• Title/Summary/Keyword: 외반

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Review of the Reasons in Cases Requiring Varus/Valgus Constrained Prosthesis in Primary Total Knee Arthroplasty (일차 슬관절 전치환술 시내·외반 구속형 치환물이 필요했던 사례들의 원인 분석)

  • Kong, Dong Yi;Park, Sang Hoon;Choi, Choong Hyeok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.253-260
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    • 2021
  • Purpose: The least constrained prosthesis is generally recommended in primary total knee arthroplasty (TKA). Nevertheless, a varus/valgus constrained (VVC) prosthesis should be implanted when a semi-constrained prosthesis is not good for adequate stability, especially in the coronal plane. In domestic situations, however, the VVC prosthesis could not always be prepared for every primary TKA case. Therefore, it is sometimes impractical to use a VVC prosthesis for unsual unstable situations. This study provides information for preparing VVC prostheses in the preoperative planning of primary TKA through an analysis of primary VVC TKA cases. Materials and Methods: This study reviewed 1,797 primary TKAs, performed between May 2003 and February 2016. The reasons for requiring VVC prosthesis and the preoperative conditions in 29 TKAs that underwent primary TKA with a VVC prosthesis were analyzed retrospectively. Results: In primary TKA, 29 cases (1.6%) in 27 patients (6 male and 21 female) used VVC prosthesis. Two patients underwent a VVC prosthesis on both knees. The mean age of the patients was 63.4 years old (34-79 years). The mean flexion contracture was 16.2° (-20°-90°), and the mean angle of great flexion was 111.7° (35°-145°). The situations requiring a VVC prosthesis were severe valgus deformity in 10 knees, knee stiffness requiring extensive soft tissue release in 10 knees, previously injured collateral ligaments in five knees, and distal femoral bone defect due to avascular necrosis in four knees. The mean tibiofemoral angle was 25.7° (21°-43°) in 10 cases with a valgus deformity. The mean flexion contracture was 37.5° (20°-90°), and the mean range of motion was 48.5° (10°-70°) in 10 cases with knee stiffness. Conclusion: The preparation of VVC prosthesis is recommended, even for primary TKA in cases of severe valgus deformity (tibiofemoral angle>20°), stiff knee (the range of motion: less than 70° with more than 20° flexion contracture), and the cases with a previous collateral ligament injury. This information will help in the preparation of adequate TKA prostheses for unusual unstable situations.

Low Grade Chondrosarcoma Presenting as Progressive Valgus Limb Deformity in a Growing Period (성장기 저등급 연골육종에 의한 사지의 진행성 외반)

  • Kang, Hyun Guy;Park, Weon Seo;Park, Seog Yun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.41-45
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    • 2014
  • A femoral bone tumor causing a valgus deformity by affecting the growth plate was found. Long intramedullary diaphyseal tumor was separated by septum at the metapysis. Low grade chondrosarcoma was confirmed diagnosed by pathologists. Progressive limb deformity can be a sign of bone tumor in growing period.

The Temporal Coordination of the Lower Extremity by Increasing High-heel Height during Walking (보행 시 하이힐 굽 높이 증가에 따른 하지의 시간 협응성)

  • Ryu, Ji-Seon
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.593-601
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    • 2009
  • The goal of this study was to investigate the lower extremity's coordination determined by temporal relations with increasing high-heel (3, 7, 9cm) while walking on a treadmill. Twelve healthy women who walked on a treadmill under three conditionswearing 3cm high-heel shoes, 7cm, and 9cm-while kinematic data were collected using a six-cameras (240Hz) Qualisys ProReflex System. From these data, knee flexion, tibia internal rotation, and foot eversion were calculated in Euler technique and found the time for occurring the maximum angle of these movements. The maximum angle of these movements occurred almost simultaneously in 3cm high-heel walking, but not in 7cm and 9cm. The ratio of time for maximum angle of the foot eversion to tibia internal rotation converged to 1 in 3cm high-heel walking, but were less than 1 in 7cm and 9cm. In conclusion, it was indicated that 3cm high-heel walking had better the lower extremity's coordination compared with 7, 9cm high-heel walking.

Effect of Foot Eversion on Knee and Ankle of Trans-tibial Amputees (인공의족의 외반 특성이 하퇴절단자의 무릎과 발목에 미치는 영향)

  • Bae, Tae-Soo;Chang, Yun-Hee;Kim, Shin-Ki;Mun, Mu-Seung
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1505-1508
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    • 2008
  • One of the important functions of prosthetic foot is the foot inversion-eversion which is so important when walking on uneven surfaces. The aim of our study was to evaluate the effect of foot eversion angle especially on knee and ankle joint for transtibial amputees by motion analysis. The experimental data were collected from three transtibial amputees and then ten healthy individuals. To simulate walking on side sloping ground, we used custom-made slope (5, 10, 15 degrees). Motion analysis was performed by 3-dimensional motion analyzer for 6 dynamic prosthetic feet. The results showed that knee abduction moments of amputated leg were decreased but those of sound leg were mainly increased as foot eversion angle increased. And ankle abduction moments of sound leg were inconsistent in magnitude and tendency between control and experimental group. Therefore foot eversioncharacteristics should be considered to develop advanced prosthetic foot.

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The Pediatric Flatfoot : Its Differential Diagnosis and Management (소아 편평족의 감별진단과 치료)

  • Kim, Hyun-Woo;Park, Jin;Kang, Eung-Shick;Park, Hui-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.1
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    • pp.91-101
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    • 2001
  • 편평족은 내측 세로궁이 소실되어 족저부가 편평하게 되는 변형의 총칭으로, 소아에서 흔하 고 보호자들의 관심이 많은 질환이다. 이학적 검사상 후족부의 외반과 전족부의 외전소견을 보이며, 감별질환을 위해 정확한 이학적 검사와 방사선학적 검사를 필요로 한다. 원인으로는 유연성 편평족, 종골 외반, 선천성 수직 거골, 부주상골, 족근골 결합등이 있으며 정상적 유 아의 경우 시간경과에 따라 저절로 호전되는 유연성 편평족이 대부분이다. 따라서 병적 편평족이 아닌 경우 편평족의 원인과 양호한 자연경과를 보호자에게 설명하는 것이 중요하다. 본 논문에서는 소아 편평족의 감별질환을 위한 각 질환에 있어서의 이학적 소견과 검사소견 그리고 이들의 치료에 대해 살펴 보고자 한다.

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Evaluation of Medial Instability of the Knee with Ultrasonography - Technical note - (초음파를 이용한 슬관절 내측 불안정 평가 -측정기법-)

  • Kim, Jung-Man;Lee, Dong-Yeob;Koh, In-Jun;Kim, Seung-Min
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.73-77
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    • 2008
  • Purpose: The purpose of this study was to describe the method of dynamic sonographic measurements in the evaluation of the MCL injury of the knee joint while applying valgus and varus stress. Materials and Methods: Seven cases of MCL injury from January to April of 2008 was used for the study. For the evaluation of the medial instability, sonography was used immediately after injury, 6 weeks and 12 weeks after conservative treatment with limited motion brace. The length between the foot of the medial femoral epicondyle and the most proximal point of the tibial cortex was measured in 30 degrees flexion with valgus and varus stress of the knee joint. Results: The foot of the medial epicondyle and the starting point of the proximal tibial cortex underneath the round portion of the articular cartilage were always able to be seen on ultrasonography, even in varus and valgus stress with gravity in 30 degrees flexion of the knee joint. The results of measurements were always constant. Conclusion: Sonography can be used in evaluation of medial instability under the dynamic valgus and varus stress of the knee joint without further injury.

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