Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.
Kim, Seong-Hun;Lee, Kye-Bok;Chung, Kyu-Rhim;Nelson, Gerald;Kim, Tae-Woo
The korean journal of orthodontics
/
v.39
no.1
/
pp.54-65
/
2009
This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy(ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy(Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.
The method of treatment in skeletal Class III malocclusion must be chosen according to an etiology and timing of the treatment. Maxillry protraction has been used as an effective treatment method in growing children with maxillary deficiency. The efficacy of maxillary protraction has been viewed as a result of downward-backward displacement of mandible and compensatory dental displacement during the treatment rather than forward -downward growth of maxilla itself. In this study, 104 subjects treated with maxllary protraction, and 19 males and 21 females with known annual growth amount have been chosen longitudinally as treated group and normal group, respectively. And changes in position of maxilla, mandible and dentition have been comparatively analyzed on the lateral cephalometric radiographs by age. The results were as follows : 1. Treated group showed more forward movement of maxilla compare to the normal group and the mandible displaced backward compare to the normal group. 2. Downward movement of maxilla in treated group was similar to that of normal group with statistical signigicance in female 12 year old group and downward movement of mandible in treated group was similar to that of normal group. 3. In treated group, maxillary central incisor moved more forward than the normal group with statistical significance in male 8, 10 year-old groups and female 8, 9, 10 year-old groups. In treated group, downward movement of maxillary central incisor was similar to that of the normal group with statistical significance in male and female 7,8 year-old groups. Considering the above results and the duration of the treatment, the forward movement of maxilla due to maxillary protraction was effective compared to normal growth amount of the normal group.
Purpose: For an isolated tear of the subscapularis tendon, the presented technique using a subclavian portal provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. Materials and Methods: The conventional method needs 2 additional portals for traction, debriding the footprint and anchor fixation for repair. The presented technique requires only an anterior portal for suture management and a subclavian portal without cannula for suture anchoring and placement of suture hooks. Results: The two suture limbs of the anchor can be placed on the subscapularis tendon by the switching technique and these limbs are repaired sequentially. Conclusion: This technique is simple and reproducible and it can be applied to partial tears and minimally retracted subscapularis tears.
Purpose: We reported the results and efficiency of arthroscopic treatment in a state of the lateral traction about the degenerative arthris of elbow Materials and Methods: Twenty one elbows with the degenerative arthritis who were followed up for at 12 months were enrolled in this study. Male were 15 cases, female were 6 cases, the mean age was 47 years and right dominant hand was 14 cases. In all cases, during arthroscopic treatment under the traction of 10 pounds, we had done synovectomy, excision of loose body and anteroposterior spur. After operation, immobilization was done in the full extension state, and then continuous passive motion (CPM) was started two day Results: The average preoperative ROM of the elbow joint was $30{\sim}l15$ degree and the average postoperative ROM of the elbow joint was $5{\sim}130$ degree. The increasement of ROM was totally 41 degree in extension 25 degree and flexion 16 degree. The decrement of VAS in pain was from 7.5 into 2.3 and the increasement of the satisfactory function was from 1.8 into 9.0. Complication was in two cases. One was paresthesia of ulnar nerve, but resolved. The other was bullae formation around the elbow joint, but cured. Conclusion: Regarding degenerative arthritis of elbow, arthroscopic treatment showed excellent result in recovery of range of motion and relief of pain. We could obtain good visual field with distraction in lateral position.
In case of skeletal Class III malocclusion with underdeveloped maxilla, the extraoral orthopedic force for the stimulation of maxillary growth or anterior reposition of the maxilla has been used clinically for the improvement of facial skeletal relationship. The purpose of this investigation was to examine the initial reaction of maxillofacial complex to the maxillary protraction by using extraoral orthopedic force. The dried human skull was used and this investigation was done by means of double exposure holographic interferometry. The protraction forces placed on the canine or the first molar were parallel, $10^{\circ}$ downward, $20^{\circ}$ downward to the occlusal plane. Fringe pattern of each protraction condition was compared and analized. The results were as follows: 1. Each maxillofacial bone displaced saparately. 2. More displacement was shown at the area of the teeth and the alveolar bone. 3. A counterclockwise rotation of the maxilla wa decreased by downward protraction and especially 20 degree downward protraction from the canine showed least rotation. 4. On the zygomatic arch, outward bend was observed and this effect was decreased by downward protraction. 5. On the zygomatic bone, the counter clockwise rotation was increased by the downward protraction. 6. When maxillary expansion was applied at the same time, outward and upward displacement with counterclockwise rotation was observed on the maxilla. 7. The lateral pterygoid plate of sphenoid bone was affected by maxillary protraction.
Crouzon syndrome Is one of the craniofacial syndromes characterized by craniosynostosis, midfacial hypolpasia and ocular proptosis. Distraction osteogenesis is becoming Important technique to treat craniofacial dyplaisa. It has nuy advantages compared with standard orthognathic surgery. Maxillary distraction osteogenesis after Le Fort III osteotomy with the RED system presents successful maxillary protraction to Crouzon syndrome patient with severe maxillary deficiency. It also allows remarkable improvement of facial esthetics and respiratory functions.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.25
no.1
/
pp.1-7
/
2019
Background: The purpose of this study is investigate the effects of cervical range of motion (ROM) and forward head posture (FHP) on cervical manual traction in normal adults. Methods: The subjects were randomly assigned to either the experimental group(Female 9, Male 6) who conducted the manual cervical traction or the control group(Female 9, Male 6) who did not conduct the any intervention. The subject in the EG have conducted the 1 set of 10 minutes of manual cervical traction per day, 2 times a week for 6 weeks. The cervical ROM was measured by the digital inclinometer and The factors of FHP was measured by cranial vertebral angle (CVA) and cranial rotation angle (CRA). Results: Comparing the cervical ROM and FHP between the experimental and control groups before and after the experiment, it could be seen that flexion, extension, right lateral flexion, left lateral flexion, CVA and CRA of the experimental group has been increased. Thus, cervical manual traction was resulted in the increased cervical ROM and decrease FHP. Conclusion: In this study, it was confirmed that cervical manual traction affects increase cervical ROM and decrease FHP that play a important role in neck stability and mobility.
Skeletal Class III malocclusion is one of the most difficult type to treat and stabilize. For a child with developing skeletal Class III malocclusion, the treatment objective would be to stimulate maxillary growth, particulary one who has markedly deficient maxilla, and to restrain excessive mandibular growth. In order to stimulate the maxillary growth, maxillary protraction appliance is the one of the effective orthopedic appliances in skeletal Class III. The purposes of this study were as follows ; evaluation of the skeletal and dental changes of the maxillary protraction in children with Class III Maxillary deficiency , comparison of the clinical effects between the group with RPE and labiolingual intraoral appliances , comparison of the clinical effects and stability related to the ages of the patients : stability of the maxillary protraction about 1 year after retention. The subjects consisted of 60 children between the ages of 8 and 13.4 who were diagnosed as Class III with maxillary deficiency and were treated with Face Mask (Delaire Type) from the Dept. of Orthodontics Yong Dong Severance Hospital, Yonsei University. 48 children wore the RPE and 12 children wore Labiolingual Appliance. Lateral Cephalograms were taken for each patient at before and after correction of anterior cross-bite in 60 children, and after an observation period of 10 to 14 months in 19 children. X and Y coordinate of 10 landmarks were analyzed using a horizontal line through sella and rotated $6^{\circ}$ down anteriorly as the horizontal reference axis, and a perpendicular verticual line through sella as the vertical reference axis. Each of the 31 measurents (10 verticals, 10 horizontals, 2 angles and 9 others) was statistically analyzed using SPSS/PC statistics. The results are as follows; 1. After maxillary protraction the maxilla and maxillary teeth moved downward and forward, while the mandible and mandibular incisor rotated downward and backward. 2. Maxillary protraction with rapid palatal expansion appliance was more effective than with labiolingual appliance. 3. More downward movement of the posterior palatal plane obserbed with maxillary protraction doing the midpalatal suture opening than with protraction after finishing the palatal expansion 4. The clinical effects of protraction and changes of the retention periods were not statistically significant among the age groups. 5. During the retention period, maxilla and maxillary teeth, and mandible and mandibular teeth moved downward and forward, however the mandibular changes were larger than the maxillary changes.
Before 1970, mandibular overgrowth was known as main cause of skeletal Class III malocclusion in growing children ; however, recent study reports that many skeletal Class III malocclusion patients also show maxillary deficiency. Since 1972, when Delaire re-accommodated Protraction Head Gear (P.H.G.), many researchers have reported that skeletal Class III discrepancies could be corrected through use of P.H.G., which induces anterior movement of maxilla and change in mandibular growth pattern into infero-posterior direction ; nevertheless, it is very difficult to predict resultant changes of orofacial region. The purpose of this study was to find out what treatment effect P.H.G. has on different study samples. Author divided 51 skeletal Class III malocclusion patients with maxillary deficiency who were treated with P.H.G. into different study groups depending on sex, treatment beginning age, intraoral appliance, and facial growth pattern. By doing so, following results were obtained. 1. Treatment beginning age and Sex Four age groups (5.8 to 8 year-old, 8 to 10 year-old, 10 to 12 year-old, 12 to 14 year-old) were compared, and no significant difference was observed. (p<0.05) There was no significant difference between the sex groups, either. (p<0.05). 2. Intraoral appliance Treatment effects of study groups that used R.P.E.(mean age of 10.2) and Labio-Lingual appliance(mean age of 8.9) were compared. There was no significant difference depending on the type of intraoral appliance that was used. (p<0.05) 3. Facial growth pattern 1) Amounts of SNB and ANB corrections were smaller in clockwise growth pattern group than those in normal or counterclockwise growth pattern group. (p<0.05) 2) Amounts of increase in Wits appraisal and mandibular plane angle were greater in counterclockwise growth pattern group than those in normal or clockwise growth pattern group. (p<0.05) 3)Amounts of increase in articular angle were greater in counter lockwise growth pattern group than those in clockwise growth pattern group. (p<0.05)
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