• Title/Summary/Keyword: 압박치료

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Treatment of Anterior Glenoid Rim Fracture with Comminuted Fragment Using Arthroscopic Reduction and AO Headless Compression Screw Fixation - A Case Report - (관절경하 AO 무두 압박 나사를 이용한 견갑골 전방 관절와 분쇄 골절의 치료 - 증례 보고 -)

  • Kim, Hyung-Sik;Koh, Il-Hyun;Kim, Sung-Guk;Chun, Yong-Min;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.94-98
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    • 2011
  • Purpose: We present a case of anterior glenoid rim comminuted fracture that was treated with arthroscopic reduction and an AO headless compression screw (HCS) fixation. Materials and Methods: A 31-year old man complained of left shoulder pain after falling down on stairs. The anterior glenoid comminuted fragments were arthroscopically reduced. Fixation with an AO HCS was done after placement of 1.1 mm Kirschner wire as a guide pin through a standard cannulated anterosuperior portal. Results: Twelve months after the operation, union of the fracture was achieved and the range of motion was fully recovered. He did not complain of any discomfort during his activities of daily living. Conclusion: An AO HCS had various screw sizes and this was good for fixation of a small glenoid fracture and a long drill bit and screw driver were useful for fixation of deep seated glenoid fracture. A short guide wire could be replaced by a 1.1 mm K-wire. An AO HCS was useful for fixation of an anterior glenoid rim comminuted fracture.

Brown-Sequard Syndrome Produced by Cervical Disc Herniation : Manual and Exercise Therapy after Operation-Case Studies (경추 추간판탈출증에 의한 브라운-시쿼드 증후군 : 수술 후 도수치료와 운동치료 효과-사례연구)

  • Kim, Myung-Joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.79-85
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    • 2009
  • 목적 : 브라운시쿼드는 대부분 척추손상과 수질외 척추 종양에서 주로 나타난다. 드물게 경추 디스크가 브라운시쿼드의 원인이 된다. 경추디스크에 의한 브라운시쿼드 증세의 수술후 물리치료 및 도수치료 결과를 보고하기 위함이다. 방법 : 50세 남자로써 브라운시쿼드 증세로 진단을 받고 수술후 좌측 팔과 다리에 운동신경에 의한 마비증세가 있었으며(팔>다리), 우측으로 감각과 온도감각이 저하된 경우이다(팔>다리). 측정방법은 통증지수(VAS), 근력(Distal PowerTracII$^{TM}$ test), 지구력(Ergometer) 측정과 심리상태(설문)를 치료전과 후를 비교하였다. 물리치료에서는 기능적 전기자극 치료와 도수치료 및 운동치료 방법을 실시하였다. 도수치료는 통증완화와 근력강화를 위한 MET, MFR, Mobilization 등을 실시하였으며, 운동은 슬링시스템 등을 이용한 운동과 견관절의 불안정을 위해 안정화운동을 실시하였다. 결과 : 이 케이스는 수술후 이상 징후가 척수압박으로 인하여 보다 넓게 통증이 나타났으며, 운동 및 감각신경이 둔해지고 온도에 대한 감각이 반대편 결손으로 나타났으며, 좌측 어깨, 팔 견갑부의 근육 마비와 우측의 감각이 떨어진 현상이 나타났다. 물리치료 후 단기목표와 장기목표에 있어서 통증과 운동 및 감각 기능이 회복되어 각각 팔 통증에서는 VAS 8 ${\rightarrow}$ 1, 상지 하지의 운동기능은 Trace ${\rightarrow}$ Good 로 평가 회복되었으며, 근력측정에서 모두 유의한 차이를 보였다. 모든 치료과정 결과에서 심리적 상태의 설문에서도 높은 점수를 얻어 긍정적 신뢰가 높아 진 것으로 나타났다. 검사결과 다리의 근력이 증가는 걷기 운동 및 에르고메터의 지구력 및 균형이 레벨1의 10분 수행능력이 레벨 20에서 30분 수행능력으로 향상되어 일상적인 활동이 가능해졌다. 결론 : 예상하지 못했던 수술 후유증(side effects)에 대한 치료과정이 환자의 심리에 심각한 부정적인 생각이 신체의 기능과 감정의 손상에 영향을 미치기 때문에 체계적이고 장기적인 치료 과정에서 기능적 향상과 더불어 정신적인 심리의 정서 안정이 매우 필요하다고 사료된다.

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Aortic Arch Rupture due to Compression Injury of the Thorax - A case report - (흉부 압박손상에 의한 대동맥궁 파열 - 1예 보고 -)

  • Lee, Gun;Lim, Chang-Young;Lee, Hyeon-Jae
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.100-103
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    • 2009
  • Traumatic rupture of the thoracic aorta is the second most common cause of death from motor vehicle accidents after head injury. About 85% of these patients do not survive to reach the hospital. The most common mechanism for this is deceleration injury, as occurs in a high speed motor vehicle accident. The aortic isthmus is the site of disruption for about 95% of all blunt thoracic aortic injuries. Another mechanism is crush injury which causes compression of the aorta between the displaced sternal body or manubrium and the thoracic vertebral column. These forces tear the inner layer of the aortic wall at an unusual location. We report here on a case of aortic arch dissection where the injury clearly occurred due to a crush injury and not because of deceleration. The surgical repair was delayed for 10 days after administering intensive medical therapy. The ascending aorta and aortic arch were replaced with an artificial graft with the patient under circulatory arrest and cerebral protection.

Lateral plantar nerve entrapment combined with a chronic plantar fasciitis in a basketball player -A case report- (농구선수에서 발생한 만성 족저근막염이 동반된 외측 족저 신경 압박증 -증례 보고-)

  • Lee, Kyung-Tai;Kim, Jun-Beom;Young, Ki-Won;Kim, Jin-Su;Park, Young-Uk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.121-124
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    • 2010
  • In athletes, repetitive low-energy impacts in plantar lesion lead often to tendinitis, stress fracture, or overuse syndrome. The major cause of heel pain in athletes is plantar fasciitis. And it is most often attributable to repetitive low energy impact, but the vast majority patients with heel pain achieve symptomatic relief with conservative treatment and return to full activities. Not commonly, Nerve entrapment may be occurred from repetitive low energy trauma in athletes, and is not as easily diagnosed. The authors observed a basketball player who complained of chronic heel pain that do not respond to conservative treatment, he had the lesions both plantar fasciitis and lateral plantar nerve entrapment. The authors described an unusual mechanism of entrapment of the lateral plantar nerve combined with a chronic plantar fasciitis in a basketball player and reported with review of literature.

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폐암 세기변조방사선치료 시 최적화된 조사계획 설정과 가상 장기 설정에 관한 연구

  • Lee, Seok;Lee, Chang-Geol;Cho, Sam-Ju;Chu, Sung-Sil;Lee, Sang-Hoon;Choi, Myung-Sun;Kim, Chul-Yong
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.34-34
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    • 2003
  • 목적 : 폐암 환자 세기변조방사선치료 과정을 소개하고, 방사선치료계획의 최적화를 위한 빔 수와 방향, 가상장기 설정 (virtual organ delineation, VOD) 및 선량 제한 인자들의 이용에 대해 평가함으로써 폐, 심장 등에 조사되는 선량을 최소화하는데 사용하는 세기변조방사선치료 (intensity modulated radiotherapy, IMRT) 기술의 유용성을 평가하고자한다. 대상 및 방법 : 종양이 종격동을 침범하여 상대적으로 장기움직임에 의한 오차가 적은 폐암환자 5 명을 대상으로 하였다. 환자고정장치는 상반신을 편안하게 유지함과 동시에 팔의 위치를 고정시킴으로써 기대할 수 있는 환자고정효과와 벨트를 이용하여 환자 상복부를 압박해줌으로써 호흡운동에 의한 장기 움직임을 감소시킬 수 있는 형태로 고안하였다. 치료계획시 빔 수와 방향은 5,7,9 문 (from 200 to 160, equispaced field, arbitrary field), 4 문 (anterior, posterior, bilateral posterior oblique field) 과 비등방 7, 9 문 (non-equispaced field, arbitrary field) 등을 사용하였다. 선량제한 ($V_{20}V_{25}$)은 문헌에 기초하여 설정하였으며, 가상장기를 적절히 사용하여 최적화된 치료계획 결과를 얻었다. 방사선치료계획 평가는 선량-체적간 히스토그람 (DVH), 등선량곡선 및 선량통계 등을 이용하여 수행하였다. 특히 가상장기 설정 전, 후의 결과 값을 분석함으로써 그 유용성을 확인하였다. 결과 : 9문 등방-IMRT와 7문 비등방-IMRT 방법이 치료계획용적의 선량균질성 (PTV dose homogeneity), 평균 폐선량 (mean lung dose) 및 $V_{20}V_{25}$ 모두에서 20% 이내의 좋은 결과를 얻을 수 있었고, 가상 장기를 설정함으로써 같은 결과를 가져옴을 알 수 있었다. 또한 폐암 세기변조방사선치료 프로토콜을 작성하여 임상에 사용함으로써 치료과정 중 발생할 수 있는 오류를 보완할 수 있음을 알 수 있었다. 결론 : 폐암 세기변조방사선치료 시 사용할 수 있는 프로토콜을 작성하였고, 적절한 가상 장기 및 조사계획 설정으로 치료계획의 최적화를 얻을 수 있음을 알 수 있었다.

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Popliteal Arterial Compression Caused by Osteochondroma: Usefulness of Doppler Ultrasonography (골연골종에 의한 슬와동맥 압박: 도플러 초음파의 유용성)

  • Jeong, Woong-Kyo;Kim, Ho-Joong;Lee, Soon-Hyuck
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.69-73
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    • 2010
  • Osteochondroma arising around the knee joint may sometimes be associated with vascular complication. Angiography is widely used to demonstrate the vascular complication, but it is invasive. Recently MR angiography is recommended as a non-invasive alternative, but it is very costly. We report a twenty-year-old man with popliteal arterial compression caused by osteochondroma who was diagnosed and assessed the surgical result by Doppler ultrasonography. And we also provide the usefulness of Doppler ultrasonography.

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The Study of Changes in Compressive Strength of Trabecular Bone with PMMA Injection in Vertebroplasty (척추성형술에서 PMMA 주입에 의한 망상골의 압축강도 변화 연구)

  • 문희옥;이문규;김정규;이태수;최귀원
    • Journal of Biomedical Engineering Research
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    • v.24 no.4
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    • pp.369-373
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    • 2003
  • The compressed fracture of spine caused by osteoporosis is one of the most frequent diseases in bone fracture. Recently the vertebroplasty has drawn much attention as a medical treatment for the compressed fracture of spine, which strengthens the vertebral body and corrects deformity, and relieves pain in patients by injecting bone cement. But because there were no research about strengthening of mechanical properties of verbral body in bone cement injection, in this study, based on the properties of PMMA, we had measured the Young's modulus for different apparent densities of intact trabecular bone and PMMA injected one from a porcine and a cadaver. Young's modulus to apparent density had a form of a power series in intact trabecular bone and had a linear relation in PMMA injected bone.

Intradural Schwannoma Associated with Lumbar Spinal Stenosis: A Cese Report (요추부 척추관 협착증과 동반된 경막내 신경초종: 증례 보고)

  • Soh, Jae-Wan;Kim, Tae-Heon;Kwon, Sai-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.106-110
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    • 2011
  • In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.

The convergence effect of medical industry through stem cell implant treatment (줄기 세포 이식 치료를 통한 의료 산업적 융합효과)

  • Lee, Tae-Hoon
    • Journal of Convergence for Information Technology
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    • v.8 no.2
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    • pp.61-65
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    • 2018
  • Our experiment studied that grafted stem cells reduced behavioral deficiency in rodent animal models of clip compressive surgery inducing spinal cord infarction. Our research proved the effect of embryonic stem cells to the spinal cord infarction caused by compressing T9-10 with an aneurysm clip, focusing the application of grafted stem cells for reduction of infarction and regeneration of spinal cord nervous injury. Therefore, our research suggests manifest results that implantation of mouse embryonic stem cell could show behavioral improvement after severe spinal cord damage. Therefore, mouse embryonic stem cell (mESC) could be useful application for the method in neurological injury. Conclusively, stem cell implant therapy may enhance the effectiveness of stem cell implant for central nervous system injury.