained from medical records. A functional evaluation using subjective shoulder value (SSV), visual analog scale (VAS), and disabilities of the arm, shoulder, and hand (DASH) questionnaires was performed, and an evaluation of preoperative and postoperative comparative Zanca view images was performed. Factors associated with functional outcomes and radiological AC reduction were analyzed. Results: A total of 83 patients completed follow-up and were included in the analysis. The mean SSV, VAS, and DASH scores were 92.8, 0.8, and 6.4, respectively. Patients who had complications experienced significantly worse functional outcomes (DASH: P=0.037). Suboptimal final AC reduction was observed in nine patients (11.1%), and significantly more frequently in patients older than 40 years (P=0.031) and in surgeries performed more than 7 days after injury (P=0.034). There were two reoperations (2.4%). Conclusions: Anatomic CC fixation with a double clavicular tunnel and three flip-buttons leads to good functional outcomes, low complication rates, and high rates of optimal AC reduction.

How Did South Korean Governments Respond during 2015 MERS Outbreak?: Application of the Adaptive Governance Framework

  • Kim, KyungWoo
    • Journal of Contemporary Eastern Asia
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    • v.16 no.1
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    • pp.69-81
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    • 2017
  • This study examines how South Korean governments responded to the outbreak of Middle East Respiratory Syndrome Coronavirus (MERS) using the adaptive governance framework. As of November 24, 2015, the MERS outbreak in South Korea resulted in the quarantine of about 17,000 people, 186 cases confirmed, and a death of 38. Although the national government had overall responsibility for MERS response, there is no clear understanding of how the ministries, agencies, and subnational governments take an adaptive response to the public health crisis. The paper uses the adaptive governance framework to understand how South Korean governments respond to the unexpected event regarding the following aspects: responsiveness, public learning, scientific learning, and representativeness of the decision mechanisms. The framework helps understand how joint efforts of the national and subnational governments were coordinated to the unexpected conditions. The study highlights the importance of adaptive governance for an effective response to a public-health related extreme event.

New evidence of Lockup Provisions: Effects on IPO Demands

  • Mohd-Rashid, Rasidah;Khaw, Karren Lee-Hwei;Mehmood, Waqas;Tajuddin, Ahmad Hakimi
    • Journal of Contemporary Eastern Asia
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    • v.21 no.1
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    • pp.43-52
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    • 2022
  • This study examines the impacts of a mandatory lockup ratio and lockup period, together with voluntary lockup, on the initial public offering (IPO) subscription rate in Malaysia. A sample of 390 IPOs launched from 2000 to 2016 was collected for analysis. The findings show that firms that adopt a lower lockup ratio and a shorter lockup period signal uncertainty about their prospects. Issuers would then show the tendency to underprice to increase investors' intention to subscribe to firms' IPO shares. This study concludes that as long as investors are aware of pertinent information about IPO firms, they should continue participating in the IPO market rather than behaving irrationally. Finally, policymakers could use the findings to improve the existing lockup provisions regulation.