• Title/Summary/Keyword: 근 파열

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Clinical Outcomes After Arthroscopic Double-Row Rotator Cuff Repair and Evaluation of Cuff Integrity by CT Arthrography (관절경적 2열 고정 회전근개 복원술 후의 임상 결과 및 CT 관절조영술을 이용한 건의 치유 평가)

  • Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.

CASES REPORT OF CLEFT ALVEOLUS REPAIR WITH PMCB GRAFT (치조골 파열환자의 자가망상골 이식을 이용한 치험례)

  • Lee, Dong-Keun;Choi, Seong-Hoon;Chung, Hyung-Bai
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.9-15
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    • 1991
  • The cleft alveolus occurs about 75% of cleft lip and palate patients. The purpose of bone grafting is improve the maxillary growth, rehabilitation of continuty of maxillary arch and providing bone for periodontal support for unerupted teeth. The bone grafting for alveolar cleft defect repair are classsified; primary bone grafting, early secondary bone grafting secondary bone grafting and late secondary bone grafting. In this article, we reported the cases of PMCB grafts for repair of the alveolar clefts showed potential benifit to the patient to induce a normal maxillary growth and providing bone foor periodontal support of unerupted teeth.

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Diagnosis for Acute Traumatic Shoulder Injuries (사고와 관련된 급성 외상성 어깨 손상의 진단)

  • 견주관절학회 보험위원회
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.52-64
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    • 2012
  • Acute traumatic shoulder injuries related to motor vehicle accidents and industrial accident has shown a steep increase recently. In regard to the causal relationship and the previous illness, the rotator cuff tear and SLAP lesion are the mostly debated among shoulder injuries related to trauma. Both the possibility of spontaneous occurrence related to their degenerative etiology and the discordance between the extent of injury and the symptom of the rotator cuff tear and SLAP lesion, make it difficult and obscure to estimate the extent of involvement of accident. Therefore, the Insurance Committee of Korean Shoulder and Elbow Society performed a questionnaire for the shoulder specialists to investigate their criteria about deciding the treatment modalities and SLAP lesion and reviewed literatures regarding the causal relationship between the accident and the rotator cuff tear and SLAP lesion. The committee recommended the diagnostic criteria to judge contribution of the accident on traumatic shoulder injuries, and to offer a guideline for disabilities.

The Result of Rotator Cuff Repair Using Arthroscopic Margin Convergence Technique in Irreparable Large and Massive Rotator Cuff Tears (해부학적 봉합이 불가능한 회전근 개 파열에서 관절경하 모서리 맞춤 술식을 이용한 봉합의 결과)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Lee, Hyung-Joon
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.46-52
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    • 2011
  • Purpose: This study was performed to assess the usefulness of non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique. Materials and Methods: Twenty-two patients were followed up more than 1 year after non-anatomical repair for irreparable large and massive rotator cuff tears using the arthroscopic margin convergence technique. The clinical evaluation was performed according to the KSS score, the UCLA score and the Visual analogue scale (VAS). The measurement of the acromio-humeral distance was performed using the shoulder anterior-posterior radiographs. The measurement of fatty degeneration and the healing status was performed using the shoulder MRI after 6 months. Results: Among twenty-two patients, follow up MRI was performed in eleven cases. Three cases were well healed, four cases were partial healed and another four cases were re-torn. The KSS and UCLA scores had significantly improved from a preoperative average of 45.0${\pm}$8.014 and 10.8${\pm}$2.302 points to 77.1${\pm}$10.151 and 30.0${\pm}$1.521 points, respectively, and the pain VAS had decreased from a preoperative average of 7.7${\pm}$0.616 points to 3.0${\pm}$1.021 points at the last follow up. Less favorable results were obtained when the patient had a grade of fatty degeneration higher than grade 3 on the preoperative MRI. Conclusion: Non-anatomical repair for irreparable large and massive rotator cuff tears by the arthroscopic margin convergence technique showed good functional results. It seems to be one of the effective treatment methods for irreparable large and massive rotator cuff tears.

Modeling of Near Fault Ground Motion due to Moderate Magnitude Earthquakes in Stable Continental Regions (안정대륙권역의 중규모지진에 의한 근단층지반운동의 모델링)

  • Kim, Jung-Han;Kim, Jae-Kwan
    • Journal of the Earthquake Engineering Society of Korea
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    • v.10 no.3 s.49
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    • pp.101-111
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    • 2006
  • This paper proposes a method for modeling new fault ground motion due to moderate size earthquakes in Stable Continental Regions (SCRs) for the first time. The near fault ground motion is characterized by a single long period velocity pulse of large amplitude. In order to model the velocity pulse, its period and peak amplitude need be determined in terms of earthquake magnitude and distance from the causative fault. Because there have been observed very few new fault ground motions, it is difficult to derive the model directly from the recorded data in SCRs. Instead an indirect approach is adopted in this work. The two parameters, the period and peak amplitude of the velocity pulse, are known to be functions of the rise time and the slip velocity. For Western United States (WUS) that belongs active tectonic regions, there art empirical formulas for these functions. The relations of rise time and slip velocity on the magnitude in SCRs are derived by comparing related data between Western United States and Central-Eastern United States that belongs to SCRs. From these relations, the functions of these pulse parameters for NFGM in SCRs can be expressed in terms of earthquake magnitude and distance. A time history of near fault ground motion of moderate magnitude earthquake in stable continental regions is synthesized by superposing the velocity pulse on the for field ground motion that is generated by stochastic method. As an demonstrative application, the response of a single degree of freedom elasto-plastic system is studied.

Recurrent Shoulder Dislocation with Rotator Cuff Tears and Bankart Lesion (중장년층에서의 회전근 개 파열과 Bankart 병변을 동반한 재발성 견관절 탈구)

  • Lee Kwang Won;Yang Dong Hyun;Ahn Jae Hoon;Kim Ha Yong;Choy Won Sik;Ha Kwon-Ick
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.81-86
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    • 2004
  • Objectives: To assess the functional outcome of Bankart repair and rotator cuff repair using miniopen technique in patients with recurrent shoulder dislocation(8 cases) with rotator cuff tears and Bankart lesion of over 40 years. Materials and Methods: From May 1991 to January 2002, twenty two patients were available to participate in the study. Mean age was 52 years old(41-67), Follow-up evaluations averaged 50.5months(10-147). Results: The patients(22 cases) were divided into two groups. Group 1: with recurrent shoulder dislocation(8 cases) with rotator cuff tears and Bankart lesion in patients over 40 years old. Group 2: without Bankart lesion(14 cases). In Group 1, mean average of forward flexion and abduction improved from 122 degrees to 154 degrees at the final follow-up and from 115 degrees to 161 degrees respectively. In terms of University of Pennsylvania patient self-assessment of pain score and VAS, scores improved from 11.0 to 5.5 and from 5.4 to 2.5 respectively. In terms of UCLA score & Constant score, scores also improved from 20.2 to 29.6 and from 48.6 to 69.0 respectively. Functional outcome of Group 1: two patients with excellent, four patients with good, and two patients with fair. Functional outcome of Group 2: two patients with excellent, six patients with good, five patients with fair, and one patient with poor. But they had no statistical significance between the two groups. All cases were improved shoulder pain at the final follow up. And six patients were satisfied with the outcome of shoulder function. Conclusions: This study demonstrates the effectiveness of Bankart repair and rotator cuff repair using miniopen technique in patients with recurrent shoulder dislocation(8 cases) with tears of rotator cuff and Bankart lesion older than 40 years. We recommend Bankart repair and rotator cuff repair at the same time.

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