• Title/Summary/Keyword: 내측 슬괵건

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Rupture of the ischial origin of the hamstring tendon - A case report - (좌골 결절부위 기시부에서 내측 슬괵건 파열 - 증례 보고 -)

  • Kim, Hyung Kan;Hwang, Sun Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.129-132
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    • 2011
  • A complete rupture of hamstring tendon originated from ischial tuberosity is a uncommon sports injury in adults. We present successful outcome obtained by attachment on ischial tuberosity using suture anchor in relatively rare case of the proximal rupture of the medial hamstring tendon sustained during landing with the review of literatures.

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Anatomic Study for Hamstring Tendon Harvest (슬괵건 채취를 위한 해부학적인 고찰)

  • Son, Jung-Hwan;Park, Chan-Jae;Jung, Gu-Hee
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.33-37
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    • 2007
  • Purpose: The harvest of hamstring tendon is technically demanding because of the inadequate identification of hamstring tendon separation and accessory tendon of semitendinosus tendon. We conducted therefore conducted an anatomic study, aiming at the anatomic knowledge for graft harvest. Materials and Methods: 20 human cadaveric knees (10 cadavers) were used for the study. The location of tendon separation in conjoined tendon and accessory tendon of semitendinosus tendon were described and recorded. Results: The location of tendon separation of conjoined tendon was average $39.68{\pm}9.97mm$ vertically and $18.57{\pm}2.91mm$ horizontally from the tibial spine. We found that the accessory structure of the semitendinosus tendon was mostly fascia-like structure(17 knees), the tendinous structure, 3 cases which was straightly located 15cm from the tibial crest. Conclusion: We propose that the expected incision for hamstring tendon harvest is centered on the inferior 40mm, medial 20mm from the tibial spine. The accessory structure of the semitendinosus tendon was mostly found of fascia-like structure.

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스포츠와 관련된 과사용 증후군 - 슬관절 -

  • Kyung, H.S.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.75-83
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    • 2008
  • 과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

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Effects of Knee Position during the Graft Fixation of the Arthroscopic Anterior Cruciate Ligament Reconstruction with Autogenous Hamstring Graft (이식 건 고정 시 슬관절 위치가 자가 슬괵건을 이용한 관절경적 전방 십자 인대 재건술 후 결과에 미치는 영향)

  • Lee, Churl-Woo;Yoo, Jae-Doo;Roh, Kwon-Jae;Park, Seong-Pil
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.143-147
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    • 2005
  • Purpose: In case of anterior cruciate ligament (ACL) reconstruction, graft tendon is generally fixed in tibial tunnel with knee extended. When reconstructing ACL using hamstring tendon, the authors aim to find out the effect of knee joint position during graft fixation on postoperative knee joint stability and range of motion. Materials and Methods: Prospective study was done on patients who have undergone ACL reconstruction using hamstring tendon from May 2002 to January 2003 We used Rigifix system (Mitek Product, Johnson and Johnson, USA) and Intrafix system for fixation. Thirty nine patients received ACL reconstruction during this period. Excluding 2 patients lost in the follow-up, 37 patients were analyzed. The mean follow-up period was 14 months $(13{\sim}25months)$. Knee position was decided alternatively without any bias. Clinical evaluation was based on Lachman test, pivot shift test, Lysholm score, IKDC(international knee documentation committee) assessment and side to side KT-1000 maximal manual arthrometer difference. Results: After the last follow-up, average postoperative Lysholm score was 93.1 poins(65-98points). According to IKDC score, 26 cases were normal, 10 cases were nearly normal, 1 case was abnormal and we had no case of severe abnormality. The mean difference from the normal side was 2.5 mm under maximal manual loading KT-1000 arthrometer. According to postoperative Lachman test, 32 cases were normal,2 cases were grade I and 1 case was grade II. There were 34 cases of normal, 2 cases of grade I and 1 case of grade II. When using maximal manual KT-1000 arthrometer side to side difference, the difference from the normal side while fixing the tibia at 20'knee flexion was 2.3 mm and at full extention the difference was 2.7 mm. The range of motion at postoperative 1 year showed 5 degree flexion contracture in 1 case at 20 degrees knee flexion and 10 degrees of flexion limitation was observed in 2 cases at full extension. Conclusion: When ACL reconstruction using autogenous hamstring tendon, anterior laxity showed no difference in its stability between two groups. Tibial side fixation at full extension may be helpful in preventing flexion contracture due to overconstrained graft tendon.

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