• Title/Summary/Keyword: 완전 파열

Search Result 105, Processing Time 0.027 seconds

The Role of Meniscal Arrow in the Treatment of the Meniscal Tear (반월상 연골 파열의 치료에서 meniscal arrow의 역할)

  • Bae, Dae Kyung;Yim, Chang Moo;Jeong, Ki Woong
    • Journal of the Korean Arthroscopy Society
    • /
    • v.3 no.1
    • /
    • pp.24-29
    • /
    • 1999
  • Purpose : The purpose of this paper is to analyze the clinical results after meniscal repair using meniscal arrow. Materials and Methods : Between May 1997 and Aug 1998, we repaired 22 tom menisci in 22 patients using meniscal arrows. There were nineteen males and three females with an average age of 27 years. There were longitudinal tear in 14 cases, Bucket-handle tear were 7 cases and horizontal tear was in 1 case. In 22 meniscus tears, 16 cases were associated with anterior cruciate ligament tear. Average number of meniscal arrow that was used were 2.5(ranged 1 to 4). Average follow-up period was 14.7 months(ranged 6 to 22 months). We evaluated the clinical results by the Tapper and Hoover's grading system. Results : There were excellent in 16 cases, good in 4 cases and fair in 2 cases on the clinical results. At the last follow up, the range of the motion of the knee joint were average 135 degrees(ranged 125 to 140 degrees). Mean time elapsed for meniscal repair were 25 minutes(ranged 15 to 40 minutes). Conclusion : Meniscal arrow has many advantages such as short operative time, easy fixation technique, and less neurovascular injury. We think that arthroscopic meniscal repair using meniscal arrow is effective treatment method in selected patient who have longitudinal, bucket-handle tear at the posterior hom associated with anterior cruciate ligament tear.

  • PDF

The results of arthroscopic repair according to the delamination of rotator cuff (회전근 개 판분리 파열에 따른 관절경하 회전근 개 봉합술의 결과)

  • Ku, Jung Hoei;Cho, Hyung Lae;Park, Man Jun;Kim, Jeong Cheol
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.10 no.2
    • /
    • pp.61-68
    • /
    • 2011
  • Purpose: We evaluated the clinical outcome after arthroscopic repair in full thickness rotator cuff tears with and without delamination. Materials and Methods: From March 2006 to October 2008, we included 48 consecutive shoulders (31 males, 17 females; mean age 57.6 years; 45~68) who had arthroscopic double row repair for fullthickness tears of the rotator cuff. Mean rotator cuff tear size was 2.8 cm (range: 1.2~3.6) and the techniques of tendon-to-bone fixation varied according to the presence of delamination; separate row fixations of bursal and articular layer were used in delaminated tear. The mean follow-up was 26 months (range: 18~33) and functional and structural results were evaluated by American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles (UCLA) scale, isokinetic strength testing and magnetic resonance imaging (MRI) obtained mean 8 months (range:6~13) postoperatively. The patterns of delamination, age, sex, symptom duration, size of tear, satisfaction rate, retear rate ware compared and significance was set at p values < 0.05. Results: Postoperative functional shoulder score improved significantly in 44 shoulders (91.7%). Delamination was observed in 15 shoulders (31%) and it extended proximally and posteriorly in the majority of shoulders, and the articular layer was thicker (8/15, 53%) and more retracted (9/15, 60%) compared with the superficial bursal layer. Final follow up functional shoulder scores showed no differences between non-delaminated and delaminated tears and the presence of delamination had no correlations with sex, symptom duration, tear size and satisfaction rate, however, older age had more delaminated tears (p=0.041). Follow up MRI in 29 shoulders revealed that fourteen (48%) shoulders had complete healing; nine (31%), partial healing; six (21%), complete retear but the half of the retear group showed favorable clinical results. 79% (15/19) in non-delaminated tear and 80% (8/10) in delaminated tear were judged as healed tendon on MRI and double-layer double row repairs in delaminated tears resulted in nearly same rate of structural integrity of single-layer double row repairs (p=0.165). Conclusion: The incidence of delamination in our series was 31% and older age had more delaminated tears. Sex, symptom duration, preoperative size of the tear, functional results and satisfaction rate had no significant correlations with the presence of delamination. Nearly the same postoperative structural integrity was noted in both delaminated and non-delaminated tears.

  • PDF

Arthroscopic Rotator Cuff Repair For Partial Articular-Surface Tendon Avulsion (PASTA) Lesion (회전근 개 관절내 부분 파열 환자의 관절경적 봉합술)

  • Lee, Bong-Gun;Cho, Nam-Su;Park, Keun-Ho;Moon, Seong-Cheol;Rhee, Yong-Girl
    • Journal of the Korean Arthroscopy Society
    • /
    • v.13 no.3
    • /
    • pp.242-248
    • /
    • 2009
  • Purpose: To evaluate the clinical and radiologic results of the arthroscopic rotator cuff repair for partial articular surface tendon avulsion lesion. Materials and Methods: Twelve patients with symptomatic, partial articular surface tendon avulsion underwent arthroscopic rotator cuff repair between Mar. 2006 and Sep. 2008. The mean follow-up period was 18.3 months(12~36 months), and the mean age at the time of surgery was 46.9-year-old(19~64 years). Three cases had underwent rotator cuff repair after conversion to full-thickness tear and nine cases had transtendon repair with preserving bursal side cuff. Results: The mean VAS during motion was 6.2 before treatment and 2.0 at final follow-up (p<0.001). The passive forward flexion improved from $163.3^{\circ}$ preoperatively to $169.8^{\circ}$ postoperatively (p=0.038). The mean UCLA score improved from 18.4 preoperatively to 30.1 with 2 excellent, 8 good and 2 fair results at final follow-up. The mean KSS improved from 61.8 preoperatively to 76.8 at final follow-up. By examining the postoperative MR images of 5 patients, complete healing was observed in all of them. Conclusion: Arthroscopic rotator cuff repair may be an effective procedure for partial articular surface tendon avulsion in pain relief and improvement of the range of motion. If the remaining bursal side cuff fibers are intact, transtendon repair procedure with preserving the intact bursal layer of the tendon can be considered. If the remaining bursal side cuff fibers are friable or little, completion from partial-thickness to full-thickness tears with subsequent cuff repair can be considered.

  • PDF

Arthroscopic Rotator Cuff Repair by Single Row Technique (회전근 개 파열에 대한 관절경적 봉합술 중 일열 봉합술의 유용성)

  • Yum, Jae-Kwang
    • Clinics in Shoulder and Elbow
    • /
    • v.11 no.2
    • /
    • pp.77-81
    • /
    • 2008
  • The goal of rotator cuff repairs is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading and optimize the biology of the tendon-bone interface until the cuff heals biologically to the bone. Single row repairs are least successful in restoring the footprint of the rotator cuff and are most susceptible to gap formation. Double row repairs have an improved load to failure and minimal gap formation. Transosseous equivalent repairs (suture bridge technique) have the highest ultimate load and resistance to shear and rotational forces and the lowest gap formation. Even though the superior advantages of double row and transosseous equivalent repairs, those techniques take longer surgical time and are more expensive than single row repairs. Therefore single row repairs can be useful in bursal side partial thickness or small size full thickess rotator cuff tear.

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
    • /
    • v.42 no.1
    • /
    • pp.100-103
    • /
    • 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.

Repair of Left Ventricular Free Wall Rupture after Acute Myocardial Infarction: Application of Pericardial Patch Covering and Fibrin Glue Compression A case report (급성심근경색 후 발생한 좌심실벽 파열에서 소심낭과 Fibrin Glue 압박을 이용한 치험 - 1예 보고 -)

  • 김상익;금동윤;원경준;오상준
    • Journal of Chest Surgery
    • /
    • v.36 no.5
    • /
    • pp.363-366
    • /
    • 2003
  • Background: Left ventricular rupture after acute myocardial infarction is a serious complication with high mortality. Emergency operation is usually the only available treatment. A 76-year-old female with persistent chest pain and syncopal attacks was admitted. Transthoracic echocardiography showed the pericardial effusion and generalized hypokinesia of the inferolateral wall of left ventricle. Coronary angiography revealed a total occlusion of the first diagonal branch. After percutaneous transluminal coronary angioplasty with coronary stent and insertion of intraaortic balloon pump, emergency operation was performed. Under cardiopulmonary bypass and cardiac arrest with cold blood cardioplegia, coronary artery bypass graft with saphenous vein, pericardial patch covering on the rupture area with 6-0 polypropylene running sutures, and fibrin glue compression under the patch were performed. We present a case of left ventricular (free wall) rupture after acute myocardial infarction.

EXCISIONAL BIOPSY OF MUCOCELE USING BIOPSY PUNCH (생검펀치를 이용한 점액낭종의 절제)

  • Hong, Eun-Hye;Choi, Byung-Jai;Lee, Jae-Ho;Choi, Hyong-Jun;Son, Heung-Kyu;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.34 no.2
    • /
    • pp.349-353
    • /
    • 2007
  • Mucocele is a clinical term of the localized superficial mucosal swelling caused by salivary retention after the obstruction or the rupture of minor salivary ducts. Various treatment methods have been suggested to lower its recurrence rate, including complete excision of lesion Biopsy punch can be used easily and simply for complete excision of mucocele. It has several advantages, such as convenience in use, low bleeding tendency, and nearly no requirements for post-operative management. In this case, biopsy punch was used for the removal of mucocele in an uncooperative child, which enable fast, simple and safe procedure, with a good result.

  • PDF

Innominate Artery Ruplure Caused by Blunt Chest Trauma -A Case Report (흉부둔상에 의한 무명동맥 파열 -치험 1례-)

  • Lee, Gun;Kim, Yong-In
    • Journal of Chest Surgery
    • /
    • v.30 no.10
    • /
    • pp.1028-1031
    • /
    • 1997
  • Rupture of an innominate artery caused by blunt chest trauma is extremel rare because this artery is short and relatively well protected by the bony cage. This report describes a 37-year-old male who sustained a blunt chest injury that resulted in an innominate artery rupture, detected by chest CT and thoracic aortography. The patient underwent an urgent operation through median sternotomy. A 3 by 3 m sized pseudoaneurysm of proximal innominate artery was found with a complete intimal tear. After the origin of the innominate artery was closed, the injured segment of artery was excised and an aorto-innominate artery bypass with a 10 mm Gore-tex graft was performed without use of a shunt. The patient was discharged 20 days later without neurologic complications and had equal blood pressure in both arms.

  • PDF

Rupture of the Anterior Papillary Muscle Caused by Occlusion of the First Diagonal Branch -Report of 1 Case - (제1 대각지 폐쇄에 의한 승모판막 전방 유두근 파열 - 1예 보고-)

  • Kim Young-Du;Moon Seok-Whan;Jo Keon-Hyeon
    • Journal of Chest Surgery
    • /
    • v.39 no.1 s.258
    • /
    • pp.64-67
    • /
    • 2006
  • Anterior papillary muscle rupture caused by occlusion of the first diagonal branch is reported to be very rare. A 66-year-old woman was transferred to our hospital for acute myocardial infarction and cardiogenic shock. Echocardiography and angiography revealed severe mitral regurgitation caused by rupture of the anterior papillary muscle and the complete occlusion of the first diagonal branch. In an emergent setting, she had been successfully treated by mitral valve replacement and coronary artery bypass grafting. She was discharged on postoperative twelfth day without any event.

Arthroscopic Vertical Enclosing Meniscus Suture -Technical Note- (관절경하 반월상연골의 수직 포위 봉합술 - 수술 수기 -)

  • Kim Jung-Man;Jahng Yoon-Jong
    • Journal of the Korean Arthroscopy Society
    • /
    • v.7 no.2
    • /
    • pp.230-232
    • /
    • 2003
  • To avoid incomplete coaptation of the peripheral tear of the meniscus an arthroscopic vertical enclosing meniscus suture technique was developed. In this technique the meniscus was not penetrated with any instruments or suture materials. This technique seems to be simple and easy to learn and to practice.

  • PDF