• Title/Summary/Keyword: 관절 운동 범위

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Posterior cruciate ligament reconstruction using fresh-frozen Achilles tendon allograft with preservation of ligament remnant (남아 있는 인대를 보존하고 신선 동결 동종 아킬레스건을 이용한 후방십자인대 재건술)

  • Kim, Yeung Jin;Chae, Soo Uk;Kim, Jong Yun;Kim, Byung Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.54-60
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    • 2011
  • Puropse: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant or elongated ligament. Materials and Methods: From October 2004 to March 2010, we performed PCL reconstruction with Achilles tendon allografts in 22 complete rupture patients. Mean age was 31.5 years. 14 cases were male and 8 cases were female. Average follow-up period was 3 years and 7 months, range from 1 year to 6 years and 4 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, IKDC score, and second look arthroscopic examination. Results: Postoperative Lysholm knee score, IKDC scores, Tegner activity scale, and posterior displacement by the Telos stress test demonstrated statistically significant improvement compared to the preoperative state. Conclusion: Arthroscopic PCL reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant showed good clinical results and posterior stability.

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Reduction Loss after Extension Block Kirschner Wire Fixation for Treatment of Bony Mallet Finger (골성 추지 신전제한 K 강선 고정술 시행 후 정복소실)

  • Kim, Byungsung;Nho, Jae-Hwi;Jung, Ki Jin;Yun, Keonhee;Park, Eunseok;Park, Sungyong
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.239-247
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    • 2018
  • Purpose: We investigated occurrence of reduction loss after extension block (EB) Kirschner wire fixation or additional interfragmentary fixation (AIF) and clinical results including extension lag of the distal interphalangeal joint for treating bony mallet finger. Methods: Forty-six patients were included with a mean follow-up of 28 months (range, 12-54 months). Twenty-seven patients were treated with EB K-wire fixation (Group A) while 19 patients were treated with AIF (Group B). We checked radiologic factors, such as amount of articular involvement, volar subluxation, mallet fragment angle, reduction loss, range of motion including extension lag, and functional outcomes using Crawford's criteria. Results: Reduction loss occurred in eight patients (17%). Differences in mean extension lag, age, preoperative volar subluxation and mallet fragment angle between patients with reduction loss and those with reduction maintaining were significant. However, there were no significant differences in gender, hand dominance, amount of articular involvement, AIF, or further flexion between reduction loss and reduction maintaining. As for patterns of displacement, there was a significant relationship between gap or step-off and extension lag. Using Crawford's evaluation criteria, functional outcomes were excellent in 31, good in 10, fair in 3, and poor in 2 patients. Conclusion: Reduction loss should be careful in older age, smaller mallet fragment angle and preoperative volar subluxation.

Anatomical Direct Reduction of Bony Mallet Finger Using Modified-Intrafocal Pinning Technique (변형-내초점 핀 고정술을 이용한 골성 망치 수지의 해부학적 직접 정복)

  • Kang, Sang-Woo;Park, Ji-Kang;Jung, Ho-Seung;Cha, Jung-Kwon;Kim, Kook-Jong
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.248-253
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    • 2018
  • Purpose: The purpose of this study was to evaluate the clinical results of anatomic reduction of bony mallet finger using modified-intrafocal pinning technique. Methods: From March 2014 to October 2017, 18 patients with bony mallet finger were treated with modified-intrafocal pinning technique. Kirschner-wire was used to directly reduction the bony fragment, and extension block pinning and distal interphalangeal joint fixation were additionally performed to minimize the loss of reduction. Postoperative pain, range of motion, and radiological evaluation were performed. Duration of bone healing, functional recovery and complication rate were evaluated and Crawford's criteria was used to determine functional outcome after surgery. Results: Bone union was achieved in all cases after a postoperative mean of 6 weeks (5-7 weeks). An average of $2.8^{\circ}$ ($0^{\circ}-10^{\circ}$) extension loss occurred in all patients. All patients showed satisfactory joint congruency and reformation of the joint surface, the mean flexion angle of the distal interphalangeal joint at the final follow-up was $72.2^{\circ}$ ($70^{\circ}-75^{\circ}$). According to Crawford's classification, 12 patients (66.7%) were excellent and 6 patients (33.3%) were good. Conclusion: Modified-intrafocal pinning technique is a method of obtaining anatomical bone healing by directly reduction and fixation of the bony fragment. Combined with other conventional percutaneous pinning procedures, it is expected that good results can be obtained if applied to appropriate indications.

Large Hill-Sachs Lesion Combined with a Rotator Cuff Tear in an Acute Traumatic Anterior Dislocation of the Shoulder in an Elderly Patient Treated with an Allogenic Iliac Tricortical Bone Graft (노인 환자의 급성 외상성 견관절 전방 탈구에서 회전근개 파열과 동반된 거대 Hill-Sachs 병변에 대해 간접 정복 및 지지대 목적의 동종 장골 삼중 피질골 이식을 통한 치료 1예)

  • Hyun, Yoonsuk;Lim, Jinkyu;Baek, Seung-Ha;Park, Jinho;Lee, Seung-Jin
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.188-192
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    • 2020
  • An indirect reduction through the bicipital groove and allogenic iliac tricortical bone graft was performed as a treatment for a large Hill-Sachs lesion with a rotator cuff tear in an acute traumatic shoulder joint dislocation in an elderly patient. Six months after surgery, the rotator cuff healing and bone union were confirmed. The patient also showed satisfactory clinical results with 95 points of the American Shoulder and Elbow Surgeons (ASES) shoulder score and active range of motion with 155° flexion, 120° abduction, and 70° external rotation and 30° internal rotation at 90° abduction. The surgical method can be considered for a large Hill-Sachs lesion with rotator cuff tear in an acute traumatic shoulder joint dislocation in elderly patients.

Radiographic Changes of the Medial Epicondyle in Little League Baseball Player (청소년기 야구선수의 주관절 내상과의 방사선학적 변화)

  • Choi Chang-Hyuk;Eum Dong-Hwan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.43-48
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    • 2002
  • Purpose : We evaluated radiographic changes and clinical manifestations of the elbow joint to identify the effects of the throwing between dominant and non-dominant arms. Materials and Methods : A hundred and five little leaguer’s baseball player in 5 elementary school and 2 middle school were evaluated for clinical symptoms and radiographic changes about elbow joint. Mean age was 12 years old and average periods of exercise were 32 months. Elbow functions were evaluated using ASES standardized assessment form and radiographic changes of medial epicondyle were examinated for enlargement, separation of the apophyses, fragmentation and irregularity. Results : Thirty seven players (35$\%$) were complained pain with throwing and the average score was 4.8 using visual analog scale. There were no significant differences in range of motion except flexion angle, valgus angle, and strength between dominant arm and non-dominant arm. Valgus laxity was more prominent in dominant arm. Ulnohumeral tenderness, radiocapitellar tenderness and medial flexor origin tenderness were in 18, 6, and 17 cases respectively in dominant arm. Medial epicondyle was enlarged in dominant arm with 13.0 by 6.3 mm compared to non-dominant arm with 11.7 by 6.1 mm. Apophyseal separation was 0.8 mm in dominant arm and 0.5 mm in non-dominant arm. Fragmentation and irregularity were 14 (13$\%$) and 25 (24$\%$) cases respectively in dominant arm. Conclusion : In little league baseball player, it needs usage of ball and bat with appropriate weight, and careful conditioning programs through throwing exercise in order to avoid elbow injuries.

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The Result of Conservative Treatment in Displaced Radial Head Fracture (전위된 요골두 골절의 보존적 치료의 결과)

  • Yi, Seung-Rim;Hahn, Sung-Ho;An, Young-Joon;Yoo, Jae-Ho;Jeon, Do-Whan;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.43-48
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    • 2005
  • Purpose: The purpose of this study is to assess the result of conservative treatment in displaced radial head fracture. Materials and Methods: We analyzed 15 cases of displaced radial head fracture who were treated conservatively from April 1992 to May 2002. Follow-up period was more than 1 year. They were all males and the average age of patients was 20.2($11{\sim}24$) years. The average follow-up period was 13.4($12{\sim}15$) months. They were able to do active pronation and supination more than 70 degrees initially, who were applied long arm splint less than 1 week. The functional rating index modified after B.F. Morrey and no further displacement and union state of fragment in simple X-ray were used in follow-up assessment. Results: On the basis of the functional rating index modified after B.F. Morrey that included elements of pain, motion, strength, and stability, the results were 8 excellent, 7 good in patients who were treated conservatively, who had union and no further displacement of fragment in follow-up. Conclusion: We conclude that if they are able to do active pronation and supination more than 70 degrees initially, we take them to do early range of motion exercise after subsiding swelling, which can restrict limitation of range of motion exercise and return to the living early.

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Effects of the Probody Massage on the Physical Characteristics, Gross Motor Function and ROM in Youth with Cerebral Palsy : Case study (프로바디마사지가 뇌병변 장애우의 신체적 특성과 대동작 기능 및 관절 가동범위에 미치는 영향 : 사례연구)

  • Kim, Eui-Suk;Yang, Jeong-Ok;Lee, Joong-Sook
    • Korean Journal of Applied Biomechanics
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    • v.25 no.4
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    • pp.453-463
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    • 2015
  • Objective : The purpose of this study was to investigate the effects of the Probody Massage Program on the physical characteristics, gross motor function and ROM (Range Of Motion) of children with cerebral palsy. Method : The subjects of this study were two children who have been diagnosed with first grade cerebral palsy that utilized T development support center located in B Metropolitan city for 8 weeks, twice a week, to carry out the Probody Massage Program for 30 minutes. Physiological reactions (height, weight, BMI, blood pressure (an index of inflammation), pulse rate) and large operating functions (sitting, crawling and the joints' range of motion as an angle of the shoulders' upper limb articulation) were measured pretest, after 4 weeks, and after 8 weeks. Results : The Probody Massage Program showed positive changes in physical characteristics (blood pressure, sitting, and crawling), gross motor function (upper limb shoulder movement), joint range of motion, height, body weight, metabolic activation and blood circulation of children with cerebral palsy. Conclusion : We believe making a practical impact on the growth and development, functional recovery of daily life, and improvement of quality of life of children with cerebral palsy by utilizing Probody Massage Program improves blood pressure (an index of inflammation), pulse, sitting, crawling, and the joints' range of motion as an angle of the shoulder joints' upper limb movement of children with cerebral palsy.

A Study on the Mandibular Movements in the Patients with TMJ Lock Closed -Range and pattern of mandibulr movement- (악관절 폐구성 과두걸림 환자의 하악운동에 관한 연구 -치료전후의 하악운동 범위 및 양상 -)

  • Sung-Chang Chung;Hyung-Suk Kim
    • Journal of Oral Medicine and Pain
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    • v.16 no.1
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    • pp.113-120
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    • 1991
  • The authors examined the patterns and various ranges of mandibular movements in TMJ lock closed patients in the frontal, sagittal and horizontal plane pre-end post-treatment. And the author obtained the following results. 1. In the frontal plane, the patterns and ranges of mandibular movement of the patients were very irregular and small before treatment. But after the treatment, the patterns were similar to the typical shield shape of the normal subjects. And the velocity of opening and closing was improved after the treatment. 2. In the sagittal plane, the mean amount of maximum mouth opening was 27.0±4.0mm before treatment and 44.0±5.4mm after treatment. And there was statistically significant improvement(p<0.005). The patterns of the movement were very irregular and small before treatment, but were similar to the shape of "Posselt's envelope of motion" after the treatment. The velocity of opening and closing was improved after the treatment 3. In the horizontal plane, the mean amount of maximum laterotrusion was 8l2±2.5mm in the affected side and 6.7±2.2mm in the non-affected side before treatment. There was a significant difference between the sides(p<0.05). After the treatment, the mean was 10.4±2.6mm in the affected side and 8.9±2.3mm in the non-affected side and there was no significant difference between the sides(p>0.05). There was no significant difference in the mean amount of maximum protrusion between the before and aftertreatment(p>0.05), but the patterns of the movements were improved.

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Closed Rupture of the Extensor Hallucis Longus Tendon by a Blunt Direct Trauma in a Taekwondo Player - A Case Report - (태권도 선수에서 직접적 둔상으로 인해 발생한 장무지신전건의 폐쇄성 파열 - 증례 보고 -)

  • Ha, Jeong-Ku;Moon, Jeong-Seok;Lee, Woo-Chun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.56-59
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    • 2009
  • Closed rupture of the extensor hallucis longus (EHL) tendon is uncommon and rarely reported. We present a Taekwondo player who had sustained a closed rupture of the EHL tendon after striking the other player's shin. He had practiced Taekwondo more than 6 hours a day for more than 6 years, including repetitive striking on the dorsum of the foot, which probably caused degeneration of the EHL tendon. The tendon ends could not be approximated directly, so reconstruction was performed with bisecting the distal tendon and combining the repair of the one end with an intercalary scar tissue and the other with tenodesis to the extensor hallucis brevis. He returned to the preoperative level of activity 6 months postoperatively with a satisfactory range of motion.

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The Effect of Proprioceptive Neuromuscular Facilitation Rehabilitation Exercise on Range of Motion, Pain, and Function of Breast Cancer Patients after Surgery (고유수용성신경근촉진법 재활운동이 수술 후 유방암 환자의 관절운동범위와 통증 및 기능에 미치는 영향)

  • Kang, Tae-Woo
    • PNF and Movement
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    • v.16 no.1
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    • pp.133-141
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    • 2018
  • Purpose: This study examined the effect of proprioceptive neuromuscular facilitation (PNF) rehabilitation exercise on postoperative range of motion (ROM), pain, and function of breast cancer patients. The purpose of this study was to provide fundamental data regarding the use of PNF rehabilitation exercise for patients with breast cancer. Methods: Fourteen patients who underwent surgery due to breast cancer were randomly divided into an experimental group (n=7) that performed PNF rehabilitation exercise and a control group (n=7) that performed general rehabilitation exercise. Both groups performed the respective exercises for 30 minutes, five times a week for 4 weeks. For the measurement of ROM, the range of shoulder abduction was measured using a clinometer smartphone application. The shoulder pain and disability index (SPADI) was used to measure the level of pain and functional activity. A paired t-test was conducted to compare within-group changes before and after the PNF rehabilitation exercise. Differences between the experimental group and control group were analyzed by an independent t-test. For all tests, the level of statistical significance was set at ${\alpha}=0.05$. Results: After the exercise, there was a significant within-group change in the ROM and SPADI in both the experimental group and control group (p<0.01). There was also a significant between-group difference in the ROM and SPADI after the intervention (p<0.05). Conclusion: Rehabilitation exercise is generally applied as a treatment for patients with breast cancer after surgery and is relatively effective. The application of PNF rehabilitation exercise may be useful in such patients, considering its effects on ROM improvement, pain reduction, and functional enhancement.